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Prager 5 Minute Videos

Price Transparency: How to Fix Healthcare

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How can a simple blood test cost $30 at one lab and $300 at another across the street? The answer to this question could save billions, as well as make healthcare more accessible and affordable for everyone. Will Bruhn, co-founder of Restoring Medicine, explains.

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Script:

How messed up is our healthcare system?

This messed up. 

Researchers compared prices amongst 53 hospitals for a standard heart procedure, called a CABG, or coronary artery bypass grafting. Not only did the researchers find a 10-fold difference in price for the same procedure across hospitals — from $44,000 dollars to $448,000 dollars; but they also found no correlation between higher prices and better quality of care. 

Other studies have shown there can be up to a 39-fold variation in price for a simple blood test across medical centers in the same metro area. 
Here’s the punchline. 

We have no idea how much we’re paying for healthcare services.
 
Why is it that when you need to get a surgery or medical test, you can’t get a price the same way you can when you shop for, say, an airline ticket? 

Imagine if the airlines didn’t post prices. Instead, when you bought your ticket, Delta just said, “we’ll bill you after your flight because we don’t know what the cost of fuel will be that day.” Then a week later you get a bill for $4,000. You’d scream bloody murder and rightly so. Yet this is precisely what we are dealing with in American healthcare.

With rare exceptions, when you go in for back surgery or a thousand other kinds of medical procedures, you have no idea how much it’s going to cost you. Worse, no one would be able to tell you if you bothered to ask.

That’s because medical billing is a ridiculously complex dance between hospitals, insurance companies, and various middlemen. The hospitals charge crazy prices — $100 for aspirin, for example — and the insurance companies and middlemen agree, through special, often secret deals, to pay some percentage of that. 

That’s how your knee replacement which the hospital says costs $50,000 on its itemized bill, actually costs you $5,000 — after your deductible. 

Out of all this confusion, one thing is crystal clear: medical costs are skyrocketing.
 
And, Americans are having more and more trouble paying the bill. 

Nearly 1 in 5 of us has medical debt in collections. 

If you think this problem doesn’t apply to you because you have insurance through your employer, and therefore your costs are covered, think again.  

Over the past five years, employees have had to increase their contribution to their premiums by 15%, in addition to a 36% increase in deductibles. Meanwhile, wage increases have not kept up, rising 14% over the same period. 

Yes, that salary increase you so richly deserved was eaten up by the increased insurance premium you had to pay. 

If the ever-increasing cost of medical care was reflected in the quality of the care you were getting — that is, if you were paying more to get better care — maybe this would make some sense, but, as we saw in the coronary bypass example, there is little or no correlation between what you pay and what you get. 

So how do we get out of this mess? 

A big part of the answer is price transparency — something almost every American wants. Even in our era of political polarization, almost 9 out of 10 Americans say they favor price transparency for medical services. 

Makes sense. 

Markets only work when consumers have the proper information to make purchasing decisions. And the two most important pieces of information are the price and the quality of a good or service. As it relates to health care, Americans don’t have access to either of those.

For the complete script visit https://www.prageru.com/video/price-transparency-how-to-fix-healthcare

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39 Comments

  1. This would not work, healthcare is a credence good meaning unless your a healthcare professional youll have no idea if its good or not. As they stated 40% of all healthcare is not "shoppable" but of the 60% that is, its subject to bounded rationality where a person has no indication on how good smth is but on price alone, so they can pay for extremely expensive medical procedures bc it could be life or death for them. Healthcare can never be treated as a normal commodity, as your not shopping around for a burger that you can always not buy, your buying for your life and even the life of your family, friends, partners or children so youll always choose whats best.

  4. Regulating prices is much more effective if you could die and there's only one company making that medicine they could ask whatever. There's also not enough competition in healthcare. You'll need to regulate at least some of it. This is not like buying a phone.

  5. There's a flaw. Yes, you need the government to intervene, sanctions against these usury/sinful acts, the people alone cannot punish hospitals just by not using their services. Like in every business, for example banks, will do all type of strategies, immoral o moral strategies, to get the costumer to consume. This will continue until the federal goverment acts against these actions that are anti-american values.

    You cannot go ahead and compare MRI studies/Blood testing/Plastic Surgery with Emergency/Urgency/Hospital cases.

  6. What high cost private healthcare is not actually higher quality? But PragerU has been busy saying that US healthcare is the best!! Also you expect regular people to understand and compare prices of various medical procedures? Really? And do it for everything? From the cost injections to pacemakers? I think you assume US citizens all have medical and financial degrees and a lot of free time to compare but that is not the case. Canadian health care is much better in my personal experience compared to US healthcare based on my personal experience in terms of quality. Also it only costs 2-5% extra in taxes but I never have to worry about going bankrupt due to medical expenses or choose between my child's life and their future/my retirement in case of major medical issues. The $20 in my wallet will be enough.

