Our first prescription solved the wholesale drug pricing problem.
But here is the second big problem and it also involves pricing. The last thing I want is the government to set prices; that would be a disaster. But we have a major health-care pricing problem today. Everybody from doctors to hospitals to MRI centers to pharmacies charge different prices to different customers. That is OK until it is taken to the extreme. Plus these service providers make it very hard for one to know what their price is (the last thing you will generally see for a pharmacy is what they charge for Xanax and the last thing you will see on a hospital’s website is what their daily charge per hospital room). And try calling them up to get their price.
First, let’s consider the different prices. An uninsured but credit-worthy (in other words one who is paying for her own care) patient might pay as much as five or six times as much for a night in the hospital as the hospital bills the US Government for a Medicare patient. But in a hurricane where a gas station charges one customer five times what they charge another customer, the gas station is convicted of felony price gouging. But the US Government condones this price gouging when it suits their pursuit of a single-payer health care system.
So consistent with prescription #1, I would allow health care providers to set their own prices. But I would set a price range they could charge one group of customers versus another group at 100% - 120%. If you are going to charge the US Government Medicare patients $100 for a procedure you can’t charge me as an uninsured patient $500. In fact you can charge me no more than $120. So you can’t rip me off to subsidize Uncle Sam’s patients. If you want the US government business price your services accordingly – if you don’t then price them a little higher.
Prescription #3 is transparency. I propose that health care providers must post on the internet what their price ranges are for their services. Doctor’s visit $50 - $60. MRI $400- $480. One night in the hospital $400 - $480. You get the idea. But don’t gouge me with a $500 service that you give to the other guy for $60.
Transparency would allow me to shop around for a fair price while considering other factors like proximity, convenience, office hours, experience in this procedure and overall client reviews (a later prescription).
The insurance companies will not endorse these “prescriptions” because it diminishes their role and their power. Today I must get health care insurance simply because without it I get gouged on each and every service that I require. I am fine with paying 20% more than the “big guys” but don’t charge me five times as much.
We need to budge the health care system towards one where patients manage far more of their treatments versus their costs. We want patients to ask their doctor “Wouldn’t an x-ray work just as well as an MRI?” We have a system where the customer could care less about price (because they are not paying the bill) and hence they only demand the best service that money (other people’s money) will buy. And by the way give it to me NOW.
You might sense that I believe in a system where patients play a much bigger role in their treatment and consider not only convenience and effectiveness but also cost. Today cost is not a consideration for most patients.
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