What if all US health care costs were transparent? | Jeanne Pinder
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What if all US health care costs were transparent? | Jeanne Pinder


So, a little while ago, members of my family
had three bits of minor surgery, about a half hour each, and we got three sets of bills. For the first one, the anesthesia bill
alone was 2,000 dollars; the second one, 2,000 dollars; the third one, 6,000 dollars. So I’m a journalist.
I’m like, what’s up with that? I found out that I was actually,
for the expensive one, being charged 1,419 dollars
for a generic anti-nausea drug that I could buy online
for two dollars and forty-nine cents. I had a long and unsatisfactory
argument with the hospital, the insurer and my employer. Everybody agreed
that this was totally fine. But it got me thinking, and the more
I talked to people, the more I realized: nobody has any idea
what stuff costs in health care. Not before, during or after
that procedure or test do you have any idea
what it’s going to cost. It’s only months later that you get
an “explanation of benefits” that explains exactly nothing. So this came back to me
a little while later. I had volunteered for a buyout
from the New York Times, where I had worked for more than
20 years as a journalist. I was looking for my next act. It turned out that next act
was to build a company telling people what stuff costs
in health care. I won a “Shark Tank”-type
pitch contest to do just that. Health costs ate up almost 18 percent
of our gross domestic product last year, but nobody has any idea what stuff costs. But what if we did know? So we started out small. We called doctors and hospitals and asked them what they would accept
as a cash payment for simple procedures. Some people were helpful. A lot of people hung up on us. Some people were just plain rude. They said, “We don’t know,” or, “Our lawyers won’t
let us tell you that,” though we did get a lot of information. We found, for example,
that here in the New York area, you could get an echocardiogram
for 200 dollars in Brooklyn or for 2,150 dollars in Manhattan,
just a few miles away. New Orleans, the same simple blood test, 19 dollars over here, 522 dollars just a few blocks away. San Francisco, the same MRI, 475 dollars or 6,221 dollars just 25 miles away. These pricing variations existed
for all the procedures and all the cities that we surveyed. Then we started to ask people
to tell us their health bills. In partnership with public radio station
WNYC here in New York, we asked women to tell us
the prices of their mammograms. People told us nobody would do that,
that it was too personal. But in the space of three weeks, 400 women told us about their prices. Then we started to make it easier
for people to share their data into our online searchable database. It’s sort of like a mash-up of Kayak.com
and the Waze traffic app for health care. (Laughter) We call it a community-created
guide to health costs. Our survey and crowdsourcing work
grew into partnerships with top newsrooms nationwide — in New Orleans, Philadelphia, San Francisco, Los Angeles,
Miami and other places. We used the data to tell stories
about people who were suffering and how to avoid that suffering,
to avoid that “gotcha” bill. A woman in New Orleans saved
nearly 4,000 dollars using our data. A San Francisco contributor
saved nearly 1,300 dollars by putting away his insurance card and paying cash. There are a lot of people
who are going to in-network hospitals and getting out-of-network bills. And then there was the hospital
that continued to bill a dead man. We learned that thousands of people
wanted to tell us their prices. They want to learn what stuff costs, find out how to argue a bill, help us solve this problem that’s hurting
them and their friends and families. We talked to people who had
to sell a car to pay a health bill, go into bankruptcy, skip a treatment because of the cost. Imagine if you could afford the diagnosis but not the cure. We set off a huge conversation about costs involving doctors and hospitals, yes,
but also their patients, or as we like to call them, people. (Laughter) We changed policy. A consumer protection bill
that had been stalled in the Louisiana legislature for 10 years passed after we launched. Let’s face it: this huge, slow-rolling
public health crisis is a national emergency. And I don’t think government’s
going to help us out anytime soon. But what if the answer was really simple: make all the prices public all the time. Would our individual bills go down?
Our health premiums? Be really clear about this: this is a United States problem. In most of the rest
of the developed world, sick people don’t have
to worry about money. It’s also true that price transparency
will not solve every problem. There will still be expensive treatments, huge friction from our insurance system. There will still be fraud and a massive problem
with overtreatment and overdiagnosis. And not everything is shoppable. Not everybody wants
the cheapest appendectomy or the cheapest cancer care. But when we talk
about these clear effects, we’re looking at a real issue
that’s actually very simple. When we first started calling for prices, we actually felt like
we were going to be arrested. It seemed kind of transgressive
to talk about medicine and health care in the same breath, and yet it became liberating, because we found not only data but also good and honest people
out there in the system who want to help folks
get the care they need at a price they can afford. And it got easier to ask. So I’ll leave you with some questions. What if we all knew what stuff cost
in health care in advance? What if, every time
you Googled for an MRI, you got drop-downs telling you
where to buy and for how much, the way you do when
you Google for a laser printer? What if all of the time and energy
and money that’s spent hiding prices was squeezed out of the system? What if each one of us could pick
the $19 test every time instead of the $522 one? Would our individual bills go down? Our premiums? I don’t know, but if you don’t ask,
you’ll never know. And you might save a ton of money. And I’ve got to think that a lot of us
and the system itself would be a lot healthier. Thank you. (Applause)

