Hospital Pricing Should Be Transparent… But Is It?

If you’ve spent any time in a hospital recently, you know that many of the costs are pretty outlandish.

We usually don’t hear about them while they’re happening. A nurse doesn’t hand a Tylenol pill to a bed-ridden patient and say, “That will be $15, please.” But when we see our itemized bill later, we gasp. 

An investigative journalist named Steven Brill explored this subject not long ago. He published his findings in Time magazine.

His conclusion after a seven-month study was that healthcare expenses are largely arbitrary, inflated and unfair. Can’t argue with that.

Inflation or Highway Robbery?

Pat Palmer is the founder of Medical Billing Advocates of America. They help patients handle medical bills. Here are a few examples of what he found on itemized bills from hospitals and other healthcare facilities.

• $93.50 for the use of an overhead light during an operation. I suppose the alternative of having the surgeon cut us open in the dark would not be advisable. But it still seems pretty steep.
• $53 for each non-sterile pair of gloves doctors and nurses use while treating us. The average hospital bill for this item was over $5,000.  
•  $23 for an alcohol swab used prior to injecting a needle to draw blood or administer a shot. The average patient paid $322 for this during their stay.
•  $20 for the use of a blood pressure cuff. Thankfully we don’t get charged $20 each time they use it on us.
•  $17.50 for a marking pen. This is used for marking the body for surgery. I hope at least the design is pretty.
•  $15 for one Tylenol pill. The bill for Tylenol is $345 for the average hospital stay.
•  $10 for each plastic cup to hold our meds. That’s just for the cup each time they bring meds, not for the meds themselves. The average hospital patient pays $440 for this during their stay. 
•  $8 for a belonging bag. If you don’t bring your own, that’s what you’ll get charged for a bag to hold your personal items.
•  $8 for a box of tissues. To make it sound more like a medical expense, one hospital listed this as a “mucus recovery system.” I’m not making this up.
•  $6.25 each time a nurse has to hand us a medicine to take by mouth. The average hospital patient paid $87.50 for this service.

It’s All Over the Place

Brill, who I mentioned a moment ago, wrote this. “The healthcare market is not a market at all. It’s a crapshoot.

“Everyone fares differently based on circumstances they can neither control nor predict.”

In addition to the exorbitant fees, many times there are clerical errors and overcharges on healthcare bills. One study found that 80 percent of bills for hospital stays contained errors.

It pays to study your itemized list very carefully and question anything that seems out of line.

‘Age of Information?’

 Hospitals and other healthcare facilities are not required to lower prices. But they are required to be transparent about them in this “age of information.”

 A Trump Administration transparency rule took effect earlier this year. Specifically, hospitals must post – in a “consumer friendly format” – the costs for 300 common and “shoppable” services. Such as having a baby or getting a joint replacement.

But some hospitals are burying this information on their websites. Or are not including all the required categories. About 30 percent of hospitals ignore the rule.

Using data that hospitals did make transparent, Kaiser Health News determined that prices are all over the map. Here’s an example. In Virginia, the average bill for a colonoscopy is $2,763. But the range across the state is $208 to $10,563.

Patients are often unaware of these differences. One study showed that 85 percent of adults had not researched online what they’d have to pay for a treatment.  

Ways to Save Money

With no guarantee that hospitals and other healthcare facilities will be transparent about their costs, it’s up to us to protect ourselves.

There are ways you can go about saving cash when it comes to hospital visits. And I don’t mean having your uncle Fred remove your gallbladder in his garage. Here are some of them.

Question every medical test. Healthcare personnel admit that between 15 and 30 percent of tests, medications and procedures are unnecessary. This is due partly to malpractice concerns. And partly to making money for facilities. We should ask why it’s being recommended. And what will happen if we don’t do it.

Make sure you’re admitted. Sometimes hospitals keep a patient overnight for observation but never officially admit them. If the patient is then sent to a nursing home for rehab, Medicare might not pay for it. Due to that lack of official admittance.

Take your own OTC meds with you. Why pay $30 for a couple of Tylenol when you can take your own over-the-counter meds for much less? Some hospitals allow this. But your chances are better if you have your family doctor’s order for it. Or for a prescription drug.

Choose your hospital wisely. Don’t just select the one closest to your home. Nonprofit hospitals are generally much more affordable than for-profit hospitals. 

Watch out for specialists. If you need one or more specialists for your treatment, use them. But beware of doctors who call in a number of specialists for you. Each of them will charge you every time they stop in for a few minutes.

Request an itemized bill. That way you can go through it line by line and determine whether you were charged for something you did not receive.

Don’t overstay your welcome. Some busy hospitals want to push patients out as quickly as possible. Others welcome you to stay longer if you want. Just remember that each day in a hospital is extremely expensive. 

It’s good news that hospitals are required to be transparent about their costs. But if you need a hospital stay, do your homework first to find out which ones actually are.