Two very different costs for the same medical procedure from two hospitals

[cthulhu_waves]

Why a joint replacement costs $30,000 in one hospital and $160,000 in another. The answer is: because no one really questions the prices.

If you need a lower joint replacement, Sibley Memorial Hospital in Washington D.C. will charge you or your insurance provider an average of $30,000, according to The Washington Post. Across town at George Washington University, the same procedure will cost $69,000. And at Las Colinas Medical Center near Dallas? $160,832.

Those bewildering price differences were revealed by the Obama administration to reporters at The Washington Post, New York Times and Huffington Post. They represent what different hospitals charge Medicare for the exact same procedures ? information the government has been collecting for years but was previously only available to researchers for a high fee.

Why is there such a wild disparity between prices? Because hospitals don't have much of an incentive to keep them low. They can essentially charge whatever they want.

Now, most Americans don't actually see or pay the eye-popping amounts that hospitals charge for procedures. Medicare, for instance, reimburses hospitals with standardized amounts for each treatment, regardless of what the hospital actually bills, notes The New York Times. And private health insurance companies negotiate the price of each procedure with every hospital.

Read more here.

[Harmon]

Blame it on Bush and 9/11 or something.

[MaDalton]

just for fun i checked what it costs in Germany - and i dont think anyone can say that they have less advanced methods or material - or that doctors are less qualified

average price: $10,000

[Grapesoda]

Originally Posted by cthulhu_waves

Why a joint replacement costs $30,000 in one hospital and $160,000 in another. The answer is: because no one really questions the prices.



Read more here.

got a full panel blood test through the DR, then guy told me to tell the lab I do not have ins and he would just put the cost on my bill with him.... $220 or something like that... same test at another lab with health ins.... $960 or so..

[dyna mo]

fuck, i just spent 5 hours in the er and the billS = $15k. $9k was a bullshit unneeded test.

and peeps are getting hip replacement for only twice that! fuck.

[Antonio]

Originally Posted by MaDalton

just for fun i checked what it costs in Germany - and i dont think anyone can say that they have less advanced methods or material - or that doctors are less qualified

average price: $10,000

probably half that price in a top hospital in any Eastern European country

[MaDalton]

Originally Posted by Antonio

probably half that price in a top hospital in any Eastern European country

indeed..

[Harmon]

Yeah, but it's not Western medicine or practices. Certain things, such as getting a boob job, you probably shouldn't seek bargain basement sales for.

If I had the choice between joint replacement in some scummy eastern European shithole for 5 gees, or Cedars Sinai for 50 gees... I'd spend 50. It's called quality of service.

[MaDalton]

Originally Posted by Harmon

Yeah, but it's not Western medicine or practices. Certain things, such as getting a boob job, you probably shouldn't seek bargain basement sales for.

If I had the choice between joint replacement in some scummy eastern European shithole for 5 gees, or Cedars Sinai for 50 gees... I'd spend 50. It's called quality of service.

lets not discuss your misconception about "eastern european shitholes" - indeed i'd rather not have that operation done in Belarus or so either

but Germany is hardly one of those countries - and it still costs "only " $10k

[purecane]

[pornguy]

Its called Capitalism. If you want to live the life of a well to do person in the US, its how you get paid.

[sarettah]

What is worse than the base prices for these services is if there are "complications". That can double or triple the cost.

Granted there are actual un-foreseens that can creep in but probably just as often complications are caused by incompetence.

So, if I do the job I get so much and if I do the job wrong I get even more.

Must be nice.

.

[madm1k3]

Originally Posted by MaDalton

but Germany is hardly one of those countries - and it still costs "only " $10k

Don't even try man, let him live is his delusional world where everything in America is right and the rest of the world is a cesspool of socialist savages begging for nickels

[dyna mo]

germany is the america of europe.

[_Richard_]

Originally Posted by MaDalton

just for fun i checked what it costs in Germany - and i dont think anyone can say that they have less advanced methods or material - or that doctors are less qualified

average price: $10,000

and we haven't even touched on the administrative/insurance costs of this 'operation'..

[GetSCORECash]

Originally Posted by MaDalton

just for fun i checked what it costs in Germany - and i dont think anyone can say that they have less advanced methods or material - or that doctors are less qualified

average price: $10,000

Keep in mind that an EU doctor earns a set amount, be it 125,000 Euros a year compared to a doctor in the states that earns several hundred thousand more for each procedure he performs. The more procedures performed by a doctor the more he earns as that is incentive. A patient is being charged $5.00 for an aspirin, not the pennies it maybe worth.

The only possible way for an EU doctor to earn as much as doctor in the states is to own a clinic and hire doctors to work for him.

[MaDalton]

Originally Posted by GetSCORECash

Keep in mind that an EU doctor earns a set amount, be it 125,000 Euros a year compared to a doctor in the states that earns several hundred thousand more for each procedure he performs. The more procedures performed by a doctor the more he earns as that is incentive. A patient is being charged $5.00 for an aspirin, not the pennies it maybe worth.

