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My Simple Proposal for Healthcare

Charge everyone the same price for the same service and disclose your prices like any other business.

Yesterday I was experiencing chest pain from lunch when I felt something got stuck in my esophagus. It worsened during the day, so I went to an urgent care clinic at 4:30. I asked if they accepted my insurance and what the charges for the procedures they were doing would be, which were pretty standard procedures: a physician examination, taking an EKG, drawing blood and doing a standard blood panel plus I assume the test for a marker that you are having a heart attack, and then a chest X-ray. They said they did not know whether my insurance would be accepted and did not know what they charged for any of those procedures. But they gave me a paper to sign that appeared to say that I would be responsible for whatever they decided later to charge me. (They later convinced me it did not actually say that but was just a consent to treat me and consent to bill my insurance. I’m still skeptical, but I agreed to sign it.)

Medical providers charge different rates to different insurers, a different amount to medicare, different amount to medicaid, and a different amount to uninsured patients. According to what I have read, they usually charge uninsured patients more, which obviously makes no sense since they are the least able to pay, but I guess they are also the least likely to be able to afford a lawyer or fight the charges, so you can get away with charging them more.

This makes no sense to charge different patients different amounts for the same procedure or service. No other industry whose clients or customers are individuals and not corporations does that. It also is unbelievable for a business to claim that it has no idea what it will charge someone and will not decide that until after the business has provided service and to require that the customer agree to pay whatever the business later decides to charge.

So I have a simple proposal I will introduce to a jury if I am elected governor.

1. Medical providers must charge all patients or payers the same price for the same service or procedure, regardless of insurer or payor, insurance status, or income, except that they may provide discounted prices for low income patients.

2. Medical providers must list on their websites and give to patients in the office on demand a list of prices for every procedure or service they conducted more than five times in the previous year.

I will not propose that they need to tell a patient before seeing him or her whether they accept the patient’s insurance since the patient should be able to check with their insurer ahead of time. But I could be persuaded to require that also.

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