Comments about ‘A market solution to fix the cost of health care’

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Published: Tuesday, Feb. 25 2014 2:09 p.m. MST

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Fitness Freak
Salt Lake City, UT

This article is spot on in ways to actually REDUCE costs for healthcare.

Its' more than a little strange to me that when I take one of the kids to the Dr. they can't tell me or even make a guess as to how much the visit (and tests)will cost.

But I don't think the health insurance companies will ever make a change by themselves. It will have to be written into law.

EVERYTHING has a cost. With the high deductibles we all have now, the BEST thing legislators could do would be to mandate that a "written estimate" be provided at the Dr. checkin station.

I don't believe for a minute that it couldn't be done - fairly easily. Every Dr. checkin station is online with the insurance co.'s anyway. If they didn't know, they could always call them.
I ALWAYS call my insurance company before I go to the Dr., but they don't tell me much of anything anyway, just that the Dr. is "covered". Nothing at all about the "labs" which is one of the big reasons people are having to pay so much for healthcare.

Ultra Bob
Cottonwood Heights, UT

It's a little hard to accept advise from someone who starts out with a blatantly false notion. I would defy that anyone could obtain a price on goods or services on more than a small minority of businesses or services of "other industries". For me the number 1 example would be the purchase of a personal vehicle, a car. Next would be airline tickets, and just about everything else I buy from clothes to medical care to computer parts.

Of all the things I buy, medical care is probably the biggest mystery of what I'm buying. Medicines with the same ingredients cost different amounts depending on the brand. And the skill and training of a doctor is not always apparent and because the results are often hidden, we have nothing to judge whether a price is good or bad.

I do not think health care should be a for profit business. I do not think that military service should be a for profit business. I do not think that law enforcement should be a for profit business.

OneWifeOnly
San Diego, CA

I agree with this article. For most medical issues it is impossible to get prices up front unless you don’t have insurance, in which case they will ask for payment in advance. My eye surgeon works a bit differently. He gave me his price and I was required to pay in advance. Then his office staff submitted on my behalf the insurance claim and I was reimbursed once the insurance company paid the claim. In the end, my out of pocket for the cost of my eye surgery was zero. When I needed ankle surgery, however, I was unable to get any of the doctors and health care providers to provide me with up front pricing—everyone I spoke to was clueless about what they would charge me until after the surgery was complete. No other industry could survive with this business model.

JoeBlow
Far East USA, SC

"When consumers can compare prices for doctor visits, hospital stays and other services, the theory goes, market competition will help keep them down."

Great concept. However, these hospitals wont provide this "transparency" without a fight. They darn sure will not do it on their own.

It will take a, wait for it, a Government regulation to require them to do it.

And they will lobby (read BRIBE) congress and mobilize the right to fight it tooth and nail.

Until we first agree that there is a problem (1/2 the country doesn't seem to think any problem exists) it will not be addressed.

Who, other than the government, has a stake in bringing down the costs to the patient? Certainly not doctors or hospitals. If they bring down the costs, they do so only in an effort to increase their bottom line, not to pass those savings on to the patient.

The insurance companies know the costs are grossly inflated and they dictate the prices. While assuring that everyone makes a tidy profit.

FT
salt lake city, UT

Information is power and that's why the insurance companies and health care providers give you very little of it. Getting quoted prices before services provided would require laws, regulations and enforcements. You won't get any of those if the GOP has it's way.

mcdugall
Murray, UT

If you really want to promote cost containment you need to address two issues. One, reduce the number of agents in the health care equation, single payer is the most optimal system, for costs. Second, address poor life style choices and place more emphasis on positive behavior changes.

Anti Government
Alpine, UT

@Ultra Bob

You are right, healthcare should be a budgetary decision like is in Canada where I am from.

My Dad needed cataract surgery to maintain quickly approaching blindness. He called to see the specialist. They told him he could get in March.....2015! That was just the waiting list for the appointment to see the specialist..... to get on the waiting list to eventually get the surgery.

Why? He is 81. They like to delay elderly patients surgery because younger people get the money allocated first.

My father is 100% independent in near perfect health living at home. Completely functional and living a lifestyle of a younger person...but that doesn't matter...because it is not for profit...it is decided by a government panel....bureaucrats with a finite budget. Once the money is spent there is simply no more money spent until the next years budget.

Cool huh?

He came down to the States and paid for his surgery and went back home.

You liberals and your grand pipe dreams of altruistic govt cronies deciding who what and when.

True transparency and competition with reasonable regulation would work better than this mess called obamacare.

