Raj Bal has a good idea. Instead of covering up the cost of health care, let’s open it up to scrutiny. Be honest – when was the last time you really examined an itemized accounting from your doctor or hospital visit? Some of us have, but we usually don’t lose sleep over it – our insurance company picks it up. We shop around for the best price on our new car, but we don’t ask for prices upfront when we go to see our doctor.
But what about procedures and costs that are not covered by insurance? Shouldn’t we know ahead of time what we are getting into? You don’t care because the insurance industry has got your back, right?
Today, individuals pay 25 percent of the $1.9 trillion a year spent on health care — the same percentage as employers. According to a March, 2007 McKinsey Quarterly article (“The Retail Revolution in Health Care”), consumer-directed health plans now have more than six million enrollees.
Didn’t know that, did you? Bal suggests that we need make medical costs more transparent. We need to make the health care profession more accountable. Just as auto sales are based on competition in the free market, so should our health care. Bal quotes HHS Secretary Michael Levitt as saying, “As we give consumers better information on how their health care dollars are spent, they will demand more value for their money, and the result will be better treatment at lower costs.”
Exactly! I admire our doctors and have been a strong proponent of caps and limitations on medical malpractice lawsuits. The frivilous nature of such suits, the willingness of juries to buy into these suits and the size of the awards has driven up the cost of malpractice insurance. This, in turn, has left many states that have loose limits on such claims facing a shortage of doctors.
On the other hand, I am asking the medical profession to be responsible to their patients. After all, we are consumers of a service and should be entitled to a fair accounting of services and some knowledge beforehand of what to expect. Even if insurance companies pick up most of the tab, doctors will have to publish set rates and fees so we know what our insurance is paying – not to mention the costs that they don’t cover.
Think about it for a moment. One of the biggest complaints about Washington is waste and overcharges in regards to Medicare and Medicaid. What if doctors were suddenly accountable to the government? What if hospitals could no longer charge $150 for an aspirin? Maybe this entire concept is too idealistic, but I believe it maybe a better way to cut health care costs and save the government billions than socialized (oh excuse me…..”universal”) health care coverage could ever accomplish.
steveflesher
Philip
Mel Maguire
Mark Ciavola
Comments
Perhaps I’m misunderstanding your conclusion, but are you saying doctors should be accountable to the government? Part of the problem with our health care system is too much government involvement – doctor and hospital fees are set by the government via Medicare, and this price-fixing leaks over into the private sector (a basic economics background will tell you this inevitably leads to high prices and inefficient use of resources).
Pricing-transparency can only be achieved when consumers own their health care dollars, and thus dictate the direction of the medical marketplace. Unfortunately, with the continuing growth of government in health care – the recent SCHIP expansion is a good example – we seem to be heading in the opposite direction.
Lily – http://sideeffectsmayvary.wordpress.com
In a way.
I’m saying that the medical profession should be responsible to the consumer (ie. the patient). A side-benefit of this required responsibility is that the average citizen will now know what they are being charged upfront, what their insurance company is paying, and (in the case of Medicare and Medicaid) what the government is paying.
I am saying that doctors and hospitals need to be more upfront with the government and stop the fraudulent expenses that they bill to federal health care programs. A published accounting of fees and schedules would, in effect, make them deal with the government in the same manner that they would deal with an individual patient. They should charge the same fees to individuals and the government. Why should there be disparity between the two? A lab fee is a lab fee. An aspirin is an aspirin – regardless of who is picking up the tab.
I’m not asking the government to regulate the industry in depth. I just think that it would be beneficial for the government to require openness in the same way that they require nutritional and ingredient labeling on most food products. You should know what you are getting before you buy.
Not very libertarian of me I guess. But it’s a proposal upon which Ralph Nader and I could probably agree. It’s a matter of corporate accountability and reducing government waste. Lots of ideological notions collide here.
