Alice Green | Aug 1, 2022 | 4
Experiment finds Shocking Variations in the Price of Medical Procedures
Whether Republican, Socialist, or Democrat, all presidential candidates agree that healthcare is one of America’s biggest issues right now. According to a recent Rasmussen poll, nearly 60% of potential voters believe reducing healthcare costs to be more important than creating a health insurance system that covers all Americans.
But what can the average American do to obtain affordable healthcare? Sharyl Attkisson partnered with Full Measure to do a little healthcare experiment. The results were outrageous.
Scott Haller, assistant researcher at Boston’s Pioneer Institute Research Group, played the project’s patient. “I was often sent to the wrong place many times,” he said.
The survey involved 54 hospitals in the following states: New York, Texas, Iowa, California, Florida, and North Carolina. “I would call the operator and ask for a cost estimate for an MRI of my left knee without contrast, and basically see where they sent me, because it could be one of many different places,” he continued.
Shopping around is vital, especially with so many people shelling out thousands of dollars (out of pocket) under Obamacare. “The reason this is important,” explains Pioneer’s Barbara Anthony, “is because we are now living in an age of high-deductible health plans. It used to be that your insurance coverage would take care of your health care expenses from the first dollar of your expenses. Well, that’s no longer the case.”
Getting a price estimate for an MRI should be simple, but Haller and his colleagues found the opposite to be true. “The operator would frequently send me straight to the MRI department,” said Haller, “who are on the front lines of giving the MRIs and often don’t know anything about the bill. We’d often get the run-around. People could be a little bit rude to you. All sorts of stuff, really.”
Getting even a small amount of information took more than 10 phone calls. “One time I was told to call an 800 number and got a coal company,” he noted, “who then immediately told me to dial 1-866 instead, and that got me where I wanted to go. They’ve obviously been through that before. But there were many times when I would leave a message, sometimes multiple messages on the same person’s phone, and they would just not get back to me after waiting over a week.”
In the end, only 25% (14) of the hospitals Haller called provided him with an estimate.
Why is it so hard for patients to obtain basic information? CEO Joe Fifer of the Healthcare Financial Management Association (HFMA) says the systems used to find prices are arcane and complex. “I don’t defend the fact that it’s very difficult for patients to navigate their way through this. That is something we need to fix. We know we need to fix it as an industry.” Fifer says there are “thousands” of codes with different prices that all depend on who is paying the bill – the government, the consumer, or a private insurance company.
“Almost all of these codes have dollars associated with them that are on these charge-masters. They really become a part of a calculation to a different payment methodology.” Pioneer Institute found the price of an MRI wildly inconsistent; for example, the procedure was $400 in LA but over $3,500 in Des Moines, Iowa.
This variation does not seem to be related to a city’s size or cost of living. In Orlando, an MRI could cost anything between $877 and $2,000; in LA, between $400 and $2,800. There was a 1,000% difference in price of an MRI in the New York City region alone. Pioneer’s research could not determine a reason for these baffling variations.
According to Fifer, hospitals are scrambling to meet consumer demand when it comes to up-front cost estimates.
“As a country, we are really lagging behind in terms of health care price transparency for consumers,” says Anthony. “We really have a long way to go, all over the country, before we give consumers the tools they need in order to spend their health care dollars wisely.”
To Hell with Obamacare!
This book was written by Joe Gilbertson of the Punching Bag Post Staff. This is the solution to the Obamacare fiasco: