Hospitals and The Wizard of Oz




Remember him?  That’s what he said in a BIG, BOOMING ROAR when he was the monstrous hologram of a Wizard looking down upon young, innocent and highly-intimidated Dorothy, her dog Toto and her three friends.

Dorothy thought that the Wizard was the only one that could get her home to Kansas, so she did not question him.  She did what she was told.

So what’s hiding behind the curtain?

Toto pulled back the curtain of “The Great and Powerful Oz!”  Toto was smart!  (Yes, dogs are smart!)

And guess who is hiding behind the curtain pulling levers and using a microphone to amplify his otherwise squeaky voice?  It’s a little ol’ man.  Not so great.  Not so powerful.  He just wanted to be.  And his power and his ego derived from Dorothy not knowing who he really was.

So why are hospitals afraid to publish their negotiated rates with insurance companies that aren’t made public?  Stephanie Armour wrote about it in the Wall Street Journal last Friday, “Hospitals Appeal Decision Upholding Disclosure of Rates Negotiated With Insurers”

What are they hiding?

Hospitals would be required to publicize the rates they negotiate with individual insurers for all services, including drugs, supplies, facility fees and care by doctors who work for the facility, according to the article.

Also according to the article, hospital groups say they would have to prepare much information to comply, which would be costly; require spreadsheets with hundreds of thousands of columns; such files could crash most standard computer systems.

The Surgery Center of Oklahoma already does exactly this.  Dr. Keith Smith and Dr. Steven Lantier have been publishing prices since 2009.  It is not like it cannot be done.  It already is.  When you hear these doctors speak, they are all about transparency, competition and most importantly – value.

Doctors are good people.  And so are the nurses and staff who run hospitals.  And so are pharmacists and the people who produce the medicines we need.  They’re just like you and me.  They’re not great and powerful.  They’re human.  They have families to care for and bills to pay….just like us.

But that’s why doctors, hospitals and pharma need to show us the prices.  It’s the right thing to do.  Hiding the prices is not good business unless you don’t wish to be fair.

If you read my post What makes up the cost of my insurance?, you’ll know some of the things that make up the input costs in a Big Mac.  I don’t want to know the cost of the inputs, I want to know how much a Big Mac costs.

So when the hospital group says that they will crash computer systems with the hundreds of thousands of columns, while perhaps true, that answer is disingenuous.  I don’t want to know the cost of the gauze or the stitches or the surgical knife!  Those are input costs.  I want to know the cost of the knee surgery.  Period.  And I want to know it upfront, before I pay a dime.

Every business publishes their prices.  It ain’t rocket science.  You cannot drive down the street without seeing a business that publishes its prices in a storefront window, on a sign or a billboard or hearing it on your radio (or your phone).  Name the last restaurant you went to that didn’t have its prices on a menu.  Every grocery shelf has the price of the item displayed.  Every clothing store has a price tag on every piece of apparel.  Hundreds of thousands of items show their prices every day… can be done.  And should be.

The reason that doctors, hospitals and pharma don’t publish their prices is that we don’t demand that they do.

We need to.

We need to pull back the curtain.

We need to be like Toto.  And Toto is smart!

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