“But the prices were on display…” “On display? I eventually had to go down to the cellar to find them.” “That’s the display department.” “With a flashlight.” “Ah, well, the lights had probably gone.” “So had the stairs.” “But look, you found the notice, didn’t you?” “Yes,” said Arthur, “yes I did. It was on display in the bottom of a locked filing cabinet stuck in a disused lavatory with a sign on the door saying ‘Beware of the Leopard.”
Can you imagine if any other business decided the price was a business secret? Store: "Ok, let's see... that'll be $56.87." Customer: "What!? I can't afford that. All I got was a loaf of bread, a quart of milk, a dozen eggs." Business: "Oh, right. Well there is the cost of the bag, and the cashier charge, you did use a basket and we do have to clean the store. But since you didn't use grocery insurance we can get this down to... $45.12." Customer: "There was never any mention of being charged to use a basket or bag. I have mine own, I could have used." Business: "Oh, no, sorry you can't use outside bags or baskets. They might be contaminated and cause more harm then good. We must insist you use ours. The bag was only $8, I don't know what the issue is."
There's a yarn store that I used to go to that had some brands that other local places didn't. The owner rarely used individual pricing stickers and maybe had one or two printed pages of items and prices near the relevant yarns. Thus, if I found something I liked, I had to be sure that I really wanted it because the owner always huffed when asked how much something was then would look at you expectantly to say you wanted it after finding the price in her electronic catalogue.
Hospitals collect full price from uninsured people who don't know that those prices are highly negotiable. Sometimes they can be negotiated down to zero.
Now you've seen a hospital post their prices. It's complicated so you do have to choose the procedure and details about the patient like age etc so it can more accurately output what the hospital charges. If you enter insurance information it gives its best guess at how much out of pocket you'd pay.
I was working on my senior research project in my undergrad degree for my BS in Biology premedicine on a yeast growth study over a 24 hours period. As such, had to monitor it by using a special machine which counted the numbers of cells ( turbidity) in the growth medium. I was comparing different types of media with trying to figure out what made them grow better based on this measurement. So, while, the factor of opaqueness in this regard has a very different meaning from what the brilliant Dr. G. is referring to obviously I believe we can understand what we're talking about.
My sister was charged so, so much for her gall bladder surgery and asked for an itemized list of charges because it was more than it should have been. Suddenly a mistake was found that the time had been 'recorded wrong' and the cost was quartered
the itemized bills are purely works of creative writing to begin with. they are post hoc rationalizations of a billing amount they wanted to reach , not an actual tally of discrete services and goods with fixed costs per unit or unit of time. if it were the latter there wouldn't be mistakes often and the costs certainly wouldn't vary by insurance or insured status or how much you complain or whether you seem litigious. that said, I have found it helps a lot to complain a lot and seem litigious. The one justified use of the suffix 'Esq' in communications, probably, is to put the fear of litigation in scummy institutions that will get away with anything they think they can, and know that the law (let alone a jury) won't be on their side if push comes to shove.
Even then, if the hospital is big enough, it might not do anything. Oh. They'll give you an itemized list and maybe even drop the "price" after a "mistake" is found, but they'll find other ways to make your life miserable. I went to one of the biggest hospital systems in the US and in my city because of severe shoulder pain that I thought might be a heart attack. Turns out that I just turn sleeping into a contact sport sometimes and almost dislocated my shoulder. In the process of getting that diagnosis, I was asked several questions and, at one point, explicitly told them, "Do not run this test. There is an absolute 0% chance that it is that. I will not pay for a negative test that I'm telling you now will be negative." They ran the test anyway without my consent. It was negative, of course. I threatened to report the hospital to the feds and I DID report the doctor to whoever does medical licenses (I forget the name atm), so they dropped the charge, and we paid the remaining bill. They then proceeded to lie to the credit reporting agencies once a year every year for seven years and report it as unpaid medical debt, forcing me to dispute it. Fortunately, I was always able to counter with the saved receipt, and after the 3rd time, the credit agency didn't even ask for the receipt anymore. They could see what was happening and just removed it as soon as I complained. After year 5, I didn't even have to dispute it anymore. They just removed it automatically. The hospital system didn't even try to change the bill amount and they never responded to my disputes, so I would win by default. They just wanted to ruin my credit, and almost 10 years later, I'm still struggling to repair my credit. They got hit with a federal fine after both the credit bureau and I complained, but the hospital continued to do it. The doctors there are amazing, but I will trash the administration to everyone who will listen and most of the people who won't listen. Had to go there again just a couple of months ago, and I'm still waiting for the other shoe to drop. I told my surgeon that the only reason that I would even step foot in that building was because of him and that if he offered that surgery at the university hospital where he teaches, I would've postponed my surgery just to go there instead. According to him, they've gotten better since then, and while I trust him with (literally) my life, I refuse to trust that hospital system until they rebuild that trust brick by brick.
It looks like hospitals are the fill places where you should be a Karen and ask for itemized prices and insist on discounts. Just remember to be mad at the finance people, not the physicians and nurses.
Next time in my mathematical for chemists class, I will tell my professor “Fourier Transform not only applicable on chemistry-related method only but also to access a price transparency posted by US hospital.”
Bimothy, please. Transparency would slightly impair the rate at which corporations, lobbyists, and pocket politicians can profit from renting out human rights at exorbitant prices. You don't want to make CEOs cry, do you?
People never think of the poor CEO's. Their multi million dollar bonuses should never be so at risk from such terrible things like "government regulations" which are just a blatant attack on the vulnerable stockholders. It's disgusting how little we value these billionaires and their hard work.
That is hilarious (and I speak as one who knows calculus and fourier transforms). A year ago I spent countless hours tracking down pricing information for an out of network (and therefore not covered, and also just plain not covered) surgical procedure, looking at two facilities where the procedure might be done. In the end I got most, but def not all of the information, and it was very, very, very hard.
Medical expenses work just like quantum mechanics. Until you actually receive the product or service, it simultaneously has every possible price, with some prices more likely than others. Once you're legally on the hook for the cost, the wavefunction collapses and the final price is revealed.