Tyler D
Meridian, ID

Price transparency is common in other industries because most are competitive and people can understand the services they are purchasing. Not so in the medical industry, especially when the procedures are complex and the need for them is immediate – in econ jargon, this creates a vertical demand curve meaning there is essentially zero market pressure for producers to provide this information.

And in reference to an earlier comment, this economic reality (vertical demand) is not in play for services such as Lasik. No one needs Lasik immediately (i.e., they have ample time to shop for a better deal) and the procedure is relatively straight forward and amenable to comparison shopping.

For anyone who thinks the market forces that make Lasik competitive would easily translate into hospital care, just try negotiating life-saving care with your cardiologist the next time you suffer a heart attack.

Market forces alone will never level this playing field, but transparency laws could help. However when you look at the MRI cost list in the referenced WSJ article, it’s hard not to conclude that single payer, Medicare-for-all is really the way to go.

cmsense
Kaysville, UT

It may be possible to provide up front pricing for routine visits, but healthcare billing is extremely complicated. Are you coming in for a 15 min visit, 25 min visit etc. Are you addressing one problem today, 2, 3, or 5 chronic conditions? Do you have a new complaint on top of the 3 chronic conditions you already have? Do you need labs or imaging today? Can the doctors office really be expected to know all the pricing for each of the thousands of possible labs that could be ordered? (insurance negotiates and pays labs seperately). A doctor doesn't even know what billing code to bill for sure until after a client is seen because billing codes are very specific. A complaint of chest pain or stomach pain could be something simple or something very serious. Hospitals and surgery centers are even more complicated and much more expensive. They bill anesthesia by the minute etc. The best that could be done is that hospitals or doctors offices be required to provide the typical costs for common conditions. Buying healthcare is much more complicated than shopping at Walmart for a bargain.

JoeBlow
Far East USA, SC

"It may be possible to provide up front pricing for routine visits, but healthcare billing is extremely complicated."

I went in for a routine outpatient procedure. The hospital gave me a "good faith estimate" prior to surgery. The actual bill was over 30% higher.

When I asked what caused the actual bill to be so much higher than the estimated bill, I was told that "those estimates dont mean anything".

And, by the way, that routine procedure was billed out at over $26,000 dollars. And that did not include the surgeon or the anesthesiologist. The surgeon made $500 which seems more than reasonable.

But $26K for a 5 hour hospital stay where for 4 hours I was either sleeping or waiting around.

Average childbirth (non c-section) is billed at around $30K in this country.

And we think insurance across state lines and tort reform is all that is needed to fix the system?

Hutterite
American Fork, UT

How about, instead of doctor and patient worrying about what a procedure or test costs, let's put a single payer health care system. That way the procedure or test is a provided service, not a profit centre, because the motivation to provide it then becomes strictly the benefit of the patient. The implied chicanery that comes into play now to maximise and capitalise on the money to be made is removed.

OneWifeOnly
San Diego, CA

@Tyler D: My eye surgery was not Lasik which is never reimbursed by insurance companies. It was not an elective procedure, although it was also not an emergency procedure. There are only a handful of doctors across the country able to treat my condition through surgery. However, I'm sure his billing practice is the direct result of successful collection of payments up front from everything ranging from an eye exam to Lasik. It is a good model for non-emergency health care that I wish other doctors and health care providers would follow.

Mike Richards
South Jordan, Utah

It does not require "government" to handle this situation. All it requires is a web page that shows how much the cost is in our area for various procedures. That's all that it would take. A simple web page that shows how much one doctor or one hospital charges compared to another. We're not stupid. If we see that one doctor or one hospital is charging more than another and if we know that we don't have "special conditions" that would cause the price to be elevated, we can shop with our feet. We do it all the time. I buy gas at the station that has the lowest price. Today, gas ranged in price from $3.09 to $3.25 per gallon. Guess where I bought gas? Guess which station went to the bottom of my list as "preferred stations"?

Government caused the problem when they froze wages. Some doctors took advantage. Most doctors are honest. Patronize those who are honest.

kiddsport
Fairview, UT

To all single-payer proponents: this idea might have some merit if it was run by someone we could trust instead of the self-serving and corrupt cads now serving themselves and their cronies out of the public trough.
Let me reiterate, transparency only comes when the payment decision is in the hands of the consumer and choices are unlimited. The only regulatory laws we need are to unfetter access to services and insurance products selected by the consumer, not the state insurance commission. To say the general public is not sophisticated enough to make good consumer choices is the height of arrogance.

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