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Comment by peapicker | Hacker News Reader

I don't recall what the itemized bill was before insurance took care of it, but with health insurance, each of my kids actual cost to me was $100 out of pocket. In the US.

I'm sure the quoted price before insurance was probably ridiculous, though.

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No one knows how much healthcare costs in the United States. Not the insurance companies. Not the hospitals. Not the doctors. No one. The prices vary widely across providers, and insurance companies. I was reading a few years ago (alas, I can't find the link, but I think it was in the LA Times. KQED was also working on this recently.[1]) where the author tried shopping around and found where same provider would come up with different itemized breakdowns depending on the insurer. It came down to the provider and the insurer negotiated prices. Say the insurer provider agrees that a procedure costs $1000, but says an x-rays can only cost $500, so the doctor fee is $500. Another insurer says treatments can cost $800, and x-rays can only cost $!00, so suddenly the doctor fee is $700. What's the true price of anything?

Under America's about the only thing you can tell is that total costs are much higher than the rest of the world, and outcomes are actually slightly worse than the rest of the OECD countries.[0]

[0] http://beta.latimes.com/nation/la-na-healthcare-comparison-2...

[1] https://www.npr.org/sections/health-shots/2014/11/17/3647197...

It shocks me that this isn't criminal. I can't think of any other good/service where we accept this sort of thing. It also really exposes the extreme arbitrary nature of healthcare pricing.

The thing is, you could figure out how much an x-ray costs. You just have amortize the cost of the machine, consumables, technicians, and radiologists over the number of images taken. The data is sitting there at every hospital, just spread out across departments. The thing is, gathering that data and calculating these numbers requires a nontrivial amount of effort, and if all you care about is if your bottom is going up or down, then what’s the point?

I understand that you think this is relevant, but I don't think it adds anything to the conversation. Sure, sometimes fees are reasonable, and sometimes (even if you 'go to a hospital covered by insurance, [see] an obstetrician in [your] plan') you get completely fucked. That's the point here, it's really tough to know what you're "signing up for" and what the costs are, even when they SHOULD be fairly transparent.

You must have great insurance. Are you in Congress?

Nope. Software Engineer. The reason it was so low is the youngest was born 18 yrs ago - long before current cost skyrocketing. Things used to be a lot better.

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