What if all US health care costs were transparent? | Jeanne Pinder

What if all US health care costs were transparent? | Jeanne Pinder


So, a little while ago, members of my family
had three bits of minor surgery, about a half hour each, and we got three sets of bills. For the first one, the anesthesia bill
alone was 2,000 dollars; the second one, 2,000 dollars; the third one, 6,000 dollars. So I’m a journalist.
I’m like, what’s up with that? I found out that I was actually,
for the expensive one, being charged 1,419 dollars
for a generic anti-nausea drug that I could buy online
for two dollars and forty-nine cents. I had a long and unsatisfactory
argument with the hospital, the insurer and my employer. Everybody agreed
that this was totally fine. But it got me thinking, and the more
I talked to people, the more I realized: nobody has any idea
what stuff costs in health care. Not before, during or after
that procedure or test do you have any idea
what it’s going to cost. It’s only months later that you get
an “explanation of benefits” that explains exactly nothing. So this came back to me
a little while later. I had volunteered for a buyout
from the New York Times, where I had worked for more than
20 years as a journalist. I was looking for my next act. It turned out that next act
was to build a company telling people what stuff costs
in health care. I won a “Shark Tank”-type
pitch contest to do just that. Health costs ate up almost 18 percent
of our gross domestic product last year, but nobody has any idea what stuff costs. But what if we did know? So we started out small. We called doctors and hospitals and asked them what they would accept
as a cash payment for simple procedures. Some people were helpful. A lot of people hung up on us. Some people were just plain rude. They said, “We don’t know,” or, “Our lawyers won’t
let us tell you that,” though we did get a lot of information. We found, for example,
that here in the New York area, you could get an echocardiogram
for 200 dollars in Brooklyn or for 2,150 dollars in Manhattan,
just a few miles away. New Orleans, the same simple blood test, 19 dollars over here, 522 dollars just a few blocks away. San Francisco, the same MRI, 475 dollars or 6,221 dollars just 25 miles away. These pricing variations existed
for all the procedures and all the cities that we surveyed. Then we started to ask people
to tell us their health bills. In partnership with public radio station
WNYC here in New York, we asked women to tell us
the prices of their mammograms. People told us nobody would do that,
that it was too personal. But in the space of three weeks, 400 women told us about their prices. Then we started to make it easier
for people to share their data into our online searchable database. It’s sort of like a mash-up of Kayak.com
and the Waze traffic app for health care. (Laughter) We call it a community-created
guide to health costs. Our survey and crowdsourcing work
grew into partnerships with top newsrooms nationwide — in New Orleans, Philadelphia, San Francisco, Los Angeles,
Miami and other places. We used the data to tell stories
about people who were suffering and how to avoid that suffering,
to avoid that “gotcha” bill. A woman in New Orleans saved
nearly 4,000 dollars using our data. A San Francisco contributor
saved nearly 1,300 dollars by putting away his insurance card and paying cash. There are a lot of people
who are going to in-network hospitals and getting out-of-network bills. And then there was the hospital
that continued to bill a dead man. We learned that thousands of people
wanted to tell us their prices. They want to learn what stuff costs, find out how to argue a bill, help us solve this problem that’s hurting
them and their friends and families. We talked to people who had
to sell a car to pay a health bill, go into bankruptcy, skip a treatment because of the cost. Imagine if you could afford the diagnosis but not the cure. We set off a huge conversation about costs involving doctors and hospitals, yes,
but also their patients, or as we like to call them, people. (Laughter) We changed policy. A consumer protection bill
that had been stalled in the Louisiana legislature for 10 years passed after we launched. Let’s face it: this huge, slow-rolling
public health crisis is a national emergency. And I don’t think government’s
going to help us out anytime soon. But what if the answer was really simple: make all the prices public all the time. Would our individual bills go down?
Our health premiums? Be really clear about this: this is a United States problem. In most of the rest
of the developed world, sick people don’t have
to worry about money. It’s also true that price transparency
will not solve every problem. There will still be expensive treatments, huge friction from our insurance system. There will still be fraud and a massive problem
with overtreatment and overdiagnosis. And not everything is shoppable. Not everybody wants
the cheapest appendectomy or the cheapest cancer care. But when we talk
about these clear effects, we’re looking at a real issue
that’s actually very simple. When we first started calling for prices, we actually felt like
we were going to be arrested. It seemed kind of transgressive
to talk about medicine and health care in the same breath, and yet it became liberating, because we found not only data but also good and honest people
out there in the system who want to help folks
get the care they need at a price they can afford. And it got easier to ask. So I’ll leave you with some questions. What if we all knew what stuff cost
in health care in advance? What if, every time
you Googled for an MRI, you got drop-downs telling you
where to buy and for how much, the way you do when
you Google for a laser printer? What if all of the time and energy
and money that’s spent hiding prices was squeezed out of the system? What if each one of us could pick
the $19 test every time instead of the $522 one? Would our individual bills go down? Our premiums? I don’t know, but if you don’t ask,
you’ll never know. And you might save a ton of money. And I’ve got to think that a lot of us
and the system itself would be a lot healthier. Thank you. (Applause)