About Bill McCormick

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100 thoughts on “What if all US health care costs were transparent? | Jeanne Pinder

  1. The US holds itself up as the bastion of capitalism and the free market and yet your health care system is anything but. The "free" market only works where pricing is transparent and people can choose based on price and other qualities of a product. It's hard to believe you stand for this.

  2. the insurance/healthcare industry won't sue her right we're talking about the worst of the worst who extort life savings out of sick people

  3. The solution: ask before treatment. Be in the know. Then pick the price which best suits you. Its different for emergencies, though.

  4. Stop voting for republicans and corporate democrats and your healthcare will be cheaper like every other developed nation.

  5. Healthcare is living healthy. You idiots pay other people so you get cheaper cost so you can take drugs that harm you costing more. Your priorities are upside down.

  6. The lack of transparency in health care prices demonstrates why it's fallacious to describe the US health care industry as a "free market".

    There are some health care facilities seeking to change that. The Surgery Center of Oklahoma is one such facility: they have all of their prices documented on their website. Many people have reported that it's often cheaper for them to buy a plane ticket to OK and pay for the treatment vs using a local hospital.

  7. Unfortunately, it's a conversation that can't be had and just has to be shut down because every time we try to have it the left tries to impose socialist health care on us and, frankly, no health care would be better than that. First we have to secure liberty, then we can worry about trivial details like life and property.

  8. it's not even the healthcare at fault. the public opinion is that people just don't want national healthcare and insurance, and that's beyond stupid lol

  9. It is not just developed but also developing countries like mine (India) have figured out medication and healthcare!!

  10. Several years ago I went to the hospital to have an abscess treated- a 15 minute procedure. First they asked if I had insurance. (no). Then they said they wanted to give me an MRI. I refused based on cost. They insisted. I insisted I could not and would not pay for an MRI to the attending physician as well as the MRI tech. They gave me the MRI.

    Then they told me to get out of their hospital, untreated. I had no insurance so they were going to leave me with my potentially lethal condition. I told them not to bother sending a bill.

    They sent a bill. For $8000.00.

    For nothing.

    They never got paid. They never will get paid.

    Luckily my abscess turned into a fistula rather than killing me.

    Screw them. I won't be surprised, or even disappointed if people start shooting up hospitals.

  11. Having the costs system be transparent so you can tell when a company is ripping you off and the company in question not being prosecuted for it? I have a better question. What would it be like if the us government actually gave a crap about others than themselves and had a system of FREE healthcare for the entire nation no matter wealth or social standing? Now how would that be?

  12. A few days ago (March 31) Canadians drove back from Florida with a dead family member in their car.
    The father died of cardiac arrest. They could not afford to bring him to a hospital and follow proper protocol.
    The family returned to Canada and advised the customs officer. At this time no charges have been laid.

  13. Transparent healthcare costs is what I've been arguing we need for a long time.
    My dad had to get a CT ended up getting charged more than $4k. Found out there was a hospital down the road 15 min he could have gone to that had new and better equipment which charges less that $2k.
    We need some legislation to require costs of typical medical tests and procedures be posted online.

  14. It is almost as if a free market under basic capitalism would be more efficient than an untransparent government style bureaucracy based system. I have no problem with someone getting rich if their business model allows their customers to have a free choice whether or not to purchase their products. The problem is when we have a cartel that does not allow true competition. You can call it government Style, Union Style, socialist Style or crony capitalism Style Healthcare, but anytime the customer at the bottom has no ability to know what they are paying for and good competitors are pushed out or are hidden from the public, the free market is being suppressed.

    The only purposes of government is to protect us from other people that will do us harm and protect us from people that will take away our rights. Any kind of Monopoly or cartel that suppresses the free market where one person cannot easily sell a product to another in a minimally regulated way needs to be stopped by the government if individuals cannot. This problem is a threat to our economy and the lives of all lower and middle-class citizens. The free market has done so much for the world to come out of abject poverty and terribly miserable conditions. Why does the healthcare cartel get a special pass in the United States?

    This problem is not going to be solved by more government control. This will be stopped by breaking the control of powerful people over less powerful people. It needs to be broken up and torn down until things get better. We don't need to shut down hospitals or start causing problems for people helping patients. The bureaucratic system needs to be shaken up were people come from more competitive Industries to start handling how finances are managed. People that will handle finances in healthcare should not be trained within the Healthcare System. They should be trained first and foremost in free market financial principles and then use those skills in healthcares Financial departments. This would be a prime example of breaking it up without destroying it.

