The Double-Edged Syringe - Transparency Week


By Timothy Dillon

Photo courtesy of Images Money

Americans now spend 20 percent of our GDP, approximately $2.8 trillion, on healthcare. This gross expense is such an important national issue that it was the subject of the cover story in TIME magazine’s March issue. Between the folds, in the article “Bitter Pill: Why Medical Bills Are Killing Us”, writer Steve Brill outlines why exactly this is.

The biggest issue: hospitals not being upfront about the cost of practices and procedures, ranging from expensive medications to costly surgeries. While insurance companies are also to blame for some of this confusion, knowing the facts and figures beforehand would make final bills less of a shock for people, and allow them to adequately prepare for these financial issues. This focused argument about hospital costs and transparency has been a catalyst that has Senate committees and citizens alike taking note.

Obamacare has gone to great lengths to ensure that all Americans will be covered by some sort of health insurance, whether it is through a state funded program or through their work, but this insurance does not cover all medical costs. So suddenly, with more people having access to better health care, it almost seems inevitable that people are biting off more care than they could financially chew.

In the wake of the TIME article, healthccare professionals are taking the hint and extending further measures to make medical costs as clear as possible. The Center for Medicare and Medicaid Services released its statistics on the 100 most common medical procedures and billings information on its website. This move, initiated by Health and Human Services Secretary Kathleen Sebelius, has prompted hospitals to begin releasing their respective data regarding costs.

In Miami Beach, FL, Mount Sinai Medical Center’s Chief Executive Officer, Steve Sonenreich, confronted the issue, stating that he would publicly share the prices his hospital presents to insurers. Furthermore, he invited other medical facilities to do the same. The key sentiment being, that when it comes to health, no one ought be left in the dark on what the cost of medical treatment is going to be.

Other facilities are beginning to follow suit, whether by choice, or in efforts to maintain a good reputation. In a Bloomberg BusinessWeek article, it was revealed that the average cost for treating a broken hip in Manhattan was over $25,000 more than the same treatment one would receive just a borough away in a Coney Island hospital. While one could consider the quality of care being a factor in pricing, is such a price margin warranted for a distance of a mere 15 miles?

At face value, hospital transparency seems like a “no duh” solution to avoiding expensive medical procedures that can cost someone their livelihood for their life’s sake. There is a catch-22 here though — it seems that the more involved people are in their healthcare decisions, the more money they are going to dish out in bills.

“I blame WebMD,” says Eileen Christie, a Christiana Hospital surgical nurse. “Suddenly anyone can go online and self-diagnose themselves and think they can just pick their cure. I mean, I go on there, but I know what I’m looking at. Not everyone has the same background as I do,” Christie explains.

WebMD offers accurate and professional medical information to the public, but one thing it lacks is a section dedicated to outlining the average costs for surgeries or procedures that people might research. Searching the site for such information only yields individual articles that sometimes indicate price margins or give advice on predicting costs, but without any averages or alternatives to costly procedures.

A major part of hospital costs is simply the length of a patient’s admission. A hospital bed is a hot commodity, especially now that more people are given access to insurance they did not have prior to Obamacare. The longer you stay admitted, the higher your medical costs rise.

What increases your stay? Many things, but a study indicates that patients who have more to say about their care will stay longer and have larger bills to pay off. So the moral of the story seems to be to trust your doctor more and be less involved, which is counter-intuitive to typical impulses toward question asking for assurance of one’s health.

Hospitals are moving to become more competitive with pricing as they become more transparent about costs. Likely factors to justify costs will be percentages of successful treatments and surgeries, as well as the quality of doctors and nurses employed. That conversation will likely come as a result of clearer billing practices as the medical industry moves to a more capitalistic model. In the meantime, to try and avoid costs, take preventative measures to stay healthy, and if you have to be admitted to a hospital, get in and get out as fast as you can.