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Perspective: Skyrocketing health care costs are caused by political corruption

Perspective: Skyrocketing health care costs are caused by political corruption

Picture of Steven Weissman

I am going public to reveal the astonishing truth. There is a simple way to instantly, with ease, end our nation’s health cost misery!

When the founder of a Miami area hospital, who was a longtime friend and client died, I became interim president. The insider’s view of the healthcare system is enough to make anyone sick.

Healthcare is the only industry exempt from the rigors of the U.S. free market system. Ask the price of any healthcare service and you will always receive the same answer: “What insurance do you have?” Billing is determined by how much can be extracted from each patient on a case by case basis. It is a predatory system that is built on the destruction of free market economics through political influence.

Value and market price are entirely irrelevant concepts. Patients who are out of network or uninsured are routinely charged 10X more than “normal” rates. This is fraud in any business – except health care.

Because there are no actual prices for medical services, there is no price competition. Without price competition, there is little resistance to charges that continually skyrocket far in excess of the inflation rate.

Price gouged consumers have no practical way to defend themselves against unreasonable medical bills. Litigation entails retaining an attorney plus an expert witness to testify regarding the reasonableness of the amount billed. In virtually every case, the cost of litigation makes defense against medical price gouging impractical. The result is health costs are the leading cause of personal bankruptcy.

Last summer, the New York Department of Consumer Affairs made national headlines when it forced Whole Foods to admit the company short-weighted customers. Our government employs thousands to protect consumers from being bamboozled on an ounce of ham, gasoline or for a fraction of a percent on a mortgage or credit card loan. However, when it comes to healthcare pricing, consumers are abandoned and health providers are shielded from free market competition.

How did we end up with predatory healthcare pricing? Pricing has been rigged by the industry that pumps, by far, the most cash into Washington. The healthcare industry spends more on lobbying than the defense, aerospace, and the oil and gas industries combined. Morally corrupt politicians have allowed the industry to foist upon our nation the highest cost medical care on earth, by a margin of at least 50% per-capita, while providing significantly lower quality than exists in other wealthy nations.

The currently fashionable concept of price transparency will not ameliorate the health cost crisis. A simple blood test for cholesterol can range from $10 to $400 or more at the same lab. Hospitalization for chest pain can result in a bill from the same hospital for the same services ranging anywhere from $3,000 to $25,000 or more. Transparency would merely show that each healthcare provider charges extraordinarily wide-ranging different prices for each service it provides and continue to sow price confusion.

Laws requiring health providers to publish price ranges or average prices are growing in popularity. Such so called “price transparency” serves as a public relations gimmick to relieve ever mounting public pressure on elected representatives. Simply put, each of us is entitled to know the actual price we will be charged for our healthcare. Limiting disclosure to price ranges or averages, while permitting providers to predatorily bill each person a different amount, unfairly benefits providers at the expense of all patients.

The solution is for Congress to require healthcare providers to publish actual prices, just like all other businesses. All patients, insured and uninsured, should be billed the same published rate for the same service. Hospitals, physicians and labs should have continued freedom to set their own prices, but predatory pricing — a different rate for each patient — must end.

When rates are set, patients will be able to shop for good healthcare value. Providers will be forced to compete based on price, quality and service. Healthcare costs will plummet.  The cost of health insurance, which is simply a direct function of underlying medical costs, will plummet as well.

Requiring actual healthcare pricing — the essential ingredient of a free and competitive market — is the only thing necessary to instantly cure our sick healthcare system.  It really is simple.

Public pressure on politicians is essential to bringing this horrendous abuse to an end.

 

Comments

Picture of <span class="username">Guest (not verified)</span>

As a care giver, I am astonished at the cost AND the waste of prescription drugs plus all the unnecessary MRI's etc just to cover the Doctors legal obligations. Stupid, stupid. And why can there not be some simple way to recycle all those wasted medications when a patient dies or is required to take a different medication for various reasons than the one they are presently taking.

Picture of <span class="username">Guest (not verified)</span>

The healthcare mess in America is caused by two things: (1) healthcare insurance companies and (2) big Pharma.

END OF SUBJECT.