    As it is right now existing Hospital bureaucracies control what other hospitals get to open in the area and who gets a medical license. You cannot come here from India as a doctor and just open a clinic because of government regulated crony capitalism and socialist Style government Healthcare. This is the only reason the government needs to get involved because they are the ones suppressing free markets.

    So when it comes to government creating a cartel because of Regulation its job is to continually break up that cartel and the multiple Parts involved that create cartel style practices. This is not a push for bigger government. This is a push for breaking up cartel and monopoly style practices with real laws with enforceable fines and criminal charges.

  15. I agree that it's insane, but doctors gotta get paid. Something needs to be done to confirm their debt and time is appropriately compensated.

  16. Exactly what happened when we made the govt transparent. If someone breathes out of their left nostril instead of the right one everyone cries. I sti believe you donโ€™t need to know everything that goes on.
    Go……live your life instead

  17. You would think that the insurance companies would want to pay the smaller amount but they actually make more money when things cost more. They're in cahoots with the medical providers / drug makers. By dealing with larger numbers they make more money as they get a percentage of the money that passes through their hands.

  18. I'm in a wheelchair due to a knee deformity. It would have been a 30 minute surgical fix if it had been done in childhood, but my insurance said the deformity had to cripple me first before they'd pat. This year, it did. Now I need a 45 minute surgery, but I no longer have insurance.

    This surgery is very common. So common that other nations do it for free in poor African nations. I will likely never have this surgery because they want $25,000 up front, with another $15,000 if a complication arises. I can't work in my condition, but since it's such a quick and easy fix I can't get disability benefits either.

    I've honestly considered doing something illegal to get arrested so I can have the surgery via the prison system. Or intentionally injuring myself further so that it has to be done via emergency surgery and I can make payments. The government is losing out on a lifetime of tax $ from a 20 something because they don't prioritize health. Anyone in the UK need a wife? I make great pies!

  19. I live in France, after 3 decades in USA. My dad got cancer and my family went bankrupt in 2001. Currently, my mother-in-law has had cancer for 2+ years, and though it is terminal and she needs constant in-home care and chemo – sometimes she visits the ER as well – not a single cent has been paid. Now for something totally cool : because I am a dual citizen, if I get sick in USA i give them my carte vital, and the hospital must take care of me and bill the Republique of France! USA is totally backwards, cares more about guns than people. USA is a great place toe visit but in a globalized world, you're better off living elsewhere.

  20. Yeah, good luck with transparency. There is NO incentive to be transparent! Medicine is a business nothing more. My insurance pays about $700 for my annual physical and for that my doctor spends about 30 seconds examining me. Really? and this past year I got a bill for 2 office visits because he answered some questions, can you believe, the guy wanted to get paid twice which the insurance company and I both said NO to. Not going to happen. Medicine or extortion on demand….same thing

  21. This is what I've been saying- all medical providers should by law publish their prices to a central website where consumers can comparison shop for medical services. Right now there's no competition because there's no transparency.

  22. The proper term for a person staying/visiting a hospital or clinic is patient, but in reality, the term should be a customer.

  23. Add prices of comparable treatments across the border or the Atlantic ocean.
    You'll see a revolution within a few years.

  24. they knew this years ago, that's why they don't bill the patients directly. they never wanted the patients to know anything. if they don't know the cost or the procedure done then they cant question anything, only pay they bill. they said it was to make it less confusing for the patient, as if they are actually doing us a favor. but it never was that, it was to keep us in the dark. healthcare is a scam at its best. and wont go anywhere anytime soon until the patient starts questioning everything that is done to them and what they or there insurance is paying for…

  25. Basically insurance companies won't allow it. Each insurance bargains with a hospital or lab for a specific price and if everyone knew the price than I surname companies couldn't bargain and get deals without it seeming unfair to other insurance companies. It'll lead to some actual competition which isn't allowed. :p

  26. What if someone set up a company and sold the information – like a Consumer Reports Subscription Service that you bought every year – and those subscribers submitted their healthcare bills for analysis of the data to support the service.

  27. It's pretty bad when you know how much its going to cost to get your car fixed but you have no idea how much your hospital bill will be

  28. Just a mention. Health care in the UK takes half as much of our GDP as it does in the USA. We don't have to 'shop around' because the National Health Service is funded from taxation

  29. Very interesting, very relevant. But That woman got to be the most boring person alive. She should really get someone else to do the presentation to sell their idea.