  8. There needs to be a law for non life threatening, urgent
    Cases that allows patients to not need to pay if they aren’t given the choice to beforehand. (For the majority of cases) if that was the case, every hospital would be giving out their prices by tomorrow

  10. Tell me how one has the ability to use cost comparison when insurance limits you to providers in “network”? They won’t pay “out of network” even if it would save $$$$ and who can understand a hospital bill or challenge it?

  12. Yup priced transparency would be a huge factor and I do want free basic healthcare as well like free yearly check up blood work x rays generic medication dental cleaning and check ups eye exams ect you know like the country should want healthier citizens and preventive care is probably the cheapest way to accomplish that I don’t expect the gov to flip the bill for my broken arm but I would hope my blood work and check ups be free to help me out a little in my mine this is common sense

  14. Is PragerU actually talking in favor of some sort of regulation? You know what really helps, if the government sets some max prices and collect some more taxes to deal with healthcare a bit more centralized. It has been tested all over the world and it really works. It makes healthcare cheaper and better.

  17. This doesn't solve the problem though. As long as treatments that are worse to the patient (for example opiods) are cheeper, insurance companies will always choose to hand those out.
    America needs a strong public healthcare, yes, with competition and without the crazy administrations of other countries, but a public one regardless.

  18. We need more Ayurveda healthcare (be open minded enough to do
    more/better unbiased research, n check out the details/evidence on the
    (upcoming) video on channel Playitalready about this), we need
    integrated record keeping, less (uneeded) college requirements to be a
    Doctor n less insurance middlemen for non-catastrophic care, n
    yes…more price disclosure, n charity, & the feds give too long
    patent life to big pharma, & we should negotiate drug prices (&
    other prices too, especially ER prices since it’s hard to shop around or
    negotiate during an ER trip lol). But…we lack everything in this
    paragraph & big pharma is the number 1 donor in Washington…

    …and they ain’t so charitable. They raise prices big time, at random, out of
    greed. We need more herbal/healthy lifestyles, discriminating only on
    pre existing conditions in your control (doing illegal/deadly drugs,
    dare devils, meat eating, drinking) and stop teaching people at a young
    age as if there's no God or karma or objective morality like it's
    survival of the fittest (which can result in less greedy people bribing
    politicians or finding loopholes which requires more taxes n regulations
    n problems etc). peace out

  27. Price Transparency is important yes, but what happens in situations where there are no alternative options (where capitalism doesn't work). e.g. there is no other hospital for hundreds of miles or it's an emergency. In that case, there should be some kind of basic regulation that prevents patients from going bankrupt because of a medical emergencies or lack of options.
    Whatever solution America uses, it should be the one with the least bureaucracy that can also actually work in all situations.
    (Personally, I would vote for Price Transparency mandates but also implement government insurance of emergency situations. (where the government and hospitals negotiate prices for emergency services only)

  29. Up until the 3:00 minute mark, this is a perfect as for Medicare for All. Corporate Republicans and Democrats alike are not for it because it takes away their kick backs from Heath Insurance and Drug companies who can take you over the coals. You don't have a private fire department or police force, why should you have private heath insurance? Heath care should come out of our taxes and be universal, combined with price transparency it is absolutely the best option

  36. 0:22. The reson for that price difference is because theres 4 different types of CABG surgery.
    0:58. There might be aditional things going on with the body that doctors may not know about until they open you up. Plus. There more focoused on saving your life first over determining your price. Especially if you need health care or whatever quickly.
    Silver lining: now there solution i think is a good idea but i also think we should get rid of the nonsense in our schools and teach the kids about usefull stuff about handleing our bodys to help reduce needed stuff at the hospital or even eliminate the need to visit. Have people better informed on stuff like heart problems and what not. When i dealt with heavy heart pain. I didnt whine to a doctor. I found out it was caffine and avoided caffine. Now i dont have alot of medcall issues but i think america is much better off learning and self handling the issues instead of some doctor who takes mkre money then child support could do the more time consuming work. Its time people take independence of there biological lives. Not just personal.

  37. Hilary Clinton was given the opportunity and the widespread mandate to enact this in 1993, with the full backing of the President. She never came close to delivering, and after about 18 months of false confidence and claims of pending success, she quietly moved on. Think of how much better off our nation would be, by now, if she'd delivered the program as she claimed she would. I was on her side at the time, but I was younger then. So much younger…