Picture of <span class="username">Guest (not verified)</span>

Maybe if congress had their free healthcare taken away and had to pay out of thier own pocket just maybe things would change

Picture of <span class="username">Guest (not verified)</span>

This is horribly disgusting that the neediest people are being cheated out of even more than they cheat the rest of us!

Picture of <span class="username">Guest (not verified)</span>

My wife used to have some test in CA and a town in IL(home). For similar tests, the costs in the hospital in IL is 20x higher than the one in CA (urgent care)!! It's totally unbelievable!!
We don't have enough money to pay the bill anyway. Have to apply the medical assist program from the hospital. Cross fingers.

Picture of <span class="username">Guest (not verified)</span>

I've seen first hand how prices are different depending on insurance.

Picture of <span class="username">Guest (not verified)</span>

Implement Mr. Weissman's suggestion to PUBLISH, publically, the costs of goods and services used in an individual's health care. Allow market forces to work! Take health care off its high-priced pedestal!

Picture of <span class="username">Guest (not verified)</span>

The idea that price compedtition would cure the health cost problem is a simpletons daydream. Adam Smith, the economist who defined the open the competitive market delineated 10 conditions necessary for free market competion to exist. Known prices is indeed one of them but the market for hospital care does not have the other 9. Focusing on price will lead to more of what Florida's current governor did with Hospital Corporation of America -- Commit the biggest fraud aggainst the USA and they paid the biggest fine ever levied.

Picture of <span class="username">Guest (not verified)</span>

Thomas, you can't spell and you don't know what you're talking about.

Picture of <span class="username">Guest (not verified)</span>

I don't think the author is proposing that increased transparency will necessarily cure the current disrepair in the US health care system. Clearly, there are numerous factors that you address... as well as issues with monopolies held by drug companies with patents. Increased transparency to the consumer (patient), however, does lead to less behind the scenes price gouging by insurance companies and is a start for creating some level of standardization. MCare reimbursement rates are set, however, little else is in terms of what is actually charged.... which is where many problems arise. Reimbursement rates do not match what is being charged, by a long shot.

Picture of <span class="username">Guest (not verified)</span>

Thomas you must work for the "Government Sanctified Protection Racket" Alias...The insurance companies who are ripping us off.

Picture of <span class="username">Guest (not verified)</span>

Thank you for writing this article and for offering a solution. I hope we can see change soon

Picture of <span class="username">Guest (not verified)</span>

I am so thankful that Mr. Weissman is shining a light on this enourmous problem. Only someone from the inside can really speak about the predatory practices and be taken seriously.
Thank you !!

Picture of <span class="username">Guest (not verified)</span>

As someone who has suffered the consequences from such a predatory system, I thank you for your honesty and courage to expose the truth.

Picture of <span class="username">Guest (not verified)</span>

I understand this all too well, that corrupt politicians are getting kickbacks from the Healthcare industry, including the Pharmaceutical corporations especially! They charged me with a bill I cannot pay, for services they claim were rendered, and in reality were not! I know of other people that have also been charged in the same way. As one that cannot qualify for the supposed Affordable Healthcare for Everybody (AKA Obamacare), I suspect my bill was even higher due to that. I have also noted that the same service rendered, or treatment is often cited twice by many healthcare facilities, inferring the cost twice, for things like drugs administered, items provided, and the like. A bedpan will often show as being charged for two times on one bill, though the patient only received one, and most often never even needed or used it!

The medical community has become about uncontrolled profiteering, with competition removed from the process so that price can be at the provider's whim. It is greed in the most heinous form. The Hippocratic Oath has no meaning anymore!

Picture of <span class="username">Guest (not verified)</span>

What you say is very true; but there is another reason for excessive health care costs: the excessive salaries of the CEO's of HMO's, PPO's, and the CEOs of health insurance companies and their cronies.

Picture of <span class="username">Guest (not verified)</span>

You left out the CEOs of the for profit and semi-profit hospitals, testing centers, etc.

Picture of <span class="username">Guest (not verified)</span>

What you say is very true; but there is another reason for excessive health care costs: the excessive salaries of the CEO's of HMO's, PPO's, and the CEOs of health insurance companies and their cronies.

