Stanley Feld M.D.,FACP,MACE
Many of you were shocked at the discrimination of pricing Denise experienced. In fact, Denise was not aware of the wide pricing range until she experienced it. I think most readers are not aware of the range of pricing for procedures.
When a physician sends you for a test that you discover is overpriced compared to the same test at other facilities who do you get angry at? The answer is the physician. What does that do to the physician-patient relationship? The patient should not be angry at the physician because I think most physicians do not know the differences in pricing between facilities.
Denise’s letter is one of many examples of the broken Healthcare system. It illustrates unfair pricing to a primary stakeholder with no insurance. The average consumer (patient) would never know it unless he experiences it as Denise did. However, the mechanics of pricing is totally logical to me as I trace the causes of the dysfunctional Healthcare System.
For physicians, it is essential that the approach to a patient’s illness is not to put a patch on a symptom and hope it goes away. Our job is to find the underlying cause of the problem, and fix it. Only then will the symptoms be relieved. Treating the symptom works short term, but you usually end up with other symptoms, or complications that are worse in the long term. Sometimes, the complications of chronic disease are non repairable.
We can all understand Denise’s pain and frustration. Is the solution to treat the symptom? Not if we are going to have a long lasting effect. We must treat the source rather than the symptom in order to repair the Healthcare system. First, we must understand the historical sources of the problem.
I submit that price transparency is an important patch to treat a bad situation. Everyone has now jumped on the need for price transparency. Aetna has announced its prices will be transparent. The AMA has called for price transparency as has the government. In the past, physicians were told that “they said” price transparency was an antitrust violation. I will have more to say about “they” in the future.
Price transparency is essential, but it alone is not going to cure the problems of the Healthcare system. Multiple other defects must be understood and cured simultaneously. The changes must have enforceable teeth, and apply to all the stakeholders. Price transparency should be directed to the primary stakeholder, the patient. The other stakeholders’ vested interests will fall into line with a simplified cost effective system as a result. Unfortunately, the only one who can force this change is the consumer and the exercise of “People Power”.