Maybe you heard something like this on the radio recently: A mom takes her new baby to the emergency department on a weekend because she thinks her daughter might have a urinary tract infection. She’s right, but regulations say the baby has to stay in the hospital for two days to ensure the infection clears. Afterwards, the mom is surprised by and concerned about a $7,000 hospital bill for the baby’s care.
The reporter says that since more companies are purchasing high-deductible health plans for their employees, it’s increasingly important that people can find out the price of their care so they can make better choices.
Jesse Gruman hears this and says, “What?”
Yes, a trip to the ED is rarely carefully planned, meaning that this mom probably didn’t go online or call around to see which ED would give her the best price.
Second, this woman didn’t know what her baby needed. How could she know what price to look for?
Third, she wasn’t sure what the problem was or what the treatment would entail, meaning it is unlikely she would have been able to discover those pesky hospital regulations about the conditions under which babies with UTIs are discharged from the ED.
However, if she had a Direct Care physician, the first thing she would have done was call them. And they would have warned her about the two-day stay. If they were a primo Direct Care physician, they might have been able to track down an open bed for her and negotiate a cash rate.
Jess Gruman writes:
“The idea that knowing the price of our care will encourage us to act like wise consumers is a hugely popular topic on blogs, in editorials and in the news. But relying on access to price information to drive changes in our health care choices is full of false promises to both us and to those who think that by merely knowing the price, we will choose cheaper, better care and result in cost savings to us and to our health care institutions.”
But Jesse failed to include one important detail — why are the prices so high?
For one, Medicare makes them so, because Medicare arbitrarily decides how much procedures cost.
And yes, we understand his point about not breaking the law that requires two-day stays for babies with UTIs. But if this woman had a Dr. Keith of SCO within 50 miles of her, we will bet our practice that he’d be able to take care of mom and baby for a far cry below their $7,000 hospital bill.
We’re not saying all of healthcare has to be shown on a menu. We’re just saying that nothing beats patients who know they’re paying for an informed doctor. And when informed doctors go to bat for these patients, that’ll be actual healthcare reform.Tweet