Who gets paid what: The ABC’s of health care pricing

Filed Under: Costs, Health plans, Patients

Who gets paid what: The ABC’s of health care pricing

Pricing is byzantine in the U.S. health care system. For any given procedure or item at any given hospital or clinic, there may be a dozen prices or more. Why? We have what’s called a third-party payer system — many bills are paid not by the patient (the recipient of the service or medication) but […]

U.S. health system: Built by the haves, disadvantaging the have-nots

Summary: Well-to-do and wealthy people think differently about health care pricing than people of more modest means. This may seem obvious, but it’s a big problem: if the system is built by the haves and services the have-nots, and also takes advantage of them, then big issues will inevitably arise. For an example of this in […]

‘Value Creation’ And ‘Value Shifting’ In Health Care: Uwe Reinhardt

Summary: Princeton economist Uwe Reinhardt writes about value shifting in health care in the current issue of Health Affairs. The money quote, for me: “My gratuitous advice to the drug industry, and to the health care industry in general, is to be very mindful of the distinction between value creation and value shifting in their […]

Who’s paying the chargemaster rate? Not just uninsured people, but also the insured

Summary: It’s long been thought that uninsured people were paying the highest prices for their medical care — that an uninsured or out-of-network patient paying cash has to pay the most. But that’s no longer true. We are learning that insured people are paying the chargemaster or sticker price, and they’re upset. Why? There’s a […]

O.K., health costs may not be going up so fast, but they’re still going up

  Costs continue to rise, even if the rise has moderated somewhat. Health insurance premium increases of 20 percent for next year are not unheard-of, and somehow everyone wants to blame the Affordable Care Act — except for Uwe Reinhardt, the health  economist, who reported this week on a new Kaiser Family Foundation study. Shockingly, […]

‘Chaos, behind a veil of secrecy’: Show me the cash flow

e-Patient Dave deBronkart is a patient advocate and author of the new book “Let Patients Help.” He has been a firm advocate of transparency in billing, and he recently posted this on his blog, epatientdave.com. We are cross-posting with his permission. * * * * * * * By e-Patient Dave deBronkart Latest in my series Let patients […]

Ways to Save, Part 5: Consumer-driven health care

Ways to Save, Part 5: Consumer-driven health care

As part of our mission to help you save money by beating back your health-care costs, we’re running a series  giving practical consumer advice about the marketplace. Here’s the first post about saving money (we suggest that you always ask the price in advance); here’s the second (even in an emergency, ask!);  and the third (do you want to decide solely […]