Originally published March 28 2015
U.S. hospitals exorbitantly overcharge patients for cheap blood tests and other simple procedures
by J. D. Heyes
(NaturalNews) The lipid panel is a simple, common blood test doctors use in modern-day medicine to measure patients' cholesterol levels. These tests are ordered millions of times per year, and it's not an overly complicated process. As noted in a Vox report recently, it's "not a procedure where some hospitals are really great at lipid panels and some are terrible." Not much room for quality variation because lab techs are merely running blood samples through a machine and reading the results.
Which is why it is baffling, to say the least, that a lipid panel in California can cost anywhere from $10 to $10,000, since, in any case, it is precisely the same test.
"What we were trying to see is, when we get down the simplest, most basic form of medicine, how much variation is there in price?" Renee Hsia, an associate professor at University of California, San Francisco, who published the huge fee variations recently in the British Medical Journal, said. "It shows how big the variation really is. We're not talking twofold or threefold differences, it's a completely different level of magnitude."
The research team compiled vast amounts of data regarding basic blood work charges from more than 100 hospitals, and it found that the charges to patients were literally all over the place.
Not just blood tests
According to the study, charges ranged from $10 per test to $10,169. Hospital pricing for basic metabolic panels, which doctors use to gauge a patient's metabolism, were $35 at one hospital and $7,303 at another.
"For every blood test that the researchers looked at, they found pretty giant variation," Vox reported. "This huge variation in the price of a really simple, incredibly basic blood test tells us a few things about the American health care system."
And the wide variations in pricing are not limited to blood tests. They exist throughout the gambit of medical services.
Hsia's previous research examined the cost of an appendectomy in California as well, and there, too, she found huge price variations. An appendectomy without any complications cost anywhere between $1,529 and $186,955.
One variable in that study, Hsia admitted, is that different hospitals treated patients differently. "Some hospital might use more IV bags than others or one doctor could be ordering a lot of blood tests," she said.
"While Fresno County had the smallest range of charges, the lowest and highest charges still differed by a remarkable $46,204," the study found, according to the Washington Post.
Now, not all patients pay the full price. Insurance companies mitigate a lot of the costs, and even then many negotiate payment structures, schemes and rates with hospitals. So does the federal government; Medicare, Medicaid and other federally insured programs often haggle to provide the best value for the patient and for the taxpayer.
But the huge disparity in pricing - and these are just California hospitals Hsia and her team have examined - says a great deal about the U.S. health care system, one of the most heavily regulated industries in the country.
'Nobody has ever really challenged it'
For one, it's virtually impossible to price-shop for a number of factors. In terms of "shopping" around for the best price on an appendectomy, for example, Hsia and her team noted:
Price shopping is improbable, if not impossible, because the services are complex, urgently needed, and no definitive diagnosis has yet been made. In our study, even if patients did have the luxury of time and clinical knowledge to 'shop around,' we found that California hospitals charge patients inconsistently for what should be similar services as defined by our relatively strict definition of uncomplicated appendicitis.
Also, Americans have a tendency to merely pay what they are charged, especially if the operation or procedure is covered by health insurance. If it isn't, however, a $10,000 blood test would put a great deal of Americans into bankruptcy.
"There's no other industry where you see this kind of extreme variation," Hsia said, as quoted by Vox. "And nobody has ever really challenged it. It shows an extreme inefficiency, and something we really need to change."
Sources:
http://www.vox.com
http://bmjopen.bmj.com
http://www.washingtonpost.com
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