Exactly. I have been shopping around the country for a rare surgical procedure and none of them will even give me an estimate without traveling to them for an in person evaluation first. So it would cost thousands of dollars for each evaluation just to find out how much surgery “might” cost.
The prices are wildly all over the place too. At my hospital a CBC with diff was cheaper than a CBC without. But even if you know the prices, it’s impossible to tell the patients what they will actually pay since we have no idea what amount the insurance will end up covering. So much for it being a “free market” system.
Once needed to get a knee MRI but I had high deductible insurance. So I called a few places to check prices. They are instructed not to give a clear answer. You have to tell them you don't have any insirance to get an actual number. The range was from $900 to $4000
i had that issue with various specialists before obamacare and just started throwing out auctioneer prices until I hit $2,000. They still hung up on me.
And then you ask an insurance company how much a medication will cost and they can't answer it either. Because it always depends on their ever-evolving formulary, the professional relationships with individual pharmacy chains, and the pricing variances of the individual stores. It's nice to know we pick insurance coverage blind.
Providers probably can’t tell what a price will be with insurance even with a high deductible plan because even with that high deductible, insurance can still have the effect of giving a ‘discount’ according to whatever contract the insurance company has with the provider. By asking for the no-insurance-cash price, that should be the highest possible amount a patient will have to pay, so that’s probably the right way to go about it.
“Yes,” said Arthur, “yes I did [find the information I was looking for]. It was on display in the bottom of a locked filing cabinet stuck in a disused lavatory with a sign on the door saying ‘Beware of the Leopard.” -- Douglas Adams, _The Hitchhiker's Guide to the Galaxy_
As an electrical engineer, I thank you for your inclusion of fourier transforms. I finally get to understand a piece of technobabble on this channel! It's a good feeling.
as a followup you should do one about how the prices on itemized bills from hospitals are literally made up bullshit, with absolutely no relationship to the CPT (or any other ) codes associated with each itemized entry. Example, I had to stay an extra day because of a stupid hospital mistake I did everything to prevent, and so when I got an outrageous bill and a portion of that was merely identified as a charge per day of admission, I insisted they drop the bill by the cost of one of the days that was their fault. they rewrote the bill to include the cost of only one day of admission instead of two, but magically the cost per day was doubled. they can do this because there is no actual cost per day of admission, there is a cost they want to charge and they work backwards from there to produce a work of fiction called an itemized bill. EVERY OTHER INDUSTRY CALLS THAT FRAUD.
So true! Literally charging $20 per 200mg of ibuprofen, you know that little pill you can get in a giant bottle for $4? They charge the fee for the doctors who check in on you and then just come up with a dollar amount for the rest and try to assign it some meaning. It has none.
When I worked at a hospital (I'm an RN), I was able to view their chargemaster. The chargemaster is basically the price list of everything the hospital charges for. Every hospital has one, so the claim that they dont have that info readily available is BS. Anyway, I took a look at it and everything was just a wash of coded numbers. Not HCPCS codes, which is billing standard, mind you. I mean 6 or 7 digit nonsense that you needed one or two SEPARATE EXCEL SHEETS or be able to make ANY sense of. The turbidity is baked right into the hospital itself. It is disgusting.
yeah I have found itemized hospital bills to be a lie and neither the CPT codes nor the hcpcs codes associated with a charge have anything to do with a predictable price for it. it's as simple as , someone thought you would pay this much , and when you fight it there is leeway to charge you less , and someone will edit the itemized bill accordingly , because it never corresponded to actual prices of individual components of care to begin with.
@@Kingchar23 I considered it. 1.) Didn't want to ruin my life and future when a company with more money and by extension exponentially more power decides to sue me into the ground if they found out it was me. 2.) It would have taken hours and hours to decode it and those that care wouldn't need that info to know it's a problem and those that don't would not be swayed by it regardless.
My favorite part of this is when you try to get this info through a phone call you have to go through 17 layers of automated call system menus just to be routed to a generic page on the website that says nothing :^)
If it has a voice menu, try saying "representative" or "speak to human". You may have to repeat it a lot, but it should get you to an actual person who can help more.
My friend showed me his hospital printout bill. It showed a sailne bag that cost $2 was charged $2,000 to Medicare. It went on from there. It's appalling. I work in medical. It's just a giant joke at this point. Let me just put this way for $170 massage. One of the contractual write-offs is $111. The patient pays a $59 copay. How much is that insurance company really paying at that point? Come on. In one scenario we bill out a $65 office charge. We get paid 16 CENTS from Humana, but here's the kick. Humana gets paid full price from Medicare, but we're supposed to write off $44 and then the patient pays a $20 copay and the insurance company only pays 16 CENTS. So once again WHO'S taking all those hits? The providers and the patients. 🤷🏼🤷🏼
I heard a story on NPR years ago about a reporter who was bitten by a rat in New York City and it got infected so he ended up staying in the hospital for a week. He interviewed the owner of the hospital and went over the billing in full detail trying to add up to the total amount. At some point the CEO admits there's "funny money" in there. All the bs of billing is to try and get as much reimbursement as possible given what hospitals are allowed to charge and what insurance companies are required to pay (they hate paying more). Let's not forget any hospital with an ER cannot legally turn away patients. If folks can't pay and aren't on insurance hospitals give care completely unreimbursed by anybody.
Yeah, the prices obviously have nothing to do with the cost on any given service. They're just making their aggregate revenue numbers work out by making up whatever on individual service lines. I wouldn't even be surprised if they retroactively fit their prices to internal cost targets. Edit: This reply is wrong in context to the above comment because I was referring to the hospital's prices. Sheri's reply below caused me to re-read. Details left as an exercise to the reader.
As someone who works in PM&R, I can tell you that the location of the prices made me SHRIEK with laughter. It's so true! "Physiatry? Do you mean podiatry? Psychiatry? Physician assistant?"
Thankfully, ChatGPT can handle Fourier Transforms. And many Americans can go to their local university and hire a math postdoc to solve one by offering to buy them lunch.
