Decatur, Ala. | Wednesday, May 22, 2013
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Medical prices need transparency

New research from Washington University proves that patients should shop around before having a medical procedure performed in a hospital.

It also raises questions about how some facilities can justify such high prices.

As part of the research, hospitals in every state were called and asked what a healthy 62-year-old woman would have to pay to get an artificial hip. The callers said the patient had no insurance but could pay for the service, according to the study published in JAMA Internal Medicine.

The quotes from the 122 hospitals ranged from $11,000 to almost $126,000.

It is difficult to understand how some hospitals could justify charging up to $115,000 more than the lowest price.

It is disturbing that about 15 percent of hospitals did not provide an estimate, even after repeated requests.

And it is troubling that the hospitals are reimbursed between $10,000 and $25,000 for the procedure from Medicare and major insurance companies, but they charge uninsured patients much higher rates.

This is just one procedure. Multiply this example across thousands of medical procedures and it is easy to pinpoint one of the many problems with U.S. health care.

Medical expenses are the No. 1 cause of personal bankruptcies in the United States, according to a study by Harvard University. Medical costs caused about 500,000 bankruptcies in 2007, according to the White House.

Price should be as important to individual patients as it is to the government and private insurance companies. But a person who is in pain and needs help should not be expected to go to as much trouble as researchers underwent just to get a hospital to release its prices and allow comparison shopping.

We don’t understand how some hospitals can justify charging $115,000 more for the same procedure.

We don’t understand how hospitals can justify charging uninsured patients more than they charge insured and Medicare patients. And we don’t understand why so many of them make it difficult to discover their prices in advance of a procedure.

Congress had a chance in 2012 to solve this problem through a bill that would have forced hospitals to make their charges known to the public.

It could be revived this year, and if it is, Congress should pass it. Patients have as much right as insurance companies to know what costs to expect.

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