Consumer quandary on health care costs

Two items in the news reflect the dilemma that health care consumers face on health care cost issues.

The Washington Post published advice from Dr. John Santa of Consumer Reports for people with health insurance but who “are facing large deductibles and also paying an increasingly large portion of the rest of the bill.”

But the Wall Street Journal reports on a Government Accounting Office report that showed:

“Consumers are usually unable to get accurate information about how much medical treatment will cost them before they receive it.

(The GAO) tried to get upfront estimates from a variety of hospitals in Denver for the price of a full knee-replacement surgery. They also approached several doctors for estimates for a diabetes screening.

None of the 19 hospitals surveyed could say what a patient with Medicare or a patient without insurance would have to pay for the knee-replacement surgery, the GAO reported. Of the 19 hospitals, two did not respond to inquiries, and 10 could not provide any price information at all. The rest offered broad ranges of potential charges, such as between $33,000 and $101,000, or an average charge, such as $82,000, based on the typical charge to an uninsured customer.”

The report concluded:

“This lack of health care price transparency presents a serious challenge for consumers who are increasingly being asked to pay a greater share of their health care costs.”

ADDENDUM: Just about a half hour after posting the above, I saw this Kaiser Health News story that also ties in: “Premiums, Deductibles And Cost Sharing In Employer Health Plans Keep Rising.”


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Susan Fitzgerald

October 28, 2011 at 5:34 pm

It is very difficult to get a price quote from a provider, and when I’ve tried it, they seem kind of huffy that I might expect them to know the actual cost (or at least price) of their services.
Even health insurers that have developed treatment cost estimator tools (based on local or regional claims averages) find themselves hamstrung because of the way services are bundled, or unbundled. You might get a price range for knee surgery alone, but be sure that includes the hospital costs, the anaesthesiologist and everything you expect to go along with that.
It’s like getting the price on a hot dog and finding out it doesn’t include the bun, plus condiments are sold separately.
Our health insurers negotiate on our behalf, but that means they get different prices from the same provider. Definitely needs more work, by providers and insurers.