christiefan915
Catalyst
This article was in today's paper and below are some excerpts. I think it makes a nice counterpoint to Damo's thread about MS drugs. Maybe someone can explain why the free market hospital system here (read: monopoly) gets to gouge patients "because they can." How is Obamacare worse than this?
"When Steven Gray was diagnosed with terminal Stage IV pancreatic cancer in 2012, he received treatment at both Johns Hopkins Hospital in Baltimore and UPMC Passavant near his Butler home. The family was fortunate, said his wife, Patty Cudoc-Gray, because their insurance covered all but the $20 co-payments for each visit.
But when she later examined the Explanation of Benefits records sent by Pittsburgh insurer Highmark, she could hardly believe what she saw:
For Mr. Gray's last round of outpatient chemo at Johns Hopkins on Jan. 10, 2013 -- including medications, IV therapy, supplies and pharmacy service -- the hospital charged $2,544.65 and was paid $2,493.06 by Highmark.
Two weeks later, for the same procedure and ancillaries, UPMC Passavant charged $13,789.75 and Highmark paid $7,704.40.
Looking at the line item charges for standard chemotherapy drugs, she later learned that Highmark paid Johns Hopkins $761.40 for 1 milligram of Docetaxel. For the same dose of the same drug, UPMC got $2,542.50.
Another example: For a 200 mg Gemcitabine injection, Hopkins collected $143.10. UPMC got $1,051. "I said, 'How can they charge five times the amount [as Johns Hopkins] and collect three times the amount?' " asked Ms. Cudoc-Gray.
Gerard Anderson, director for the Center for Hospital Finance and Management at the Johns Hopkins Bloomberg School of Public Health in Baltimore, thinks he knows why UPMC charges more.
"Basically the answer is simple: Because they can," he said. "There is nobody telling them how much they can charge and so they charge as much as they can get."
Mr. Anderson said the Grays' experience illustrates the ills of the current health care payment system, which outside of Medicare sets no limits on what a hospital can charge -- even as it keeps those charges hidden from the consumers who end up paying higher insurance premiums.
Ms. Cudoc-Gray "had no idea about the relative costs prior to going to both places," said Mr. Anderson. "And she couldn't have because the prices are unknown. They're a secret."
Read more: http://www.post-gazette.com/busines...ary-widely/stories/201402160092#ixzz2MwbjhD2p
"When Steven Gray was diagnosed with terminal Stage IV pancreatic cancer in 2012, he received treatment at both Johns Hopkins Hospital in Baltimore and UPMC Passavant near his Butler home. The family was fortunate, said his wife, Patty Cudoc-Gray, because their insurance covered all but the $20 co-payments for each visit.
But when she later examined the Explanation of Benefits records sent by Pittsburgh insurer Highmark, she could hardly believe what she saw:
For Mr. Gray's last round of outpatient chemo at Johns Hopkins on Jan. 10, 2013 -- including medications, IV therapy, supplies and pharmacy service -- the hospital charged $2,544.65 and was paid $2,493.06 by Highmark.
Two weeks later, for the same procedure and ancillaries, UPMC Passavant charged $13,789.75 and Highmark paid $7,704.40.
Looking at the line item charges for standard chemotherapy drugs, she later learned that Highmark paid Johns Hopkins $761.40 for 1 milligram of Docetaxel. For the same dose of the same drug, UPMC got $2,542.50.
Another example: For a 200 mg Gemcitabine injection, Hopkins collected $143.10. UPMC got $1,051. "I said, 'How can they charge five times the amount [as Johns Hopkins] and collect three times the amount?' " asked Ms. Cudoc-Gray.
Gerard Anderson, director for the Center for Hospital Finance and Management at the Johns Hopkins Bloomberg School of Public Health in Baltimore, thinks he knows why UPMC charges more.
"Basically the answer is simple: Because they can," he said. "There is nobody telling them how much they can charge and so they charge as much as they can get."
Mr. Anderson said the Grays' experience illustrates the ills of the current health care payment system, which outside of Medicare sets no limits on what a hospital can charge -- even as it keeps those charges hidden from the consumers who end up paying higher insurance premiums.
Ms. Cudoc-Gray "had no idea about the relative costs prior to going to both places," said Mr. Anderson. "And she couldn't have because the prices are unknown. They're a secret."
Read more: http://www.post-gazette.com/busines...ary-widely/stories/201402160092#ixzz2MwbjhD2p
because of your shameless attempts to annoy me.
