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Monday, July 24, 2006
How much, doc?
The Atlanta Journal-Constitution
The best battles are those where deep-pocketed competitors vie for the love and affection of the huddled masses. So it is that an insurer with 3,300 employees that pays the medical bills for 40 percent of Georgia’s privately insured patients is locked in public tit-for-tat negotiations with a healthcare conglomerate that employs 5,000 and generates net patient revenues of $737 million. The parties: Blue Cross and Blue Shield of Georgia on the one side, Piedmont Healthcare of Atlanta, on the other.
Do we have a dog in this fight? You bet. Blue Cross contends Piedmont’s charges are unreasonably high for the market. Piedmont says that it’s merely asking Blue Cross to pay fees comparable to those charged other carriers.
Not enough about the proposed reimbursements in dispute has been revealed publicly to pick the bad guy — but in principle, this corner’s with Blue Cross, even if it means long-term patients are put in positions where they opt for financial reasons to go elsewhere.
At some point, all of us have to become aware of, and concerned about, what medical services cost. I recently underwent a sleep apnea study that cost about $1,500. Had I been paying the bill, I probably wouldn’t. The physician appeared slightly discombobulated when I asked the cost. He guessed, and assured me that the fee had been negotiated and that I needn’t worry.
But I did. The third-party payment system that keeps us unmindful and unconcerned about what things cost is a major contributor to health care inflation. As with government money, it’s “free.” Until that changes, the nation has no hope of containing, much less curing, inflation.
I do believe the solution is to change the system. A combination of health care savings accounts combined with catastrophic care insurance would give individuals a reason to care what services cost. I believe, too, that every recipient of taxpayer-provided medical care should be charged a co-pay and given financial incentive to avoid over-utilization.
Meantime, though, some payer with clout — Blue Cross, in this case — should be hanging tough, questioning charges and dropping the bomb when they believe them unreasonable, even if it means patients have to go elsewhere. Costs matter. Nothing’s free. Even if we don’t pay on the spot, we pay more in taxes and get less in salaries because of it.
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