Comment by lolsal | Hacker News Reader

Comment by lolsal | Hacker News Reader

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How would doctors and hospitals account for complications or non-standard 'things' that come up during treatment? I don't think it's reasonable to try to document every outcome or potential action taken. It's easy for me to think "setting a cast on a broken arm should cost $X.", but having had it done before, there can be complications - existing fractures, location of fracture, skin conditions, etc.

I absolutely would love things to be transparent, but I think healthcare is more like fixing software bugs than delivering well-scoped features. It's very hard to estimate anything beyond the most basic, superficial issues.

Just to be totally clear, I want prices posted online. I'm just worried there would be asterisks next to everything and then they would be useless. Perhaps that's an opportunity for differentiation in hospitals: "broken bone - cast set: $X - all inclusive".

There are at least two ways to approach variable costs. One is to have a price to treat a condition, e.g. a hospital can charge $X for a pregnancy, regardless of whether it’s a C-section or a vaginal birth. The other is to allow the variable charge but to disclose it as it happens, just like auto shops do. If I see a doctor for $75, and the doctor determines that I need a $17 strep test, the doctor can tell me that the strep test is $17 before doing it.

This does impose an annoyance cost on every little charge, which I think is a good thing. If a medical practice really wants to charge for every piece of gauze they use, then this should annoy the patient up front so the practice has an incentive to stop doing it.

> One is to have a price to treat a condition, e.g. a hospital can charge $X for a pregnancy, regardless of whether it’s a C-section or a vaginal birth

The side effect of such a policy is that hospitals will then have huge incentives to perform the cheaper procedure. E.g. if the real price of C-section is higher than the real price of vaginal birth, but the effective price for both is mandated by the government, then hospitals will have too much pressure not to perform C-sections (even when they'd result in better outcomes for the patient).

What you just described is the ultimate bait and switch scam though.

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