This year the federal government ordered hospitals to publish a complete list of the prices they have negotiated with insurers. Some hospitals have complied; many have not (they just ignore it and pay a fine). Even when the prices are published, the data is nearly impenetrable. In one case, a hospital posted information about one treatment that spread its prices across 269 web pages.
At any rate, what the data has shown so far is that, depending
on the insurers, hospitals are charging patients wildly different amounts for
the same services and a single insurer can have half-dozen different prices within the same facility. What’s more, major health insurers are often negotiating unfavorable
rates for their customers. In many cases, insured patients are getting prices that
are higher than if they pretended to have no coverage at all. As to Medicare, it generally covers 87 percent of the cost of care. Often major health plans
pay more than four times the Medicare rate for a routine colonoscopy and more
than ten times for an MRI scan.
Examples of ranges for insurance prices:
- Basic knee MRI at Massachusetts General: From $877 to $4,140.
- Emergency room foot X-ray at Baylor Medical Center: $832 (no insurance) to $1,727.
- Colonoscopy at Beaumont Hospital in Royal Oak, Michigan: $732 to $1,801.
- Pregnancy test at University of Pennsylvania hospital: $10 (no insurance) to $93.
- Rabies shot at Layton hospital in Utah: $16,953 to $37,214
It matters. If your insurer negotiates a bad deal and you
have a high-deductible plan, you’re responsible for thousands of dollars in
costs before coverage kicks in. Sixteen percent of insured families currently have
a medical debt with a median amount of $2000. When choosing a plan, you have no
way of knowing how this is going to turn out—what you’ll end up paying when the
time comes. Neither do employers or the government. What a mess.
For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.
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