A Victory for Medical Consumers in Wisconsin
The headline in Sunday's Milwaukee (Wisconsin) Journal read "Exposing hospital costs". It turns out a local suburban Milwaukee company HealthCare Direct LLC, has signed a deal with two large Milwaukee area medical providers who have agreed to provide 26 medical procedures at a guaranteed flat rate. The Journal published some of these negotiated flat rates. I'll bet you "peanuts" would like to know how your costs in Milwaukee (and probably everywhere else for that matter) stack up once the veil of secrecy is partially lifted.
The Journal compared the flat rate costs HealthCare was able to negotiate and the prices for the same procedures at several other Milwaukee area providers. Guess what, there was a difference of up to 112% in some of the costs - for exactly the same procedure. This result should not be a surprise in a system where prices and costs are allowed to be a mystery shrouded in an enigma. I wonder how long it will take for the prices charged by the other providers to gravitate towards the HealthCare negotiated prices. I'll bet it isn't long.
I think the Milwaukee example is a good start towards holding the medical industry accountable. It needs to go much farther, however. For one, outpatient procedure costs are not part of the disclosure. Neither are the costs local doctors charge for routine examinations and things like reading an xray. If we as consumers are expected to shoulder the burden of higher out of pocket medical costs, we need far more transparency from the medical community.
I think all of us can make our voices heard (and make a difference) in this debate by doing the following:
Become an educated consumer. Check out prices on state web sites. Always ask for an estimate up front for routine procedures. If the hospital cannot give you one, go somewhere else, and let them know you are doing so.
Become an activist. It's your money - if you do not protect it who will? Write your lawmakers. If they saw fit to protect you and I from the horrors of the muffler shop down the street, this issue certainly should merit their attention. Tell them to write legislation forcing medical providers to provide binding cost estimates, flat rates for common procedures, and force them into binding arbitration in cases of rate disputes.
Force insurers to disclose the discounts they receive from network providers. How am I supposed to figure out which $300 per month premium is the better deal when I have no idea what kind of discount the insurer negotiated with the health care network. In business we use non disclosure agreements to protect us when we disclose sensitive contract information like rates. Rather than tell us the prices and discounts are a secret, have us sign non disclosures and let us make an informed decision.
There is lots to be done to ensure we get a fair deal from the medical community. This community has lots to lose if they have to come clean on pricing and costs. You and I have lots to gain. How you respond may be the difference between the medical community winning and us consumers winning. I would rather see us win, how about you?
The Journal compared the flat rate costs HealthCare was able to negotiate and the prices for the same procedures at several other Milwaukee area providers. Guess what, there was a difference of up to 112% in some of the costs - for exactly the same procedure. This result should not be a surprise in a system where prices and costs are allowed to be a mystery shrouded in an enigma. I wonder how long it will take for the prices charged by the other providers to gravitate towards the HealthCare negotiated prices. I'll bet it isn't long.
I think the Milwaukee example is a good start towards holding the medical industry accountable. It needs to go much farther, however. For one, outpatient procedure costs are not part of the disclosure. Neither are the costs local doctors charge for routine examinations and things like reading an xray. If we as consumers are expected to shoulder the burden of higher out of pocket medical costs, we need far more transparency from the medical community.
I think all of us can make our voices heard (and make a difference) in this debate by doing the following:
Become an educated consumer. Check out prices on state web sites. Always ask for an estimate up front for routine procedures. If the hospital cannot give you one, go somewhere else, and let them know you are doing so.
Become an activist. It's your money - if you do not protect it who will? Write your lawmakers. If they saw fit to protect you and I from the horrors of the muffler shop down the street, this issue certainly should merit their attention. Tell them to write legislation forcing medical providers to provide binding cost estimates, flat rates for common procedures, and force them into binding arbitration in cases of rate disputes.
Force insurers to disclose the discounts they receive from network providers. How am I supposed to figure out which $300 per month premium is the better deal when I have no idea what kind of discount the insurer negotiated with the health care network. In business we use non disclosure agreements to protect us when we disclose sensitive contract information like rates. Rather than tell us the prices and discounts are a secret, have us sign non disclosures and let us make an informed decision.
There is lots to be done to ensure we get a fair deal from the medical community. This community has lots to lose if they have to come clean on pricing and costs. You and I have lots to gain. How you respond may be the difference between the medical community winning and us consumers winning. I would rather see us win, how about you?
posted by slates at 5:24 AM
1 Comments:
Slates.. call me when / if you get this.. mansfield
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