KnightExemplar wrote:Check out the Surgery Center of Oklahoma, which only exists now because high-deductables are a thing.
Check out their pricing disclaimer. Particularly this
Once again, if you are scheduled for surgery at our facility and insurance is to be filed by us, these prices listed on our website do not apply to you.
Those prices are cash upfront with a high degree of uncertainty. If there is a problem, if you have to be hospitalized, or any of the numerous things that could happen once the surgeon cuts, you will have to be prepared to pay that additional amount which is, to all intents and purposes uncalculable.
But if a catastrophe happens, the typical high-deductible plan will cover catastrophes (ie: My "Bronze" plan covers 100% of my costs above $6000). However, I'm very interested in knowing the cost of my health care because my "High-Deductible Bronze" plan covers 0% of my costs below $3000, and only a % of the costs between $3000 and $6000.
In any case, it has become possible
to actually price shop. Under a Co-Pay system, I wouldn't give a crap because it'd all be the same "Co-pay". (Note: Co-pays aren't banned under the ACA. They're just discouraged. There are tax-incentives to offer high-deductible plans)
Another note: pre-ACA, it was possible for insurance companies to only be regional (or worse: in-network only). So if your Ambulance Driver took you to the wrong "out-of-network" hospital, your insurance company would pay nothing, and the entire bill would be your responsibility. Because ACA banned
this practice... forcing insurance companies to at least pay for some "out of network" costs. So regardless, it is now possible to use any
health care plan in the country to pay for a surgery in Oklahoma.
An Oklahoma surgery would be "out of network" (as defined by the ACA), so in my personal case
, my "out of network" deductible is now $6000 and my maximum out-of-pocket is $12000. (A hefty amount, but I don't travel much and my plan covers basically every hospital in my city / state, so I don't really plan to be out-of-network personally). But still, the Oklahoma prices do in fact provide me some degree of leverage. I can always fly to Oklahoma and seek a cheaper surgery if the prices locally turn out to be absurd.
So the important issue here is simply the publishing of prices. I'd expect that hospitals in locations with lower cost of living will start taking advantage of the internet as well as transparent pricing, offering an online marketplace of health services. Medical tourism is a good thing, especially if its supported by the health care laws to encourage medical tourism within the country.
Sure price matters. But the price you care about is where the body is buried. I've turned down jobs which didn't carry health care plans that served my families needs. Insurance plans offered by business are money on the table. Insurance companies operate at the scale where they can and do demand discounts on the services they pay for. This is precisely why I hire them and bleed current income to them constantly. The calculation is how much I am prepared to pay to cover me against the risks that I know exist. And how much the plan will force me to go out of pocket for to receive that service. These are the prices I worry about.
Look at a concept called pay for performance or outcome based reimbursement.
Yeah... that wasn't working. That's why the ACA tried to design other market-based incentives.
There's a certain insanity to the health care system. I go to the doctor. The doctor reports to my insurance company the procedure she did. The insurance company then pays the doctor.
Insurance companies fund research looking for cheaper (but not necessarily better) care. Drug companies fund research looking for more profitable (but not necessarily better) care. The few independent research groups at public universities vested purely in the public interest are small... and typically only have 21-year old white college-educated males as test subjects. So the research is biased and/or crap, and nobody really trusts each other. Ugghhhhhh....
First Strike +1/+1 and Indestructible.