The Lack Of Price Transparency
Stanley Feld M.D., FACP, MACE.
I believe the New York Times is doing a great disservice to the American
public in its biased promotion of the virtues of Obamacare. The intellectuals
of our society read the Times and never question this bias. In fact the Times
publishes letters from these intellectuals that confirm its biased statements. The more letters that come in the more they
are published. Before anyone knows it the bias becomes the truth.
On July 8 2013 the NYT published an article entitled “What Does Birth Cost? Hard to Tell”
The article's opening
paragraph reveals its bias.
continually told that when it comes to health care, we need to be savvy and
shop around for the best prices. To that end, policy experts and politicians
promote health care savings accounts, saying they make “health care consumers”
(a k a patients) more conscious of prices, bringing down the cost of medical
It goes through this woeful story of how an uninsured
pregnant woman tries to find a best price for her delivery from hospitals in
“Here is what happened to my daughter, Therese Allison, when she
tried to be just the sort of shrewd and informed patient that politicians
At this point I realized the article was another New York
Times propaganda article implying the potential virtues of Obamacare. President
Obama and the Democrats have mandated that patients like this buy healthcare
insurance from health insurance exchanges. They want patients to be dependent
on the government and not give patients the choice to make their own independent
The healthcare system’s dice are loaded against this woman’s
independent free choice.
“ Pregnancy is a pre-existing
condition, so she can’t get health insurance at any price. And
now that the birth of her baby is imminent, she wants to find out what a
delivery will cost, maybe even negotiate a price for this expensive procedure.”
Therese’s midwife offered to call the two hospitals the midwife
uses. She wanted pricing for an uncomplicated normal vaginal delivery without
an epidural. Therese’s plan was to leave the hospital the next day.
One hospital gave her a conditional price estimate. The other
didn’t. The second told her to apply for Medicaid. She thought there should be
a law making hospital systems reveal their prices.
Uwe Reinhardt, a
Princeton health care economist who is a frequent contributor to The New York
Times said hospitals do not have to their reveal prices.
“He said. Hospitals do not have to tell you their prices, and
often they keep them secret until they send the bill.”
“When I was chair of the New Jersey commission on hospitals two
years ago, my wife, at my behest, tried to get a price for a normal delivery
from the Princeton Medical Center,” Dr. Reinhardt said. “She pretended to be an
uninsured entrepreneur earning $80,000 a year. She got nowhere. I then called
to try out a colonoscopy. I got nowhere too.”
Dr. Reinhardt is a big fan of Obamacare. His implication is the
Obama administration is going to fix the non-transparency barrier.
Dr. Reinhardt said, “The situation is all so
The problem is he does not
offer a solution to fix the problem.
The Obama administration has tried to break the price
transparency barrier by publishing Medicare and Medicaid prices. The effort is
confusing, insufficient and incomplete.
Medicare and Medicaid reimbursements have been published in some
states in the past. Private insurance reimbursements to hospital systems have
been published for some diseases but it has been incomplete and
These reimbursement figures have been difficult to find on the
Internet. Additionally the prices have nothing to do with private healthcare insurance
contract prices of private insurance co-pay.
The Obama administration just had Medicare publish a giant spreadsheet with its payments for
the 100 most popular hospital procedures and treatments in 3,000 hospitals
across the country using claims data.
The moment the ICM-10 coding system is mandatory the number of diagnostic
codes will increase from 18,000 to 68,000. ICM-10 coding will decrease consumers’
ability to understand reimbursement and co-pays.
Pregnancy is not on the Medicare spreadsheet list along with
many other common procedures. The claims data is not connected to private
insurance payments and co-pays. As I have pointed out in the past, claims data
is notoriously inaccurate.
What is needed is a smartphone app listing prices for consumers
by zip code similar to Travelocity and Kayak for airline tickets and hotels. Consumers’
pricing would be instantly transparent.
There is no indication that the Obama administration is working
It is up to consumers to force the issue of price transparency.
It will lead to price competition and decrease the cost of healthcare..
Physicians in some parts of the country have taken the
initiative to encourage real price transparency and price competition.
I do not think we can rely on the government.
The Obama administration’s goal is to not have a healthcare system
with free market competition. He wants a government controlled healthcare