100 thoughts on “What if all US health care costs were transparent? | Jeanne Pinder

  1. What if Canadian Healthcare taxes were transparent? When you add in the LOCAL taxes it's 50% in the highest bracket. Just hand over HALF your paycheck. No problem.

  2. Extortion at its finest.

    Pay, or die.

    When the mob does it, we jail them, when Drs do it, or insurance companies do it, we just say that's business.

  3. President Trump agreed with this and signed an executive order now forcing medical providers to tell patients when asked how much their services will cost. https://www.youtube.com/watch?v=qIcMnbea3E4

  4. The quality of care is overwhelmingly better in the US.

    Our system is corrupted by lawyers, politicians, big pharma, big gov, and individual abuse.

  5. When a Missouri “not for profit” hospital charged my insurance company the cost of a liter of novacane for a few cc’s I was told it was because that’s how they cover the cost of uninsured patients. They also charged $250k for a heart stent procedure that had to be done a second time 18 months later at $350k the second time. When I question these charges they said, “Well we could drop taking your insurance.”

  6. What about, the many layers of middlemen. The back and forth with the insurance companies.
    I’m in Canada. My elderly parents, are on a revolving door basis, with their Dr’s, and the hospital. It is so simple, to check them in, and out, like a hotel. When in good enough shape to go home again, they go. Wether a few hours, or a week. Yes it’s us the taxpayer. But only having a single payer, for everything that is needed. Has to be cheaper, and Is far less stressful.
    The joke here. Is there is a strong business lobby, trying to privatize our system.
    Follow the money. Don’t be conned, by big business.

  7. US Healthcare if like run Mafia's. Just the weapons have changed. Instead of Guns & Knives, its Insurance & Deductible.

  8. Yeah like how they just take the expense of insurance right out of your paycheck. Kind of out of sight out of mind. It’s a con game.

  9. Svein Gerald Hansen
    I totally got your message the first time. I’m in Canada. Where, I’m so grateful to be able to take my elderly parents to the hospital as needed. They are checked in, and out, like it was a hotel, (actually easier, and faster). With no direct cost to me. As a self employed, it’s nice to not be bankrupted, by your parents. Imagine the stress, taking your old dad to the hospital.
    But our system is under the threat of, a strong business lobby. That wants us to be like the US. They can smell the huge profits. And currently, we have to pay our Dr’s crazy amounts, to discourage them from going south.

  10. The first thing everyone must understand and accept when discussing healthcare in the US, and healthcare reform in the US in particular, is this:

    American healthcare is operating exactly as its owners and operators want it to operate. It's working, it's working well, and it's working as intended.

