Tuesday Editorial: Shopping for health care should be easier

Making it easier for Floridians to shop for health care is a worthy goal, but right now it's a nearly impossible one because of a system that's designed to provide little transparency.

However, there are some opportunities to be wise shoppers. So it's encouraging that President Donald Trump's administration is pushing to allow patients to know the real prices behind medical procedures, according to The Wall Street Journal.

Insurers could be forced to publicize the negotiated rates they pay for services, which could affect the 159 million Americans who get health insurance through their employer. Doctors and hospitals, meanwhile, might have to give patients the total cost of services or treatment upfront.

This is nothing totally new: more than 20 states have price transparency laws for prescription drugs. But the need has grown in recent years as deductibles have risen 212 percent since 2008, according to the Kaiser Family Foundation.

A spokesman for a hospital trade group said price disclosure wouldn't give consumers an accurate picture. And why not? Because the system is too complicated to figure out upfront -- and in some cases insurers and providers have non-disclosure agreements.

But there are some common procedures, such as knee and hip replacements, that can provide a total cost picture in most cases.

In an ideal world a smartphone app would be able to give consumers both quality ratings and cost numbers for common services and procedures.

Avoiding hospital mistakes

A recent study shows that the risk of dying has gotten worse at the lowest-ranked hospitals, according to a report from Leapfrog Group, a nonprofit group.

Using data from about 2,600 hospitals since 2016, Leapfrog assigned letter grades from A to F to hospitals. Of course, these grades should be taken with a grain of salt: as many hospital officials rightly noted, medical facilities that treat the sickest patients get worse results than those that treat healthier and wealthier patients.

About 33 percent of the hospitals received an A grade, 25 percent got B, 36 percent got a C and 6 percent got a D grade.

Patients at C-rated hospitals have an 88 percent increased risk of avoidable death compared to A-rated hospitals.

It's estimated that more than 50,000 lives could be saved if all hospitals performed at the level of an A-rated one.

Rating nursing homes

There can be dramatic differences between the best and worst rehabilitation care in nursing homes. Medicare has a star rating for quality on its Nursing Home Compare website; it also uses 13 specific measures of rehabilitation care.

Nationally just 30 percent of nursing homes received the best five-star rating while at the other end 13 percent got one star.

Short-term health policies

Price is a good reason to sign up for short-term health insurance -- but these policies can cost more in the long run, according to the American Cancer Society Cancer Action Network.

Policies were studied in Florida and six other states. While premiums may be low, the out-of-pocket costs may be high, reported the News Service of Florida.

A 57-year-old female nonsmoker who develops cancer would have to pay $63,000 in the first month of coverage under a short-term plan; compare that to $7,900 in costs for network care under a policy through the Affordable Care Act.

Short-term plans also may exclude coverage of pre-existing conditions and benefits, maternity care, preventive care, prescription drugs and treatment for mental health and substance abuse issues.

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