If you’re having brain surgery, it shouldn’t be rocket science to figure out how much you’re going to pay.
Unfortunately, a new government move to get hospitals to become more price-competitive and transparent has led to a mostly incomprehensible list of jargon and numbers that, to the average consumer of medical services, will mean nothing.
Add to that the complexities of an insurance-driven health care market, where providers negotiate discounts and consumers pay varying deductibles and percentages based on their plans, and the new “transparency” is meaningless.
Surely, government and the industry can do better.
The price lists are the product of a well-meaning Trump administration order, which went into effect Jan. 1. The order hinges on a single sentence of the Affordable Care Act that requires each hospital to establish and make public a list of “standard charges for items and services provided by the hospital.”
The idea is a good one. If hospitals make their prices public, consumers could make informed choices when scheduling elective surgeries, and competitive pressures would force hospitals to lower their prices.
That would work in a true free-market setting. Unfortunately, it promises to do little in a market cluttered with third-party insurance contracts, where patients are far removed from the actual costs of procedures and where hospitals, as has been apparent since Jan. 1, obfuscate by using medical terms average people can’t understand.
Consumers can’t even be sure they are comparing the exact same procedures from one hospital to the next, and the figures provided often do not include other charges from physicians, anesthesiologists or others involved in a surgical procedure.
We looked at two Wasatch Front hospitals to illustrate the point. American Fork Hospital published a long list of procedures and services along with prices, ranging from low-priced items such as “Q9958 HOCM CYCSTOGRAFIN/PER 1 ML” for 21 cents to more expensive procedures, such as a “MECH THROMB OF DIALY CIRC W STENT*” for $23,915.81.
St. Mark’s Hospital in Salt Lake City, meanwhile, requires consumers to press an “insured” or “uninsured” button to obtain estimates. The “insured” option leads to a page that asks people to call a service center for an estimate based on their plan. The “uninsured” button leads to a disclaimer and then a list of procedures that includes broad price ranges and equally broad hospital stay estimates. A phone number is available for more advanced estimates.21 comments on this story
It may be impossible to get meaningful numbers in a system so complicated by technical terms, negotiated rates and discounts, but Washington could help by establishing a uniform reporting procedure that would allow consumers to compare similar procedures at different hospitals.
Also, hospitals should be required to publish success rates for various procedures, as well as consumer feedback.
Even with that, consumers would be hampered by insurance rules that often provide a limited list of contracted hospitals — adding another layer of complication and further illustrating how tangled and unwieldy American health care costs have become.
Transparency is a worthy goal that should not be abandoned. Getting a handle on medical costs, however, won’t be so easy.