    American healthcare was never intended for its patients. It is, first and foremost, about generating revenue. Profit is the primary consideration, and patient care is secondary.

    Unless/until this changes, no significant level of reform will follow.

  11. Just a note. There was a movie made by Michael Moore, Sicko , many years ago, well it didn't make a dent in the system, that's what I noticed.

  12. I am a strong republican, and i know that government run healthcare would be unbelievably destructive, however like most reblicans, i am on board with price transparency. Trump was been working to demand price transparency, but it keeps getting shot down either by the lobbyists or the democrats becuase it "doesn't do enough". If the democrats would quit with this impeachment hoax and help trump out, we could have a much better system.

  13. The very fact that you need to do research to understand the 'product' you are buying to survive/get help proves that health care should never be in this kind of market. Health Care should never be a 'product', it should be a service for the people without the need to worry about cost.

  14. Is she asking for what Trump is getting rolling? https://www.cnn.com/2020/01/03/perspectives/health-care-transparency/index.html

  15. I once asked a Lilly Pharm. rep about hospital billing and he got offended. I basically called him a liar which he was. Lies and deceit are the norm in Health Care in all areas.

  16. This is kind of a simplistic solution. What "something costs" is often different from the Practice or hospital's "Full Pricing" which, due to the way insurances bill and function – is almost never paid. This is why on your insurance bills you will often see this higher amount billed for a procedure, then an "amount paid by insurance", then a "write off" of the balance. So if they are calling around and getting the right prices, staff could be giving inflated (NOBODY pays that) amounts…

  17. "A" and "B" get together to decide what "C" shall do for "D"
    The result is "F"
    We live in Free Market Democracy but thanks to Leftist Collectivism and Croni Capitalism medical industry is not a subject of free market competition.

  18. Unfortunately each hospital admission is completely unique. Adding up the cost of each supply, time spent by staff and the overhead / infrastructure needed to provide those diverse services is extremely difficult. Healthcare is not an assembly line – far from it. Its like building custom homes. Some costs are easy to track while others have to be built into what the builder charges for their service. There is no set standard for determining how much something really costs. The old apples and oranges problem on a massive scale. Larger healthcare systems are better suited for overcoming these accounting obstacles because of their scale. Healthcare systems ( such as you community hospital) wish it were as easy as it sound to provide to the penny accountability for services. Life for them would be so much easier if they could do it for everything they do.

  19. If you bring your car to any automotive repair shop, they are obligated by law to disclose the cost of all repairs, including the potential cost of something that may be found upon tear down inspection. All repairs already have a fixed industry cost in terms of labor hours as do all healthcare providers. There is no reason costs shouldn't be disclosed up front in either industry, except the healthcare lobby dumps your money into politicians pockets so they can hold American's health for ransom.

  20. https://www.hhs.gov/about/news/2019/11/15/trump-administration-announces-historic-price-transparency-and-lower-healthcare-costs-for-all-americans.html

  21. Just shows you how much US citizens are ripped off by business because of their restrictive practices. Look how the rest of the developed world manages its systems, life is hard enough without worrying whether illness is going to bankrupt you.

  22. American healthcare=thievery.
    Cash payments are no longer an option as most don't discount anything anymore for cash let alone even take cash as payment.
    This is why gov forces most employers to offer health insurance. They know most could never afford it and there would be a lot more outrage and support for singlepayer or some other major change to our system of they didn't get employers involved. So employers are stuck paying on average $600 a month per employee per month while employees still have to pay on average $200/single $350/family per month premiums, any deductible and oop costs. And when healthcare providers see you have employer health insurance they salivate knowing they are going to charge your insurance everything they possibly can.
    While there are many high cost procedures and treatments ect the biggest thieves of all are dentists, orthodontists and periodontists. Almost no insurance has decent dental coverage and they take advantage of that fully by financing costs mostly to people with children but everyone is fair game.
    My mom had 3 jobs her entire life, a car dealer, a parking cop and then a controller at a dentist/orthodontist which is someone who does most of the paper and computer work which mostly involves getting people to pay their bills. She told me she felt like a monster at her last job the controller. She had never had so many people cry, scream, plead ect. While that practice was fairly small for a dual dentistry she said at all times both the dentist and the orthodontist each had 1 million or more in payments owed to them at all times, not counting the people that paid in full at time of service. She said she saw about an average of 3 million a year in profits for each dr. The 12 years she was there. Think about that. A single person in a small dual practice making 3 million a year every year. Most medical doctors don't even come close to this, ever. While im not sold on med4all i would definitely be for med4all with dental.

