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Hospital Price Gaps Show Just How Broken the US Health-Care Market Is (www.bloomberg.com)

submitted 11 months ago by [email protected] to c/[email protected]

46 comments fedilink hide all child comments

When a baby is about to arrive, every minute counts. Yet when Jen Villa of Salinas, California, was in labor, she and her partner drove 45 minutes in the middle of the night, bypassing nearby hospitals to reach one they could afford.

For years, the price of hospital care has been hidden from patients, companies and taxpayers who get the bills — and that secrecy has made a hospital visit in some places prohibitively expensive. It has also fostered disparities, forcing people to pay far more depending on where they go.

...

Federal rules put in place in 2021 require hospitals to make their prices public so consumers can compare them and know ahead of time how much going to one will cost. While many hospitals have been slow to comply, the emerging picture has revealed imbalances that leave patients like Villa weighing saving money against being seen by a preferred doctor or at facilities closer to home.

A Bloomberg News analysis of data compiled by Rand Corp. found more than 350 hospitals in communities across the US with significantly lower-cost competitors within 5 miles. More than half the time, the less expensive facilities had quality ratings that were similar or superior to their pricier neighbors. If patients are willing to travel as far as Villa did for lower cost care, they’re likely to find it: Almost half of US hospitals are within 30 miles of a significantly less expensive competitor, according to Bloomberg’s analysis of the Rand data.

Such inconsistencies seem to defy the normal market forces that shape prices for most goods and services...

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[–] [email protected] 46 points 11 months ago

Speaking from the pharmacy perspective.

Banks wove their way into drug transactions as a middleman called Pharmacy benefits managers. They stand between insurance and pharmacies to prevent collision, but instead, what we see is insurance companies pay a lot for drugs, while pharmacies see very little for that drug. Over 50% is being taken by the PBM because they're "preventing" collision. Don't even get me started on the vertically integrated pharmacies like CVS and United who abuse their position to force consumers to use their pharmacies instead of competitors or use "technological advancements" to keep their prices lower than their competitors.

NYC is currently trying to pass legislation to fix this, but that's only at the state level.

Wall Street needs to get the fuck out of healthcare and healthcare needs to stay the fuck out of Wall Street. Once a healthcare org talks about share holders, we're no longer talking about patients.