Sutter Health bleeds patients, and not just as a medical procedure. 
A recent article by journalist Peter Waldman for Bloomberg News that ran in the 8/22/10 edition of the San Jose Mercury News provides some amazing price comparisons. A MRI of a knee costs $1,271 at a Sacramento Sutter Health facility while a nearby center charges $696. That is a $575 difference. A whopping 45% more expensive. An Silicon Valley obstetrician delivering a baby at a Sutter facility costs an astounding $5,890 while another local provider charges $2,052. Could they be doing anything that warrants an additional $3,838 (yes that is 65% more with Sutter Health)?
The list goes on. An abdominal CT scan in San Francisco cost $1,500 more at a Sutter facility then another hospital. A colonoscopy is a bargain at only $400 more. Yikes, no wonder The Squirrelologist can not afford to get sick, though reading these figures makes us want to throw up our nuts.
Why does Sutter Health charge so much more? They offer up the usual array of worthless answers about how they offer a better experience and outcomes for patients. 40-70% better? I think not.
One of the major causes of this problem is the lack of transparency in pricing. Time and again patients are told to compare prices and make good health care decisions that are affordable, but when the prices of medical care are not available that is impossible. Most of the agreements that large health service providers have with insurance companies prohibit the insurers from posting the contracted costs of services with the provider. This leaves the consumer in a position where they can not get the prices for services from their insurer or from the provider so they have to blindly accept services and pay whatever the provider can get away with.
Now The Squirrelologist is not suggesting we move to a socialized form of medicine but we do strongly support an increased level of transparency. How about a law that requires insurance companies and large health care providers to post their charges in an easy to find, clear manner. If you want to buy a television you check the price in your local store, walk into a Best Buy and then check out prices on Amazon or other on-line retailers. You decide if you want the cheapest price regardless of customer service and convenience or if you are willing to pay a bit more to be able to return it to a nearby store or have a conversation with a salesperson. But if you want to decide if you would like to choose a less expensive physician or lab or clinic you have no idea what you are paying. Maybe, if you are lucky, you can navigate a system designed not to make this information available and ask the provider what the cost is. They tell you it depends on who your insurance company is and that you have to contact them to find out what he contracted price is. Then the insurance company doesn’t want to tell you and sends you back and forth until you give up. Maybe they post some average prices online but either the service you need is not listed or if it is, you still don’t get the actual cost for the provider you are interested in. And that all assumes you have hours and hours free to research. Most of us go to the doctor or hospital when we are sick and getting medical care takes priority over detailed comparison shopping.
If competition is supposed to keep costs in line and drive improvements in service then we have created a system that is designed to eliminate competition and slow down the rate of progress. It’s not a question of if you support the health care reforms of the Democrats or the Republicans. Transparency is a concept that we all can get behind. Capitalism and competition are not perfect but lets allow those market forces to actually work to the benefit of consumers and drive health care costs to reasonable levels. Everyone is entitled to earn a fair profit for their work and if they can get more, good for them. But to allow the system to be gamed to the benefit of powerful business interests to the detriment of the rest of society is just to squirrelly for us. To Sutter Health and the other non-transparent providers of health care our bleeding bad nut of the day.
The Squirrelologist 
Vistaprint sucks and a Bieberific Brady Update.
I am pleased to report that The Squirrelologist is alive and well. After a lengthy absence due to an extensive field study I am back to report on my squirrelly findings.
The” most squirrelly corporate behavior and example of bait and switch tactics Bad Nut Award” goes to Vistaprint. It seems that the powers that be at Vistaprint have not gotten the notice that you are supposed to honor the prices you clearly advertise.
Your very own Squirrelologist went to Vistaprint to order some business cards for his other nut collecting ventures. The site very clearly promotes 500 business cards for $10. Should you go to the “premium business cards” link and follow it to the pricing you will find the same great price. Follow the links at that bottom of the page to pricing and yet again, the same prices clearly listed. Sounds great so far. Now start to place an order, it gets even better. The site tells you that shipping on card orders in quantities over 500 is free. This deal just keeps getting better and better. But wait, this can’t be so. Nothing is this good, and this company is no exception.
Since this deal seemed so good I decided to order three different sets of cards. What did I discover, the first set costs the advertised price but the second two sets cost three times as much. It’s not the price that bothers me so much as the fact that no where on the site does it say the listed prices are only applicable to the first item ordered and additional items will have different prices.
Finding this bait and switch somewhat disturbing I decide to investigate this squirrelly behavior and call customer service. The first individual I get listens to my complaint and says he can see about creating a different offer to improve the price. Already a bad sign of worse things yet to come. The representative comes back with a new offer that brings the cost down significantly, though still not as low as it should be if they honored their advertised prices. And to make matters worse, suddenly there are shipping costs. And we are not just talking about average shipping costs, these are grossly inflated shipping costs with a significant profit margin built-in.
Shocked at this outrageous bait and switch I ask to speak to a supervisor to share the fact that California frowns on companies not honoring their advertised prices. I am connected to the soon to be infamous customer service supervisor Latoya in Montego Bay, Jamaica. Latoya appears to have a very distinct job, to be as rude and argumentative as possible with customers. Latoya’s response to my requests to be shown anywhere on the Vistaprint site that the advertised prices are only applicable to one item and that other items will be charged at different prices is to essentially go $#*% myself. She raises her voice to a near yelling volume, constantly tries to interrupt when the other party is speaking and tries to speak over them to shut down whatever they are trying to say. It seems that if you are right about something and Vistaprint is wrong, the corporate policy is to yell at you until you give up and go away.
Little did Vistaprint and Latoya know, they were dealing with the Squirrelologist. A trained expert in researching just this sort of squirrelly behavior. In addition to sharing this story with all of the faithful Squirrelologist readers, it was also shared with Dennis Rockstroh, consumer advocate and writer of the Action Line column in the San Jose Mercury News. Dennis and his consumer advocate colleagues share in much of the initial inspiration for The Squirrelogist. Be a good nut and read Dennis’s column and send him or your local advocate your reports about lousy business practices at Vistaprint and other companies. They can help.
So to Vistaprint, our Bad Nut of the Day award and two pieces of advice, honor your advertised prices and be honest and clear about any changes or limitations, and show Latoya the door.
****Special Tom Brady Bieber hairdo update****
After extensive observation the Bieberific object observed on Tom’s head over the last few months appears to be an as yet unidentified species. This species seems to have an unexplainable behavioral impact on adolescent girls and underwear models. It does however seem to have a negative impact on Tom Terrific’s quarterback skills. 131 completions for 198 attempts and only 1362 yards through 7 weeks. Even Alex Smith has thrown for more yards, Yikes. The Pats are 5-1 but it will be hard to maintain that spot behind the Jets with Brady’s Bieber chasing off Moss like talent. Rumor has it that the Bradber bit Fred Taylor’s foot and is responsible for his missing so much time.
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Filed under Business, Commentary, Good Nut / Bad Nut, Sports
Tagged as bait and switch, Bieber, Customer service, Tom Brady, Vistaprint