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PaperclipPerfector  12d ago (text post)   30515 thread views

Culture War Roundup for the week of December 9, 2024

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Reminds me of "How to Do Health Care Right" by The Dreaded Jim:

My wife was advised to get a colonoscopy. We shopped around, got a reasonable price at a doctor with a good reputation, negotiated with the insurance company, did all the stuff one does in an environment which actually has prices. Then after the colonoscopy was done, the hospital pulled a huge list of stupendously expensive charges out of their ass, most of which were obviously ridiculous or completely made up out of thin air, just trying it on to see what they could get away with, and all of which were charges we had definitely not agreed to, nor consented to in any way, formal or informal, written or unwritten. They just were not used to doing stuff on the basis that one has a definite price, and that the price one charges affects demand for one’s services. The concept seemed alien and incomprehensible to them. Mentally, they were socialists.

In Singapore, they advertise prices.

Some years later, I had the following conversations with various US health care providers. I recorded the conversations:

Conversation with Stanford Hospital:

Me

My wife needs a colonoscopy: Could you give me a price on it?

Stanford Hospital: (businesslike tone)

Twenty five hundred to thirty five hundred.

Me

You do this all the time. Can’t you give me a specific price?

Stanford Hospital: (cooler tone)

Sorry

Me

Is $3500 the all up, all included price to both myself and my insurance?

Stanford Hospital: (businesslike tone)

It only includes the doctors fee, and does not include any additional services

Me

So after I have this done, any number of people could then charge me any fee they like in addition to the thirty five hundred?

Stanford Hospital: (distinctly chilly tone)

I am afraid so.

O’Connor Hospital

Me

My wife needs a colonoscopy: Could you give me a price on it.

O’Connor Hospital

Do you have a primary physician?

Me

Yes, my primary physician has advised this procedure, but it seems expensive. I am looking for a price.

O’Connor Hospital (outraged and indignant)

We don’t give out prices!

Mercy General Hospital

Me

I am looking for a price on a colonoscopy.

Mercy General Hospital hangs up without a word.

Saint Joseph’s medical center of Stockton:

I am transferred to financial counselling, who transferred me to “Estimates” The estimating lady appreciated my problem and made sympathetic noises.

She then asks me for a CPT code. I then research what CPT codes are, and discover that an operation can result in any CPT, and any number of CPTs. I discover that no matter what CPT I give, it is unlikely to be correct or sufficient, that additional CPTs can show up any time. A CPT would only be useful if it was possible to know in advance what CPTs would result from a colonoscopy, but the CPTs are only decided after the colonoscopy, usually long after the colonoscopy.

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