Undergrad electrical engineers need to know them for calculating frequency responses in circuits. No need for those fancy-pants lunches, coffee for a junior will do.
I've had so much trouble with "Mark all the crosswalks" CAPTCHA that I'd take a calculus problem. I've never taken calculus, but at least I can input the problem into a search engine instead of dealing with 8-bit street-view images.
At 1:03 You can't really do price scouting if your insides are on the outside You also shouldn't be expected to make rational decisions while sick, or even worse, have a full degree in medicine to actually understand the difference between hospitals, or worser still, be able to differentiate between hospitals safety standards, knowing the ins and outs of each hospital
I love this series. I already have a Pavlovian reaction to this time of the day that I no longer wait for CZcams to push this on my feed and I now voluntarily seek the next ep hahaha "Instead of choosing photos of cars, you have to do calculus." 😂😂😂
As an engineer, Fourier transforms bring it on. All those years of studying will finally pay off when I input it into Wolfram Alpha and just copy-paste the results. 😅
YES! I am in late middle age and have had one form or another of BCBS insurance for decades. Even if I call them to check, I never have clue what my out-of-pocket expenses will be. Ever.
"We need turbidity." I was drinking something at the time and almost choked. Yes, I'm prone to using five dollars words from time to time, myself. You know, intermittently.
The things this law did right: -Made it a requirement for the price listings to be in a machine readable format (excel, CSV, flat file, etc) The things this law messed up: - They forgot to specify how procedures should be displayed, so a lot of the transparency comes down to being able to predict which ICD-10 codes they're going to hit you with. Which, unless you work both in healthcare and in health billing, well, that could be problematic.
And I thought it was great when healthcare facilities had to start posting which licensing and oversight agencies were responsible for which service providers! Yay! Now we just need to start speaking up! Healthcare should be a consumer-driven industry! Thanks for this video!
Not consumer driven. Some people have the strange ideas about what qualifies as healthcare. The U.S. definitely needs better regulations to limit high prices.
As one who failed university math course (mostly calculus) in the medical school and so became a pathologist, and dealing with pricing regulations of our department for about 6 years (thankfully I don't need to do this anymore, Social Security in China now is NUTZ), This one is super hilarious.
I did a 10 week course at university on fourier transforms/methods and still don't have a clue what they were. That was absolutely a "shut up and calculate" course.
Today I learned : Turbidity is the cloudiness or haziness of a fluid caused by large numbers of individual particles that are generally invisible to the naked eye, similar to smoke in air. The Fourier transform is an extension of the Fourier series, which in its most general form introduces the use of complex exponential functions. Thanks doc
No joke! "Is there part of a crosswalk behind that dumpster, maybe way down the road." It sure would be easier if the pictures weren't practically 8-bit.
What I love about this series is that alot of this applies to 3rd world countries like the one I live in. Only difference is that it's government insurance.
@@Emilio1985thats a 4th world country. It is so developed but government failed to put a leash in time on corporate so people suffer. I feel like corporations should disclose why they need to be so large like google doesn't do so much work they don't need to be so large and they clearly are just developing trash.
USA is only a 1st world country on paper. It’s the Genie problem… you want water on tap, here ya go. buuuuuut, it’s gonna give you cancer(Cold Water Creek). Sooooo many “superfund” sites in our area and so many more that SHOULD be superfund sites. You want industry… buuuuuuut here’s your sky rocketing asthma rates aaaaannnnnd more cancer. You want energy… well here is your lung cancer from coal burning. Micro-plastics, forever chemicals, even FRUIT had twice as much sugar in it than it did in 2002. So here is your obesity/diabetes and so on and so on.
Dr G, if this is the hospital's CEO, should not the assistant be Himothy? As you explained yourself, "Jimothy works for health insurance, Himothy works for the hospital CEO, Bimothy works in publishing. They are all brothers." Brilliant video as usual.
I only had to pass Calculus 1 in college. I had to spend every day in the tutor's office that semester. Even the word calculus brings forth feelings of dread.
Patient: Sooo... how much will this cost? Customer service: Do you have insurance? Patient: No, that's why i'm asking/No, this is out of network Customer service: We have a program for uninsured Patient: Sounds great... but how much will this cost? Customer service: We also have social workers that can make an assesment and determine if you qualify for a sliding scale fee. Patient: Wonderful... however... how much will this cost? Customer service: Once you arrive we will make sure to put you in contact with someone of the financial department to inform you about that. Patient: Alright Days later Financial department: It will arrive in a bill to your address. Patient: Wait... isn't there a law called "No surprise act" Financial department: It only applies to emegencies in this state plus you must wait for the system to calculate the charges. Patient: Alright Days later Collection agency: Hi, this is the collection agency you owe $500 to X hospital how do you want to make your payment?? Patient: F**k
One of our local hospitals has a procedure listed as "$450, discounted $450 to $0" for uninsured patients. Curious, I called the "price transparency line," where I was informed that those prices are not the same as what they have on their end, and that they're effectively meaningless. Exciting to know that even when hospitals do comply, they're not accurate!
Even with price transparency, your insurance determines which hospital you're allowed to receive care at. I would rather get a $10,000 CT scan and pay $100 rather than a $5,000 CT scan that I had to pay $5,000 for.
"It's true, it's true "... (I don't know where I got this, but I use it often, mostly in my head so as not to be annoying to everyone else) author unknown
Always remember that one of the founders of HCA was Jack Massey who made his first fortune with Kentucky Fried Chicken. He took 3Corporations to the Big Board(Dow Jones) Kentucky Fried Chicken, Mrs. Winner's Chicken & Hospital Corporation of America. Make Sense Now?
My grandmother went to an ER recently (she was fine), they did a cat scan and put a preemptive IV in. The hospital billed Medicare 16K, Medicare only paid a portion of that, which the hospital said was fine.
