I really hope this goes through. Right now, the opacity of prices for health care is a huge problem.
A friend of mine that works in health care admin and IT described walking into a doctor’s office ‘like walking into a used car lot.’
It seems to be one of those few holdout areas where the information economy hasn’t affected. Maybe it’s even perverted it, by enabling data holders to optimize inefficiency for their own benefit.
They are less certain whether a particular course of treatment will be coded in one way or another.
It's probably not a good payment model, it doesn't make any sense for the insurance company to be taking on risk that the provider should be bearing, but here we are.
The data simply needs to be price per code per insurance policy. I understand providers may not want people bickering over what codes are used, but they ought to be able to produce that report easily.
- It costs exactly $20
- It costs not more than $30 allowing negotiation
- You may only charge one price for all customers
- You may not charge more than some n percentage over the national average in the last business quarter
Prices negotiated between payer and provider today are already 1 + N year length contracts. Having one transparent national price list would 1000x easier than the hundreds of thousands of healthcare administrators that exist today whose sole job is to negotiate and determine price lists.
What exactly do you think is going to change in the market?
I'm in favor of what you suggest, but it will come with increases in Medicare costs.
So hospital utilization would not change.
Remember I'm talking about the payment for any particular procedure, not the number of procedures an average person has.
I know from when I was healthy individual in my 20s, that I tried to avoid doctors visits as much as I could - even though I had killer coverage (90-95%).
I still paid premiums (well my company did) but I simply didn't go.
The problem now is there is no downward price pressure from competition and transparency. Market controls are an extreme solution which will likely have unintended negative consequences.
None of these exist today in the market for US healthcare...but they do for fast food. Trying to compare the two would be extremely disingenuous.
It is in medical providers best interest to raise prices.
Efficient markets need more competition, but in healthcare the market is fragmented and once a provider or insurance gets big enough it gets acquired by another leading to larger duopolies.
We were getting a blood work for wifr, and when we checked pricing online we were shocked to learn that self pay price was around 300 and through insurance it would be 8k. Crazy, and no free market would function this way. Except when they are not free and have messed up regulations.