The only possible way for an EU doctor to earn as much as doctor in the states is to own a clinic and hire doctors to work for him.

so every doctor in the US that works in a hospital has his salary based on performance? hard to imagine..

but even if so - i WAAY prefer the system over here then - because instead of making doctors millionaires, it helps keeping the healthcare costs for everyone acceptable

and like you said - if a doctor wants to open his own clinic or practice he's free to do so.

[crockett]

It's not that simple .. Pretty much no one pays those prices. But it's one of the key problems with the US medical system and it's never gonna change because no politician would ever dare touch the subject.

It all comes down to how hospitals billing practices work. They either price high and discount big or price low and discount less. The high price is the bargaining chip. Many try to claim it's because of uninsured but that's not true either.

It's simply the system feeding on it's self and the same hospital might have 20 different prices for that same surgery all dependent on whom they are billing.

[Harmon]

Originally Posted by MaDalton

so every doctor in the US that works in a hospital has his salary based on performance? hard to imagine..

Doctors in the US work FROM a hospital, not FOR a hospital.

[MaDalton]

Originally Posted by Harmon

Doctors in the US work FROM a hospital, not FOR a hospital.

aha - interesting...

after watching all seasons of Scrubs i thought there can be both

[sperbonzo]

Originally Posted by pornguy

Its called Capitalism. If you want to live the life of a well to do person in the US, its how you get paid.

Actually no. It's NOT because of capitalism. It's because the states have all mandated a massive number of procedures that insurance carriers MUST carry. In the 50s and 60s, people typically bought insurance that only covered catastrophic events. For all other services they paid cash, or worked out a payment plan with the Doctor. Because of that, people actually paid attention to their bill, and would seek out the price/quality doctor that they wanted to pay. This kept costs low, through competition in the free market. Doctors and hospitals were incentivised to keep the bills low or risk losing customers to the competition.

In the 70s, state government began putting in all kinds of stipulations about the things that insurance carriers HAD to cover. People stopped looking at their doctor bills. They simply handed over their insurance card and forgot about it. Costs went up because no one shopped around. There was no free market incentive to keep the costs lower because the state mandated coverage removed it..




.

[dyna mo]

Originally Posted by Harmon

Doctors in the US work FROM a hospital, not FOR a hospital.

not accurate.

i had surgery recently and my main doctor, not the surgeon, was a hospital staff doctor.

[C H R I S]

This excellent article explains alot about insane pricing differences.... it's a long but very good article.



http://www.time.com/time/magazine/ar...136864,00.html

[Barry-xlovecam]

I looked at the fees charge rates in the local area here they varied 300% between the local hospitals -- regionally within the state they varied (lowest to highest) 400% WTF?

It is all in the same locality -- I am not comparing New York City fees to Jackson, Mississippi fees. Maybe, Medicaid pays 20% of the fee charges, Medicare a bit more, private insurance negotiate rates that can vary a lot, 40% to 60% of the "asking price". And the real kicker is the least able to pay -- the uninsured get billed to top rates, then the majority of them don't pay or cannot pay and the government reimburses the hospital at the lowest rate (Medicaid rate).

So, what happens is that the insured subsidize many services with the hospitals jacking up the "asking price" resulting in higher insurance premiums.

Now, the insurance company's negotiated rates are subject to a policy owner's deductible -- 20% up to $2K - $10K?

Goes down like this: insurance company #1 negotiates $17,000 and insurance company #2 negotiates $28,000 for the same procedure at the same hospital that has a "asking price" of $44,000. You pay 20% of that negotiated "contract price" as your deductible!

I am not sure who is fucking who here but the first place to start controlling health care costs is a transparent, fairer and competitive marketplace price. That $44,000 procedure might get Medicare reimbursement at $9,000 with the balance charged off, and what can be recovered paid by the insurers of the private insured patient.

This is one reason the current insurance premiums are unreasonably costly in the USA. Next to be revealed are the insurance company's negotiated rates -- why does insurance company #1 negotiate $17,000 and insurance company #2 negotiate $28,000 for the same procedure at the same hospital? Are they just incompetent negotiators or is someone taking kick-backs?

This should be interesting as it develops ...

This would only matter to you if you have skin in the game, or want to, or are forced to get into the game.

[Antonio]

Originally Posted by Harmon

Yeah, but it's not Western medicine or practices. Certain things, such as getting a boob job, you probably shouldn't seek bargain basement sales for.

If I had the choice between joint replacement in some scummy eastern European shithole for 5 gees, or Cedars Sinai for 50 gees... I'd spend 50. It's called quality of service.

Your choice, I had a choice between paying $6000 to a US programmer and $500 to an Easter European programmer a few years back (both from this forum) and I chose the latter - the script was done exactly as I wanted it and I received fantastic support when needed.

Of course, the more primitive people are afraid of the "unknown" and everything outside their trailer park is "foreign" or "scummy" and cannot be trusted. You can always post verified stats, which prove that breast implant operations done in private hospitals in Eastern Europe have much lower success rate than the ones done in the US … let’s see them.

