How’s a Little Medical Bill Transparency Sound?

by John Kiernan on May 16, 2012

medical expense transparencyImagine entering a restaurant and being told to wait for a table by a surly host, who shrugs off your repeated contention that you have reservations before handing over a questionnaire about your history as a restaurant patron and instructing you to complete it. Then, when you’re finally led into the dining room, you’re given a menu written completely in French that lists a whole bunch of foreign-sounding dishes, but no accompanying prices. You inquire and are told that the bill will be worked out at the end of the meal. Now, is that something you’re likely to put up with?

Of course you would, but not in a restaurant setting. We as Americans reserve such treatment for our doctor’s offices.

Such is the state of our nation’s healthcare system. We enter appointments in the dark about how much each test and procedure will cost us and what amount our insurance will cover. To make things even more complicated, how much you wind up paying depends on the aptitude for filing insurance claims displayed by the office staff. After all, if forms aren’t processed correctly, you could wind up footing more of the bill than is deserved, and the onus will be on you to spend countless hours trying to rectify the mistake.

You can’t even figure out which doctors charge the most competitive prices because everyone’s situation is different. That prevents the type of word-of-mouth consumer intelligence that clues people into the fact that the new neighborhood restaurant isn’t worth a try or that there is a new speed camera over on Elm Street, for example.

So, what can we do to fix this broken system?

Acknowledging that a problem does indeed exist is a good first step. After that, the medical industry needs a strong infusion of transparency.

Doctors and insurance companies should be forced to work together to create a system that enables them to quote patients clear-cut prices prior to appointments and procedures. Such a system would dramatically increase efficiency in the healthcare industry given that we would all be able to practice the same type of comparison shopping that is common when shopping for a credit card, TV, plumber, you name it.

It’s interesting that after the decades of the healthcare system being broken, the only trend we’re seeing toward increased transparency is in the direct care market. More physicians are beginning to offer basic healthcare services – such as X-ray, stitches, basic tests, preventative care, etc. – for monthly fees on par with many gym memberships. Patients seem to gravitate toward such services because of the clear correlation between what is paid for and what is received, minus any uncertainty and hassle. Nevertheless, it’s obvious that the current woes are far too entrenched for the private market to correct on its own.

Given that Washington cannot reach any consensus around healthcare, perhaps they can start by agreeing to bring healthcare transparency to par with that of every other industry in which money exchanges hands. Right now, what’s clear is that nothing is clear about the way the healthcare industry is run, and that clearly needs to change! So, anyone have any suggestions?

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