Wednesday, April 10, 2013

Health Care Costs: Bill For Clipping One Toenail: $1,206

Ezra Klein had an illuminating, scary piece on the Washington Post's Wonkblog recently.

There's been much discussion about how health care costs are so high because basically insurers, health providers and others can charge what they want.

A reader noted the clipping of one toenail in a hospital setting cost $1,206, according to Klein.

The reader who sent Klein the information on the toenail clipping said it was just the kind of thing you'd do in your bathroom for free. True, in this case, they had to do tests to make sure the toenail wasn't infected. There was no infection.

The price tag for this simple procedure included $248 for the office visit, $182 for a biopsy and $328 for the treatment room.

The person involved called various billing offices, where workers said the prices were outrageous, but "nothing could be done."

End of story.  Left unexplained by the billing people, apparently, is why "nothing could be done."

I smell a rat.

In an earlier column, Klein wrote:

"Providers largely charge what they can get away with, often offering different prices to different insurers, and an even higher price to the uninsured.

Health care is an unusual product in that it is difficult, and sometimes impossible, for the customer to say 'no.' In certain cases, the customer is passed out, or otherwise incapable of making decisions about her care, and the decisions are made by providers whose mandate is, correctly, to save lives rather than money."

In other countries, health care is less expensive than in the United States because other countries negotiate aggressively with providers and thus, prices are lower. Klein said in the U.S., it's a free for all

If all this is true, why do we let providers get away with it? I understand the unwillingness to futz around with the marketplace. But what if the marketplace is all messed up?

And the deeper questions are: If someone is screwing the hell out of us and playing with our health care, who is it and what can we do about it? I hope the journalists keep digging.


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