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For Healthcare Consumers, Ignorance Is No Longer Bliss

Like nerdy number-crunching health journalists across America, I spent much of Wednesday poring over newly released government figures revealing – for the first time ever – the colossal disparities between what hospitals across the country charge for common procedures and pills.

The 17,511-page document spills the beans about what 3,300 hospitals charge for 100 common inpatient services, and is being lauded as an “end to medical billing secrecy” and the dawn of a new age of medical transparency.

“Currently, consumers don’t know what a hospital is charging them or their insurance company for a given procedure, like a knee replacement, or how much of a price difference there is at different hospitals, even within the same city,” Health and Human Services Secretary Kathleen Sebelius said in a statement Wednesday. “This data will help fill that gap.”

Maybe so. But right now – as a woefully uninsured mother who has always naively, and trustingly gone to the nearest hospital – I just feel ripped-off.

Why exactly does it cost $223,000 to have a joint replacement in Monterey Park, Calif., but only $5,300 for the same procedure in Ada, Okla.? Why does – as the Denver Post reported – the Medical Center of Aurora charge $59,000 to treat pneumonia, while the Arkansas Valley Regional hospital charges $17,000? And why does the cost of treating a heart failure patient in Denver range from $21,000 to $46,000, depending on which ER you happen to land in?

Clearly, the caliber of doctor and facility varies from place to place, some hospitals serve older or sicker patients than others, and prices will rightly reflect that to a degree. But is there ever a justification for the same procedure to cost 40 times as much in one hospital as in another?

This is not the first time I have puzzled over the vast price differences between medical care Here and medical care There.

On a recent trip to Peru, when a friend fell gravely ill with a bleeding GI infection, we made our way to a small, friendly clinic high in the Peruvian Andes where a licensed MD examined her, gave her some antibiotics, and sent us on our way. She was vastly better within 24 hours. Price tag for visit and pills: $10 U.S. dollars. Here, it would have cost well over $100, and I am not convinced the outcome would have been as good.

Upon returning, when I was hit with my own lingering stomach problems, I visited my local hospital where I underwent a series of blood and stool tests. A month later I was hit with a bill for nearly $800 (which my insurance company did not cover) to tell me, essentially, that I did not have giardia.

“How could this possibly cost so much, and I still don’t even know what’s wrong with me?”  I asked, pleading unsuccessfully with a cocky accounting department guy to lower my bill.

His condescending answer, after noting that there were probably other Colorado hospitals that would have charged less:

“Health care is like anything else. You have to shop around to get the best price.”

Sadly, it looks like we are all going to have to be doing a lot more of that.

Lisa Marshall is a freelance health and medical science writer in Lyons, Colo. Connect at www.lisaannmarshall.com.

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