Before Agreeing to Pay,
Find Out the Price
12 February 2013

Obvious, don’t you think? And yet the idea is wholly foreign to American health care.

When the Clintons came into Washington in 1992, determined to enact universal health care, I said to myself, and shouted to those nearby, that they’d have been wiser to begin with an examination of health care costs, which were obviously not market-priced at the time. Just how out of whack costs were and are, however, even I couldn’t have imagined. Today’s Times features a senior thesis by one Jaime Rosenthal, at Washington University in St Louis. Rosenthal called up more than 100 hospitals to ask how much a hip replacement would cost his (fictitious) grandmother. It should be no surprise that many hospitals had a hard time answering the question. What is a surprise is the range of prices: from $11,000 to $126,000.

Dr. Cram said the study did contain some good news: some of the country’s top-ranked hospitals came up with “bargain basement prices” in response to repeated calls. “If you’re a good consumer and shop around, you can get a good price — you don’t have to pay $120,000 for a Honda,” he said.

But that shopping can be arduous in a market not set up to respond to consumers. To get a total price, Ms. Rosenthal often had to call the hospital to get its estimate for on-site care, and a separate quote from doctors. And many were simply perplexed when she asked for a price upfront, Ms. Rosenthal said, adding, “The people who answered didn’t know what to do with the question.”

Hip replacement is a common procedure that many older people require. Somebody has got some work cut out.

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