US hospitals and drug companies are claiming that a Trump regulation demanding transparency in pricing is violating their right to free speech. The rule demands that health and pharmaceutical companies disclose pricing of their services as well as the discounts that they negotiate with trade groups and insurance companies, and they don't want to do so.
Let me explain:
I went to the emergency room about ten years ago because I woke up with my heart racing along at 140 beats per minute. An EKG showed an abnormal heart rhythm called Afib. I was far too young for that, so I was admitted to the hospital. They attempted several doses of medicine to no effect. After an hour or so, while the hospital was running tests, the problem resolved by itself, They hospital held me overnight, and then I was discharged.
A week later, the bill came in the mail: it was over $13,000. I went in to talk to the hospital's billing department to give them my insurance information. They gave me a revised bill that reflected the "negotiated discount pricing" from the insurance company. The new bill was $1,100, with $500 of that being my copay and the insurance company paying the other $600.
How can a negotiated discount be over 90% off the full price? Since the hospital is willing to accept that low of a price, it seems to indicate that they can make money at that price, so what is the deal? My opinion is that the insurance companies need prices for uninsured people to be scary high, so that people all clamor for insurance. I could see a discount of 10, 20, or even 30% off, but more than 90% as a discount seems to be some kind of scam.
This is why the companies hate this rule demanding transparency, because that practice would have to come to an end, once people realized they are being duped. Disclosing prices and discounts would be a great way to allow consumers to decide for themselves whether or not to patronize a business. Can you imagine any other business where the prices are not disclosed to the consumer until after purchase?
Bring free market pricing back to health care. Let consumers know the price beforehand, and watch medical pricing become more affordable.
I have a friend that is self pay medical services. I.e. no insurance. Our local doctor's office has a slight discount for her.
ReplyDeleteThe other month we why in to have a yearly examine and pap smear done.
When we came out we "paid in full". I asked and was told multiple times it was the complete bill.
Around $80. So not bad.
A month later we got a bill from them for $150ish. We get on the phone, talk firmly to the billing department. Tell them we are going to file fraud charges with the state.
We got that bill reversed. Seems that the doctor's office only had prices for their procedures but not for lab work. But there did the billing for the lab.
In order to know what it is going to cost we have to know, while in the room with the doctor, what Labs they are going to order, what lab is going to do the work, contact the lab to know how much it is going to cost us for that lab work.
All because there is no published price list that could be incorporated with the doctor's office.
At least the office now gives us a sheet of paper when we self pay that says there might be extra third party charges.
In my admittedly limited experience pushing the idea of free market reforms, people seem to focus on the "3-sigma" (far from normal) case of being taken unconscious into an ER or otherwise not being able to make those decisions of whom to see and what to have done.
ReplyDeleteThey seem to not think of the other 99% of their interactions that are more like the office visit Therefore mentions.
I always point out that an open free market is what has reduced the cost of everything else in their lives, and the things where costs go up out of proportion to everything else are medical and college, which are the province of big government and not the market.
Years ago I watched an episode of a show where a reporter/author and his wife "lived like normal people". I've. Dude pretended to be somebody with a high school education and no real experience.
ReplyDeleteHe got a job, complained about how hard it was to make ends meet. Then his wife got and UTI, something that they had experience with.
So the went to the ER to get it treated. Good the bill to show us the nobody on a blue collar safe can afford medical care. Bill less for around $500.
My friend from above had an infection. We went to urgent Care. Paid $100 and they have her "sample" antibiotics. Our total cost was that $100 and a 15 minute wait.
Thier's was $500 plus the meds at the pharmacy plus 3 hour wait time...