  23. this was very poorly presented. This woman is clearly not a speaker. The information is important but no solution was really given.

  24. I’m all for capitalism… but it’s utterly disgusting that the health industry absolutely rips people off based on their misfortunes. The fact that someone falls and breaks a wrist (for e.g.) should not mean someone gets to make 1000’s of % markups on drugs.

  25. The American health care system is simply criminal, it's dishonest and should be illegal. Unfortunately most people have been brainwashed to believe that a healthcare system that benefits everyone is bad and is akin to socialism. Smh

  26. I'm confused isnt this a form of fraud, any person caught doing something similar to the govt would be under the jail ….

  27. Had the Democrats worked with, instead of against Trump, we were would have had transparency AND competition by now. The dems get big donations from Lawyers to support the status quo.

  28. After some drunk, high fool with his lights off swerved into our lane and crashed into us, my ambulance ride was 1500. My mri and emergency room visit was 90,000 dollars!
    Enough for helicopter lessons!
    My family laughed it off as they said the insurance company would pay it off, as they did. But they still didn’t get it, that it wasn’t right!

  29. When healthcare becomes "free", transparency disappears because the government will be in charge and taxpayers will never see the bill. Taxpayers won't have any idea what the real charges are, they will only see it in tax increases every few years.

  30. Healthcare with insurance companies and pharmacies in USA is a real issue. If the government isn't able to take charge because of lobbying and corruption, we should take care with our voices and wallets. Thank you 🙏. Also, I'm adding my pricing info to "clear health costs". Please do the same.

  31. The US health care system is a legalised fraud system….1400 dollars for something that costs 2.49 is fraud no matter who says it's not.

  32. The whole concept of Obamacare was to try and force everybody into buying health insurance, under the false assumption that more customers would spread out the cost. Instead it just generated greater profits for insurance companies, because nothing was done to address the issue of why insurance is so overpriced in the first place. I'm sure it had nothing to do with these same greedy corporations giving sizable donations to various political campaigns…

  33. This should be require viewing for all the idiot politicians making claims to fix health care. They all end up focusing who pays instead of how much things cost. It makes no difference who pays, whether insurance companies or the Federal gov't. Insurance companies have their operating costs and necessary profits, gov't has its fraud, waste, and abuse. Measured against the huge variable of what's being charged, both of those are meaningless. If we can't find a way to reduce prices, it doesn't matter who pays, but fixing that side of the equation is much harder work. That's why almost none of the politicians focus on it.

  34. CarMax's, up front, no haggle pricing policy is one of the main reasons they dominate the used car market. The first health care company to adopt a CarMax policy on upfront, no haggle pricing could wreck the industry as they shift to profiting off volume instead of trying to nickel and dime every procedure.

  35. the fact, that we need to do stuff like this is crazy… I could not imagine getting injured in America and afterwards paying medical bills for the rest of my life

  36. Healthcare cost transparency – YES
    Socialized Government run Healthcare – NEVER
    People don’t be fooled by liberal ideology let the free enterprise system in the USA work.
    This is why all Americans need to be active and VOTE. Your vote is your voice.
    Government will never take care of you but in slave you.

  37. This sight will explode if the bills passed by the trump administration Nov. ‘19 forcing hospitals to make public the cost for certain procedures is implemented Jan 1 2021.