Picture of <span class="username">Guest (not verified)</span>

I applaud Dr. Weissman for talking about something so true that most avoid. Everything he says on his article is true and I should know. If doctors know that you have a good insurance they will test you to no end and will even tell you that you need surgeries that someone with not enough common sense will believe thus making very good money off of you and this is another very good reason why they raise insurance premiums every year. My co-workers (all 2,000), friends, family and I could take better care of ourselves; unfortunately with what they charge for labs and other care is impossible. How do we get rid of corrupt people in Congress when they have been there so long and "owe" everyone favors that they will never change or, better yet, leave so someone honest can take their place. It is time we really speak up and unite to end this, not just for our sake but for the sake of our elderly and future generations!

Picture of <span class="username">Guest (not verified)</span>

Healthcare costs should be transparent and equal for all people! People have a right to know what their healthcare will cost, and the idea of charging different prices for the same services is outrageous! The price should be the price whether or not a person has insurance! People in this country go without needed drugs and health care for monetary reasons and this is an unforgiveable disgrace!

Picture of <span class="username">Guest (not verified)</span>

It's so very hard to believe that after all these years of fighting for a healthcare system that works for the Country's many, is put in the hands of the few, (save some true reformers) whom have no interest in the health of the Country, it's people and the system itself. How did this Country get so flushed with greed? A very sad awareness of such blessed nation.
I do believe one thing; insurance companies sucks so many dollars out of the system, dollars that can be used to heal, to research, to build an even better infrastructure of healthcare the world has ever seen. It's preposterous, and it seems "it's ok", for the power they hold keeps our politicians and constituents alike SILENT.

Picture of <span class="username">Guest (not verified)</span>

Finally, something written about healthcare that actually makes sense!!

Picture of <span class="username">Guest (not verified)</span>

Dear author,

Did you work for a for-profit hospital because this is *NOT* at all how all healthcare providers work. I work at a not-for-profit hospital and all of our charges are based on MEDICARE REIMBURSMENT SCHEDULES. We don't constantly adjust our pricing for each payer because that would be ludicrous (we deal with probably close to 30 different payers and that's not including the non-contracted subsidiaries who all have their own rules). You want to know why a hospital visit costs an arm and a leg? Because health insurance payers only pay healthcare providers a *FRACTION* of the bill. Also, when it comes to patients paying their own bills I think you're pulling that "10X" figure out of somewhere dark and empty because most healthcare providers offer a 40-60% *discount* on self-pay. Granted, that can still mean enormously large hospital bills, but that's why not-for-profits like my hospital have financial assistance programs that completely write off patient's debts who are uninsured and don't have the means to pay their bills. Again, you may have worked at a for-profit hospital but if you want to go after the *REAL* bad guys, go after the health insurance payers. You know, the one's who take 20% of people's pay checks every year but when the patient has to actually use the service they've been paying for go "oh...yeah I don't see why we need cover that medication" or "oh, you needed heart surgery? Yeah well you didn't acquire an authorization from us to do so ....yeah". Sorry if this whole posts sounds like an attack, but you don't seem to have the whole picture and admittedly neither do I so I figured I would post a counter argument to keep a mob of ignorant readers who have no concept of how health care providers and insurance providers interact.

