New proposed Trump administration regulations aim to make how much hospitals charge patients more transparent—a continuation of federal Obama era initiatives to pull the curtain back on the notoriously opaque American health care system by making hospital service charges easily available online. But, as with the Obama administration efforts, questions remain on just how useful the hospital pricing information will be for average U.S. consumers.
The proposal from the Centers for Medicare & Medicaid Services (CMS) is part of its annual guidance for Medicare, the gigantic federal program that covers millions upon millions of elderly and disabled Americans. Its purpose is ambitious: To nudge American health care to more quality care and away from the fee-for-service model that rewards conducting more tests and services.
This is a darn good idea. When I had my aortic valve replaced, I asked the paperwork clerk what this was going to cost. "About $120,000." I was already in a gown, and on a bed, so I wasn't going shopping. But when this was billed to Blue Cross, it became $4000. The whole "For your insurer, it is a tiny fraction of our cash pay price," is just nonsense. The huge discount drives up the price of uninsured patients.
The hospitals give the huge discounts because otherwise the insurers would steer the patients elsewhere. That indeed results in ridiculous prices paid by those without insurance, and those with suboptimal insurance.
ReplyDeleteA friend recently sold a company whose business was to intervene between hospitals and self insured companies, getting the latter the same breaks as the big insurance companies. They were very good at it.
The whole health payments system, everywhere in the world, is messed up. It is either socialized, with the horrors that brings, or private, with these other sorts of crazy results.
Medicare is rapidly becoming second class insurance, because it doesn't pay BTW, as well as private insurance.