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Medical SymbolLast fall, I looked into the lack of transparency in pricing for surgeries at local hospitals. Patients are charged based on their insurance, as hospitals and insurers negotiate prices in advance. It can be difficult for patients to comparison shop.

The federal government is pushing for more transparency. This week, it posted online what each hospital bills Medicare for procedures. It found dramatic differences in prices. The New York Times reports:

In Saint Augustine, Fla., one hospital typically billed nearly $40,000 to remove a gallbladder using minimally invasive surgery, while one in Orange Park, Fla., charged $91,000.

In one hospital in Dallas, the average bill for treating simple pneumonia was $14,610, while another there charged over $38,000.

Data being released for the first time by the government on Wednesday shows that hospitals charge Medicare wildly differing amounts — sometimes 10 to 20 times what Medicare typically reimburses — for the same procedure, raising questions about how hospitals determine prices and why they differ so widely.

(snip)

“There’s very little transparency out there about what doctors and hospitals are charging for services,” Mr. (Robert) Zirkelbach (a spokesman for America’s Health Insurance Plans) said. “Much of the public policy focus has been on health insurance premiums and has largely ignored what hospitals and doctors are charging.”

The federal data has good news for Rochester hospitals. All bill Medicare less than the U.S. average. (Use this New York Times interactive tool.) They charge closer to what Medicare reimburses.

There were still disparities, some of them significant, in pricing among Rochester hospitals. Unity charges $22,595 for a major joint replacement. Strong charges $23,475. Rochester General charges $28,345.

The New York Times quoted experts who said hospitals have been raising prices to make up the difference and those without insurance, people who can least afford it, are the ones paying the highest prices.

Links of the Day:

– Average airfare Upstate: Albany: $411 Syracuse: $405 Rochester: $338 Buffalo: $313

– A Monroe High School custodian does students’ laundryand much more.

– Wegmans announces a line of gluten-free products. But one probably doesn’t have to go gluten-free.

– Xerox is closing a call center in Oregon. Call centers are bad economic development.

– Congress has hindered the investigation into the Boston bombing because it does not require better data on guns.

Charles Ramsey, rescuer of Cleveland women, now famous.

 

4 Responses to Step Forward in Transparency

  1. May 8, 2013 at 11:45 am Joe in Spencerport responds:

    Knowing prices beforehand is becoming increasingly important as more and more people are pushed into high deductible plans.

  2. May 8, 2013 at 7:18 pm Animule responds:

    Medicine and education are two industries that have the least transparent pricing.

    This is no accident.

    The cost (to the consumer) of both of these industries is skyrocketing. This is also no accident.

    In order to tamp down price inflation in both industries, consumers need realistic price information to encourage competition. The lack of price information exists to deter competition between hospitals, and between colleges. But competition DRIVES DOWN PRICES.

    Colleges, for instance, shouldn’t have a bogus “list” price and then negotiate “one on one” deals with prospective students. Hospitals are even less transparent. Transparent pricing would help bend the cost curve for both industries the same way it does for almost anything else.

  3. May 8, 2013 at 8:33 pm Orielly responds:

    “Medicine and education are two industries that have the least transparent pricing”

    Coincidentally (or not) they are also segments of our society that are bastions of Democrats and Liberals.

    They both are not operating in “free markets” which is how they want it, and both are opposed to competition, because they say they are “above that”.

    And the fact that their services can and do send numerous, thousands of middle class American families into bankruptcy every year… is never these two segments faults never do they take the blame, for overcharging and not controlling their costs to the marketplace, but rather the blame goes on poor financial management in these affected families.

    Meanwhile the Joel Siglemans of this world, make millions a year leading Medical schools and hospitals, Executives in their insurance industry “non profits’ have 10M dollar retirements, and the First lady can have her income doubled to 350K in a year working as a VP in a hospital where she was hardly ever there, and no one in those business segments questions any of it.

  4. May 8, 2013 at 8:42 pm Orielly responds:

    And Racheal, with most of Rochester outraged at the salary and BONUS being paid to Mr. Perez at Kodak why is no one in your local media having reporting and informing, who are the members of the Kodak board of directors who approved his salary and BONUS?

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