
A woman had a baby. Then her hospital charged her $39.35 to hold it - mcgwiz
http://www.vox.com/2016/10/4/13160624/medical-bills-birth-delivery
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11thEarlOfMar
> consumers are totally divorced from prices.

It is really bad.

I was charged $1,950 for an ambulance ride. Until the ambulance company
learned that I had insurance. Then the price dropped to $790 _even though the
ride wasn 't covered by my benefits_. I was charged 61% less because I had
insurance. I can't imagine how anyone who is uninsured can financially survive
even relatively minor injuries or illnesses. They have the least ability to
pay, and get charged the most. It's so upside down, it pisses me off. And
that's hard to do.

A large part of the problem is that insurance companies negotiate prices with
care providers, and every insurance company can therefore get a different set
of prices at the same facility. So even if we collectively reported what we
paid to an open database, you couldn't be assured of getting the same price as
me on the same procedure if we had different insurance companies.

~~~
arkades
This is not strictly an issue of bargaining out pricing contracts. Hospitals
are not held to account by consumers to provide transparent pricing, so they
don't.

The same hospital that will tell you "we don't know how much this operation
will cost; it depends on too many variables" takes a lump-sum payment from
Medicare (via DRG) for the same procedure - which ought to tell you they know
damn well what, on average, that procedure is going to consist of. If they can
tell you what codes it will generally include, that can be translated into
cost.

They're not even trying to deceive you. The parts of the hospital that deal
with you, vs. building around DRGs, are entirely divorced. Your physician
literally doesn't know what the procedure will cost you. His office manager
literally doesn't know. The billing department doesn't know. And the people
who do know? They don't talk to physicians and patients.

I've worked /in/ clinical business ops. in an academic medical center and
couldn't get my hands on that information (too politically sensitive).

