To Cut Healthcare Costs, Let's Start With the Secret Prices

Reader Comments
Back to article

when you work for a company most of your health care costs are covered by an employer, but when you don't have the possibility to have an insurance through an employer you are required to buy your own health care insurance which the cost is outrageous already for an individual wanting a health insurance and to top it off, after going to a doctors visits or doing exams, you litterally pay the entire cost out of YOUR OWN POCKET, because the insurances has set standards for the individual on their own coverage versus the covered individual under an employers plan........I will ask you how wrong is that?
however I do agree that doctors SET their own costs to what they want and it to be, it should be changed on that level first, then on the insurance level.

S.D of VA 5:42PM July 03, 2010

The Making Home Affordable Program is not even successful. Now the Healthcare Reform, I don't want to see what is to come. Let's just tackle one problem at a time. Then go to the next. Home Modification is still an issue, now it's healthcare. What's next? What food we're allowed to buy, what quality of air to breathe? I can say for a fact that I am not going to be able to afford health insurance if it's $1400/per month for family and $800 for individual. It's probably cheaper to pay the fine of $750 at the end of the year for not having health insurance. I was happy about health insurance because I thought it was going to be like $50 per month for individual and $200 per family but $1400 is ridiculous! I have insurance thru work but it's like $175 per paycheck for individual and $375 per paycheck for family, and my check is only $575 net, come on now I do have other expenses, like shelter, gas, food, personal hygienes and a car payment! Too bad we can't drive a horse-drawn carriage to work. I would've saved!!

Kate of CA 5:33AM January 04, 2010

Perhaps the government could start by leveling the playing field between free standing surgery centers and hospital based surgery centers.
Currently, by law, hospital based surgery centers are compensated about 160% of what free standing surgery centers received. This is an across the board differential for all outpatient procedures.
Our government, the one that's complaining about the costs, put this law in place.
Seems fairly simple to pass a law and say that a surgical procedure is worth so much, no matter where it is performed.

edward hurst of TX 6:17PM November 09, 2009

The "cost" of a procedure isn't what medicare pays. As most physicians (including myself) who actually take care of patients know, you actually LOSE money taking care of medicare and medicaid patients. That's why we're always talking about what your "payor mix" is when looking at a job. The more medicaid/medicare you have, the more money you lose. We see these patients sometimes out of necesity as we are required to, but most of the times just out of pure love of what we do.
Why is it they always put on TV and on the news/websites physicians who never take care of patients? Academic physicians make money regardless of whether they see patients or not. Physician "consultants" never see patients, they just offer their opinion. These kind of doctors are out of touch with reality. Unfortunately, like all bean-counters, they are the ones helping shape policy, not the rest of us who are too busy taking care of patients to try to scrape up a living.
Why won't Obama and these Dems limit lawsuits? Is it because trial lawyers have bought and paid for the Dems?
Also of note, the AMA does NOT speak for most physicians. Not a single other physician I know agree with the changes that are being made. Most physicians I know are leaving the AMA. The older physicians who can will leave medical practice altogether as it is already tight enough.
Why are physicians not really involved in the entire process? We've been boxed out of the entire process.
I see the downfall of American medical practice.

Jon of TX 10:17AM November 08, 2009

Finally I've read and been substantiated in my belief that insurance companies are not the real culprits in the health care issue as much as the actual health care providers. I've said that the health care "corporations", and that is what they are, have set the price and insurance companies, although not without blemish, have simply followed suit by raising premiums to keep up with prices. Governmental regulation is the only answer to our spiraling costs. The public option where a "usual customary fee" is established is the only way to control the greed of these publicly held corporations. Make a profit - fine, but let be a set percentage not "whatever the market will bear".

patrick of OH 11:01AM November 02, 2009

The problem with the entire healthcare system is that hospitals and medical establishments do not publish prices. They claim things are "too complex" to price; however, in countries like Singapore prices are readily published.
Competition works when people can analyze the comparative quality of the same or similar good or service versus the comparative price for the same thing provided by various other providers. When price transparency doesn't exist people charge what they want to charge. That is why tourists almost always get overcharged... because they don't know what a fair price for something is.
Just as tourists lack knowledge of various prices, so too consumers of healthcare lack knowledge of a procedure they might get only once in a lifetime. Further, there are few sources that publish what something costs and the comparative benefits between different providers. Insurers often know...but guess what, they don't know everything and furthermore they aren't telling (because that is their monopoly and they use it to force you to maintain your coverage...or else you have to pay what the plebeians in the cheap seats pay, which is vastly more).
If health providers were required to publish their prices for various things, which woudln't cost them anything...since they already know what their costs are and then consumers got a chance to compare these prices before they ordered a procedure then costs would come down. Competition does work! Costs can come down.
This is a solution to healthcare that wouldn't cost anybody anything. It's free. Furthermore, its the "American" way of doing things. No stuffy burrocracy or maze of red tape. Just give everyone a price list and watch the competitive incentives of the varying institutions play against one another to provide the best value at the lowest cost over the long term.
Who knows, eventually instead of paying more and getting less healthcare than the rest of the industrialized world we might pay less and get much more.
Of course, this doesn't work for emergencies, because in those cases you pay what you have to. But it can work for 90% of everything else.

