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Show Me the Money
The Health Care Prices the AMA Didn’t Want You to See

The Obama Administration announced this week that it will soon make public data on the practices of 880,000 doctors who participated in Medicare in 2012. The most important part of the data, which could be released early next week, will be the information about Medicare reimbursements for standard procedures.

In the U.S., consumers of care aren’t the true customers of the medical industry because most payments get filtered through third parties. The true customers are the government and private insurers, both of which have access to data about payment rates that ordinary Americans often lack. Reintroducing price signals into the system, even if all the transactions are still mediated through third parties, is important. Medicare reimbursement rates tend to be lower than those of private insurers, so this data will not be a perfect tool for understanding how pricing works. But it does give the average American a ballpark for what procedures cost one of the two big customers in the health care field. And that kind of awareness could over time bring some pressure to bear on prices in general, as people start to wonder if they’re getting the best value for their insurance dollar.

If you need further evidence of why this is important, check out this nugget from the end of the WaPo story on the release:

The American Medical Association expressed reservations, arguing that the information could be misleading and that physicians should be permitted to correct inaccuracies in their records.

The “broad” approach to releasing information could “result in unwarranted bias against physicians that can destroy careers,” the association said in a statement.

The AMA, it should be noted, has been fighting to keep this pricing information secret since the late 1970s. There are some legitimate grounds for this anxiety among doctors, but their concerns are eminently addressable, especially in today’s world where databases can be updated and shared online in real time.

Battles for price transparency are still ongoing throughout the country, from court houses to state houses. Let’s hope they all end like this one did, and soon.

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  • Dantes

    Wait a minute. I don’t think doctors are generally opposed to releasing what Medicare reimbursement for procedures is. What we don’t like as a doctor is releasing what procedures I do and what I was paid by Medicare. That is different. The price paid by Medicare is pretty much fixed.

    Plus, doctors don’t set Medicare prices! That’s set by Medicare! You don’t know much about this, do you?

  • gfnc55

    I’m unclear as to the point of this article. I think most folks, even those with little understanding of the costs involved in running a medical practice, will be surprised at how little Medicare pays. In many cases it barely pays enough to cover overhead.

    • Andrew Allison

      As well you should be. Surely it’s clear that Medicare reimbursement is only applicable to Medicare insurance claims and bears little relationship to any other form of reimbursement. The golden information which non-Medicare consumers need is the billed cost: Thanks to ACA, they face a $4,000 deductible and up to $6,350 for an individual plan and $12,700 for a family maximum annual expenditure. Welcome to “affordable” healthcare.

  • Jacksonian_Libertarian

    I think an easy way to make consumers more price conscious of medical costs, would be to replace the copays (generally $20) now common, with a set percentage (5%-10%) of the actual bill. In order to get the full effect of the “Feedback of Competition”, consumers would have to pay 100% of their bills. But even a paying a small percentage will change the way consumers engage with the medical industry, and the industry would have to show what they are charging for everything in order to figure how much the consumer must pay.

  • hal

    Need medical care? Go to India.

  • Charles Hurst

    Why would they be truthful about anything having to do with Obamacare. Like the fact it cannot sustain itself? And the fact their pundits continue to insist that rates are far more affordable when we know for a fact the rates for people actually working have dramatically increased. And how about the greatest lie told about ACA. That it isn’t really Marxist. That this is how insurance is supposed to work.

    Incorrect. ACA is the epitome of Marxism. It takes from one man to provide for another. With auto insurance if I wreck my car my rates go up. And one doesn’t have cheaper rates based on his income. Obamacare is Marxism. One who is less successful is sustained by those who pay more.

    Deception is also a propagated tactic of Karl himself. This isn’t theory of maybe Barry will lie. He already has. He said people could keep their plan. That didn’t happen—on a massive scale. He said premiums would be cheaper—they have increased on a massive scale. Unless you are a welfare recipient or illegal invader—why then it is free. Or if you decided to be a videography major and are making now 20K a year in Hollywood as the first “success story” made its way through the net.

    So should I believe him now? Probably not. What I do believe will happen is we will soon collapse as a nation. Not because my fiction says so—because history says so. Barry just hammered the final nail into our coffin. We can’t sustain ACA. The entitlement class is enrolling and the working and youth are not. And we already have 17 trillion dollars of debt with no intention of rectifying it.So sure Mr. Progressive, everything will be fine, I’m certain. See you on the battlefield.

    Charles Hurst. Author of THE SECOND FALL. An offbeat story of Armageddon. And creator of THE RUNNINGWOLF EZINE



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