New Data Exposes Scammy Hospital Pricing; Now Let's Crowdsource Some More
from the it's-a-step dept
A few months ago, we wrote about Steven Brill's amazing article in Time Magazine about hospital billing. As we noted at the time, the story confirmed what many people believed: that healthcare is a giant economic scam, and it's often the hospitals (not necessarily the insurance companies) who are driving the massive increases in costs. A big part of the scam is the fact that hospitals don't reveal their price list -- known as the "chargemaster." It's all a giant secret. There's no such thing as comparison shopping. There's simply no data anywhere.Well, that may be changing. The US government just released data on what various hospitals charge for various things, along with how much Medicare actually pays in return. This has quickly resulted in people noticing massive differences in pricing for the same treatment in different hospitals (including, at times, hospitals very close to one another). This release definitely provides some significant data about just how massively hospitals are overcharging for things, even if most patients never pay the listed fees.
Still, it's not quite enough. Brill has responded to the release by noting that while this is a big deal and can be quite helpful in highlighting how broken the system really is (and hopefully will lead to a lot more reporting on the subject), it could go much further:
The feds need to publish chargemaster and Medicare pricing for the most frequent outpatient procedures and diagnostic tests at clinics—two huge profit venues in the medical world. But an even bigger step toward transparency would be collecting data that Medicare doesn’t have: exactly what insurance companies pay to the various hospitals, testing clinics and other providers for various treatments and services.While hospitals and insurance providers clearly will not want to give up that information, Bill points out that patients do find out this information, so perhaps we should crowdsource the data:
After all, as the hospitals themselves concede in downplaying their chargemasters, these insurance prices are the ones that affect most patients.
And that is one price list where there is close to zero transparency.
So even if insurance companies don't want to participate, Brill writes, states could crowdsource price information from patients:For a market to work in any effective manner, pricing information must be clear. It's not that way at all in healthcare, and it needs to get that way fast if we're ever to get healthcare pricing under control....state pricing centers could gather the information from patients who volunteer, in exchange for a promise that their names won't be used, to submit their Explanations of Benefits. After all, a hospital or insurance company can't claim a patient can be prohibited from talking about or making public his or her own bill.
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Filed Under: chargemaster, crowdsourcing, data, healthcare, healthcare costs, hospital pricing, medicare, steven brill
Reader Comments
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Yup
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Re: Yup
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I'm confused by this comment. You can't be arguing that the type of fraud you mention is somehow better and not worthy of outrage, can you?
In any case, the problem of doctors ordering useless procedures is enormous. And it's mostly a US problem, related to two things:
How we pay doctors. They get paid by the procedure instead of a flat rate salary. The more tests a doc orders, the more money he makes.
Malpractice lawsuits. If the doctor fails to detect a condition that a test would have revealed, he can be subject to a malpractice suit. Even if he wins, his rates go up. Therefore, the common CYA procedure is to order every test that might be remotely related to the symptoms the patient is presenting.
The worst part of all this isn't really the money (as bad as that is), but what the AC mentions. All tests have a false positive rate, and some of those useless tests will indicate a problem that doesn't exist, resulting in treatment that is unnecessary. And sometimes harmful.
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Re: Yup
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Copyrights
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Re: Copyrights
Theyve got a good scam going for now.
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Re: Copyrights
As the link says, "secret ingredients" and the like would be filed under trade secrets... which has a somewhat different set of rules that aren't quite as... helpful.
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Are you insane?
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They could get therapy, but that is waaaay expensive.
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Unless their lawyers are completely insane or stupid, I think at that point they'd probably drop the threats.
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"We can crowd source but we can't publish the data since the hospital must have a copyright on it and most likely will exercise their rights."
See...turning it into a copyright game..
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But without a price list, you can't comparison shop, even for planned care. And if you can't comparison shop, then there's no incentive (or any reason at all) to compete.
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You may be able to pay the $129, but the 9 other people who come in for the same procedure won't pay it, so they make you pay for them by jacking the rates.
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I smell bogus trademark and DMCA claims coming =)
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Entrepreneurial docs, too
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Bullshit.
Sorry to curse, but these legislators have no clue what they're talking about (no surprise there).
Anyone who has insurance knows we're locked into a very specific group of health care facilities. In order to save money, we're required to stick with these facilities and physicians.
And the hospitals know it, which is precisely why they charge what they do.
Should the law pass, I still won't have a choice to select the hospital which charges less for the same procedure.
But thanks, government, for pretending this is an issue Americans need so they can sit back and fume they can't make a choice because their insurance prevents it.
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And then there's specialty care. I was born with congenital heart problems, and normal cardiologists know ZERO about congenital heart problems because everyone used to die very young who had such a problem.
Two years ago I landed in the hospital with stomach problems (ulcers were blocking almost the entire path from my stomach to the rest of my digestive system, the medicine to treat it wasn't working). The first hospital I went to was right next to my home. That hospital's doctors were all ready to do an MRI to find out the exact problem and do surgery to fix me, but the cardiologist, knowing nothing about congenital heart problems, didn't feel comfortable caring for me, and wouldn't approve anything. So they had to transfer me to another hospital.
While that other hospital did cure me with surgery eventually, they took forever, and moved so much slower, to the point that we started to openly wonder if they were moving slow on purpose to milk as much money as possible from the insurance company (because I was requiring several bags of expensive IV fluids a day, it wasn't until after I was well enough to not need them anymore that they seemed to actually start pushing to get me out of there sooner rather then later).
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Re:
- a public health system that competes with the private (transport included)
- escalate taxes for expensive hospitals
- downright punish abusers with fines
- tight regulation (ie: forbid charging more than the market average for medicine and others while leaving internal costs such as the appointments with the doctors or lodging/accommodations when needed and always to a limit that can be discussed)
You see, capitalism doesn't care if you die, it cares about profit. Sometimes societal rejection will prevent some predatory behavior. Other times regulation is needed.
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I wouldn't let any ideas of how hospitals will try to keep their privacy regarding pricing prevent any efforts to start revealing the big picture.
The days of hospitals seeing the sick as patients has long been replaced with the business of healthcare and customers. Administration has trumped doctors and nurses for a long time.
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There is a need for emphasis here
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I like this.someone said what if it is Copyrighted......Well it will get Crowdsourced anyways legal or illegal.
We are all being taken to the cleaners and we are going to get this all in the open.
To bad if you do not like it.The Public will really want to know if they are being thieved or not.
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At least three variables to compare
1. The price.
2. The quality of care.
3. Do you actually need it?
I've been shopping online for dental care lately and have found relatively little helpful information.
Some websites post prices, but usually they are average prices (not what individual dentists charge).
Some dentists have lower prices than others, but the most recommended dentists seem to be the least in need of using competitive pricing. So you wonder if lower cost also means lower quality.
Finally, other than the basics, a lot of dental services are pitched like services and the websites tell you why you should get a procedure done. Trying to find unbiased info is hard. And, unfortunately, some dental services are trendy. They are popular now, but then in ten years from now, you find out whatever you were talked into having done in the past is no longer recommended.
I suppose ultimately I prefer to get info on how to avoid needing health care in the first place.
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Re: At least three variables to compare
It's not easy finding the right person to work on your car or on your body.
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From the other side...
(Wow, that turned into a rant there...oops!)
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Re: From the other side...
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Try this one out
Seems to be getting at what the article is describing...
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