Hospital Price Transparency Shows Complicated Economics of Healthcare

The question of how we pay for healthcare in this country is complicated. Logically, you would think that if you go to a hospital for a service, like getting an MRI, the hospital charges the patient what it costs to use the MRI machine, and then the insurance company would cover part of that cost, and the patient would cover the rest, according to what kind of health insurance plan your employer offers you.

But according to data analyzed by the New York Times, hospitals are charging patients wildly different amounts for the same basic services, everything from an MRI, to an X-ray, to a pregnancy test. 

And, the reporters say, there's evidence that major health insurers are negotiating "surprisingly unfavorable rates for their customers" with some examples of people getting lower rates for services, if they would have pretended to have no insurance at all. 

We know this because the federal government has ordered hospitals to publish a complete list of the prices they negotiate with private insurers. And even though four hospital associations sued the government to block the transparency rule, they lost twice, and the rule took affect this January. 

For example, at a hospital at the University of Mississippi, a colonoscopy costs $1400 with a Cigna plan, $2100 with an Aetna plan, yet only $780 for people with no insurance at all. 

At the Hospital of the University of Pennsylvania, a pregnancy test costs $18 for Blue Cross patients in Pennsylvania, but goes up to $93 if that patient with Blue Cross lives in nearby New Jersey, and only costs $10 with no insurance at all. 

Joining the Sound of Ideas to talk more about this investigation into hospital price transparency, is one of the New York Times reporters following this story, Sarah Kliff.

Later in the hour, my conversation with the legendary Cleveland entruepreneur and philanthropist, Milton Maltz, who wrote a book about his "Passion for Broadcasting."

And, we'll meet the lifetime achievement winner of the Anisfield Wolf Book Awards.

-Sarah Kliff, Reporter, NY Times

- Milton Maltz, Chairman and Chief Executive Officer, The Malrite Company & Author, “A Passion for Broadcasting”

-Samuel Delany, Writer & Lifetime Achievement Winner, Anisfield-Wolf Book Award