Picture of <span class="username">Guest (not verified)</span>

Dear Matthew, many of us have worked for non profit hospitals for years and in my experience every "accepted 3rd party insurer" has a contractually negotiated reimbursement rate with the hospital and they're rarely all the same. Hospitals (profit and non profit) don't universally bill and accept payment based on their Medicare Rate Schedules (which vary based on many criteria but are cost based) and hospitals routinely inflate the price of services knowing that they will collect only a percentage of their billed charges. The only folks really getting the shaft in that arrangement are the private pay patients who have no or inadequate insurance. To the normal patient unlucky enough to end up in the hospital without adequate insurance or financial resources, some Hospitals offer relief in the form of charity and charge write-offs. Many others decline all services to Medicaid patients. Make no mistake, hospitals routinely get reimbursed by the donations to their associated charities in this charity scenario. Public or Municipal hospitals may actually take a financial hit but that shortfall is routinely covered by taxpayers in the form of bonds, levies or general taxes. There is little to no incentive for health care providers to control costs in the absence of standard costs for health care services. Moreover, there's often a disincentive in the form of capital spending on unneeded, impractical or overly expensive equipment to ensure not loosing out on next year's capital budget that are built into the rates. Cost plus is the same nonsense that governments use when awarding federal, state or local government contracts. Truth is, unless there's someone pushing responsible cost management, and I understand government is rarely the best at this, hospital and health care costs escalate well beyond the movement of inflation, wages, or any other reasonable standard of measurement. As you point out, insurers are a huge part of the problem as well. Attempting to dictate the standard of care for any patient shouldn't be in the hands of health insurers and their political associates. Further, insurers are a problem with routine double digit annual increases in premiums to employers, but so is fraud, waste and abuse (this has nothing to do specifically with Obamacare, fraud, waste and abuse have been around in healthcare for years). For every hospital that accepts cash discounts and provide charity care, there are many others that turn patients away for lack of insurance/resources. I don't know the solution, I'm not blind to the regulatory issues in healthcare but shedding a continuous light on the problem certainly can't hurt and many of us are not ignorant readers! Thanks for your post.

Picture of <span class="username">Guest (not verified)</span>

I was recently part of a clinical trial for a Psoriasis medication. It worked wonders, almost completely clearing up my Psoriasis and keeping my arthritis in check. The trial ended in the beginning of May. Since then, my health has gone downhill. The drug (Xeljanz) is on the market and Medicaid DID approve my prescription for it, but it's only half the dose that I was taking while part of the trial. I've only been taking it for a little while, but so far it doesn't seem to be doing much. My Psoriasis has improved, but both my knees hurt and my entire lower left leg is swollen. It's possible that this lower dose won't have the same effect as what I was taking during the trial. To equal the trial dose, I would need twice the amount of pills and I doubt that Medicaid would pay for that, since the cash price listed on the slip for the existing prescription was $4,040!

The company has some financial assistance programs available, but only if you're NOT on medicaid.

Picture of <span class="username">Guest (not verified)</span>

Matthew J -- The fact that certain institutions (like yours) take a charitable approach is admirable. But you are obfuscating Steven Weissman's point. nothing you say changes the strength of his point in any way.

His point is, prices are systematically hidden from the the actual customer -- the patient -- receiving the service. This makes it utterly impossible for that customer to shop around for the best value. You can't deny this! The fact that you deal with 30 or 3000 "payers" has nothing to do with Weissman's point. Medicare reimbursement has nothing to do with his point. Everything you say may be valid, and maybe it further complicates the already outrageous health-care landscape Weissman describes. But allow for all of it, and it's still impossible for me, if I need a medical test or procedure, to find out where I can get the apples-to-apples best price for the best quality and service.

Nothing you mention -- not Medicare reimbursements, not your hospital's case-by-case magnanimity, nothing -- does anything to inject free-market competition into the system. Nothing you mention deters any doctor, or hospital, or pharmacy, or insurance company from price-gouging patients at will. Patients remain completely in the dark. We have no idea what we <i>ought</i> to be paying or what we <i>could</i> be paying. In that predatory environment, it is inevitable that prices skyrocket. Make it competitive, and prices will fall (assuming they're too high on account of non-competitive price-gouging, as we all know they are).

But hey -- if everything is just as you say, then why don't you publish your fees and prices? For everything? Why not join Weissman in campaigning for a law requiring that every other provider in your industry publish them as well? If you are everything you profess, you'll survive the increased competition far better than most of your fellow-providers.

Finally, what makes you believe "most healthcare providers offer a 40-60% *discount* on self-pay"? In nearly 30 years of self-pay health-care, I never once was offered any such discount. In nearly every case, if I needed surgery (or anything else), I was billed (and required to pay) the full prices that the doctor and the hospital would have billed my insurance company, if I had had insurance. After prolonged negotiations, I typically ended up paying those full prices to avoid a collection lawsuit. And I did so knowing that -- as you rightly say -- the insurance company would have paid only a fraction of that. Too bad you weren't around to write off my debt, as you say you'd have done!

