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Copying my comment below. The government not only allows healthcare providers to reveal their prices, it encourages it. The graf about the government is a polit
by showerst 13y ago
Copying my comment below. The government not only allows healthcare providers to reveal their prices, it encourages it. The graf about the government is a political statement, not a policy fact, and does not belong in a news story.
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Medicare/caid prices are standardized and public. They also release data on what specific hospitals bill for the most common procedures.
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/ http://www.cms.gov/Research-Statistics-Data-and-Systems/Stat...
Dealing with Medicare/caid involves lots of additional overhead and billing oversight, but that graf is a political cheap shot, not anything related to transparency.
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Hijacking my top comment with a more info edit -
If you don't know, Pricing Data in the US for health care is super insane, partially because both insurers and regulators need billing to fall into a semi-standardized set of 'billing codes' that don't really map well to actual care.
There are regulations about only billing the government for 'procedures' and not 'overhead', and medical procedures often don't map well to billing codes because they're new or slightly different. So basically after a procedure or hospital stay, the care givers make up a basic list of the things they did and the drugs given, etc, and it's passed on to a billing department, who maps to a set of codes that might differ depending on who's paying (gov't vs insurer 1 vs insurer 2). This is by definition lossy.
It's an oversimplification, but one hospital might say "Well we've got a superstar brain surgeon here whose time is 3x as expensive as normal, but can only bill for 'BRAIN SURGEON - 1 HOUR', so we'll crank the prices up on the scalpel and the tylenol to compensate", where another picks totally different things to compensate the prices on because they have a different cost structure.
Big insurers expect to be negotiated with separately for competitive advantage reasons, and sometimes use different billing codes anyway, so even if you had the closely guarded master price list of the hospital, it wouldn't necessarily do you any good.
For the uninsured, the occasional price-insensitive person rolls in (aka the "Saudi Prince wants his own wing for cancer treatment" situation), so they jack the uninsured prices WAY up only expecting a few percent back from 98% of patients. This further breaks the pricing data, and causes major problems for less-saavy people who are used to seeing a bill and being expected to pay it, as opposed to negotiate.
Bottom line: It's complicated, and politically fraught. If you're interested, Oreilly's "Hacking Healthcare" is a great intro to how billing and the new CMS Meaninful use stuff works.
- pdx 13y agoPricing transparency, for whatever reason, does not exist as a rule in the medical industry. The "charge masters", are a joke that the hospitals themselves admit are useless as indicators of actual prices paid unless you're out of pocket, and then you get to pay them. Even then, the charge masters, as useless as they are, are still kept well hidden from all but the most inquisitive. I hope you're right about the government not hindering medical pricing transparency. Now we need to get them to mandate it.
- sbercus10 13y agoIf this topic is at all interesting to you, you should read Steven Brill's dissertation in TIME titled "Better Pill" from a few months ago. Since TIME has a paywall, here is a link to the PDF of the article: http://livingwithmcl.com/BitterPill.pdf http://livingwithmcl.com/BitterPill.pdf
- tylee78 13y agoyes. that's an amazing piece of research. this article really opened my eyes. after studying that article it's much clearer how healthcare can and should be reformed.
- rogerbinns 13y agoEven getting lab work done is ridiculous. There isn't any discretion, risk, variability or uncertainty involved. A cholesterol test is a cholesterol test. I needed a bunch of tests a while back and pay for them myself. The labs don't put their prices online - you have to call. And then you have to talk to multiple departments because they just aren't setup to tell you pricing and require fragments of information from other departments. Astonishingly I did eventually find somewhere that posted prices, and they turned out to be a quarter of what would have been charged from the regular lab. I wrote more about it here https://plus.google.com/110166527124367568225/posts/eiThZXx7RHE https://plus.google.com/110166527124367568225/posts/eiThZXx7...
- rthomas6 13y agoYou and the article seem to be saying totally contradictory things. Was the article just outright lying, or is there some nuance I'm missing?