Jimothy was such a hilarious name I wanted to use it in my skits but didn't like the idea of using something that someone else came up with. I was so mad I didn't think of it first! 😂 So I came up with Dimbert, & am happy with it, so when I heard this I thought at first you said "Dimothy" & I was like NOOaoOOaoOooo "I'm relieved it's Bimithy 😅😅 so hilarious
Beware 😉 There's Jimothy who works for/in Healthcare Hell, Bimothy who works in Publishing Purgatory, and Himothy who works for the demonic Hospital CEO/Hell (all brothers) ... and then there's Tristopher (we believe he's a cousin lol) 😉
Calculus. My mom was a general surgeon, and it was the bane of her undergrad. She literally decided to memorize the textbook to survive and pass. This is the perfect captcha to keep almost everyone in the dark.
I went to the ER recently. Surely I will have sticker shock when I get the bills. Thanks to this video I decided to look up the pricing. The pricing page is not something "normal" and easy to read, but rather a .json file, so I have to use my computer programming background to decipher the pricing for my situation. So, yea, the goal to confuscate is real
The problem is people go to doctors and hospitals expecting to get better, or even survive. As soon as you give up that fantasy it all gets easier and starts to make sense.
I used to work for HCA in a non-medical position (facilities maintenance). It was an easy job most days, until 2 years later when I started to feel all those midnight and 3am calls for miniscule issues. Yes, the maintenance crew is on call as well, especially in a rural facility like I was in. Combine that with no funding for necessary equipment and money hungry directors, you get hell for patients and workers alike.
My hospital puts their master price sheet in an accessible spot, but it has over 500k rows in it and dozens of entries with the same name, all of which are technical abbreviations. Your depiction checks out.
I can't wait for Bimothy, Jimothy and the others to get a new job where they can actually help people out and not serve evil corporations. Even better, they could become CEO themself! Edit: Changed he to they and himself to themself.
I am happy that when I got an infected blister that was described as "necrotic" by a medic I didnt have to worry about how much it would cost me. I could just go to my local minor injuries, wait 15 minutes to be seen by a nurse and walk out with some antibiotics. The NHS might have its flaws, but I would take it any day over American healthcare. The peace of mind knowing I can just go and get help without worry is so good.
Literally just talked about this today. Because I gave someone the billed amounts for a procedure (had already sent them an estimate letter) but their insurance does not release *their* allowed amounts.
“But the prices were on display…”
“On display? I eventually had to go down to the cellar to find them.”
“That’s the display department.”
“With a flashlight.”
“Ah, well, the lights had probably gone.”
“So had the stairs.”
“But look, you found the notice, didn’t you?”
“Yes,” said Arthur, “yes I did. It was on display in the bottom of a locked filing cabinet stuck in a disused lavatory with a sign on the door saying ‘Beware of the Leopard.”
Hitchhiking to our doom
Is this a book? If so what's the title? If not, you should write it!
@@caspenbeeI think it's a movie. Or a TV show. Or possibly a radio play.
Douglas Adams, The Hitchhiker's Guide to the Galaxy @@caspenbee
@@caspenbeeHitchhiker's Guide to the Galaxy by Douglas Adams
Can you imagine if any other business decided the price was a business secret?
Store: "Ok, let's see... that'll be $56.87."
Customer: "What!? I can't afford that. All I got was a loaf of bread, a quart of milk, a dozen eggs."
Business: "Oh, right. Well there is the cost of the bag, and the cashier charge, you did use a basket and we do have to clean the store. But since you didn't use grocery insurance we can get this down to... $45.12."
Customer: "There was never any mention of being charged to use a basket or bag. I have mine own, I could have used."
Business: "Oh, no, sorry you can't use outside bags or baskets. They might be contaminated and cause more harm then good. We must insist you use ours. The bag was only $8, I don't know what the issue is."
There's a yarn store that I used to go to that had some brands that other local places didn't. The owner rarely used individual pricing stickers and maybe had one or two printed pages of items and prices near the relevant yarns. Thus, if I found something I liked, I had to be sure that I really wanted it because the owner always huffed when asked how much something was then would look at you expectantly to say you wanted it after finding the price in her electronic catalogue.
They could do it if they really wanted it, but it would cost a lot of money and honestly you can get more profits from the healthcare market
This is a BEAUTIFUL example. Well illustrated.👏🏼👏🏼👏🏼
It's not like to medical, seems like all they teach in MBA schools is how to hide more fees and provide less for more money.
Don't give grocery stores any ideas. They already work hard at ripping people off as it is.
I've been arguing this for years. A lack of transparency is half the reason hospitals can overcharge
And pressure from insurance companies is the other half of the reason so many do overcharge.
And the other half is executives not getting stacked up like sandbags😂
maybe we might ought to change that up a bit🤔
It applies to *all kinds of business,* actually. Together with individual pricing. Welcome to when capitalism wins 🤗
Hospitals collect full price from uninsured people who don't know that those prices are highly negotiable. Sometimes they can be negotiated down to zero.
@@karmadave2000
exactly. see my previous comment, if it hasn't been removed or hidden.
Just learned a new word: turbidity. Plus I've never seen a hospital post their prices.
Well clearly someone doesn’t know calculus /joking
@@cexilady3333I stopped after algebra 2!
Now you've seen a hospital post their prices. It's complicated so you do have to choose the procedure and details about the patient like age etc so it can more accurately output what the hospital charges. If you enter insurance information it gives its best guess at how much out of pocket you'd pay.
I was working on my senior research project in my undergrad degree for my BS in Biology premedicine on a yeast growth study over a 24 hours period. As such, had to monitor it by using a special machine which counted the numbers of cells ( turbidity) in the growth medium. I was comparing different types of media with trying to figure out what made them grow better based on this measurement. So, while, the factor of opaqueness in this regard has a very different meaning from what the brilliant Dr. G. is referring to obviously I believe we can understand what we're talking about.
@@amandamiller6995this may be the first time in a while where I completely understand and also have no idea what you've just said, lol.
