A few weeks ago, I was struck by Steven Brill's report for Time magazine on out-of-control hospital billing. (Time subscribers can read the full article online.) Even as a health care professional, it was stunning to learn how costs vary widely from one hospital to another, or even from one patient to another. Being without health insurance is such a double-edged sword -- not only do you have to pay everything out of pocket, but you're also charged the highest possible rates.
One crucial point is that hospitals keep their price list under lock and key. The "chargemaster," as they call it, is a closely-guarded secret. At least, until now.
Imagine heading to your local car dealership to shop for a new ride. You step onto the lot, expecting to browse various models and compare prices, but instead the dealer simply hands you the keys to your new car -- along with the bill. By the time you realize you've bought a car you can't afford, it's too late: if you don't pay up, you could face bankruptcy.
Now take this story a step further. What if you found out that another dealership sells exactly the same car for thousands less? Or, even worse, that your own dealer was selling the same car to another customer for a fraction of what you paid. Hospitals are not used-car lots, but I'm sure you understand my point. It's impossible to make reasonable choices about our health care if we don't have all the facts.
The federal government just released the prices hospitals charge for 100 common procedures, and the results are astounding. Here in Washington, D.C., the same service can be fifty, sixty -- even ninety thousand dollars more expensive at some hospitals.
A few people grumbled that Brill's article only stated the obvious (health care costs are out of control!) without suggesting a solution. Now we see that his hard work is paying off, forcing a little sunshine into the complex world of health care. I think that's a step in the right direction!