Trump administration orders hospitals to post pricing

[dobieg]

Donald Trump Did Something Right
His administration has ordered hospitals to reveal their prices. If patients and politicians pay attention, this could be a big deal.

By Elisabeth Rosenthal
Dr. Rosenthal was an emergency room doctor before becoming a journalist.

As Donald Trump was fighting with Congress over the shutdown and funding for a border wall, his administration implemented a new rule that could be a game-changer for health care.

Starting this month, hospitals must publicly reveal the contents of their master price lists — called “chargemasters” — online. These are the prices that most patients never notice because their insurers negotiate them down or they appear buried as line items on hospital bills. What has long been shrouded in darkness is now being thrown into the light.

https://www.nytimes.com/2019/01/21/opinion/trump-hospital-prices.html



This might,..might,....be an important step in reeling in out of control health care costs. If hospitals are required to post pricing, in theory that should cause competition and hopefully drive down pricing as hospitals would likely compete with each other.


This is one of the reasons I trust Trump more than Democrats. He tackles the underlying issue of healthcare cost vs just throwing boundless amounts of money at the issue. If ObamaCare would have looked at reigning in costs along with insuring more people, perhaps millions like myself would have gotten behind it.

 

[Slyfox696]

https://www.nytimes.com/2019/01/21/opinion/trump-hospital-prices.html



This might,..might,....be an important step in reeling in out of control health care costs. If hospitals are required to post pricing, in theory that should cause competition and hopefully drive down pricing as hospitals would likely compete with each other.

Sounds great in theory, and something I probably would have hailed a couple years ago. However, I now have a family member with a job in the legal department in a hospital and, quite frankly, while this sounds great in theory, it is not very practical in reality. In fact, it can actually lead to more confusion, as every case is different.

If nothing else, getting people to understand this is a baseline price and the charges are likely to increase from there is a good thing, but I think it needs to include the fact the prices are only a starting point and not an ending point.

 

[Praxas]

https://www.nytimes.com/2019/01/21/opinion/trump-hospital-prices.html

This might,..might,....be an important step in reeling in out of control health care costs. If hospitals are required to post pricing, in theory that should cause competition and hopefully drive down pricing as hospitals would likely compete with each other.


This is one of the reasons I trust Trump more than Democrats. He tackles the underlying issue of healthcare cost vs just throwing boundless amounts of money at the issue. If ObamaCare would have looked at reigning in costs along with insuring more people, perhaps millions like myself would have gotten behind it.

We will need to see, but I'd wager that Hospital prices (while they may differ some) are around the same price for most of the common procedures which is still way to high for an end user. The cost benefit to the end user, compared to what insurances pay, will be negligible. I'm not against this and I actually agree with Trump on this, but I just don't think the results are going to really change anything because there really isn't a difference in price between hospitals on common procedures.

 

[sangha]

https://www.nytimes.com/2019/01/21/opinion/trump-hospital-prices.html



This might,..might,....be an important step in reeling in out of control health care costs. If hospitals are required to post pricing, in theory that should cause competition and hopefully drive down pricing as hospitals would likely compete with each other.


This is one of the reasons I trust Trump more than Democrats. He tackles the underlying issue of healthcare cost vs just throwing boundless amounts of money at the issue. If ObamaCare would have looked at reigning in costs along with insuring more people, perhaps millions like myself would have gotten behind it.

While a step in the right direction, it is far from an important one, nor does it do much to tackle the problems of healthcare costs.

For one thing, as Slyfox points out, the baseline price is not what one pays. It is merely the starting point used to determine what a procedure will cost for a specific individual. For another, individual patients do not get to choose which procedures they will be having, nor do they know what they are, or what the DRG codes are for those procedures. Then add in the fact that insurance coverage also determines the price --depending on what fee the insurance company has, or has not, negotiated with the hospital, and you end up with the patient being unable to determine what the actual price that will be charged for the procedure. And then there is the fact that most people will be covered by their insurance and will pay little to nothing for the services, eliminating the incentive for them to put in the large effort required to compare prices.

 

[Xelor]

This idea, by my reckoning, sounds good, but given the nature of how healthcare delivery works, is toothless. The price disclosure stipulation doesn't at all address the "underlying issue" because, contrary to what you've noted, the underlying issue isn't the cost of healthcare. The underlying issue is the economic structure/model of the US healthcare system: healthcare practitioner labor model, care delivery and care payment. The system structure is that of a confluence of monopsony and monopolistic competition, both being further "effed up" by entrenched and enthusiastically embraced moral hazard.