My sister was charged so, so much for her gall bladder surgery and asked for an itemized list of charges because it was more than it should have been. Suddenly a mistake was found that the time had been 'recorded wrong' and the cost was quartered
the itemized bills are purely works of creative writing to begin with. they are post hoc rationalizations of a billing amount they wanted to reach , not an actual tally of discrete services and goods with fixed costs per unit or unit of time. if it were the latter there wouldn't be mistakes often and the costs certainly wouldn't vary by insurance or insured status or how much you complain or whether you seem litigious.
that said, I have found it helps a lot to complain a lot and seem litigious. The one justified use of the suffix 'Esq' in communications, probably, is to put the fear of litigation in scummy institutions that will get away with anything they think they can, and know that the law (let alone a jury) won't be on their side if push comes to shove.
This is sadly common. I'm a hospital employee and was billed ($50) for a equipment we never used.
Asking for an itemized bill apparently will often reduce the "price"
Even then, if the hospital is big enough, it might not do anything. Oh. They'll give you an itemized list and maybe even drop the "price" after a "mistake" is found, but they'll find other ways to make your life miserable.
I went to one of the biggest hospital systems in the US and in my city because of severe shoulder pain that I thought might be a heart attack. Turns out that I just turn sleeping into a contact sport sometimes and almost dislocated my shoulder. In the process of getting that diagnosis, I was asked several questions and, at one point, explicitly told them, "Do not run this test. There is an absolute 0% chance that it is that. I will not pay for a negative test that I'm telling you now will be negative." They ran the test anyway without my consent. It was negative, of course. I threatened to report the hospital to the feds and I DID report the doctor to whoever does medical licenses (I forget the name atm), so they dropped the charge, and we paid the remaining bill. They then proceeded to lie to the credit reporting agencies once a year every year for seven years and report it as unpaid medical debt, forcing me to dispute it. Fortunately, I was always able to counter with the saved receipt, and after the 3rd time, the credit agency didn't even ask for the receipt anymore. They could see what was happening and just removed it as soon as I complained. After year 5, I didn't even have to dispute it anymore. They just removed it automatically. The hospital system didn't even try to change the bill amount and they never responded to my disputes, so I would win by default. They just wanted to ruin my credit, and almost 10 years later, I'm still struggling to repair my credit. They got hit with a federal fine after both the credit bureau and I complained, but the hospital continued to do it. The doctors there are amazing, but I will trash the administration to everyone who will listen and most of the people who won't listen.
Had to go there again just a couple of months ago, and I'm still waiting for the other shoe to drop. I told my surgeon that the only reason that I would even step foot in that building was because of him and that if he offered that surgery at the university hospital where he teaches, I would've postponed my surgery just to go there instead. According to him, they've gotten better since then, and while I trust him with (literally) my life, I refuse to trust that hospital system until they rebuild that trust brick by brick.
It looks like hospitals are the fill places where you should be a Karen and ask for itemized prices and insist on discounts. Just remember to be mad at the finance people, not the physicians and nurses.
Next time in my mathematical for chemists class, I will tell my professor “Fourier Transform not only applicable on chemistry-related method only but also to access a price transparency posted by US hospital.”
I believe it's also used in audio engineering.
Fourier transforms are widely used to process analog and digital signals in general. They are awesome!
You need the Fourier Transform to understand the frequency of health care price changes.
@@dr_ari_gami - I used to use the DFT to capture optical flow.
Fourier analysis is pretty widely used in science and engineering.
Bimothy, please. Transparency would slightly impair the rate at which corporations, lobbyists, and pocket politicians can profit from renting out human rights at exorbitant prices. You don't want to make CEOs cry, do you?
People never think of the poor CEO's. Their multi million dollar bonuses should never be so at risk from such terrible things like "government regulations" which are just a blatant attack on the vulnerable stockholders. It's disgusting how little we value these billionaires and their hard work.
renting out human *lives*
YES
Yes, I would like that very much
Yes, yes I do.
I was not expecting the placement into the PM&R page. As a physiatrist, I appreciated the hilarious acknowledgment!
That is hilarious (and I speak as one who knows calculus and fourier transforms). A year ago I spent countless hours tracking down pricing information for an out of network (and therefore not covered, and also just plain not covered) surgical procedure, looking at two facilities where the procedure might be done. In the end I got most, but def not all of the information, and it was very, very, very hard.
Truth! I’m a former nurse case manager and I feel for the elderly subscriber who attempts such a daunting task. I salute you.
Medical expenses work just like quantum mechanics. Until you actually receive the product or service, it simultaneously has every possible price, with some prices more likely than others. Once you're legally on the hook for the cost, the wavefunction collapses and the final price is revealed.
Exactly. I have been shopping around the country for a rare surgical procedure and none of them will even give me an estimate without traveling to them for an in person evaluation first. So it would cost thousands of dollars for each evaluation just to find out how much surgery “might” cost.
🏆
The prices are wildly all over the place too. At my hospital a CBC with diff was cheaper than a CBC without. But even if you know the prices, it’s impossible to tell the patients what they will actually pay since we have no idea what amount the insurance will end up covering. So much for it being a “free market” system.
Once needed to get a knee MRI but I had high deductible insurance. So I called a few places to check prices. They are instructed not to give a clear answer. You have to tell them you don't have any insirance to get an actual number. The range was from $900 to $4000
I had the same experience with doctors offices too.
i had that issue with various specialists before obamacare and just started throwing out auctioneer prices until I hit $2,000. They still hung up on me.
And then you ask an insurance company how much a medication will cost and they can't answer it either. Because it always depends on their ever-evolving formulary, the professional relationships with individual pharmacy chains, and the pricing variances of the individual stores. It's nice to know we pick insurance coverage blind.
Providers probably can’t tell what a price will be with insurance even with a high deductible plan because even with that high deductible, insurance can still have the effect of giving a ‘discount’ according to whatever contract the insurance company has with the provider. By asking for the no-insurance-cash price, that should be the highest possible amount a patient will have to pay, so that’s probably the right way to go about it.
Poor PM&R! Physiatrists and PM&R therapists are so underrated, and yet they’re absolute lifesavers.
“Yes,” said Arthur, “yes I did [find the information I was looking for]. It was on display in the bottom of a locked filing cabinet stuck in a disused lavatory with a sign on the door saying ‘Beware of the Leopard.” -- Douglas Adams, _The Hitchhiker's Guide to the Galaxy_
I was just thinking about the Vogon Constructor Fleet's explanation about how people could access the info on the new hyperspace bypass.
