I blog about free markets in medical care and transparent pricing.
A legislative healthcare expert in Washington D.C. recently told me that the Medicare payment to “not for profit” hospitals here in Oklahoma City for any of the surgeries for which we have listed prices on our website is double what we have listed. For Medicare.
We are told that Medicare is going broke when surgical care for half what they pay is present in the same city. We are also told that these “not for profit” hospitals are going broke at these rates of payment, while they continue to build their marble and mahogany temples all over the place, each of which serves as an instrument of bankruptcy for all levels of government and individuals.
I read with interest the piece by Jaclyn Cosgrove who writes in the September 7th edition of “The Oklahoman” about a poor patient who needs a colonoscopy. ”Put yourself in that place…your’re making $10 an hour, you’re 50 years old and you need a $1000 test…what are you going to do? Nothing,” said Lou Carmichael, the CEO of Variety Care.
Variety Care operates a group of what are called community health centers, designed specifically to help the poor, particularly those who fall through the government cracks. That their CEO quotes $1000 as a reasonable price for a colonoscopy shows that even charitable organizations such as Variety Care (they take some government money but are also partially privately funded) are not immune from the hospital mercenaries.
A physician-owned gastroenterology lab here in Oklahoma City will do a colonoscopy for $550. Best gastroenterologists in the state in my opinion. All-inclusive. All day long. And make money doing it. Gastroenterologists who are employees of hospitals perform colonoscopies for their boss for 6 times this amount at one hospital I know of here in Oklahoma.
The director of a charity here in Oklahoma City once told me that they could provide three cochlear implant procedures at our physician-owned surgery center for every one they paid for a the “not for profit hospital.” Greedy doctors!
You can obtain open heart surgery here in Oklahoma City at a physician-owned facility (best cardiac care in this entire region) for about the same price as one year’s insurance premiums. I hope that everyone will begin to understand that health care doesn’t really cost that much. What the giant hospitals charge for healthcare is another matter, altogether though.
When asked to explain why we charge so little, rather than justify my charges, I typically turn it around and remind people that it’s the institution charging 6-10 times what we do that has some explaining to do, not me. The big hospitals do this while claiming they are not making a profit, paying no tax, building like mad, engaging in brazen hostile takeovers of private physician practices, paying their administrators millions of dollars (each) and bragging about their contribution and benefit to the community.
You don’t think the hospitals would “donate” to organizations like Variety Care in an attempt to control patient referral patterns do you? If they did, I’m sure they would claim this as part of their benefit to the community, as well, charging $3000 for the colonoscopy, taking $1000 and “benefitting” the community with this $2000 “donation,”part of which they will be rebated through the uncompensated care scheme!
Insurance policies are designed to keep you from asking what health care costs, as people typically only care about their “out of pocket” expense. It’s time to start asking how much your healthcare costs. In my opinion, this alone could cut spending on health care by as much as 50%. That Medicare pays hospitals twice what is listed on our website is evidence of this, I think.
G. Keith Smith, M.D.