Tuesday, March 15, 2005
Woman with HSA finds out how hospital pricing really works - or doesn't
[Christopher Snowbeck, "The cost of a stitch, like all things medical, is not as clear as it seems," The Pittsburgh Post-Gazette, 13 March 2005.]
Patients are beginning the switch to consumer-driven plans and following through on the promise of those plans to create cost-conscious consumers. As this occurs, the media is increasingly likely to focus on the inability of health care providers to deliver prices based in some way on reality:
What's a fair price for a stitch?
It's a question that Michelle Boxer would like to answer, since the Ohio woman's two sons are becoming frequent visitors to emergency rooms.
Boxer's 5-year-old needed six stitches to the head in April after he vaulted a couch and landed on a coffee table. The total charges from a doctor and hospital in Dayton came to less than $100 per stitch.
Boxer's other son cut his hand on a broken cup during a visit to suburban Pittsburgh in July. Charges for hospital and physician care at UPMC Passavant Cranberry came to more than $400 per stitch.
"I just want them to explain it," said Boxer, who is contesting the UPMC bill. "I have a hard time paying something when it seems they're just trying to rip me off."
"The bottom line is that pricing for medical care, including emergency care, is a confusing mess," said Dr. Arthur Kellerman, chairman of the emergency medicine department at Emory University in Atlanta. "Come to think of it, the whole system is a mess."
Michelle Boxer is paying attention to her bills from UPMC Passavant Cranberry because the hospital was outside her health plan's network, meaning she is responsible for more than one-third of the charges. So she is scrutinizing her bills the way proponents of Health Savings Accounts might recommend.
Called HSAs for short, the accounts typically couple high deductible insurance policies that cover the cost of large health care bills with tax-free savings accounts from which individuals buy other medical services. They have been promoted by the Bush Administration as a solution to runaway health costs.
Greg Scandlen, director of the Galen Institute's Center for Consumer Driven Health Care in Washington, D.C., says the day of simplicity has already arrived in some places. There is a physician in Tennessee who does, in fact, charge by the stitch, Scandlen said.
Hospitals have been less enthusiastic about change, Scandlen said, but they might be forced to by class action lawsuits that have highlighted the high charges uninsured patients receive.
"I think we're entering a whole new world," he said.
[Greg Scandlen, "Choice is revolutionizing health care," The Flint Hills Center, 28 September 2004.]
[Christopher Snowbeck, "The cost of a stitch, like all things medical, is not as clear as it seems," The Pittsburgh Post-Gazette, 13 March 2005.]
Patients are beginning the switch to consumer-driven plans and following through on the promise of those plans to create cost-conscious consumers. As this occurs, the media is increasingly likely to focus on the inability of health care providers to deliver prices based in some way on reality:
What's a fair price for a stitch?
It's a question that Michelle Boxer would like to answer, since the Ohio woman's two sons are becoming frequent visitors to emergency rooms.
Boxer's 5-year-old needed six stitches to the head in April after he vaulted a couch and landed on a coffee table. The total charges from a doctor and hospital in Dayton came to less than $100 per stitch.
Boxer's other son cut his hand on a broken cup during a visit to suburban Pittsburgh in July. Charges for hospital and physician care at UPMC Passavant Cranberry came to more than $400 per stitch.
"I just want them to explain it," said Boxer, who is contesting the UPMC bill. "I have a hard time paying something when it seems they're just trying to rip me off."
"The bottom line is that pricing for medical care, including emergency care, is a confusing mess," said Dr. Arthur Kellerman, chairman of the emergency medicine department at Emory University in Atlanta. "Come to think of it, the whole system is a mess."
Michelle Boxer is paying attention to her bills from UPMC Passavant Cranberry because the hospital was outside her health plan's network, meaning she is responsible for more than one-third of the charges. So she is scrutinizing her bills the way proponents of Health Savings Accounts might recommend.
Called HSAs for short, the accounts typically couple high deductible insurance policies that cover the cost of large health care bills with tax-free savings accounts from which individuals buy other medical services. They have been promoted by the Bush Administration as a solution to runaway health costs.
Greg Scandlen, director of the Galen Institute's Center for Consumer Driven Health Care in Washington, D.C., says the day of simplicity has already arrived in some places. There is a physician in Tennessee who does, in fact, charge by the stitch, Scandlen said.
Hospitals have been less enthusiastic about change, Scandlen said, but they might be forced to by class action lawsuits that have highlighted the high charges uninsured patients receive.
"I think we're entering a whole new world," he said.
[Greg Scandlen, "Choice is revolutionizing health care," The Flint Hills Center, 28 September 2004.]
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