Picture of <span class="username">Guest (not verified)</span>

You remind me of things I knew and had forgotten. Thank you for your clarity of thought on the matter.

Picture of <span class="username">Guest (not verified)</span>

As someone who uses a health share ministry for health care, I have NEVER been offered a 40-60% discount, and believe me. I ask about discounts politely. I'm lucky to get 10%. When my son had his appendix out, the local children's hospital offered a big fat zero percent discount and initially wanted $800 monthly payments. It took a professionally trained negotiator to reduce that amount to something more reasonable. Hospitals would rather have you apply for medicaid, and if income guidelines are met, then you can apply for their needs based program. I guarantee we would qualify, but we don't want medicaid. We utilized medicaid for a time after our second child was born and there is a noticeable difference in how medical personnel treat you (assume you are less intelligent). We prefer to stand on our own two feet, but the result is being penalized in the medical billing office. My current doctor offers a 20% discount, but only when I call after the bill arrives. That is the greatest discount I've ever received in 15 years of negotiating, so this 40-60% claim simply is not true.

Picture of <span class="username">Guest (not verified)</span>

The cost for insurance is insane, but you cannot be turned down for pre-existing conditions. The Insurance Companies are trying to make money in other ways, with the tier system which is a scam no matter how you look at it. My hospital
agreed and wrote off a co-pay. The financial aid offices in For or Non Profit Hospitals are a joke. The only way you can get out of paying what you owe is to die or be so poor, you can't pay attention!

Picture of <span class="username">Guest (not verified)</span>

Just set rates for all providers (hospital, physicians, Pharma, ancillary) for all lines of business. medicare rates or Medicaid rates take your pick BUT if the provider decides not to contract make the rates paid to non-participating providers 10% less. Problem solved. Big Pharma the same 340b rates become the rate and close the loophole that big Pharma rates for 340b that allows for rate increases set by big Pharma. Same rule here if the drug company decides not to contract but provides the service or drug then the rate is 10% less.

All innovation then will be focused not a doing more with less efficacy but efficacy for less! Little known fact one third of all healthcare spend is medical appropriate but completely unnecessary. That's one trillion a year folks!

Picture of <span class="username">Guest (not verified)</span>

Everyone wants to make somebody else the reason for out-of-control pricing, but any argument so concocted does not refute the author's main point that firm pricing improves free market function. Forcing hospitals to publish actual prices would allow consumers to be better stewards of their healthcare spending. (It's up to them if they take advantage of that.) When a car repairmen gives me an estimate he tells me the exact price of a part he will use and an hourly rate for labor. A hotel tells me the daily rate for a room and then charges me for the extras that I choose to utilize, along with an exact price. Hospitals should do the same thing. I cannot imagine a consumer being happy going to the grocery store and being told that the price of milk is between $5 and $37 per gallon and that you will find out at checkout.

Picture of <span class="username">Guest (not verified)</span>

LIES WE BELIEVE....Here’s a lie some believe: Not-for-profit hospitals don’t make a profit.…Not really.
“Not-for-profit” means they don’t pay tax. That’s what it really means.
And what a competitive advantage that grants a hospital when they have no tax burden whatsoever. Imagine what your life would be like if you did not pay taxes at all. How would your standard of living change?
You can tell these so-called not-for-profit hospitals are interested in making a profit just by looking around and seeing all of the billboard advertisements, or seeing television advertisements during the Super Bowl, or watching them buy out physician practices in an effort to maximize their market share in a community.
“Not-for-profit” means “does not pay tax.” So how do they achieve the accounting fiction of not making a profit? Well, they do this by looking for red ink wherever they can find it. You see, many of these not-for-profit hospitals are making so much money, they have to find red ink wherever they can. Even if they have to invent it with fictional, gigantic hospital charges.
What they don’t collect, they write off as a loss, which helps them maintain the fiction of their not-for-profit status. This is a lie I think many of you believe, and it’s a good one to start telling the truth about..

