Price Gauging

[bluemarlin08]

Wife broke her ankle 7 weeks ago and we returned to the doctor yesterday. They cut the old cast of and put he in a walkin boot. They told me they will bill BC 375 but we won't have to pay that amount. Go to check out and the boot was repriced to 275. Later, I go on line direct to the manufactorer's retail website and can buy the same boot for 75. Why would BC agree to pay these outrageous prices. Pretty good deal for the doc office 266% markup. The rate he charged was just for the boot, other charges for office visit.

 

[Crabcake Johnny]

Because BC doesn't have to pay those prices.....you do.

 

[bluemarlin08]

I understand, but if I had met my max OOP, they would pay this charge. Had similar thing a few years ago when I had met max oop, needed CPAP, $3200 from med supply house, same machine on line 450.

 

[Crabcake Johnny]

You pay for it regardless - either out of pocket or in the way of premiums.

 

[scagnt83]

You pay for it regardless - either out of pocket or in the way of premiums.

pretty much!!!

 

[Crabcake Johnny]

1) Price transparency
2) Tort reform
3) Personal responsibility

Until those three things are addressed there will be no answer to the health care crisis.

 

[scagnt83]

This is a prime example of waste in the system.

If the patient can find an item online for less than half of what the hospital charges, then the hospital should be charging at least that online price, or less considering that they should be buying in bulk.

The insurance companies found that higher prices brings them higher revenue; and even if profit margins and percentages stay the same, a higher amount of revenue is a good thing for a company.

This is why the insurance companies have never fought the inflated prices of doctors and hospitals too much; if they can pass the inflation down to consumers and tell them "thats just the way it is" and the consumers dont fight back against it, then what incentive do they have to fight it??? That is why we pay $12 for one damn aspirin when we are in the hospital!!!

If the gov. wants to regulate something, why dont they regulate the mark up on medical devices, procedures, and drugs.

Then do some constructive tort reform and put caps on lawsuits, prices would drop substantially.

 

[Crabcake Johnny]

This is where I have zero expertise but I can only guess the hospitals have a lot of pull.

I can see it going something like this:

"Hey, Blue Cross, John's Hopkins here. Here's our new reimbursement schedule. I know you're going to say WOW, we're asking for a lot of money, but if you don't agree to our terms that's fine, just let all of your members know that we no longer welcome Blue Cross and we'll get other hospitals to follow suit....since basically we own most of them."

 

[VolAgent]

Not that 275 is justified, but the doctor is entitled to a markup. Unless it is a very large practice, I doubt he turns it over very often, so it costs money to sit on that inventory. If he can buy it for 75, somewhere between 100-125 is reasonable depending on how often he moves the item. Ordering it online and waiting for it to arrive really isn't feasible as he needs it right then and there.

Now $12 for an aspirin, there is no justification for that kind of markup. Other than cost shifting from charity cases and write-offs.

 

[bluemarlin08]

I never would have paid much attention if I wasn't on a HDHP. I carefully monitor costs. I was really upset after I left the office, the doc probablt made more yesterday selling equipment than office visits.