Hold the presses!
We have a modern day Easter Sunday miracle! The Charlotte Observer used logic and reason in
one of its editorials. They for once
agreed with North Carolina Republicans on a legislative matter. Who says the Lord doesn’t work in mysterious
ways?
I, like many others, have written about the rising
cost of health care. One of the inflationary
factors is our third-party payer system.
Hospitals are not held accountable for what they charge. Finally, North Carolina’s General Assembly
decided to do something about it. Here
are some of their proposals, as reported in the News & Observer:
• Require
hospitals to report prices for their 50 most common “episodes of care,” such as
tonsillectomies. The information would be sent to the nonprofit North Carolina
Health Information Exchange, which would make the information publicly
available on its web site. Hospitals would have to report how much uninsured
patients, Medicare, Medicaid and the five largest insurers pay for each episode
of care.
• Mandate that
every hospital conspicuously post its charity care policy – both on its
premises and on its website – along with the amount it spent on charity care in
the previous year. The newspapers’ investigation found that most North Carolina
hospitals were spending less than 3 percent of their budgets on free care for
the poor and uninsured.
While most
hospitals have charity care policies, patients don’t always learn about them.
More than a third of the state’s hospitals provided no details about their
charity care policies on their websites, the newspapers found.
• Prohibit
hospitals from charging multiple times for outpatient radiology services that
are rendered only once.
Blue Cross and
Blue Shield of North Carolina says such overcharging often happens when
technicians take several images of a patient during radiology scans. For each
image, hospitals often bill identical “technical component” fees – for such
things as setting up IV fluids – even though the setup is performed only once.
Blue Cross has been battling hospitals over that practice.
• Reward
hospitals that have low Medicaid costs. Under a system used to maximize federal
Medicaid funding, North Carolina requires most hospitals to pay an up-front
assessment each year. The state then uses that money as a match to draw federal
Medicaid dollars, and returns most of the money assessed to the hospitals. If
the new legislation passes, the state would return most of the assessment
dollars to hospitals with low Medicaid costs.
• Ban hospitals
owned by the state – including UNC Hospitals – from seizing the tax refunds of
patients who don’t pay their bills. Only state-owned hospitals have this power.
“It’s a fairness issue,” said Brown, who co-chairs the Senate Appropriations
Committee. “…We’re trying to level the playing field so everyone is treated the
same.”
• Encourage a
change in leadership at Community Care of North Carolina, a much-praised
program aimed at helping Medicaid recipients stay healthy and avoid trips to
emergency rooms.
And for good
measure here is what the Disturber had to say about that Republican idea of
health care savings accounts:
But as insurance deductibles have
spiked and more Americans have taken advantage of Health Savings Accounts,
consumers have become more attuned to that last line of the medical bill. And
while hospitals say rightly that the price of a procedure is subject to the
varying costs of everyone in the operating room, some medical markets have
shown that putting it all together is possible. Cosmetic surgeons, for example,
offer upfront estimates.
Such transparency, on a wider scale,
can benefit both patients and providers. If hospitals must show you what
procedures cost, they’ll be motivated to justify those costs with better outcomes
and efficiencies. It’s called competition, but first we have to ask. We applaud
Sens. Rucho and Brown for doing so.
This might be the second coming
after all!
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