by Rodger Malcolm Mitchell, www.nofica.com
Everyone wants price transparency in health care, except for . . . well . . . almost everyone
Price transparency in health care is a great idea.
Let’s say your house needs a new roof. You solicit three bids, you obtain references, and you choose the cheapest, best-referenced roofer. That’s the way to make expensive purchases.
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Let’s say you need a knee operation. You can do the same: Solicit three bids from doctors, anesthesiologists, hospitals and the hospitals’ pharmacies, and then you obtain references for all of the above.
Finally, you’ll choose the cheapest, best referenced of each. Right?
Not a chance.
Maybe, just maybe, you’ll find reliable and informed (from Aunt Suzie?) references for doctors, and maybe the doctors all will give you estimates of cost, and maybe the doctors won’t tell you, “Cost depends on what we find.”
Even then, will you really manage to receive cost estimates for all the ambulances, nurses, anesthesiologists, hospitals, rehabs, and pharmaceuticals, many of which you can’t anticipate?
The whole process is way too complex, uncertain, and beyond your lay understanding. And anyway, your insurance may pick up 80%, or less, so why even bother?
Overall, it’s an impossible task, but it is exactly the “solution” the rich people think you should follow, and to assist you, they contribute to articles about medical care “price transparency,” when they should be talking about free medical care.
The idea is to make you believe you actually can do something about high medical prices, and if you don’t, it’s all your fault.
How Price Transparency Can Control the Cost of Health Care
March 1, 2016 Publisher: Robert Wood Johnson Foundation Publication: Health Policy
Many people are calling for greater price transparency in health care, where patients can clearly see the price of a treatment and determine how much they will pay out-of-pocket before receiving care.
Experts have long agreed that price transparency in the health care industry has a number of positive consequences.
It is an important information-gathering tool for consumers who want to compare prices so they can make more informed decisions about their health care.
Most people in American want greater price transparency and would compare health care prices if given the option, according to Public Agenda.
Oh, sure you would.
If, by some miraculous intervention, you managed to learn what your doctor, hospital, nurses, medicines, etc. will cost, then what?
Are you going to shop around for the cheapest nurses and ambulance service? Will you search out the cheapest anesthesiologist and the bargain-priced hypodermic needle?
When was the last time you did that?
The Healthcare Financial Management Association highlights a number of tools that can be used to increase price transparency, like Member Payment Estimator by Aetna®, as well as crowdsourced platforms like ClearHealthCosts.
Check out the Member Payment Estimator and you’ll be told:
“The Member Payment Estimator lets employees – our members – estimate how much they’ll pay out of pocket for medical tests, office visits and procedures ahead of time. No more surprise bills. Or bills that are higher than expected.
“About 43 percent of households put off care because of costs. Our online tool lets employees compare costs for up to 10 doctors or facilities at once.
“This helps them avoid paying more than they have to.”
Isn’t that exactly what you want? To slog through price comparisons of medical factors you don’t understand and can’t evaluate for quality, so you can judge whether to go to Hospital A which has the cheapest aspirin prices or Hospital B, which offers a half dozen room-rate alternatives?
Even if that labor appeals to you, the deck still is stacked against you:
Many providers and insurance companies have succeeded in keeping health care prices opaque using non-disclosure agreements and restrictive gag clauses in contracts.
Because of this, a majority of states have been unsuccessful in achieving greater price transparency to help consumers make educated choices about their health care.
And, surprisingly, even the insurance companies don’t want medical price transparency.
Insurers and hospitals love secret prices
Steven Pearlstein
The Washington Post
As costs skyrocket, the Department of Health and Human Services is proposing new rules that would require hospitals to publish “their minimum and maximum rates for 300 common services.”
And, given this list, you, being an “expert” in medical procedures, will easily calculate which “common services” will apply to your next procedure, and then you will add up all those costs to make your medical decision. Sure you will.
And you’ll especially be delighted when you learn that the big bucks went to the thousands of “uncommon” services, which just happened to be the ones your procedure involved.
It would also make insurers reveal the prices they’ve negotiated for services and publish them on an interactive website that lets customers compare providers.
Thus, knowing your hospital’s gross profit on 300 common services, you’ll be able to . . . uh, what? . . . . go to the least profitable hospital??
Hospitals and insurers have teamed up to fight this. Hospitals claim that the rule would compel them to stop offering discounts and raise prices. That’s nonsense.
Look at New Hampshire. The state began “listing how much customers of different insurance plans would be charged at different hospitals and labs for medical imaging such as X-rays, CT scans, and MRIs.”
After five years, out-of-pocket costs fell 11 percent while the cost of imaging for insurers went down as well.
That’s nice. The costs your insurer pays would decline. But . . .
And the insurance companies? You might think lower costs would make them happy.
But they don’t actually want to drive down prices; in fact, “both hospitals and insurers profit more when prices and premiums are high.”
The thing the insurers “really care about is whether they are getting a better price than their competitors.” Transparency would expose this con game.
In summary:
- The medical community doesn’t want price transparency
- The insurance companies don’t want price transparency
- And you shouldn’t want price transparency if it is a substitute for free Medicare for all – which is exactly what it would be.
And that is the whole con. You are supposed to believe that price transparency is a good alternative to free health care, which our Monetarily Sovereign government easily could fund.
The insurance companies surely don’t want Medicare for All, because it would put them out of business.
And the rich, who control America, don’t want Medicare for All, because that would narrow the income/wealth/power Gap between the rich and you.
And strangely, even you don’t want Medicare for All because you cruelly have been lied to and told it is “socialism” (It isn’t).
As a result, you prefer to keep your incomplete, expensive health insurance policy and all its deductibles, or do without health care insurance at all.
After all, if it doesn’t cost you anything it’s too good to be true.
You want to pay, pay, pay – unlike the rich and the politicians who get their comprehensive health care free.
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