Had an enjoyable late night conversation with Dr. Lyle Berkowitz last night. For some reason, both of our busy schedules always have us setting up a phone meeting starting at 10:30 or later. Fascinating discussions.
He sent me the link to this flashy “shopping” site for healthcare services in the Minneapolis area. While I think it looks ok, it fails miserably just like every other site on the internet trying to “empower” healthcare “consumers” with price information for offered services. While this sounds nice and like a no-brainer, there are major flaws in this concept. First, most of the price information they present are the same prices a service provider bills an insurance company. For instance, searching for a brain MRI yields an I’m sure very lovely radiology center that charges $1900. $1900! How about this? Anyone living in Minneapolis who needs a brain MRI, please let me know. They can find a plane ticket to NYC for about $299 round trip and I’ll show them a lovely radiology center here in Chelsea that charges $550! Total cost $849! They save $1050 and get a trip to NYC out of it!
The unfortunate reality is that these providers cannot publish the real-life charges they actually bill a cash-paying patient. That would be illegal in today’s world. Don’t you think an insurance company would be quite “upset” if they just got a bill from Dr. Jones for $1900 and then visited this website and saw that they advertise the same service for $500? The price differential between what providers bill an insurance company and what they actually receive in reimbursement is absurd. My solution to the healthcare crisis for the 90 million people who will be paying cash for their healthcare four years from now (includes the uninsured and the 40 million expected to have high-deductible plans)…arm the people with the price that a doctor actually gets reimbursed for the service, not what a doctor bills the insurance company. Imagine if I knew that a doctor is reimbursed $53 for a chest X-ray and I went to that radiologist and said, “Hey I’ll give you $70 for a chest X-ray…take it or leave it.” That radiologist would be stupid to decline your offer. It’s $17 more than what he’s reimbursed and it’s cash in her pocket that very day without the overhead of dealing with a corrupt insurance company. Anyway, Carol, it’s a good start. But you also have to realize who the real healthcare consumers are – and it ain’t patients. Big Pharma understands this quite well. There are two consumers in healthcare. The first and most important…doctors. They tell patients what they need to “buy.” The second is the patient walking aimlessly through a dark void of price information and competition and most of the time not even spending their own money as they throw down their $20 copay for $140 a month Lipitor. Carol if you want to succeed in this screwed up economy, follow Big Pharma. They know how to influence spending in the healthcare economy.