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Monday, July 20, 2009

$2,000 for that Colonoscopy!?

Congress isn't really debating health care reform right now. That's because the House's latest effort isn't going to change or reform our health care system but rather cause it to reach 20% of GDP sooner by adding taxes to business and wealthy individuals to cover more people. Granted it's easier to address coverage first and costs second but I don't think this is an example of that long-term thinking.

Last summer, Oregon passed a law that is taking a step towards health care reform. It required insurance companies to post the costs of 30 common medical procedures via Treatment Cost Estimators on July 1st. It's a step towards helping consumers understand the real costs of health care services, transparency, and giving information that helps with decisions. The fact that we can research the features of a rotating tie rack twelve ways to Sunday but have no information about who gives the best colonoscopies is a major gap.

One has to be a member of the health plan to see a treatment cost estimator but Regence has started to share their tool as well as provide information to contribute to the debate on the real costs of health care. While the tool's website is riddled by excessive flash graphics, it's the only treatment cost estimator that's available to the public. Click on the "Cost Generator" if you check out the link. I give Regence credit for investing their marketing resources on shaping the discussion of the future of health care rather than only spending money on leads and costs per clicks. While I didn't like their flash graphics, the website is probably geared towards a younger audience. That is probably deliberate as perhaps Regence is trying to reach those who aren't traditionally engaged in the health care debate and not trying to protect their Medicare turf.

Finally, a colonoscopy really does cost $2,000. That's a lot of money for looking around where the sun don't shine. On the flip side, a mammogram only costs $200 and is proven to save lives. This information should cause one to ask questions like, why don't we pay for a mammogram for every woman in this country since it is relatively cheap? We can fund it by paying for less colonoscopies.


MaybeMBA said...

I had a long conversation with an administrator at the UoC hospitals this spring about pricing transparency. He really made it sound completely impossible to put a price in advance on anything the hospital did. I don't get it! (How the hell do they figure out what to charge anway?) But I'll leave it to you to fix ... (but I have to say the current "reform" is not seeming promising. What we need is a more competitive market where individuals can find the right coverage for themselves regardless of employment status. Requiring employers to offer health insurance is the least of our problems. Shouldn't we finally divorce health insurance from employment already? I hope they can summon the political will to final tax health benefits.)

Oh ... and guess what it cost for me to lay in the delivery room (after a 15 minute delivery w/o complications) for the mandatory two hours? ... $5k. Among other interesting tidbits on my bill.

Deadhedge said...

Hi MaybeMBA,

That must have been an interesting conversation. My uncle runs their psychiatry department so I have heard some UofC stories. Hospitals have set up their billing systems to maximize Medicare revenue by listing as many procedure codes as possible. As a result, the hospital's price or "charges" is meaningless. That's their biggest weakness in health care reform, the fact that they have changed their systems so they have bad data on what their services actually cost.

However, they do know how much insurance companies will pay them (aka Allowed Amount) and you're right, could tell you how much something costs (just like what the dentist does). But as you could tell, hospitals and doctors aren't ready to think that way and incorporate cost into treatment discussions. I have a feeling someone higher up on the food chain than me is going to make them.

I once busted a doctor on overcharging me for the visit because the put a higher intensity code on the bill (If you google search the CPT codes on the bill, you can see what they mean). When I called the office to discuss, they knew exactly who I was as that probably doesn't happen often.

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