A Long Beach hospital charged Jo Ann Snyder $6,707 for a CT scan of her abdomen and pelvis after colon surgery. But because she had health insurance with Blue Shield of California, her share was much less: $2,336. Then Snyder tripped across one of the little-known secrets of healthcare: If she hadn’t used her insurance, her bill would have been even lower, just $1,054. “I couldn’t believe it,” said Snyder, a 57-year-old hair salon manager. “I was really upset that I got charged so much and Blue Shield allowed that. You expect them to work harder for you and negotiate a better deal.”
Unknown to most consumers, many hospitals and physicians offer steep discounts for cash-paying patients regardless of income. But there’s a catch: Typically you can get the lowest price only if you don’t use your health insurance. That disparity in pricing is coming under fire from people like Snyder, who say it’s unfair for patients who pay hefty insurance premiums and deductibles to be penalized with higher rates for treatment. The difference in price can be stunning. Los Alamitos Medical Center, for instance, lists a CT scan of the abdomen on a state website for $4,423. Blue Shield says its negotiated rate at the hospital is about $2,400. When The Times called for a cash price, the hospital said it was $250.
“It frustrates people because there’s no correlation between what things cost and what is charged,” said Paul Keckley, executive director of the Deloitte Center for Health Solutions, a research arm of the accounting firm. “It changes the game when healthcare’s secrets aren’t so secret.” Snyder’s experience is hardly unique. In addition to Los Alamitos, The Times contacted seven other hospitals across Southern California, and nearly all had similar disparities between what a patient would pay through an insurer and the cash price offered for a common CT, or computed tomography, scan, which provides a more detailed image than an X-ray.
I rolled my eyes when I read Mrs. Snyder’s comments. Not that I disagreed with her expectations about health-care costs. But Blue Shield and the rest in the AHIP cartel don’t care about the price American’s pay. They care how to make the most money they can and if that means screwing the public that’s what will happen.
I mentioned earlier in the week how the public option fight changed the progressive movement. You had a popular, compromise measure that the public supported, where advocates did everything right, getting their pledges and using allies to make demands, and none of it mattered. It bred cynicism for future fights.
Underneath all that was a belief that the public option’s fate represented a sellout, that forces inside Washington cut a deal, whether with the hospital industry or the insurance industry or whoever, to get rid of the public option at the last minute. Tom Daschle confirmed this in a book all the way back in 2010, which he then had to walk back. And other reports have made similar claims, though nobody could nail it down.
Now, Richard Kirsch, who was the head for Health Care for America Now, the labor-backed coalition trying to pass the Affordable Care Act in 2010, admitted that the public option was traded away in the midst of the fight.
The book is Fighting For Our Health, by Richard Kirsch, who directed the advocacy group Health Care for America Now during the push for reform. HCAN is a well financed umbrella group backed by scores of liberal groups, unions, and other reformers — making Kirsch a close witness to the entire saga. He confirms that the White House treated the public option like a bargaining chip with powerful industry players, and believes that when his group became most critical of the bill mid-way through the fight, that top White House aides sought to have him canned.
“The White House had negotiated a number of deals with the health industry, designed to win their support for reform, including agreeing to oppose a robust public option, which would have the greatest clout to control how much providers got paid,” writes Kirsch, largely confirming what has become an open secret in Washington.
I think this sellout exposed Democrats and separated them from the progressive movement like nothing else has. Anyway, I like to think that…