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
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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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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?
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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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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
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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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seems a little pricey to me but that may follow the cost-of-living index for the area, or perhaps proximity to some of thereknowned medical services in the NE. Please note that they offerdiscounts for cash, presumably as it saves them the hassles ofpaperwork in triplicate, paying salaries and overhead of insurancecompanies, government, and other intermediary agencies while chargesare challenged, verified, litigated, delayed, refused, and so on. Adermatologist in my city gives 30% cash discount, so the costs ofcollection must be near 30% of the bill - a very sizeable amount. I'veheard an incredible amount of an RN's time is wasted on paperwork thatfeeds 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).
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