LAWD 😂
As an electrical engineer, I thank you for your inclusion of fourier transforms. I finally get to understand a piece of technobabble on this channel! It's a good feeling.
as a followup you should do one about how the prices on itemized bills from hospitals are literally made up bullshit, with absolutely no relationship to the CPT (or any other ) codes associated with each itemized entry. Example, I had to stay an extra day because of a stupid hospital mistake I did everything to prevent, and so when I got an outrageous bill and a portion of that was merely identified as a charge per day of admission, I insisted they drop the bill by the cost of one of the days that was their fault. they rewrote the bill to include the cost of only one day of admission instead of two, but magically the cost per day was doubled. they can do this because there is no actual cost per day of admission, there is a cost they want to charge and they work backwards from there to produce a work of fiction called an itemized bill. EVERY OTHER INDUSTRY CALLS THAT FRAUD.
So true! Literally charging $20 per 200mg of ibuprofen, you know that little pill you can get in a giant bottle for $4?
They charge the fee for the doctors who check in on you and then just come up with a dollar amount for the rest and try to assign it some meaning. It has none.
When I worked at a hospital (I'm an RN), I was able to view their chargemaster. The chargemaster is basically the price list of everything the hospital charges for. Every hospital has one, so the claim that they dont have that info readily available is BS.
Anyway, I took a look at it and everything was just a wash of coded numbers. Not HCPCS codes, which is billing standard, mind you. I mean 6 or 7 digit nonsense that you needed one or two SEPARATE EXCEL SHEETS or be able to make ANY sense of. The turbidity is baked right into the hospital itself. It is disgusting.
Searching the internet for Healthcare price transparency leads to nothing.
Nurses should start leaking these chargmasters and spereadsheets to the public
yeah I have found itemized hospital bills to be a lie and neither the CPT codes nor the hcpcs codes associated with a charge have anything to do with a predictable price for it. it's as simple as , someone thought you would pay this much , and when you fight it there is leeway to charge you less , and someone will edit the itemized bill accordingly , because it never corresponded to actual prices of individual components of care to begin with.
and if any other industry did this on a fraction of the same scale it would be rightly regarded as fraud
@@Kingchar23 I considered it. 1.) Didn't want to ruin my life and future when a company with more money and by extension exponentially more power decides to sue me into the ground if they found out it was me.
2.) It would have taken hours and hours to decode it and those that care wouldn't need that info to know it's a problem and those that don't would not be swayed by it regardless.
In Germany, the prices are fixed nationwide and made public. When you do any of the listed treatments, you get what you refer to.
My favorite part of this is when you try to get this info through a phone call you have to go through 17 layers of automated call system menus just to be routed to a generic page on the website that says nothing :^)
If it has a voice menu, try saying "representative" or "speak to human". You may have to repeat it a lot, but it should get you to an actual person who can help more.
My friend showed me his hospital printout bill. It showed a sailne bag that cost $2 was charged $2,000 to Medicare. It went on from there. It's appalling. I work in medical. It's just a giant joke at this point. Let me just put this way for $170 massage. One of the contractual write-offs is $111. The patient pays a $59 copay. How much is that insurance company really paying at that point? Come on. In one scenario we bill out a $65 office charge. We get paid 16 CENTS from Humana, but here's the kick. Humana gets paid full price from Medicare, but we're supposed to write off $44 and then the patient pays a $20 copay and the insurance company only pays 16 CENTS. So once again WHO'S taking all those hits? The providers and the patients. 🤷🏼🤷🏼
I heard a story on NPR years ago about a reporter who was bitten by a rat in New York City and it got infected so he ended up staying in the hospital for a week. He interviewed the owner of the hospital and went over the billing in full detail trying to add up to the total amount. At some point the CEO admits there's "funny money" in there. All the bs of billing is to try and get as much reimbursement as possible given what hospitals are allowed to charge and what insurance companies are required to pay (they hate paying more). Let's not forget any hospital with an ER cannot legally turn away patients. If folks can't pay and aren't on insurance hospitals give care completely unreimbursed by anybody.
Yes!
Yeah, the prices obviously have nothing to do with the cost on any given service. They're just making their aggregate revenue numbers work out by making up whatever on individual service lines. I wouldn't even be surprised if they retroactively fit their prices to internal cost targets.
Edit: This reply is wrong in context to the above comment because I was referring to the hospital's prices. Sheri's reply below caused me to re-read. Details left as an exercise to the reader.
Is that under Medicare Advantage? I'm going to be figuring out retirement health insurance soon and I'm scared. And I can do fourier transform.
Wait, Humana is allowed to keep the difference? WHY IS THAT LEGAL!?
As an EDS patient with a physiatrist, I burst out laughing when you said PM&R
As someone who works in PM&R, I can tell you that the location of the prices made me SHRIEK with laughter. It's so true! "Physiatry? Do you mean podiatry? Psychiatry? Physician assistant?"
Amazing call back to the physiatry video!
Thankfully, ChatGPT can handle Fourier Transforms. And many Americans can go to their local university and hire a math postdoc to solve one by offering to buy them lunch.
Undergrad electrical engineers need to know them for calculating frequency responses in circuits. No need for those fancy-pants lunches, coffee for a junior will do.
As an informatics grad student with a math background, I have rarely felt so seen 😂
I've had so much trouble with "Mark all the crosswalks" CAPTCHA that I'd take a calculus problem. I've never taken calculus, but at least I can input the problem into a search engine instead of dealing with 8-bit street-view images.
I'm too broke from the American Healthcare Industry to buy a grad student lunch 😢
Wolfram alpha will take this question for me
At 1:03
You can't really do price scouting if your insides are on the outside
You also shouldn't be expected to make rational decisions while sick, or even worse, have a full degree in medicine to actually understand the difference between hospitals, or worser still, be able to differentiate between hospitals safety standards, knowing the ins and outs of each hospital
I love this series. I already have a Pavlovian reaction to this time of the day that I no longer wait for CZcams to push this on my feed and I now voluntarily seek the next ep hahaha
"Instead of choosing photos of cars, you have to do calculus." 😂😂😂
Brilliant, as usual, plus bonus points for using the word "turbidity"
Finally, my teaching of Fourier Series in Differential Equations pays off. I'm looking forward to the bump in enrollment!
