I was listening to the Diane Rehm show this morning. She had a panel discussion on Health Care, Obama Care and Health Care Costs. They touched on a couple of issues that I find rather under discussed and it struck me as odd after a while that no one really dug in on the topics.
Here is Topic 1…
Why is it that the cost of a procedure or a piece of gear etc, varies according to who is paying? If you’re lucky enough to be covered by a relatively old fashioned policy like I am you will see on your explanation of benefits that the Doctor, Hospital, Clinic, Dentist…(the provider) charged one price but the insurance agreed to pay another, the provider agreed to that and wrote off some or all of the rest and you paid your deductible plus some additional cost sometimes for one arcane reason or another.
The Provider and the Insurer have some pre agreed price sheet that you never get to see. (You never get to see any price sheet that I know of.) Blue Cross Blue Shield apparently has one price sheet, UHC another, Medicare and Medicaid another, and the uninsured are hammered with the top line rate. An uninsured person who cannot prove he/she can pay up front is charged a higher rate again, (at least that appears to be the game) and then the hospital hounds the near-victim for some ‘pittance fraction’ that in the end is still probably more than an insurer would have paid.
If there were an industry agreed to list of procedures etc (which has to be effectively in place.) You, a consultant, a doctor w/should be able to tell what services you require and you should be able to look up what those services cost on the web comparing various providers. There should be various providers offering various prices and various deals, that you can work through and figure out what is the best value solution for you and your family quite quickly.
This way the insurance companies could reduce costs because they no longer have to individually negotiate prices, rebates, write-offs with each set of providers, the providers likewise can reduce costs for the reciprocal reason.
Administration costs are a huge part of the Health Care Expenses these days and to me this seems to be one of the myriad reasons why.
Health Care Costs are rising almost uncontrollably and the lack of a price comparison mechanism seems to me to be a significant issue.