First, the latest T. T. Mitchell Consulting Newsletter, Credibility, and the latest Healthcare Newsletter, Three Things, are now available.
Because I’m in health care, I’ve been reading a lot of things lately that talk about how health care is going to take a tumble in these bad economic days, and how many people are falling into debt because they can’t pay their bills, hospital bills being big among those debts. There are many truths in what I’ve been reading, along with some things that aren’t close to being true. I guess that’s pretty standard, because a lot of what we’re hearing about our financial crisis is the same type of thing.
However, I’m going on record to make one specific point: there isn’t a single person in trouble because of a hospital’s charge master. A charge master is a list of charges that hospitals and physicians charge for. They’re comprised of procedures, pharmaceuticals, and supplies. The reason hospitals and physicians have them is twofold. One reason is because it makes the capturing of charges on patients easier to do because of reason number two, every item that can be captured and billed has to have some kind of codes attached to them in order to get them paid by insurance companies.
Here’s the thing, though. A charge master is only a tool used by medical entities to handle the financial side of their business. A retail business has its list of prices also, but when you go to the store you see either a price tag on an item or above an item. Many other places you go that sel only a few specific things may have their fees listed. In today’s world, there are more hospitals that are going to what’s known as price transparency, which means they’re trying to set up ways for patients to see how much services may cost them. I say “may” because, in health care, the diagnosis you go to see someone for may not be the same diagnosis later on, in which case sometimes the procedures change midstream, and then the prices change. One rarely hears of a patient complaining, especially if the procedure helped them feel better or save their life.
What affects prices, and therefore patient’s responsibilities, isn’t the charge master, but the hospital’s financial position and financial policies. Hospitals and physicians in general work hard to base pricing policies on reimbursements from insurance companies and the actual expenses they have. Those decisions are what ends up on a charge master as it pertains to prices. It’s not the charge master specifically, though, and anyone who states this either doesn’t have any understanding of how health care finance works, or is trying to find a tool to inflame the public in some fashion.
Want to know a truth? It seem that most people don’t care anyway, so those people trying to vilify the charge master are beating a dead horse.
True, the price of health care keeps going up, and there does need to be some reform that, unfortunately, I’m predicting isn’t going to happen for a very long time. But let’s blame the right sources.
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September 30th, 2008 at 10:24 am
So, tell me Mitch, does the US Government subsidize medical care at all. Ours does in the form of Medicare.
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September 30th, 2008 at 10:36 am
In ways, yes it does. We have Medicare and we also have Medicaid, which is for low income people. What we don’t have is mandatory coverage for those “in between” folks, which is those who make too much money for Medicaid and work at companies that don’t have enough employees for health insurance to be mandatory.
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September 30th, 2008 at 7:15 pm
Ours private cover isn’t mandatory, but the government does allow a kickback for those who take it on. It’s because our Medicare covers everyone, regardless of wealth, and so the government sweetens the deal for private cover to take pressure off the public system.
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September 30th, 2008 at 7:49 pm
Over here, Medicare is only for the aged or disabled. The term “kickback” is a major negative term; hospitals can lose their licenses to it. lol That’s an interesting take on how insurance could go, with the government offering incentives for private insurance carriers. Here, that happens only with Medicare and Medicaid HMOs.
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September 30th, 2008 at 9:51 pm
maybe it was a poor choice of words, but what I meant was we get a tax incentive for going private.
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September 30th, 2008 at 10:42 pm
Tax incentives to individuals; now that’s interesting, for sure. From what I understand, if you have the private insurance you get care quicker, at least in some instances.
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September 30th, 2008 at 11:02 pm
That’s for sure. Whereas some people could be waiting many months for an operation, if you have Private health cover you can usually get in within weeks.
There are also other benefits like private room where available, and the food is usually better as well. I reckon that is something your Government should consider.
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