Motown legend Smokey Robinson once advised: “You better shop around.” The Trump Administration is trying to make it easier to shop around for healthcare.
The Department of Health and Human Services is weighing a proposed price-transparency rule, to make purchasing medical care more like the rest of the economy, and less like today’s opaque, baffling, frustrating mess.
Imagine if your grocery store operated like your local hospital. You would walk in and find no price tags on anything. But, being hungry, you would fill your shopping basket, leave the store without paying a dime, drive home, and make dinner.
Three months later, rather than receive one invoice from your grocer, a flood of bills would deluge your mail box: The butcher’s charge for ground beef: $75. The baker’s expense for hamburger buns: $125. The candlestick maker’s cost: $150 — each.
Few Americans have bought a quart of milk, a gallon of gas, or a pair of socks without checking its price tag. But almost no one has any idea what medical care costs. Since third-party insurance companies handle most bills, prices are virtually classified.
About 18 months ago, I underwent several medical procedures included with my in-network specialty care. Or so I thought. About three months later, a cascade of surprise bills arrived for assorted things that I believed were covered. Prices ranged wildly. My plan fully paid some items. I got socked with others. Some were in between.
Also my medical statements are unfathomable. “This is not a bill,” many bafflingly declare. A totally confounding quasi-spread sheet includes list prices, negotiated prices, allowances, deductions, patient’s share, co-pays, deductibles, etc. I stare at these documents, and my MBA doesn’t help. Only medical bills trigger such intense head scratching.
Americans might not have to take this anymore.
HHS is considering a great idea: Doctors, clinics, hospitals, and pharmacies would have to inform patients what this procedure, that drug, or this device actually costs. Equipped with prices — the most basic data in any market — Americans would be empowered to shop around and make better-informed healthcare choices. The ensuing competition among medical providers should lower outlays — as it does everywhere else in the economy.
Of course, prices should be the least of one’s worries in an ambulance, en route to an emergency room. That will not change. But for the vast majority of medical visits that are non-emergencies, patients would have time to compare prices and make wise, affordable decisions.
These human stories, available online, underscore why the time is now for Americans to see the true price of healthcare and shop around for medicine.
• “I had to go to the ER back in Dec 2018 and was admitted for 4 days,” Florida’s Denise Poston writes. “As of April 2019, I’m still receiving new substantial invoices from random folks that must have walked by my gurney….Oh, and I’m 63 years old and was charged for a pregnancy test.”
• “Once I needed an x-ray and was told to use the hospital x-ray department,” Maine’s Rebecca Pringle-Gleske explains. “I pushed until I got the rate – it was about $500. The same x-ray cost me about $115 at a local urgent care center.”
• “I know most recently when I had a routine physical, I couldn’t find out – even when I asked – what the cost of the blood work was going to be,” Georgia’s Mark Lindow laments. “I had to pay a certain part of that, insurance took care of the rest. But I wanted to know what MY part of the cost would be, and could not get an answer from the lab! That is ridiculous.”
Lindow adds: “Shopping prices for health services and prescriptions should be transparent, and as easy to do, as it is for anything else.”