The lack of price transparency in the health care system is one of those things that most people would agree is a problem if they think about it for a second. Nevertheless, given the tone of the mainstream debate on healthcare, most people seem to not think about it very much.If you end up in the emergency room, for example, you may well notice some very large numbers on your bill as you leave. If you’re fortunate enough to have insurance, those inflated numbers quickly lose your attention when you see that your costs will be limited to whatever your copay is. And if you don’t have insurance, the stress of dealing with such a massive bill in its entirety might obscure the outrageous individual markups.In both cases, the question is formulated as “who will pay this bill”, and not around “why is this bill so darned high in the first place?” We hope stories like this one in the Times last week helps change that attitude. The subject: the outrageous cost of bags of saline used in IV drips. A must-read:
It is no secret that medical care in the United States is overpriced. But as the tale of the humble IV bag shows all too clearly, it is secrecy that helps keep prices high: hidden in the underbrush of transactions among multiple buyers and sellers, and in the hieroglyphics of hospital bills.At every step from manufacturer to patient, there are confidential deals among the major players, including drug companies, purchasing organizations and distributors, and insurers. These deals so obscure prices and profits that even participants cannot say what the simplest component of care actually costs, let alone what it should cost.
At every step of the way, the reporter’s attempt to figure out how and where the costs get so high, she was stonewalled by representatives of hospitals, pharmaceutical companies, and other actors. Even a request for the government to release information hasn’t yet been been fully met.Price transparency is a must if we ever hope to make any progress on real healthcare reform. Luckily, some groups are moving forward with this, and last week North Carolina’s governor signed a law requiring the state’s hospitals to release the negotiated prices of the 140 most common procedures. It’s a start. We hope many more states take note and follow suit.[Photo of stethoscope and money courtesy of Shutterstock.]