Skip to comments.How to Make America's Health-care System Great Again
Posted on 05/11/2018 6:22:55 PM PDT by huckfillary
Heres a simple idea to help lower healthcare costs: Publish prices. A bipartisan group of state lawmakers in Colorado is pushing a bill to do precisely that. The Comprehensive Health Care Billing Transparency Act would allow Coloradans to see the true price of any health service they useexams, procedures, prescriptionsbefore they undertake treatment.
If passed, the legislation would mandate that hospitals and other facilities disclose the base fees they charge for specific services before applying any discounts, rebates, or other charge adjustment mechanisms. Every bill sent to a patient would need to include an itemized list, which would allow patients to see if a service had been marked up. By making such information available up front, the legislation would reintroduce competition to Colorados opaque health care markets.
The bill is the brainchild of Denver businessman David Silverstein, who made news last year when he suggested that consumers stop paying their medical bills until providers show how they arrived at the prices being charged. Silverstein is the founder of BrokenHealthcare.org, a nonprofit that hopes other states will follow Colorados lead in legislating greater health care transparency.
As profound a change as the Colorado bill represents, all it really would do is let consumers deal with health care the way they do any other product or service. Think about it: When you want to buy a car, you shop around, comparing the quality and price of competing models and the offerings at different dealerships. The same is true for practically everything else Americans buy: refrigerators, houses, office supplies, washing machines, computers, and on and on.
Why is health care the big exception? Because the prices are obscured. Particularly if youre covered by health insurance, you never know the true cost of treatment. Theres no incentive to shop around. This isnt merely a fluke of the system, but a well-executed scam. Just look at the gag clauses written into pharmacy and hospital contracts, which can prevent providers from telling you that it could be cheaper to pay with cash instead of using your insurance.
Keeping prices hidden provides no benefit to the patient. It serves only to help middlemen turn a tidy profit. When you use your insurance to pay for a prescription, a pharmacy benefit manager may get a cut of the fee. Your hospital probably has a similar deal with the group purchasing organization, or GPO, that supplies it with everything from saline to anesthetics to antibiotics. [Source: Tom Coburn, Wall Street Journal 5/5/18]
How to make American health care great again?
A free market.
The Colorado bill rests on a basic free market principle: Customer and service provider accountability.
When you purchase gas, you know what youre paying. When you pay for a hotel room, purchase groceries or buy a pair of shoes, you know what youre paying.
Free and self-responsible people need and want to know what theyre paying for things. The reason we dont know what medical care procedures and surgeries cost is because government policies have kept those facts hidden from us. Yes, as Tom Coburn wrote in his Wall Street Journal article, its a scam of epic proportions. But its not a conspiracy of insurance companies. Its all a creation of the government.
Colorados proposal will not restore a free market in medicine. Its not enough. But its a step in the right direction. For medical care to become a truly free market, well have to deregulate the entire industry and eventually privatize Medicare and Medicaid, two programs on the fast track to bankruptcy anyway.
At that point, medical doctors/hospitals and patient-customers will have a great opportunity to start over. In economic terms, prices are a form of communication between sellers and buyers. In moral and psychological terms, prices are a way for responsible and thinking human beings to make reasonable and plausible decisions affecting their health and lives.
Government never should have taken that right and responsibility away from us. The single biggest way government did so is through establishing Medicare, giving federal control over the bulk of medical care in this country. Unfortunately, Medicare remains a popular program. But Medicare takes in way, way less than the federal government pays out. Ditto for Medicaid, which has gone far beyond a benefit for poor and unemployed people. These programs cannot and will not last, and America will face a health care day of reckoning when it all finally blows up.
Its absurd and immoral that government took this capacity to make pricing decisions away from us, in the United States of America of all places. Right now in Colorado, theres a hint of a free market trying to make its way back into the minds and bodies of individual persons.
The free market is the only moral and practical solution ever devised for humans to live rationally and in peace. Nothing less will resolve the continuing crisis that is health care.
The problem with this is that folks continually use medical “insurance” to pay their way.
Posting prices is great when the patient is the actual customer. Unfortunately, the real client of the Dr. is the one who pays them directly - carriers and the gov.
Exactly. This is a useless effort unless patients are paying their own bills.
What do people care how much anything costs, when all they do is put the hospital in touch with their insurance company and forget about it?
Easy... .Dump everything having any kind of relation to OBAMACARE.
Next, - STOP all WELFARE and Medicaid to illegals.
Lastly, If Cities want Sanctuary STATUS? It’s all on their
However, with $3000 to 6000 dollar deductibles, and 20%+ co-pay, patients are highly motivated to ensure their pockets aren’t picked by crooked hospitals.
Look up how common it is for hospital’s accounting dept “Charge Master” book rates to utilize a 1000 percent markup over actual costs!
Many U.S. hospitals mark up prices 1,000 percent: study - Reuters
Jun 8, 2015 ... Many U.S. hospitals mark up prices
1,000 percent: study ... care insured patients pay a percentage of chargemaster prices, she said.
