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You already agreed that it can have value. Just give them the information that you have. You're out of excuses.
I did not.
Yes you did.
...did you listen to what I said at all?
Yup. You said that costs sometimes matter. Just inform your patients.
The cost for prescription drugs is reasonably knowable and often knowable with respect to how your insurance covers them. We choose with this information in mind and generally involve patients in shared decision making if such a thing is applicable for that clinical situation.
When you come to my office for an office visit I do not know in advance what I will bill for, because that depends on what you tell me. I can't tell you that in advance. No information is available beforehand. It is also not relevant because I will either have a cash pay fee schedule or you will pay a copay or other fee depending on your insurance. Both the cash pay fee schedule and copay/coinsurance exist independent of whatever billing codes I use and what value is being assigned to them.
For hospital based care, which is what we spent most of this conversation talking about, PATIENTS CANNOT MAKE DECISIONS BASED OFF OF PRICES.
The price and cost are not what the patient pays.
Thank you for affirming my belief that Americans cannot be trusted to reform healthcare in a sensible way.
I've had several conversations with medical staff which go something like this:
And then SURPRISE SURPRISE their quote turns out to be useful for making decisions and estimating how much I will pay.
And I'll further grant that you (the individual) probably aren't personally empowered to give meaningful price estimates. But @ControlsFreak is right that you (as synecdoche for your employer and the supply chain behind you) do have access to information on what you will ask from insurance, and that has a connection to what insurance will pay, which will in turn be connected to the cost born by the consumer.
And yes, costs aren't always perfectly predictable. The same is true for mechanics and contractors. But we don't have to play a game of make-believe for them to give me a estimate.
This information matters to people. You (synecdoche) should give it to them.
Some important things to note here:
The majority of the average patient's interaction with healthcare are the type of thing where this has some element of technical feasibility. You are likely thinking "okay what's the cash price for a relatively constrained activity like an allergy shot, elective MRI, even a basic procedure like a colonoscopy" the whole system (I'll come back to this) has some possibility of delivering this to you. However the system is designed around the more important and more complicated activities like a hospital stay. If you show up the ED with diverticulitis you could be seen in the ED and sent home with conservative management. You could be put in obs for a day and started on Zosyn and fluids and kept NPO, you could have a perf leading to surgical management, necrosis, and a 3 month hospital stay. Nobody knows any of the numbers associated with this visit until it's done. It's extremely hard to legislate for one but not capture the other, so it's easy to end up with meaningless bullshit numbers if you put a law down. In a healthy system the people involved will try and give you numbers when it's possible. Your doctor will usually be able to estimate what the professional fee for his visit with you will be, but:
Physicians aren't in control of this. Usually when this comes up people demand the burden be on the doctor. I have other shit to do....like clinical work? Keeping up with the changes in billing is a full-time job for sometimes something like hundreds of staff. Elsewhere in this thread we have someone who used to work in insurance passing around misinformation - it's hard to keep track of this stuff and estimates are usually considered binding if not legally then in someone's mind. We can't feasible deliver this. Often the billing department can't deliver this until after we do our job because they aren't clinical. You'd need to have a meeting with your insurance, the billing department, and the physician in advance to have something with any accuracy for anything remotely complicated (and again we can get in a spitball distance but people get pissed at healthcare if you are wrong at all it'd be worse than not trying). On a more micro level it's worth keeping in mind that working for a health system these days usually involves surrendering lots of control, including often over billing. I can't control the billing department and what they put down, but:
Health systems aren't in control of this. Most importantly we can't control insurance. Insurance decides how much you get stuck with. Usually we get a feel for what common plans and what common charges will end up resulting in but an insurance company can essentially decide to randomly say "no I'm not paying for that" which may or may not get addressed. While I've been rightly smacked on the nose for forgetting about coinsurance and other things like that, ultimately the person who decides what to do with the bill is not me or my hospital and I have no control over them and they are famously awful.
What is the number for the next procedure that you are just about to get informed consent for?
Then you should have no problem supporting a requirement that your employer figure it out.
No one has asked you to.
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