Erin of VA 2:20PM October 31, 2009

How refreshing to see this article by Dr.Healy who has identified the true problem of Health Care- cost of procedures.
Dr.Healy in her article states that the problem is not over consumption of procedures and hospital admissions. Unfortunately,this is not the the current belief of the Obama administration.
The president and his director of the Budget, Peter Orszag are believers in the idea that it is over consumption by patients of procedures, the use of medical devises like stents and pace-makers, and the over use of hospital admissions which have driven up costs in Medicare.
Who has not heard this president say that a greedy doctors see a child with a sore throat- and want to make a lot of money by removing his tonsils, or a diabetic is looked at as a patient who should receive wellness treatment, but geedy doctors want to make tens of thousands by amputating his leg.
And there is the final statement that there are geographic differences in the county where the good hospital, like the Mayo Clinic, gets better outcomes with less costs; than a similar hospital in a different area which has worse outcomes, but higher costs.
When Obama is quoting studies he is quoting the Dartmouth Atlas.
When you type this into your Internet you will get their home page and if you scroll down to their " white paper, " it will talk about its reforms for Obama- and describe its tenets.
This study divides the nation into geograpic sections which have good hospitals- that have lower Medicare costs with good outcomes and inept ones- which have high costs with less than great outcomes.
The Dartmouth Atlas insists that it is greedy doctors who create an over supply of hospitals and push to have them filled, and also push patients, who they claim are cowed by doctors' opinions to have procedures like hip replacements that raises Medicare reinbursement costs.They also dislike tests like Cat Scans, Mri's etc.It is no accident that in the Baucus bill medical devices will be taxed like stents and pace-makers.
This study has bee challenged by some Harvard researchers who claim it has flaws in their methods which skew the results by 30 to 50% by using zip codes that cover 30.000 people which makes it impossible to determine the true mean of the patients' poverty level.
Harvard recomends the more modern method to determine this mean by using tracts which contain 4,000 or blocks which have 1,000 people. The hospitals Obama claimed which had poorer outcomes but higher costs had patients with more cases of serious disease and also multiple severe illnesses at once like diabetes, heart disease, and renal failure. So in reality, there was no causal relationship between over consumption of hospital beds, etc. and costs.
Obama plans to use the lower Medicare reinbursement level of his so-called good hospitals as a base he will force on all hospitals, even though sick and poorer patients push up costs, and with this base will not be able to survive.

my name is peggy. www.abloggerwithoutablog.com of PA 8:55PM October 23, 2009

It's the economy, stupid. Obama's embracing of a Goldman Sachs dominated economic advisory counselis not helping solve the problems of providing health care. The fact that both parties are loaded with Congress people and Senators that accept money from insurance and Big Pharma lobbyists and do their bidding on opposing legislation that would lower costs for medical treatment is not helping health reform. Putting insurance industry under the Sherman Anti-trust Act is a great start and if passed can be more effective than the public option. Also, we should be able to import drugs from Canada and Europe. I'll never understand why the Democrats caved in immediately on single payer and Big Pharma's demand --no drugs from Canada.

Jack Golding of KS 3:43PM October 22, 2009

My BCN certficate 1.04 refers to outpatient surgery as applying a 25% deductible. I had such a procedure done in May and having studied health care unversal, single-pay in significant detail for purposes of drafting my own bill I was a bit dismayed to receive a bill for $223, or my expected portion. Problem is my research does not support this as a "surgery". BCN's argument revolves around their using the AMA CPT manual, which has nothing whatsoever to do with contract law. There is no definition in the policy specific to surgery or any scope procedures, therefore I am appealing to BCN and in Level 2 at this time. If they do not reverse, I will turn it into a civil action, possibly class action. Your opine please. Dave/CFSM Director

Dave of MI 10:09AM October 14, 2009

My Dad recently had a 'filling' done on one of his teeth. The dentist charged him $320, for ONE filling and x-rays. How in the world is the average 'working man' who makes $30-40k a year supposed to be able to pay for that, when that is usually the most he can save in a MONTH?
We need MORE doctors, and MORE dentists!!! I'm sure if there were more, there could be some competition. I'd gladly pay $250, or $200, or $150, or maybe what I think it is 'worth', less than $50. The way it is now, the dentists seem to have their working space setup to have at least 3-5 patients sitting in chairs all at once. He just goes around like it is a 'cattle call'; working on one then the other, then back to this or that one.
How many patients a day? 30?? I bet every dentist out there is running 30 patients a day. That's nearly $10,000 a day raked in. Having MORE dentists would cut this exorbitant cost down-to-size. the way it is right now, the medical 'professionals' are a bunch of money-hungry crooks!

ed of OK 7:18AM October 07, 2009