Think tank’s report proposes new laws requiring transparency in health care costs
By Patrick Malone, The Santa Fe New Mexican | |
McClatchy-Tribune Information Services |
In
But in
It's just one in a litany of problems facing patients in a state that ranks last in the nation in access and affordability of health care. A new report by Think New Mexico, an independent think tank based in
In its annual report to be released Monday, Think New Mexico recommends public disclosure of hospital pricing and quality ratings, and universal pricing for all patients, regardless of whether they're insured.
The report's cover art aptly captures the dilemma Think New Mexico wants to unravel. It depicts a doctor handcuffed and bound by cash-register tape at the bedside of a blindfolded patient. The familiar markings of a U.S. currency note frame the scene.
"Except that it is actually worse than that, because in the health care market, you are usually shopping for essential goods and services, like a pacemaker, not a pair of jeans," says the report, "Making Health Care More Affordable by Increasing Transparency and Ending Price Discrimination."
The report paints a dismal picture of the health care landscape in
Between 1980 and 2009, the amount New Mexicans spent on health care increased from about 6 percent to about 17 percent of their earnings, and it is expected to rise higher in the years ahead.
"Today
Think
For example, the report spotlights gaping variations in the prices from one hospital to the next for the same procedure. Treating a blood infection at
Patients with commercial insurance almost always pay less than the sticker price for medical services because their insurers negotiate rates with hospitals. But uninsured patients can face eye-popping bills for the full rate. What they can't pay, hospitals sometimes forgive. Those losses, which tend to be proportional to how high hospitals set their rates, make up a hospital's uncompensated care, which in turn hospitals cite as proof of their charitable giving.
Think
After doggedly studying how hospitals develop their pricing, Rigsby challenged medical charges for a hernia operation and colonoscopy that amounted to four times more than the
To close the cost divide between people with insurance and those without it, Think New Mexico proposes a change in law that would require hospitals in the state to develop a single price schedule for their procedures that applied to all patients, regardless of whether they are insured. Patients who are financially unable to pay their bills would still be eligible for discounts based on the plan the think tank envisions.
Under the proposal, the state would seek a waiver from the federal government so that
The recommendations also include requiring hospitals or insurers to disclose health care pricing and payment information to the
"As far as possible, the prices should be inclusive (i.e. include facility fees, physician fees and test costs) and be bundled by procedure so patients can easily interpret and understand the information," the report recommends.
These recommendations would require a new law prohibiting "gag clauses" in contracts between insurers and health care providers. The provision not to publicly disclose terms of the pricing agreements between hospitals and insurance companies is common.
"Once gag clauses are outlawed in
How lawmakers and stakeholders such as the insurance industry and hospital organizations will react to the report's recommendations remains to be seen, because it has not yet been released to them. But Nathan said he hopes
"The status quo is not an option. If
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