The database of hospital rates compiled by the New York Times and researchers at University of Maryland-Baltimore details how patients are charged drastically different prices for the same medical care depending on what insurance company they use—with some procedures costing less if a patient has no insurance at all.
"Keep these prices in mind the next time you see a report...that tries to figure out whether a particular single payer plan's reimbursement rate would be unworkable."
—Matt Bruenig, People's Policy Project
Patients receiving an M.R.I. 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.
"The worrying thing is that the third party you're paying to negotiate on your behalf isn't doing as well as you would on your own," Zack Cooper, a health economist at Yale, told the Times.
As the Times reported, an insurance company can have several prices for the same service at a single hospital, "based on which plan was chosen at open enrollment, and whether it was bought as an individual or through work."
While Americans choosing health insurance plans may spend significant time painstakingly comparing deductibles, monthly premiums, and the providers who accept a certain plan, most people "have no idea that they may also be picking a much worse price when they later need care," wrote Sarah Kliff and Josh Katz at the Times.
The secrecy with which hospitals and insurers are still operating despite the new transparency rule has left insurers with "little incentive to negotiate well" on their customers' behalf, they wrote.
One mother of a young patient, Caroline Eichelberger, struggled to find out how much she would have to pay for a rabies vaccine her son needed. Her Cigna plan covered $4,198 for the vaccine containing two drugs, but since she had a $3,500 deductible, she attempted to find a way of saving money:
Neither the hospitals she called nor her insurer would give her answers.
She made her decision based on the little information she could get: a hospital, Layton, that said it would charge her $787 if she paid cash. The price for paying with insurance wouldn’t be available for another week or two, she 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 left out a drug her son would need.
"It was the most convoluted, useless process,” Eichelberger, told the Times.
The report proves that "the U.S. truly has one of the worst healthcare systems in the world," tweeted Daniel Aldana Cohen, a sociology professor at Berkeley, who was one of many observers who took note of the research on social media.
While the newly publicized price data alone is unlikely to reduce healthcare costs, suggested journalist Jon Walker, it could intensify pressure to radically change the U.S. healthcare system and further discredit claims that a government-run or single-payer healthcare system, in which patients would be charged nothing for medical care at the point of service, would be unaffordable and "unrealistic."
This content originally appeared on Common Dreams - Breaking News & Views for the Progressive Community and was authored by Julia Conley.
Julia Conley | Radio Free (2021-08-23T14:24:05+00:00) Once Secret Prices Expose ‘Irrational and Cruel’ Nature of US Healthcare System. Retrieved from https://www.radiofree.org/2021/08/23/once-secret-prices-expose-irrational-and-cruel-nature-of-us-healthcare-system-2/
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