As an engineer, Fourier transforms bring it on. All those years of studying will finally pay off when I input it into Wolfram Alpha and just copy-paste the results. 😅
Best crossover since Easy Languages
YES! I am in late middle age and have had one form or another of BCBS insurance for decades. Even if I call them to check, I never have clue what my out-of-pocket expenses will be. Ever.
"We need turbidity."
I was drinking something at the time and almost choked. Yes, I'm prone to using five dollars words from time to time, myself.
You know, intermittently.
Ah yes, how could I forget the importance of Fourier transformations in understanding why an alcohol wipe costs $15,000.
The things this law did right:
-Made it a requirement for the price listings to be in a machine readable format (excel, CSV, flat file, etc)
The things this law messed up:
- They forgot to specify how procedures should be displayed, so a lot of the transparency comes down to being able to predict which ICD-10 codes they're going to hit you with. Which, unless you work both in healthcare and in health billing, well, that could be problematic.
And I thought it was great when healthcare facilities had to start posting which licensing and oversight agencies were responsible for which service providers! Yay! Now we just need to start speaking up! Healthcare should be a consumer-driven industry! Thanks for this video!
Not consumer driven. Some people have the strange ideas about what qualifies as healthcare. The U.S. definitely needs better regulations to limit high prices.
As one who failed university math course (mostly calculus) in the medical school and so became a pathologist, and dealing with pricing regulations of our department for about 6 years (thankfully I don't need to do this anymore, Social Security in China now is NUTZ), This one is super hilarious.
I did a 10 week course at university on fourier transforms/methods and still don't have a clue what they were. That was absolutely a "shut up and calculate" course.
Just plug it into wolfram alpha smh
I learned that the opposite of transparency is turbidity...I got so focused on this so I hope I didn't miss a more important learning point.
Today I learned :
Turbidity is the cloudiness or haziness of a fluid caused by large numbers of individual particles that are generally invisible to the naked eye, similar to smoke in air.
The Fourier transform is an extension of the Fourier series, which in its most general form introduces the use of complex exponential functions.
Thanks doc
Finally an easier captcha. This is something I could get behind!
No joke! "Is there part of a crosswalk behind that dumpster, maybe way down the road." It sure would be easier if the pictures weren't practically 8-bit.
😂😂😂 OMG we were just having this convo in the OR, lol! No one knows what PM&R is! Also great job calling out HCA!!!
What I love about this series is that alot of this applies to 3rd world countries like the one I live in. Only difference is that it's government insurance.
I also live in a 3rd world country. The United States of America.
@@Emilio1985thats a 4th world country. It is so developed but government failed to put a leash in time on corporate so people suffer. I feel like corporations should disclose why they need to be so large like google doesn't do so much work they don't need to be so large and they clearly are just developing trash.
@@FFn101literal landfill material cuz planned obsolescence
@@Emilio1985Trevor Noah fan?
USA is only a 1st world country on paper. It’s the Genie problem… you want water on tap, here ya go. buuuuuut, it’s gonna give you cancer(Cold Water Creek). Sooooo many “superfund” sites in our area and so many more that SHOULD be superfund sites. You want industry… buuuuuuut here’s your sky rocketing asthma rates aaaaannnnnd more cancer. You want energy… well here is your lung cancer from coal burning. Micro-plastics, forever chemicals, even FRUIT had twice as much sugar in it than it did in 2002. So here is your obesity/diabetes and so on and so on.
You are SO on target with this one! Wouldn't it be great to have "simple and honest" as the guiding light in healthcare? We can dream, can't we?
Dr G, if this is the hospital's CEO, should not the assistant be Himothy? As you explained yourself, "Jimothy works for health insurance, Himothy works for the hospital CEO, Bimothy works in publishing. They are all brothers."
Brilliant video as usual.
I was wondering if this should be Jimothy instead of Bimothy!
@@Mia24601 I understand your confusion. There's also Tristopher who looks the same as Bimothy, Jimothy and Himothy. Maybe he is their cousin. 🤓
As an engineer, I appreciate the calculus humor.
I only had to pass Calculus 1 in college. I had to spend every day in the tutor's office that semester. Even the word calculus brings forth feelings of dread.
Patient: Sooo... how much will this cost?
Customer service: Do you have insurance?
Patient: No, that's why i'm asking/No, this is out of network
Customer service: We have a program for uninsured
Patient: Sounds great... but how much will this cost?
Customer service: We also have social workers that can make an assesment and determine if you qualify for a sliding scale fee.
Patient: Wonderful... however... how much will this cost?
Customer service: Once you arrive we will make sure to put you in contact with someone of the financial department to inform you about that.
Patient: Alright
Days later
Financial department: It will arrive in a bill to your address.
Patient: Wait... isn't there a law called "No surprise act"
Financial department: It only applies to emegencies in this state plus you must wait for the system to calculate the charges.
Patient: Alright
Days later
Collection agency: Hi, this is the collection agency you owe $500 to X hospital how do you want to make your payment??
Patient: F**k
yeah. "I'll give you $2k cash no questions; what is the precise dollar amount on paper?."
"I'm sorry, our calendar is full until 2025, goodbye"
suprised he didnt say. we payed the fine of 100k and meanwhile we made 1000k
This is exactly what I was thinking
THIS.
Hospital estimates be like: "Total cost for procedure******: $4,265" where each asterisk outlines something in fine print
Turbidity. That’s a good one. Can I request you also refer to hospital pricing as a web of opacity?
One of our local hospitals has a procedure listed as "$450, discounted $450 to $0" for uninsured patients. Curious, I called the "price transparency line," where I was informed that those prices are not the same as what they have on their end, and that they're effectively meaningless. Exciting to know that even when hospitals do comply, they're not accurate!
