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How would you feel if, after paying your airfare in advance and enjoying a safe trip to grandma’s for the holidays, you were hit three weeks later with a separate bill from the co-pilot?
That’s the scenario concocted by financial analyst John R. Graham in a recent Forbes.com op-ed to illustrate the absurdity of what we go through with healthcare. Costs are worked out among insurers, providers and government. Patients often think they are at a hospital and under the care of a doctor that is “in network,” to use a common insurance term, but then they get a separate bill from an out-of-network anesthesiologist or some other specialist.
A survey by the Consumer Reports National Research Center found that one-third of people with private insurance end up surprised by extra medical bills they weren’t counting on.
Marc Harrison, the new president and CEO of Intermountain Health Care, met with the combined editorial boards of KSL and the Deseret News on Monday. Among other things, he talked about the need for price transparency.
It’s coming, he said, but it won’t be easy for a lot of health care professionals. ““I think it’ going to be tough for a lot of folks and it’s going to require a different mindset,” he said. “I think that the patient, the consumer, is going to demand it because she or he is going to have a lot of skin in the game.”
Harrison said he talks with his colleagues about this. He tells them, “Like it or not, the world has changed. And I think we’re going to embrace that.”
But to get from here to there will be hard. One of the problems with the Affordable Care Act was that it focused mainly on access — getting everyone covered by health insurance. It did virtually nothing about costs, except to indirectly raise them by imposing new rules and requirements.
In a wide-ranging healthcare reform paper published during the campaign, President-elect Donald Trump said he wants to: “Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.”
Given the intersection of insurance companies, doctors, various providers and pharmaceutical companies, that could be much harder than it sounds. But if, as Harrison said, consumers were to begin clamoring for it, the change would become politically easier.
The trouble is, consumers really pay only a small percentage of the costs they incur. That tends to put a damper on much of the clamoring. Jokes about the TSA aside, having surgery is really nothing like flying to grandma’s house.