So, a year ago I had a hip replacement - going nicely, thank you. On March 30 I had a fall and I needed to be reevaluated. Part of the reevaluation was hip xrays, including lying down and standing up. I just saw the Explanation Of Benefits for that little endeavor -- $1,175 total billed, $763.75 paid.
Outrageous. This is where the money is going in health care, imaging and hospitals, not to mention $250, 7 minute specialty "consults." There is lots of money out there to be saved, none of it in primary care. How long would we in pediatrics have to work to get paid $763.75?
This is why reform is needed.
We hear too much about "unnecessary procedures." Yes, there are lots of them. But what we don't hear enough about, at all, is the price of these procedures. That's the most important element missing from Atul Gawande's New Yorker article. Cut down on price to reasonable levels and we are part of the way home.
Budd Shenkin
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Ah, the market for health care can't get the price right and it can't get the quantity right. It is fair to say that the market fails when it comes to health care. Our biggest problem is finding a politically acceptible substitute for market forces short of a centralized body setting prices and quantity -- that scares people.
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