For-profit hospitals mark up prices by more than 1,000 percent ...
Jun 15, 2015 ... Of the 50 U.S. hospitals that mark
up prices the most, 49 of them are part of for- profit hospital chains, according to the study’s authors, Ge Bai of ...
Making (some) sense of hospital list prices - AEI
Apr 4, 2017 ... Hospital list prices often called
Chargemaster prices have become ... markup on Aspirin, it is tempting to regard hospital Chargemaster pricing as ... in the current market (high priced hospitals charge closer to 1000%).
Some Hospitals Marking Up Prices More Than 1,000 Percent - 2015 ...
Jun 8, 2015 ... The 50 hospitals in the U.S. with the
highest markup of prices over ... Many hospital patients don’t actually pay the charge master or full price.
50 hospitals with markups of around 1,000 percent - CBS News
Jun 8, 2015 ... A new study finds that compared to
costs that Medicare allows, some hospitals hav
Price transparency is fundamental to addressing the root cause of the spiraling cost of healthcare. The other piece is the requirement that insurance payments can only be made directly to the named insured. No direct payments to doctors, hospitals, etc. Medical providers must provide actual itemized invoices (same as any other business) and payments must “flow through” the service recipient regardless of whether those payments are reimbursed by insurance.
Here are better ways to lower healthcare costs:
1.) Tort reform. Put a strict cap on these frivolous lawsuits.
2.) Crack down on the waste, fraud, and abuse in Medicare/Medicaid.
3.) Start informing people that they need to use the local “doc in a box” instead of the hospital ER for minor injuries and sniffles.
4.) Ask these illegals who flood our hospital ER’s as to what country they came from. That way the hospital or the federal government can bill mexico, guatamala, etc for the healthcare of THEIR citizens.
Government has no inclination to reform “healthcare”. It’s a cash cow to them as they are paid off. What do they care, they have the best health coverage on the planet.
What I mean by government is that if the hospitals are unsuccessful in collecting the bills from these foreign nationals, it can be handled by the state department or other agency to enact sanctions, tariffs, taxes, etc against countries such as mexico for failure to pay.
If you have to buy your own insurance - don’t
Simply tell doctors and providers you will pay CASH promptly, if they offer you the medicaid reimbursable rate.
This is a good start - but until you do tort reform you are just picking at the margins.
True. I have a family member that works insurance sales. Hospitals are supposed to charge per their contract with the insurer, yet they routinely amp up the price and send an extra bill to the patient. My family member has gotten some other family members out of high bills by simply calling the accounting department and questioning the practice.
And here’s a trick I discovered by accident: I was in an accident once. Went for ride in ambulance for brief ER check up. I had hit my head enough to cause a flash of memory loss. Tech on scene asked if I knew my head was bleeding and I didn’t remember it being hit. At ER, they said that was common and a longer memory loss would be something to worry about.
Anyway, I gave them my regular med insurance card at the hospital. They did not cover it because it was auto related. Now you’d think an ER visit would be expensive, which it would’ve been had I given the auto card. But because I didn’t, accounting must’ve treated me as some sort of non-payer and sent the bill immediately to collections, which is sold as discount.
So when I received a collection bill for $75 before even receiving a bill from the hospital, I happily paid it. BTW I did due diligence to ensure the collection bill was not a scam. The hospital called a month later and I gave them my payment info. They knew not to try to bill me twice apparently!
For the general thread subject, my belief is that gov was too involved in insurance long before commie care as the states dictated policy content (which is the main reason smaller insurers didn’t sell across state lines BTW).
Medical “insurance” has not been insurance for awhile. Insurance is financial mitigation of risk, period. In the med world, you see it used as some third party discount coupon. I.e., you wouldn’t use your car insurance for fuel fill ups and oil changes would you?
The system has basically removed the patient from the financial part of the deal. Coming to the posting of charges, there’s no reason the med world can’t act like the auto world - you go to a mechanic that charges a minimum rate for diagnosis. If not determined, they tell you you’d have to pay for more diagnosis time. If determined, they provide an estimate to fix. If, in the course of fixing, other things are discovered or if it costs more, they give you another estimate again. This does not happen in the med world because they are dealing with the carrier, not the patient.
So I agree philosophically with a price post, but I only see untenable logistics for a practice to do that in the current “insurance” environment because, even with the deductible in mind, the patient is charged differently based on the arrangement with the carrier and who that carrier is. To top it off, cash-patient rates are often lower than insured rates.
So to me, it’s just a matter of timing. Get the gov out of insurance first and THEN talk to me about posting rates. Nevertheless, if they are forced to post in this environment, it may do SOME good in the sense that the patient will see the markup the carrier indirectly imposes on the practice. It will serve as an eye opener to many.
FRiend, thank you for a very well thought out reply and suggestions going forward.
Transparency would be a very good place to start.