For anyone who has ever been in an emergency medical situation, you know there is no worse feeling than getting a bill in the mail and realizing a simple x-ray and bandage just cost you $2,000. It can be hard to stomach the fact that any treatment you receive will be expensive, and many insurance companies can and will undoubtedly try to find a way to skirt responsibility of payment. What is most worrisome about the health care system, however, is that there is no accountability or good explanations for what patients are actually paying for.
Many times neither the patient nor the doctor knows what factors of a particular treatment make it so expensive, and this causes widespread public distrust of the entire health care system. When a patient is billed, there is no sort of itemization that explains the intricacies of the service provided. The public needs to make providers accountable for the costs they incur, in addition to being able to justify these decisions to those footing the bill. The lack of transparency when it comes to medical bills for basic health care, emergency hospital visits and routine checkups is a huge disservice to those in need of treatment.
The U has made one small but profound step in fixing this massive discrepancy within the health care system. Vivian Lee, senior vice president for health sciences at the U, recently implemented a computer system which carefully analyzes and organizes factors central to treatment such as devices, drugs and time spent with the patient by professionals like doctors and nurses. The software tracks this information as well as other data (such as how long a patient spends in the hospital and whether they are being readmitted) so healthcare professionals can literally break down the cost of treatment in order to show patients what they are paying for.
Lee has been able to pinpoint information that was previously nonexistent — from the cost of each minute in the ER (82 cents), to the cost of an operating room for an orthopedic surgery ($12). By looking closely at supply costs and labor costs specific to each payment (since not even the same treatment for two different people will use the same amount of resources) Lee and her colleagues have been able to pinpoint where efficiency is lacking and improve treatment while saving money. An additional strategy the U health care system has implemented is requiring each resident to justify why they ordered a specific lab test, since 20 to 50 percent of hospital lab tests have proven to be completely unnecessary for the patient and the hospital. Thanks to this new rule, the hospital has saved about $200,000 per year and has helped prevent patients from having to pay for extra tests that aren’t covered by their insurance policies.
These changes have gained traction with a few hospitals across the country, but every health care system should be required to enforce this kind of transparency as well as gain some sort of consistency across the board in terms of evaluating costs for certain procedures. As of now, costs for the same treatment can differ massively from one hospital to the next. Data released from the federal centers for Medicare and Medicaid services after looking at 3,300 hospitals and health care providers found that where one Florida hospital can charge $40,000 to remove a gallbladder, another Florida hospital will charge $91,000. Shocking examples like this are found across the country, and many times hospitals will charge a patient 10 to 20 times what Medicare will reimburse, putting the patient at a huge disadvantage.
As a result of this, 42.9 million Americans have unpaid medical bills and no way of understanding the costs they have been slammed with. More than half of the debt on credit reports are from medically related expenses. People with unpaid medical bills also suffer more in other aspects of life, such as finding affordable housing or basic necessities. Requiring medical treatment is not in a patient’s control and it is an individual’s right to receive adequate care as well as adequate knowledge about the cost of that service. Utah is making huge progress in starting to address this inefficacy and lack of transparency within health systems, but there is much work to do to ensure a safer economical future for all patients.