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Article on medical pricing


This is one of the first pieces I've seen that documents prices for medical services. I hope it may be helpful to some for more accurate planning purposes.
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It's interesting that in all other business that I can think of at the moment, pricing is not only "disclosed" but is wantonly advertised. Even attorneys will tell you their hourly rates - even if they don't tell you they charge $30 bucks for each e-mail. Hospitals, however, instruct insurance companies to keep their prices secret. The article referenced goes into this in some depth.
Please, no one even begin to think I'm in favor of forcing hospitals to give services for free, or under some 'price control' scheme from government. But I do think hospitals should publish and distribute price lists for services. If that were routinely and responsibly done, we could all make much better evaluations of what we are paying insurance companies for - versus what we would pay in cash - and how much we are getting in return.
My position on all this health care debate is that cash for services is the best way to go. Capitalism and free markets assume anti-trust laws and regulation will be enforced to keep them fair and competitive. Under those circumstances, the consumer chooses, not the government.
Reply to
dapperdobbs

Which prices? Every hospital has at least three separate prices for each service; the Medicare price, the insurance company contract price (which may vary between insurance plans) and the price they charge those who do not have insurance.
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 .Bill.
Reply to
Bill

All three lists - but I would like to know where you got information about three price tiers. Is there a website you went to, an article you read, or what?
Reply to
dapperdobbs

Numerous articles over the years combined with personal experience. Can I cite one off the top of my head? No. Sorry.
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 .Bill.
Reply to
Bill

In article ,
Anyone (like me) on traditional Medicare can see from the Explanation of Benefits that there is an amount billed and an amount approved (which is what the hospital accepts as payment in full. My bypass was billed at $105K, the hospital accepted $26K. Similar discounts applied to physicians billings
Anyone with PPO insurance can similarly see discounts. In this areas PPOs pay slightly more than Medicare. If the hospital and insurer can't agree than the hospital may be excluded from the insurer's network.
I have seen the exclusion at work locally. I am sure that some people make their insurer choices based on that and some hospitals are willing to lose a few potential patients.
If one would look at insurer's premiums in the areas where hospitals have pricing power one would see higher premiums than elsewhere
Reply to
Avrum Lapin

This is a search result for hospital prices. Apparently some localities require price lists made available - e.g. Wooster Community Hospital (Massachusetts?)
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Wooster seems a little pricey to me but that may follow the cost-of- living index for the area, or perhaps proximity to some of the reknowned medical services in the NE. Please note that they offer discounts for cash, presumably as it saves them the hassles of paperwork in triplicate, paying salaries and overhead of insurance companies, government, and other intermediary agencies while charges are challenged, verified, litigated, delayed, refused, and so on. A dermatologist in my city gives 30% cash discount, so the costs of collection must be near 30% of the bill - a very sizeable amount. I've heard an incredible amount of an RN's time is wasted on paperwork that feeds lawyes and bureaucracies.
Best policy to save money on medical is to take good care of one's family and body, and meet a sudden death while having a great time (no loose ends left behind in one's plans, no "I love you" left unsaid).
Reply to
dapperdobbs

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