Picture of <span class="username">Guest (not verified)</span>

This is so True! In April this year I had Ct scans done of my chest, abdomen and pelvis at a hospital. My co-pay was $100, medicare paid $243 for a total of $343!! The total bill that I did not have to pay was $5346.00!!

Picture of <span class="username">Guest (not verified)</span>

As the House of representatives is completely stalled for a sit-in by said PAID members of Congress, this garbage about predatory pricing goes unchecked. Unbelievable

Picture of <span class="username">Guest (not verified)</span>

so how can the average American make a difference?? How do we change the system?

Picture of <span class="username">Guest (not verified)</span>

no one should go bankrupt bc they got sick! Washington needs to stop taking lobbyist money and remember why they have the job they do!

Picture of <span class="username">Guest (not verified)</span>

Thank you for this piece, I share the view entirely and am sharing it on social media.

Picture of <span class="username">Guest (not verified)</span>

Non profit hospitals may not mark up services as much as profit based ones, but non profit hospitals are not very common. All the hospitals around my area are ALL for profit! I would give anything for the days when hospital's main goal was healthcare, NOT the all mighty dollar!

Picture of <span class="username">Guest (not verified)</span>

Of course for profit and non-profit hospitals work the same. Matthew J can claim that his place uses 'Medicare rates', but he doesn't say what percentage of Medicare rates he charges. If he's giving 40 to 60 percent 'discounts' to people without insurance, then he is admitting that he marks up his own prices by a minimum of 100 percent; otherwise he would not be able to cover his costs. But I'll bet he marks it up more that that. It doesn't matter, though. He says it's all the payer's fault. And if all payers were to shut down, would you cut your costs by 40 to 69 percent? Somehow I doubt it.

Picture of <span class="username">Guest (not verified)</span>

Matthew,

You mentioned that "most healthcare providers offer a 40-60% *discount* on self-pay."
I live in the Los Angeles area and the only self-pay discount I have received is for X-Rays and MRIs.
I recently had to take my son to the ER. My insurance covered nothing. I paid $1800 for one x-ray and 120 seconds of the attending physician's time. I was told by the hospital billing department that since it is a not-for-profit hospital, my bill would have been $300 if I was uninsured.

Picture of <span class="username">Guest (not verified)</span>

Thank you for putting some light on why costs are so crazy. I think you're very courageous to come forth with the information. Health care cost controls were not put into the federal "heath plan" because of all the people who want to scam as much as they can from the federal government. Everything around us is failing the citizens of this country while the RICH are getting richer and the middle class is disappearing. This is definitely one of the reasons. How sad.

Picture of <span class="username">Guest (not verified)</span>

Thank you Steven for an excellent article. You say "When rates are set, patients will be able to shop for good healthcare value." However, if most patients are covered by insurance, they won't price shop unless it means money out of their pocket. This seems like a big potential downside to your proposal. Any comment?

Picture of <span class="username">Guest (not verified)</span>

I find a lot to agree with above, but I take issue with the idea that health care can really be a free market commodity. For market forces to operate, people have to have options and decide what value is worth what expenditure, and be able to freely select among competing products and services. Health care in this country currently operates by limiting people's choices, even in the non-emergency situations where they have no choice other than get to the nearest ER or trauma center or die, with no time for market research. Fee-for-service results in incentives to provide more services. Capitation results in incentives to avoid providing services. Cherry-picking, excluding pre-existing conditions, and refusing "experimental" care in an arbitrary manner results in people being unable to get the right care for their condition and ending up with expensive emergency care and a poor quality (and sometimes quantity) of life. The PPACA was a huge step in the right direction in that regard. When all people ages 18-65 can go to the doctor when they are sick without risking medical bankruptcy or being unable to pay the rent or mortgage, we will have a healthier workforce, and it really should be seen as an investment rather than derided as a frivolous "entitlement" that people do not deserve; price and reimbursement controls must be intelligently structured and designed to make it work for both patients and providers.