Bro is queuing up the lawsuits. But he's fighting the good fight. Godspeed Glauco.
Even with price transparency, your insurance determines which hospital you're allowed to receive care at. I would rather get a $10,000 CT scan and pay $100 rather than a $5,000 CT scan that I had to pay $5,000 for.
That would mean that your insurance actually covered a procedure for you! I'm skeptical that mine ever will.
Completely irrelevant response
Oh hey we found the united healthcare worker in the comments cool
Shoutout to Bimothy for keeping it real, he’s my GUY.
Listening to the last videos has been so crazy that I'm honestly not sure if the calculus thing is a joke.
If it’s not, I think I’ve found myself a niche market.
VIDEO IDEA - Hospitals sub-contracting a company for ER physicians causes them to be out of network when hospital is in network
"It's true, it's true "... (I don't know where I got this, but I use it often, mostly in my head so as not to be annoying to everyone else) author unknown
An HCA cameo! Omg! :D
**snort laugh**
Dallas, Texas 🌻
Poor PM&R catching strays, lol! An underappreciated department for sure!
I did the same procedure in two different hospitals. One costs 30% more than the other. And I only know that after I pay. How?!
Hospital transparency is good. It means you can shop around find the best care and the price you like. ❤
Unless the hospital system has a monopoly in your geographic area.
Always remember that one of the founders of HCA was Jack Massey who made his first fortune with Kentucky Fried Chicken.
He took 3Corporations to the Big Board(Dow Jones) Kentucky Fried Chicken, Mrs. Winner's Chicken & Hospital Corporation of America.
Make Sense Now?
My grandmother went to an ER recently (she was fine), they did a cat scan and put a preemptive IV in. The hospital billed Medicare 16K, Medicare only paid a portion of that, which the hospital said was fine.
After watching your videos, I can argue that Fourier transform is much less complicated and much more useful than US health system!
I love this captcha idea - gonna steal that. Thanks!
Brilliant!
I genuinely don't know what I like more... the names or the critical (and funny) content...
Thank you for this one in particular.
Good thing as an electrical engineer, I can do Fourier Transmforms. lol
the ending was amazing! :D
Jimothy was such a hilarious name I wanted to use it in my skits but didn't like the idea of using something that someone else came up with. I was so mad I didn't think of it first! 😂 So I came up with Dimbert, & am happy with it, so when I heard this I thought at first you said "Dimothy" & I was like NOOaoOOaoOooo
"I'm relieved it's Bimithy 😅😅 so hilarious
Beware 😉
There's Jimothy who works for/in Healthcare Hell, Bimothy who works in Publishing Purgatory, and Himothy who works for the demonic Hospital CEO/Hell (all brothers) ... and then there's Tristopher (we believe he's a cousin lol) 😉
Calculus. My mom was a general surgeon, and it was the bane of her undergrad. She literally decided to memorize the textbook to survive and pass. This is the perfect captcha to keep almost everyone in the dark.
OMG the award.... I love it!!
Yes! Fourier transforms are essential to our proper understanding of US health insurance.
I cannot like these enough!!!
I went to the ER recently. Surely I will have sticker shock when I get the bills. Thanks to this video I decided to look up the pricing. The pricing page is not something "normal" and easy to read, but rather a .json file, so I have to use my computer programming background to decipher the pricing for my situation. So, yea, the goal to confuscate is real
The problem is people go to doctors and hospitals expecting to get better, or even survive. As soon as you give up that fantasy it all gets easier and starts to make sense.
I used to work for HCA in a non-medical position (facilities maintenance). It was an easy job most days, until 2 years later when I started to feel all those midnight and 3am calls for miniscule issues. Yes, the maintenance crew is on call as well, especially in a rural facility like I was in. Combine that with no funding for necessary equipment and money hungry directors, you get hell for patients and workers alike.
Dr. G is the biggest contributor to PM&R's rising competitiveness in match -M3 trying to match into PM&R in the future
Now I can finally tell my students how they will be able to apply their math degrees to real life.
My hospital puts their master price sheet in an accessible spot, but it has over 500k rows in it and dozens of entries with the same name, all of which are technical abbreviations. Your depiction checks out.
“Nobody knows what PM&R is!” 😂
I love my PM&R doctor, but I didn’t know what it stood for until I was referred to him.
The master list 😊
Brilliant
I can't wait for Bimothy, Jimothy and the others to get a new job where they can actually help people out and not serve evil corporations.
Even better, they could become CEO themself!
Edit: Changed he to they and himself to themself.
Never came in so early!! Hi Dr. Glaucomflecken!!
They should increase transparency in real estate and automotive sales as well.
Keep the PM & R jokes coming 😂
Omg this is so well directed... 😂
I am happy that when I got an infected blister that was described as "necrotic" by a medic I didnt have to worry about how much it would cost me. I could just go to my local minor injuries, wait 15 minutes to be seen by a nurse and walk out with some antibiotics.
The NHS might have its flaws, but I would take it any day over American healthcare. The peace of mind knowing I can just go and get help without worry is so good.
This is, bleakly, my favorite.
People told me that once I'm out in the real world, I'd never use what i learned in calculus. Boy, were they ever wrong!
"But it's a government rule" 🤣🤣🤣😭 If it's laugh or cry, at least you make us laugh.
Literally just talked about this today. Because I gave someone the billed amounts for a procedure (had already sent them an estimate letter) but their insurance does not release *their* allowed amounts.
"It's a standard security measure."
Yeah, for the fucking computer! 😹
Bimothy's boss' niece must be the one who uploads it on God-knows-what website and apparently his niece turn her calculus homework into a captcha
Preach it, Bimothy!!
Jokes on you! I'm into that math!!!
Jokes on you, I've finished a full calculus series. Bring it on captcha.
When he said calculus I cracked my knuckles and said "let's do this"
There’s a first time for everything! Turbidity and calculus 😅
My degree is in electrical engineering. Fourier analysis is an everyday thing! Checkmate, HCA!
Fourier transforms... man, that brings me back to college