Getting the "Just Right" Price for Health Care

Did you ever watch the game show “The Price is Right”?  It’s interesting to wonder if, instead of guessing the prices of fancy cars or dishwashers, contestants were asked “what’s the difference in the median price of a c-section in Kennewick vs Bremerton?” (Answer: If you said “$13,500, you’re a winner!!!)  or “How many times more expensive is treating a stroke in the highest billing hospital vs lowest billing hospital in WA?” (Answer: 3 times more expensive). And more importantly:  “What is the actual cost of this care vs what hospitals charge various payers?”

Washington state legislators understand the vital importance of bringing health care prices down and in line with actual costs, if we are to have a health system that covers everyone while ensuring quality, equity, and access.  The last few years have seen a flurry of bills aimed at giving the state more leverage to control health care prices. E2SSB 5399, the UHCC will play a significant role, as will E2HSB 1272 the Health Care Transparency bill, and ESSB 5203 the state drug purchasing bill.  But we still have a long way to go.

David Belk, MD, author of The Great American Healthcare Scam: How Kickbacks, Collusion and Propaganda have Exploded Healthcare Costs in the United States, provides an important perspective on what’s behind these crazy health care prices and how they can be better controlled.  We're so fortunate to have him discuss his findings with us at our next hour-long Zoom discussion meeting, April 14 at 7 pm. RSVP here. Please join us!

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Washington State

HCFA-WA’s Cris Currie, RN, has an Opinion Letter published in the March 21 Spokesman Review calling out state Senator Mike Padden (4th LD) on his vote against the Universal Health Care Commission bill, and being “out of touch on the reality of modern health care”.  Check out his letter here (for Spokesman-Review subscribers), reprinted here with permission.

This Yakima area hospital showcases the vulnerability of rural hospitals to financial instability, made worse by the COVID-19 pandemic.
Pandemic shows importance and challenges of rural hospitals

8 minute video: Hidden Barriers- The persistent disparities in accessing WA health care.  A year into the pandemic, low-income people of color are still struggling to afford and access health care.  Small businesses often cannot cover employees, whose income falls too high for public benefits but still too low to afford private coverage.

Check out the other videos in the Hidden Barriers series here.

National

The American Rescue plan has passed.  It expands health coverage temporarily and will benefit uninsured Washingtonians, but allows continued government subsidization of high health care prices.
American Rescue Plan Could Significantly Enhance Health Insurance Coverage

The prices that private insurance pays providers  are much higher than what Medicare spends for the same care. This study shows overall health spending could be reduced by $350 billion a year, with employer plans saving $310 million, if private plans reimbursed at the same rate as Medicare.  While hospitals and doctors would oppose such cuts to their revenue, currently there is very little incentive or pressure to keep prices in line with costs, especially where hospitals are able to consolidate.
Limiting Private Insurance Reimbursement to Medicare Rates Would Reduce Health Spending by About $350 Billion in 2021

With their deep pockets, the healthcare industry holds disproportionate power and influence with legislators, and the health insurance industry, in particular, has hampered the path to affordable publicly financed universal health care for far too long. HR 1, The For the People Act, calls for restrictions on corporate campaign finance including:

• Calling for a constitutional amendment to overturn Citizens United
• Public financing of small-dollar campaign donations with a 6:1 federal matching program
• Putting sunshine on dark money campaign contributions

This bill passed the House and is now facing some stiff opposition in the Senate.
H.R. 1: The Path to Democracy in America