Lily, that was a thoughtful post. I do think that you and Philip agree here.
It seems to me when he says to keep “social” healthcare out, he’s advocating keeping it out of government.
I work for a small business (my family runs) and pay our own healthcare. My Uncle himself pays $750 per month for insurance. It’s a price to pay for his independence.
I think more than anything, insurance premiums should be investigated. We yammer on about gas prices when we’re all getting raped by our insurance providers (not just health either).
I guarantee if Hillary could get away with it, she’d find a way to tax us on pur premiums just as her party advocated taxing us on fuel as well.
Good point, Steve. I forgot to mention in my post that a lot of unscrupulous doctors and hospitals are gouging the insurance companies as well as the government.
If transparency is achieved and free market forces enter into the medical field, then our insurance premiums could (if they are being honest with us) go way down. Why? Because the insurance companies aren’t having to shell out as much money to pay for our care. That could also mean lower or no deductibles or co-pays. And (again if they are being up-and-up), the insurance companies could afford to cover many of the services that we currently pay for out of pocket as well as alternative or preventative medical practices and procedures not currently covered.
I’m not sure why this isn’t being done and why the insurance companies haven’t fought for this. At first glance, it would appear to benefit the insurance companies a lot. They may well be advocating this without my knowledge. Or there maybe dark motives behind ignoring this that I’m not aware of.
Thanks for the post, Lily!
I think we are probably in agreement as to what our “perfect” health care system would look like. I do wish there was pricing transparency – it’s a bit ridiculous that many doctors and nurses have no idea how much their services cost. It’s also ridiculous that hospitals secretly negotiate prices between different insurance companies, so no one really knows the true cost of a service.
It’s a difficult situation, because which should come first? Do we need pricing transparency to wake the consumer up to these problems and drive demand, or do we need consumers to have more freedom in how their dollars are spent (HSAs, HRAs, more choices in insurance plans, etc) so that they will drive the demand for transparency? I don’t have the answers. I just wish people would wake up and realize that socialized medicine is not the answer – so often I hear that someone is all for free market, but that you can’t apply the market to health care…its simply not true. You just have to think outside the box a bit. One of their common arguments is that the administrative costs of running Medicare is so low compared to private insurance. A good counterargument is that one reason those costs are so low is that they have the social-security administration collect their fees; they could also stand to increase those administrative costs given the fraudulent billing practices of some doctors – a bit more oversight wouldn’t hurt in that case (save some of those tax dollars!) – I think this is the point you were making.
As for the insurance companies, you have to remember that they have a financial stake involved in getting people covered. They may be on your side when it comes to transparency that would lower their costs, but they will also be on the side of a politician that requires individuals/employers to purchase insurance – and they will lobby for that mandated coverage to be as extensive as possible (and thus expensive for the consumer).
Anyway, I enjoyed your post and the comments. Keep fighting the good fight!
Great comments Lily.
We’re on the same side. Health care is such a major issue. It all seems so simple from where we stand, but translating anything into reality in Washington is a major challenge.
I, being self employed have to have my own insurance. I pay, 100 dollars a month. I’m married, 29 and see the doctor about 1 time per year. When I do go, I have to pay a 20 dollar co-pay and then another 43 dollars for them to process my labs. I don’t have prescription coverage, and pay roughly 80 dollars a month for my birth control. If I don’t carry insurance and am injured in a car accident, I’ll be paying medical bills for the rest of my life.
Part of the issue with health-care is that people go to the doctor for every whip-stitchin’ issue that they have. They don’t do their best to get over it (via OTC meds and rest), b/c they have no copay or a very low copay. If everyone had to pay every time they went to the doctor there’d be less people going to the doctor for everything. Health insurance is part of the reason for high health care costs. That and the ridiculous law-suits that are brought against doctors.
Furthermore, I can’t write any of my medical costs off my taxes, because it’s always less than the 7.5% allowed. I hope I got that right, Steve!