I don't oppose having hospitals post their prices for goods and services; however, I think their doing so will have little to no impact on the prices of those goods/services. I think it will be ineffectual to the end of lowering prices because:

• Hospitals don't with one another compete for care receivers' spending:
  • Care receivers choose doctors based, presumably, on something having to do with something pertaining to the doctor. Whatever doctor they choose has privileges at one or more hospitals in the doctor's area. Maybe one's chosen doctor has privileges at a hospital that has materially lower costs for a given good/service, maybe the doctor doesn't. Either way, at least to me, it doesn't make sense that one'd change doctors because s/he doesn't have privileges at the lowest price or price-competitive hospital. The absurdity grows when the doctor in question is a specialist rather than a GP/internist.
• Emergency Services:
  • When one calls 911, one certainly can ask them to take one to "this or that" facility; however, in general, 911 crews can't take one to "facility X" if "facility Y" is between the site of the patient's pickup and "facility X" and "facility X" has availability for an incoming emergency patient. Things work a bit differently in major catastrophe and air transport scenarios, but those are exceptions, not norms.
    
    For instance, where I live in DC, the places a 911 crew will take me are GW (closest), Georgetown (2nd closest), Howard (3rd closest). If GW has availability, that's where they'd take me. Period. If GW isn't available, and the other two both have availability, were I (or someone speaking on my behalf) to ask them to take me to G-town or Howard, each is about the same distance from my home, they'd take me to the one I prefer if both have availability. (The crews also take traffic conditions into consideration, and that too could override my preference.) All three would have to be unavailable, or I'd have to have some sort of very unique situation/ailment, for them to even consider taking me to the Hospital Center, Sibley, etc.
    
    In the DC burbs, there are urgent care "pseudo-hospitals" that can handle what one might call "limited" emergencies. Those facilities can, if nothing else, stabilize one enough for subsequent transfer to a full-service hospital. They have a different doctor-staffing model than do hospitals; the doctors there are employees of the facility. They can do some surgeries, administer a host of basic medical treatments, perform routine diagnostics (EKG, EEG, CAT scan, etc.). These facilities are adjuncts of some hospital organization, so if one gets transferred from them to an standard hospital, one's only going to be taken to a hospital with which the facility is affiliated.
• Complexity:
  • If you've ever had a procedure performed in a hospital, you'll find that there are a swarm of things (goods/services) that get done and that you likely have no idea of what they are. That doesn't mean those things are unnecessary. It means that hospital compile and state their procedure elements as though they are a bill of materials they'll deliver to a healthcare procurement expert who knows what all those abstrusely named things are. Why do they do that? Because the most important recipients of those detailed listings are healthcare procurement experts; they're the insurance company employees who authorize payment of the bill.
    
    
    
• Control:
  • As go the procedures a hospital performs, what say has a patient in them? None
  • As go what the insurer pays for, what say has a patient in them? None
  • Are hospital pricing strategies going to drive at what hospitals doctors seek privileges? No
  • How will seeing a list of prices for procedures and items, of which one has no idea of whether one needs them, help? It won't.
  • Do hospital administrators know they don't actually compete with one another? Yes

 

[mike2810]

imo, pretty worthless at this point to determine what my out of pocket would be for a procedure/hospital visit.

Out of pocket costs vary from insurance to insurance. Cost vary from hospital to hospital. Depends if the facility is preferred provider or not within your insurance Depends if all the doctors/specialists/support are preferred or not. Depends on if you have or have met your yearly deductible. Depends if you have hit your yearly out of pocket max.

I do find it interesting when I get my insurance statement. Doctor submits X dollars for the visit. Insurance pays Y, which is lower than submitted for visit because the Doctor is a preferred provider. I own only my deductible, unless I have met the max for the year.

 

[Greenbeard]

This is one of the reasons I trust Trump more than Democrats. He tackles the underlying issue of healthcare cost vs just throwing boundless amounts of money at the issue. If ObamaCare would have looked at reigning in costs along with insuring more people, perhaps millions like myself would have gotten behind it.

This is an Obamacare provision.

 

[Grokmaster]

https://www.nytimes.com/2019/01/21/opinion/trump-hospital-prices.html



This might,..might,....be an important step in reeling in out of control health care costs. If hospitals are required to post pricing, in theory that should cause competition and hopefully drive down pricing as hospitals would likely compete with each other.


This is one of the reasons I trust Trump more than Democrats. He tackles the underlying issue of healthcare cost vs just throwing boundless amounts of money at the issue. If ObamaCare would have looked at reigning in costs along with insuring more people, perhaps millions like myself would have gotten behind it.

Did the same thing for prescription drugs at the retail level.

ZERO CREDIT from the Fake News/Lying Left, naturally.