Interested in shopping for the best deal on a recommended medical procedure, with health insurance or even without?
What, are you sick or something?
Martha Bebinger, a reporter with Kaiser Health News, tried to comparison-shop when her doctor said she should undergo an MRI for migraines last summer. What she got instead was a classic runaround that is both systematic and symptomatic for American health care.
Because Bebinger had health insurance, she knew she would be out only a $25 copayment, regardless of where she had the MRI. But being a curious reporter, she decided to see for herself if you can shop for expensive medical procedures the same way you shop for broccoli or paper towels.
At the first hospital she tried, Boston's Newton-Wellesley, she failed to receive so much as a ballpark quote after being transferred from the doctor to radiology to billing.
She had better luck at Massachusetts General, arguably one of the nation's finest and most expensive hospitals, which quoted her its uninsured rate of $5,315. What would the cost be with insurance? They couldn't tell her.
So, she tried Shields, an independent laboratory chain that specializes in MRIs and other radiology tests. Shields quoted her $2,000 but said they would charge her health insurer as little as $600.
Bebinger opted to have her MRI performed at Newton-Wellesley, figuring that the bill would fall somewhere between Mass General and Shields. To her surprise, not only did the hospital charge her insurer an uninsured rate of $7,468, it also had inexplicably taken and charged her for two MRIs, even though her doctor had ordered only one.
Bebinger never did find out what an MRI costs on the "free market," but she's relieved that her test turned up nothing that a little sleep won't cure.
Why would a hospital charge nearly $8,000 for the same procedure an independent lab bills at $600? "Newton-Wellesley said that it costs a lot to keep a hospital open 24 hours a day," Bebinger writes. "Hospitals lose a lot of money on some services and make it up on other services."
Bebinger's story once again illustrates the need for health care reform, both to rein in the apparent overbilling that feeds medical inflation and to extend to health care consumers the same courtesy we expect at stores and restaurants: the opportunity to see the price before we buy.
Follow me on Twitter: @omnisaurus
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