Another Reason

…to get Government—at the Federal and at the State level—out of the way of a free market for health care and for health care coverage, which must include price transparency if there’s to be true price and quality of product/service competition. This illustration is in Boston.

An Emergency Room visit to Massachusetts General Hospital for a particular problem covered by Blue Cross Blue Shield of Massachusetts would cost the patient and his employer together nearly $950. In fairness to BCBSoM, some other providers of health coverage for the same problem at MassGen charge substantially the same total price. At Carney Hospital, just three miles away, though, the same problem with the same provider would be only a bit under $550—$400 less.

It gets more variable. An ER trip to MassGen for a patient with substantially the same problem and whose coverage was through an Aetna PPO would cost $2,170. At Carney the cost would be in the range of $550.

But never mind, Government Knows Better:

The Massachusetts Health Policy Commission…called for capping the prices of the state’s costliest hospitals.

No. Price caps provide no incentive to innovate, to improve quality, to lower prices. Secretive negotiations between health coverage providers and health providers provide no such incentives, either. Secretive pricing by health providers provides no incentives.

Competition among health coverage providers and among health providers provides those incentives because superior quality of care and lower prices are what attract customers, and open competition is what produces those outcomes. The lack is especially insidious with hospital ERs, since those “customers” are in dire straights and in no position to shop around.

Those folks (all partakers of health provision and health coverage provision, but especially prospective ER users) need to prior plan before the trip becomes necessary. That requires an ability to compare among health coverage providers and among health providers. That, in turn, requires price transparency among health coverage providers—not just for premiums charged the customer and his employer (which already are pretty visible), but the prices paid each of the hospitals in the area.

Transparency also requires hospitals to make their prices publicly available. An example of this is with Surgery Center of Oklahoma. This facility doesn’t have emergency room facilities, but their model is easily extensible to all hospital and all prompt care facilities.

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