[Sly]

Originally Posted by sperbonzo

Actually no. It's NOT because of capitalism. It's because the states have all mandated a massive number of procedures that insurance carriers MUST carry. In the 50s and 60s, people typically bought insurance that only covered catastrophic events. For all other services they paid cash, or worked out a payment plan with the Doctor. Because of that, people actually paid attention to their bill, and would seek out the price/quality doctor that they wanted to pay. This kept costs low, through competition in the free market. Doctors and hospitals were incentivised to keep the bills low or risk losing customers to the competition.

In the 70s, state government began putting in all kinds of stipulations about the things that insurance carriers HAD to cover. People stopped looking at their doctor bills. They simply handed over their insurance card and forgot about it. Costs went up because no one shopped around. There was no free market incentive to keep the costs lower because the state mandated coverage removed it..




.

Everyone that has insurance should read this and then think about whether or not they ever consider or care about their medical bills, unless they have to make a payment out of the bill.

[sarettah]

All of this is largely smoke and mirrors.

The Medicare payment rate is re-computed every year or couple of years (I don't recall the schedule and I am too lazy to go google it). The computation for each procedure is a percentage of the average billing for that procedure across a certain time period.

Most insurance companies use the Medicare rate as the beginning of their negotiations with their various vendors.

So Doctors and Hospitals generally publish and charge a much higher cost then they ever actually get paid because that raises the average billing amount going into the next round of computations.

.

[seeandsee]

i guess its because someone is doing only rich people

[_Richard_]

if the US has private for-profit prisons.. why would the medical system be any different?

cause people care?

[campimp]

Originally Posted by Harmon

If I had the choice between joint replacement in some scummy eastern European shithole for 5 gees, or Cedars Sinai for 50 gees... I'd spend 50. It's called quality of service.

As someone from the U.S. who lived a considerable amount of time in Romania I can assure you that the doctors there are pretty well trained, at least in Bucharest where i lived. Would I want to have an operation in a little hospital somewhere in the Romanian countryside? No, but you shouldn't assume all places in Eastern Europe are "shitholes", you make yourself look like the foolish American the rest of the world hates

healthcare in the US is by no means the best in the world, but I understand you will never accept that, and that's fine, I know plenty of people who feel the same. Those people also tend to hang on to the false belief american universities provide the best education in the world.

There are plenty of advantages to living in America, but superior healthcare and education are not 2 of them. At best our medical care is on par with other countries, and as for education, our current educational standards are far below the rest of the world, including some of those "shithole" eastern european countries

I would be more than happy to go to germany and get the same medical help for a far lower price, but that's just me

[dyna mo]

Originally Posted by Sly

Everyone that has insurance should read this and then think about whether or not they ever consider or care about their medical bills, unless they have to make a payment out of the bill.

everyone who reads that would benefit from knowing it's a misrepresentation.

fact is, the move to insurance limited people's choices on doctors and hospitals, by design. people didn't just all the sudden get lazy just because they (we) got insurance cards.

[Kolargol]

Originally Posted by MaDalton

indeed..

8000 GBP in the UK, operation by one of top orthopedic surgeons.

[theking]

The same thing applies to prescription drugs. It pays to drugstore shop because the variance between the price for the same identical drugs can be in the hundreds of dollars. Also one should try to buy generic drugs when possible rather than brand names as the same thing can apply to the price.

[purecane]

you guys haven't even touched on the subject of fraud in this whole thread....the governor of this fine state was found guilty of systematically over-billing medicare for over 2 billion$$$$ figure that and other thieves into your equations......

[bigluv]

Anything that you dont know the price clearly up front, and is difficult to compare between providers, means prices creep up. Throw in insurance companies, and government funding, and thats another factor.

Biggest thing to reduce prices, create transparency and comparability.

Also, it might help if everyone in america wasn't such a government subsidized corn fed fat piece of shit.

[John-ACWM]

Also provided a good answer.

[privatesociety]

Insane, the countrys who get free healthcare and moan dont know how lucky they are

[OY]

Originally Posted by sperbonzo

Actually no. It's NOT because of capitalism. It's because the states have all mandated a massive number of procedures that insurance carriers MUST carry. In the 50s and 60s, people typically bought insurance that only covered catastrophic events. For all other services they paid cash, or worked out a payment plan with the Doctor. Because of that, people actually paid attention to their bill, and would seek out the price/quality doctor that they wanted to pay. This kept costs low, through competition in the free market. Doctors and hospitals were incentivised to keep the bills low or risk losing customers to the competition.

In the 70s, state government began putting in all kinds of stipulations about the things that insurance carriers HAD to cover. People stopped looking at their doctor bills. They simply handed over their insurance card and forgot about it. Costs went up because no one shopped around. There was no free market incentive to keep the costs lower because the state mandated coverage removed it..




.

I believe it!

Do you have some specifics on what years these mandates were put in place? It would be great to get some specifics on who was in power in the different states that put these measures into place.

[Supz]

Originally Posted by purecane73

Why even post a pic of Obama. This has been going on probably since before he was in politics.