Once Secret Prices expose the “irrational and cruel” nature of America’s health care system
The database of hospital tariffs compiled by the New York Times and researchers at the University of Maryland-Baltimore detail how patients are billed dramatically different prices for the same medical care depending on the insurance company they use, with some procedures costing less if a patient doesn’t. has no insurance.
“Keep these prices in mind the next time you see a report … which tries to determine whether the reimbursement rate for a particular single-payer plan would be impractical.”
âMatt Bruenig, People’s Policy Project
Patients receiving an MRI at Memorial Regional Hospital in Hollywood, Florida will be billed between $ 1,827 and $ 2,455 if they have a Cigna, Humana, or Blue Cross plan, and only $ 262 if they have Medicare.
âWhat’s worrying is that the third party you pay to negotiate on your behalf isn’t doing as well as you would on your own,â said Zack Cooper, health economist at Yale. Times.
As the Times reported, an insurance company may have multiple prices for the same service in the same hospital, “depending on the plan that was chosen during open enrollment, and whether it was purchased as an individual or in the framework of the work “.
While Americans who choose health insurance plans may spend a lot of time painstakingly comparing deductibles, monthly premiums, and providers who agree to a certain plan, most people “have no idea that they can too. pick a much worse price when they need care later, “Sarah Kliff and Josh Katz wrote at Times.
The secrecy with which hospitals and insurers still operate despite the new transparency rule has left insurers “little incentive to negotiate well” on behalf of their clients, they wrote.
A mother of a young patient, Caroline Eichelberger, struggled with how much she should pay for a rabies vaccine her son needed. Her Cigna plan covered $ 4,198 for the two-drug vaccine, but since she had a $ 3,500 deductible, she tried to find a way to save money:
Neither the hospitals she called nor her insurer gave her any answers.
She made her decision based on what little information she was able to get: a hospital, Layton, who said he would charge her $ 787 if she paid in cash. The price tag with the insurance wouldn’t be available for a week or two, he was told.
But even the cash price didn’t turn out to be right: a few weeks after the visit, the hospital billed her an additional $ 2,260.
It turns out that the original estimate was missing a drug that her son would need.
“It was the most complicated and unnecessary process,” Eichelberger told the Times.
The report proves that “the United States truly has one of the worst health care systems in the world,” tweeted Daniel Aldana Cohen, a sociology professor at Berkeley, who was one of the many observers who took note of the research on social media.
While the recently released pricing data is unlikely to reduce healthcare costs, journalist Jon Walker suggested, it could intensify the pressure to radically change the US healthcare system and further discredit claims, according to journalist Jon Walker. that a government-run or single-payer health system, in which patients would not be billed for point-of-care medical care, would be unaffordable and âunrealisticâ.