I just received a statement from our local hospital where my wife received a laser procedure to correct previous cataract surgery. The charge for use of the “treatment room” was $3,973 … or was it? Medicare paid $406.14 and the hospital billed me $101.54 simply adjusting the balance of $3,465.32.
On a doctors charge the fee was $85.00 and my private insurance allowed $74.98 and I had to pay 20%.
My daughter took my grand daughter to the pediatrician with the flu. The doctor billed $200 (for a short office visit mind you). However, the member rate was $164.05.
So, what is the real cost of health care? What price gives a fair return to the provider?
Is volume unnecessarily increased to offset forced discount prices?
Do the preset lower reimbursements from Medicare and even lower from Medicaid force higher prices for the balance of the population?
What would happen if there was a fair single allowable fee for services regardless of the source of payment?
How can we declare health care affordable when we don’t even know its price? And yet this is only part of the equation. What about the use of health care, what is appropriate, and what constitutes quality?
I suspect we don’t really know the answer to any of these questions and until we do we will never come close to efficient or what may be called affordable health care, affordable to every American that is.