3 Ways To Stop Hospitals From Overcharging Patients – Forbes
Part one of this story, “3 Ways Hospitals Overcharge You,” focused on a trio of hospital billing practices that can leave patients befuddled and their pocketbooks empty. They include the enigmatic “chargemaster,” creative upcoding techniques and pernicious “out-of-network” fees.
Today’s column examines what can be done to assist patients who often have no way of knowing in advance how much their hospital care will cost.
The Role Of Government In Healthcare & Hospital Bills
Governmental programs tend to be relatively inefficient and administratively burdensome. That’s why I don’t see a role for government in the direct provision of medical care outside of the U.S. Department of Veterans Affairs (VA), with its strong statutory requirements, along with some public safety-net programs paid through Medicaid.
However, I do believe there is a crucial role the fed and states can play in protecting patients.
Within a free, market-based healthcare system, there must be a robust regulatory framework with common rules that promote healthy competition. And within this framework, regulations need to (a) prohibit monopolistic control over pricing and (b) keep unethical providers and insurance companies from taking advantage of consumers. With that, here are three hospital billing safeguards the government should pursue immediately:
1. Unmask The Chargemaster. Consumers have the right to know in advance when a hospital intends to charge $15 for a Tylenol caplet or $100 to turn on the overhead light in an operating room. In this era of high-deductible health plans and growing out-of-pocket expenses, it’s more essential than ever to lay these prices bare.
A reasonable step for the federal government would be to pass legislation that makes “chargemaster” prices public. By pulling back the curtain on hospital accounting departments, researchers and consumer groups could create tools that help patients comparison-shop their options. And why not let patients compare the cost of a hip replacement or diagnostic procedure? After all, this type of standardization and transparency has already helped consumers make more informed health plan decisions within the Affordable Care Act’s insurance marketplace.