Picture of <span class="username">Guest (not verified)</span>

The whole health care industry needs revamped. Hospitals started charging exorbitant prices after hospitals were closing because they couldn't afford to stay open but instead of inflationary rates they went extreme. Health insurance shouldn't be Obama care because it's against God and they should let people take a vote on insurance for the whole country instead of the government deciding for the people that's not a we the people government. Also, the cost of items should be posted for people to know and not just find out the cost when your billed.

Picture of <span class="username">Guest (not verified)</span>

These are all facets of our price gouging for profit medical system. Far and away the most expensive in the world, yet decidedly substandard. The massive lobbyist spending assures that our corrupt politicians don't enact consumer protection laws to regulate the health industry (which includes hospitals, pharmaceuticals, insurance companies, CEO salaries etc.). A single payer system could solve SOME of the waste, yet it's enactment has been blocked for years. It's a national disgrace that we should all be ashamed of.

Picture of <span class="username">Guest (not verified)</span>

I have two stories to tell. When I had back surgery in 2003 I was in the hospital for 18 hours. My hospital bill (excluding surgeon and anesthesiologist) was $13,000. My insurance company had a contract in place where the total that they and I together would be responsible for was 50% of this amount (ie $6500). My excellent insurance paid 90% of this $6500 and I paid 10% (ie $650 out of pocket for me). Other insurances have different contracts for the rate and the amount that they will pay. Someone with no insurance gets billed for the $13,000 dollars and this is what they are responsible to pay unless they get the hospital to enroll them in a "charity care" program or they file bankruptcy, or they die. I also worked in a dialysis facilty for many years. The medicare rate for a dialysis treatment at the time was $125, of which medicare paid 80% of this and the patient paid the rest. Privately insured patients were billed $500 per treatment by our facility and depending on their insurance contract would have different amounts that had to be paid (between the insurance company and the patient together) which may have only totalled 1/2 of the $500 or could have been somewhere else along line between 1/2 of the $500 and the entire amount. I agree, this system needs to be fixed because the cost for the same service does vary greatly depending on the type of insurance company and negotiated contract that they have with the hospital/health care organization and the cost is rarely discussed in advance of the service provided.

Picture of <span class="username">Guest (not verified)</span>

Steven Weissman's faith in the free market is deeply touching but misplaced. While he addresses one (of many) problems with our health care system, his solution misses the point. If I suddenly suffer intense chest pain, does Weissman really believe that my first impulse will be to check with Google to find the hospital offering me the lowest, transparent price for a treatment? When Gilead Pharmaceutical charges $90,000 for a treatment for Hepatitis C, Sovaldi, that costs them around $200 to produce, openly and transparently, we are seeing the 'free market' at work. Note that in Switzerland, health insurance providers refuse to pay this price and Sovaldi is not available to patients unless they pay for it themselves. Price transparency is a good idea but in my opinion will not significantly reduce medical costs.

Picture of <span class="username">Guest (not verified)</span>

I spent 3 days in the hospital all because my blood pressure was low and they claimed they couldn't find a reason for it, i got exrays,catscans,and an MRI.i saw a orthopedic doctor, a cardiologist,an ear,nose and throat guy,a hospitalist (what ever that is ) nurse practioners,phlebotomists , physical therapists etc.... 27,800 dollars all for....as it turned out to be low potassium levels caused by medication prescribed by my physician.as my company is self insured, they are exempt from any rules that applies to insurance companies, i ended up paying 4,000 out of my own pocket because some of these procedures were deemed not necessary.

Picture of <span class="username">Guest (not verified)</span>

I spent 3 days in the hospital all because my blood pressure was low and they claimed they couldn't find a reason for it, i got exrays,catscans,and an MRI.i saw a orthopedic doctor, a cardiologist,an ear,nose and throat guy,a hospitalist (what ever that is ) nurse practioners,phlebotomists , physical therapists etc.... 27,800 dollars all for....as it turned out to be low potassium levels caused by medication prescribed by my physician.as my company is self insured, they are exempt from any rules that applies to insurance companies, i ended up paying 4,000 out of my own pocket because some of these procedures were deemed not necessary.

Picture of <span class="username">Guest (not verified)</span>

I worked for a non profit hospital and your account is not accurate of a non profit. They only get paid a fraction of what the bill is worth especially from medicare.

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