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.