  30. Ok there are some MAJOR issues with this, because none of this takes into account "Skill". In many cases, when your being administered anesthetics. You are not just paying for the medicine, your paying for the "Skill" of the person administering it. How good he is at monitoring flow rates, at monitoring vitals, at recognizing situations before the start and making the necessary changes BEFORE a situation becomes a complication.

    With something like, an MRI or X-ray, how "New" is the machine, how much detail can they get on it, how much radiation will you be exposed to, Do you want to pay 230 for a 30 year old machine that could have you glowing in the dark afterwords? 550 for a machine that will work but might not have the contrast or image quality to see a small anomaly, or 3200 for a top of the line, machine that needs more power, more techs, more time, is in greater demand, and who's tech's can identify even the smallest problems and decide if further steps are needed?

    To use a car analogy, do you want to pay 19.99 for an oil filter, and 20 dollars for a mechanic who… might leave their cleaning rag inside the filter holder… or 19.99 for the same filter, but 60 dollars for a mechanic who will not only replace it but make sure its actually compatible , make sure all the bolts are tightened down properly and give the engine a few tests to make sure the instillation was done right, an the part is working properly.

  31. This is the single best thing we can do for healthcare in the US. Thank you Jeanne Pinder for helping this along.

  32. Wow…even private health care in Canada is cheaper than the US.
    Canada has a 2 tier system, Public and Private.

    I went to a private clinic and thought I would pay American prices. Nope.–200$ CAD for doctor's visit, no waiting. I was seen on time on my appointed time, and 3 complimentary phone calls. 50$ CAD for blood work and an email with my blood test results.

    11$ CAD for my monthly meds.

    Total of 261$ CAD for private health care, blood tests and 3 calls from my doctor each week in one month to ensure I was fine on my meds.

    That's 195$ USD.

    Man…so happy to live in Canada.

  33. The reason why healthcare costs so much is due to all the beurocracy. There's too many people on this planet, so useless, needless and pointless jobs are created just for the sake of having needless positions for needless people. It's time we purged the useless.

  34. It just happend, Trump signed an Executive Order for Transparent Healthcare cost… Heathcare cost will now by law be Transparent,

  35. Weird this recommendation show up in my feed after a few hours later,after Trump sign the executive Order to make healthcare billing Transparent,apparently were gonna be able to know the Prices in Advance

  36. Trump just signed an executive order today to make healthcare costs more transparent. The more you know.

  37. Well, SURPRISE, SURPRISE, PRESIDENT TRUMP SIGNED an EXECUTIVE ORDER to make all medical costs TRANSPARENT AND UP FRONT PRICING TODAY 24 June 2019!. ( " but he's such a terrible President, impeach, impeach! ") LMAO!!! TAKE THAT! you bloody PRICE GOUGING CLINIC!!!

  38. This is on the way to getting fixed now with latest executive order https://www.youtube.com/watch?v=sWm8reQuftA

  39. Long live President Donald Trump and all involved in bringing transparency to health care costs in the U.S. Some folks want to hate him for all the wrong reasons and are frightened by his style. They long for the limp-wristed renegade obama, or feel hilldog would have us in better shape. Time will tell us that 45 is one of the best we've ever had.

  40. You mean like the Executive Order our AMAZING President Trump just signed?! MAKING AMERICA GREAT AGAIN!!!! ๐Ÿ‡บ๐Ÿ‡ธ ๐Ÿ‡บ๐Ÿ‡ธ ๐Ÿ‡บ๐Ÿ‡ธ VOTE TRUMP AGAIN 2020

  41. THANK YOU PRESIDENT TRUMP FOR MAKING THIS HAPPEN! NEW EXECUTIVE ORDER TO MAKE THIS LAW SIGNED YESTERDAY ๐Ÿค—๐Ÿค—๐Ÿค— I love trump!

  42. RAPIST IN THE TRANSPARENCY…PYSCOLOGICAL WEAPONS….TO INSLAVE HUMAN…IS NOT OF GOD..YOUR USING ARTIFICIAL SOULS TO CREATE ILLNESS AND ELECTRONIC PROBES.

  43. Well abracadabra wishes granted. Trump just issued an executive order on June 25, 2019 that now makes it mandatory that all medical services by hospitals and doctors have the costs stated up front before services are rendered. This means people can now Google (as she mentions in the Ted talk) for the best rates which translates to much lower costs because now it introduces competition and competition is a beautiful thing by leveling the playing field. So everything this speaker is saying about transparency is now reality. Hallelujah!

  44. The reason that health care cost goes up is due the Illgeal Aliens and indigents. They dont pay their bills so the burden gets passed on to the law abiding citizens who pay their Bill's. It's easy stop giving free medical care to illegal aliens and the prices will drop.

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