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Sentences I am happy about in the Senate bill: Part I

Page 12:

Each hospital operating within the United States shall for each year establish (and update) and make public (in accordance with guidelines developed by the Secretary) a list of the hospital’s standard charges for items and services provided by the hospital, including for diagnosis-related groups.

Pricing transparency!

By Ezra Klein  |  December 19, 2009; 1:03 PM ET
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And if not, then what? A fine of $10 for every year they don't fulfill this legal requirement?

Posted by: Gray62 | December 19, 2009 1:10 PM | Report abuse

Ben Nelson (and Lieberman before him) have been pretty explicit about the parts of the compromise that are "untouchable" by the House. But I would imagine that there are ways to tinker with some of the less controversial (or well known) parts of the bill to improve things for low-income people or strengthen the cost controls, both of which would make liberals a bit happier. I'd like to see these ideas communicated to Nancy Pelosi and Henry Waxman, though not too loudly lest Lieberman decide he wants to kill more stuff progressives like.

It sounds like Reid got more in there than many were giving him credit for.

Posted by: Mimikatz | December 19, 2009 1:16 PM | Report abuse

It doesn't really matter what hospitals charge. Insurance companies or entitlement programs are the ones paying the bill.

No, there's a progressive thought.

Posted by: bobsteph1234 | December 19, 2009 1:31 PM | Report abuse

Charges, Ezra, not prices. Although there is a section on market pricing as well.

Charges are MSRP, but much more distorted.

Posted by: wisewon | December 19, 2009 2:47 PM | Report abuse


Posted by: jkaren | December 19, 2009 3:29 PM | Report abuse

These prices are as useless as the ones on every hotel room door. Meanwhile, we are prevented from knowing the real amounts providers are accepting, because the Japan experience shows that gives consumers more power than the lobbyists want us to have.

Posted by: bmull | December 19, 2009 3:50 PM | Report abuse

Gray62 took the words out of my mouth.

Minor punitive measures or "voluntary compliance" are useless.

Posted by: randomcurmudgeon | December 19, 2009 4:48 PM | Report abuse

"I'd like to see these ideas communicated to Nancy Pelosi and Henry Waxman, though not too loudly lest Lieberman decide he wants to kill more stuff progressives like."

It's not just progressives that like this. Pricing transparency is key to market function.

Posted by: staticvars | December 20, 2009 1:38 AM | Report abuse

A hospital's standard charges are used in calculating Medicare outlier payments (and they have been a target for abuses in recent years because of that), but they've always been disclosed to the Government, if not the public at large. I don't know what else they're used for.

Posted by: tomtildrum | December 20, 2009 10:21 AM | Report abuse

Wow. Other posters seem skeptical that this will work right away, and maybe they're right, but it's a huuuge leap forward for American health care to arm consumers with at least some basic knowledge about what they're getting.

Posted by: jeffwacker | December 20, 2009 10:41 AM | Report abuse

Some states already disclose this info, as do private websites, so the local newspapers run annually a "most and least "expensive" hospitals" story. There are a few challenges to doing this well (as someone who has to figure out how to do it). First, There tens of thousands of individual chargeable items at the typical hospital, so a full "price' list is impractical. Second, pricing at a higher aggregate level is difficult because of the great variability in utilization between patients. The pencil-necked policy wonk will claim that variability as proof of unnecessary variation in practice, which some of it surely is, but more of it is due to the underlying variability of patients. As just one example: if you are pricing a surgery, and one of your patients in your sample was a hemophiliac, he would have received biologic clotting factor, which costs many thousands of dollars. If you don't screen him out, your "price" for that surgery will be MUCH higher. And you often can't count on large numbers to wash out this variation. Some individual procedures really are rare, so the underlying variation between patients predominates. It will be an interesting analytical exercise to see how this plays out. If one is serious about a policy to move towards pricing transparency, everyone, regulators and patients, is going to have to become a LOT more familiar with basic statistics like "mean, median and standard deviation." Your experience may vary. Past performance is not a predictor of future results, etc.

Posted by: rdb66 | December 20, 2009 12:08 PM | Report abuse

With MOST hospitals already owned by the United States government (as federal, state or county/municipal, or reservation facilities) I doubt that provision has much of a meaning to the overwhelming majority of patients.

Typical of almost all Democrat ideas, they sound good on the surface to their mind numbed, kneejerk, easily led and uneducated masses, but when you get down to the FACTS those ideas turn to the dross their proponents know them to be.

You guys ought to pull Bernie Sanders Leftwingtard credentials BTW.

Posted by: muawiyah | December 20, 2009 6:55 PM | Report abuse

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