Where a Redneck Jew, a Hispanic Catholic, and a Computer Geek write about Gun Rights, Self Defense and whatever else we can think about.
Disclosing prices and discounts would be a great way to allow consumers to decide for themselves whether or not to patronize a business. Can you imagine any other business where the prices are not disclosed to the consumer until after purchase?
I can imagine the multi billion dollar lawsuits that might be brought when people finds out how much have they been fleeced on Insurance because of these “games”.
Semi-retired like Vito Corleone before the heart attack. Consiglieri to J.Kb and AWA. I lived in a Gun Control Paradise: It sucked and got people killed. I do believe that Freedom scares the political elites.
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I’m pretty high up in a large corporations that owns a couple hundred hospitals. Everyone is *freaking out* about this, and the lie they’re telling themselves is that this is bad for consumers because our competitors will…..raise prices to match ours once they find out how much we charge.
These people all supported Obamacare because they believed they would make money hand over fist if everyone were required to have insurance instead of Medicaid, so I’m just sitting back and watching it burn.
“…the lie they are telling themselves” — sounds like they got their management training at PG&E in CA, and flunked out for being too dumb for that outfit.
Pricing for every drug, test, service, and medical supply, as well as the billing rate of every doctor (by name) and staff position (by pay grade, e.g, “nurse, level 1”) should be available at the front desk like a menu.
Problem with this, as attractive in concept as it is, is that your “menu” would pretty quickly start to look like an old style, large city, phone book. The Blues, due to their market dominance, negotiate sizeable discounts. ‘Caid, because Dah Goobermint, mandates very, very hefty discounts from “list price”. (That’s part of why trying to get ‘caid patients referred to specialists, often involves sending them across the state: puny money, few specialists).
Then, there’s the “complexity of visit” issue. A “nurse visit” (for your B-12 injection, f’rinstance) is cheaper than an average complexity “refill my BP meds” visit, which is cheaper than a “Holy Stool! When did your face start to droop like that!” Visit. (Had one of them, last week)
Some of those you can identify prospectively, some, not so much.
So, it can be very complicated.
That is the beauty of free markets. That phone book sized pricing schedule would self correct. Once consumers can’t understand the billing, they will go elsewhere.
I was going to make the same point. As soon as customers get a bill that is why different than what they thought the menu said they will refuse to pay or call a lawyer. It will end up about as complicated as a Jiffy-Lube service board.
What I hope for is pharmacies adding services. Imagine if CVS had an x-ray machine. You hurt your ankle. Go to CVS, for $75 they will x-ray it, send the x-ray to a radiologist (all digital now) who will tell you if it’s sprained or broken.
If it’s sprained, they can wrap it for $50 or you get buy your own ace bandage and do it yourself. If it’s broken, you can go the hospital and the hospital can download the x-ray using the code on your CVS receipt.
I’d like to move heath insurance towards more like car insurance. Where transparent pricing makes it cost competitive and you can chose to use insurance or not depending on the cost. If getting a digital abdominal x-ray for my dog cost me $75, why shouldn’t cost the same for me? It’s the same Siemens x-ray machine.
The biggest issue I have with our present “health care pricing” approach, is the difference in pricing if you have insurance vs. if you don’t. Head over to Divemedic’s blog for a good example of this.
One example of “have insurance vs don’t” pricing. A dental office near me offered their own “insurance” but it was only available if you did not have dental insurance. The office insurance cost $20/year and payed 50% of all work done at that office. In essence they doubled their prices if you had insurance.
Boris: you are TOTALLY correct. I had a cardiac cath w/stenting several years ago, when between insurances. Gross bill: nigh into heart stoppingly high.
Fortunately, (a) the hospital offered a pretty hefty “prompt payment” discount.
I learned that when, 3 days post Cath, I called the billing department.
This folds, neatly, into (b) my credit union operating under the delusion that I was/am creditworthy.
A delusion that I went to great lengths, to not correct.
With those pieces in place, it was merely breathtakingly expensive.
As in, “nice new truck, tricked out just the way I want it”.
So, Boris, you are correct.
Demonstrating clearly that when a third party is responsible for paying, the consumer does not care what the actual cost is.
If the politicians actually want to see medical care prices drop, they should write a law preventing doctors from directly billing insurance. Force the consumer to put the entire cost of an office visit (or other reasonable cost medical care) on their own checkbook, then seek reimbursement from the insurance company.
I bet if little Miss Soccermom discovered that having a doctor look at little Johnnie’s boo-boo to “be sure” costs $380, not $20, she would be a lot less likely to go to the doctor for every bump and bruise. Additionally, if you actually know what the cost really is, you will shop around, instead of just going to the nearest doctor. Same with pharmacist, PT, etc… An adjustment at my chiropractor is $140 if I pay cash. I know this because he posts his rates. At the cracker down the street…. who knows.
Unfortunately making the consumer pay directly will just make them stop going for many things. For example, I should probably go to the Dr for a cold I’ve had for 3 weeks that hasn’t improved, but if it costs me $380 instead of $0-$20, I am much more likely to wait until I die to go and that is just a small low stakes example.
I don’t have the complete answer to our insurance issues, but I do know what the first step is. Stop calling it and treating it as insurance because it is not treated like just about any other type of insurance by the vast majority of its users and start calling it and treating it like a membership to a medical discount club.
Second, eliminate in/out of network or at the very least stop fucking people over when they don’t have a choice.
Third, make buying across state lines possible.
Not so complicated – I have a contract with my insurance company, they have a contract with the PPO. Every single price for every single procedure has already been set. The only problem is the other two parties don’t want to divulge what rates the agreed to.