Saturday, November 24, 2007

Health Price Disclosures: Go For It

There's progress on the "health care" costs front.

Sen. Jim Sullivan (D-Wauwatosa) and Rep. Steve Wieckert (R-Appleton) this week introduced a bill requiring health care providers and insurance companies to make available information about the cost of procedures or services to patients who ask for it.

And maybe more progress to follow:

Rep. Leah Vukmir (R-Wauwatosa), chairwoman of the Assembly's Committee on Health and Health Care Reform, said she would introduce her own proposal in the coming weeks.

"Merely taking the top 50 procedures out there, what if you have procedure 51?" Vukmir said. "How does that help you?"

Knowledge is power. The difference between "list" and "negotiated" prices for hospital and MD care is often substantial, raising the question "what's it REALLY worth?" in the mind of the consumer--especially the consumer who is un-insured.

4 comments:

  1. How about requiring health care providers to disclose the cost of procedures to the physicians that order them?

    I've had experiences with more than one physician where they were surprised by the cost of an imagining procedure at their own clinic or the cost of the medications that they prescribed. If you have decent group insurance it doesn't matter. But with my crappy private policy I paid huge out-of-pocket costs.

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  2. Cynic that I am, I'm of the opinion that doctors in clinics associated with certain hospitals are like lawyers in a large law firm. Like the lawyers they are expected to 'generate income' for the firm. Thus multiple procedures are ordered which have little bearing on the complaint or the diagnostic outcome.

    Case in point. Some time ago my daughter went to the clinic with a sprained ankle. First there was an X-ray - which showed nothing. Then a CAT scan was done - which also showed nothing. Finally an MRI was done and, guess what? Yep, showed nothing.

    All this for a sprained ankle...? Ad of course as our insurance only covered a percentage of the cost, we were out many hundreds of dollars. So, cui bono?

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  3. Well, yes and no...

    Some testing is done to cover the MD's ass. They get sued and usually lose if they mis-diagnose.

    On the other hand, you can always tell the MD "no" when they suggest a test.

    A pediatrician wanted to admit one of mine to Children's in Milwaukee--and I told him 'no way--it will be St Joe's.' Children's has a rep for overcharging.

    She went to St Joe's.

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  4. "On the other hand, you can always tell the MD 'no' when they suggest a test."

    Which is what I did with my doctor (same clinic, different MD) subsequently, when his justification for the tests was: "Well you have insurance, don't you...?"

    Yes, I do - to the tune of $10k+ per year and some additional thousands in out-of-pocket costs.

    I switched doctors, finding one who is not attached to a clinic and is more on the lines of an old style GP.

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