  38. 8 Years Old Kid Need 200,000 Urgently For Heart Surgery

    As a commoners sometimes we will donate for those who need money for surgery.

    But i wonder whats in the mind of the respective doctor in charge if he read that in the newspaper?

  39. I would say make all costs transparent and let the people decide. Poor people should be given financial support for health care, but "single payer" centralism isn't in the interest of citizens.

  40. Hi I live in Australia. I have had to minor cancer operations over the past year. My Specialist suggested that instead of using my private insurance that I "go public" rather that a private patient and use Medicare. He said that the hospital " Royal North Shore " has state of the art care facilities and that I should save my money.
    Two operations over 2 months both operations, 5 hours each 4 days in hospital 1st operation, 5 days in hospital the second operation. All the scans, tests etc. Plus 30 treatments of radiation over 6 weeks. Total cost $450.00.
    And a wait of only 1 month for the first operation due to tests and scans. It was considered life threatening so no delays. So that's Australian Medicare. Not to mention the very cheap pharmaceutical costs no more than $35.00 per Month. 2%of everyone gross wages pays for the national care.

    Two operations over two months

  41. Every business I have ever delta with concealed what producing the product cost them. They also concealed their profit. IMHO we need should show both.

  42. We all know we are being ripped off, but don't know what to do about it. I'm not really in favor of socialized medical care, but our current system is out of control.

  43. My wife was diagnosed with cancer 90 days before she was eligible for Medicare. Her chemo treatments cost $60,000.00 per treatment. When she went on Medicare the price for the same chemo treatment dropped to $10,000.00 and the government was only paying $3,800.00 which the hospital was accepting as payment in full. I have always wondered why I was paying the other $54,200.00

  44. think about getting your car worked on, it about the same as medical care except in pricing, by law rate must be posted and an itemized bill before the work in down, can you imagine if it was like heath care, never in a million years, why is health care different?

  45. The US health case system is like having an email delivered by a postman
    on a bicycle and him refusing to hand it over until you pay a bribe.

  46. The US health case system is like having an email delivered by a postman
    on a bicycle and him refusing to hand it over until you pay a bribe.

  47. Price is always elevated when you think someone else is paying. Trust me insurance companies know the prices and often times dictate them. So you pay the doctors the actual price and the insurance companies pay close to nothing but still collect that premium every month. You always get the actual price when you dont have insurance. Thats why I hate the affordable care act. Now I have to pay a fine bc I want to pay the actual price.

  48. The USA health care system is the MOST WELL ORGANISED SYSTEM of FRAUD and TOTALLY CORRUPTED!!!
    The medical equipment at medical centres of NYC and big USA cities is OBSOLETE!!!
    The medical staff of NYC medical centres is Slack, Rude, Unqualified in Dirty Uniform!!!
    To Complain. ..It's Useless!!
    FBI and CIA are the key part of a corrupted system!!!!!
    It's real America: CORRUPTION, LAWLESSNESS, PERSECUTION and KILLING by FBI and CIA of Innocent American Citizens, WHO WERE TRYING TO FIGHT LAWLESSNESS, CORRUPTION and FRAUD!!!

  49. In mexico doctors are alot cheaper medicine is alot cheaper another thing in mexico you can get medicine that actually works in the us they give you something that doesnt work first and if you keep insisting the keep changing you up just messing up your liver

  50. Hospital systems are a silent foe. They are there to make a profit. They will suggest unnecessary procedures that are expensive. And are geographically convenient. So if if ppl in rural areas get too cute, they can just remove themselves.

  51. My insurance company would send me back braces, arm braces, and knee braces. I never ordered it or saw a doctor for this. I called them and asked why am I getting this and I found out by putting things together. The insurance company was making money from sending people devices. These people are sleaze-balls of slime. We are nothing but a steady stream of profit for them.

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