The Chargemaster and it's role in the healthcare system
Author: Dr. William Rappaport
Date: April 2017
In the past couple of weeks we have seen much debate regarding the health care system. President Trump tried to reform Obama Care in what he termed “Repeal and Replace”. The bill ultimately did not pass because the president had no support in the house and senate.
This begs the question of where is the real problem? What can be done about the costs of rising healthcare in our country?
All the politicians have it wrong, Republicans and Democrats. It's not about who pays for healthcare; it's all about the pricing from supplies to procedures. This pricing is determined arbitrarily by the same facilities that are supposed to be loyal to saving a life. THE HOSPITALS!
Why should a pacemaker cost $56,000 in one hospital and $23,000 in another? Why should a box of gauze be charged at $77 when you can buy a box for a dollar? Until we rein in the hospitals, which represent 33% of a trillion dollar medical budget, we will never control costs and will never have an open and fair market.
The Charge-master is the hospital’s comprehensive, arbitrary and ludicrous menu of items such as drugs, procedures, blood tests, supplies and imaging. These items have prices that billing department’s follow in hospitals to bill patients and/or their insurances. It can be described as a hospitals revenue stream template.
Currently there is no legislation and this pricing differs from hospital to hospital. For instance, cancer drugs labeled as “life-saving” cost thousands of dollars for each infusion. This is based on the drug company’s monopoly. So forget about the American Healthcare Act or ACA. Until we look at the PRICING done by hospitals and other clinical services our system is doomed to continued rising costs and no government legislation will rein it in until we regulate the drug companies and the hospital charge masters.
Please read this article to understand: time.com/198/bitter-pill-why-medical-bills-are-killing-us