According to data compiled by The Wall Street Journal, the medical centers’ rates for state Medicaid and Medicare systems are generally lower than for private insurers.
The price of the same procedure can vary up to 10 times in the US depending on the patient’s insurance company, revealed this Thursday The Wall Street Journal, when analyzing the data of around 6,000 American hospitals.
In particular, cesarean delivery can cost between $ 6,241 and $ 60,584. The factors that determine the price are the hospital fees and their inclusion in the network of the pregnant woman’s insurance company.
It’s not just about regional differences. Reviewing data from the Sutter Health hospital system, which includes 24 Northern California medical centers, journalists learned that a heart procedure varies between 89.752 for clients of the government Medicare coverage program, and 515.697 Dollars for patients whose insurance company does not include the hospital in their network. The minimum price for private insurers is $ 197,900.
For hip or knee replacement, the state Medicaid program for people in need must pay 3.264 dollars and Medicare, $ 16,439. For commercial insurers, prices start at $ 51,895, and the highest rate — for companies that don’t include the hospital in their network — reaches 81.617 Dollars.
From Sutter Health they indicated that the rates depend on negotiations with each insurance company in particular. For his part, the former executive of the insurance company Cigna Corp., Alan Muney, confirmed that companies have to work with higher rates than the state ones.
“This is probably typical of what you will see in large delivery systems“said the businessman.
Quality does not depend on price
American hospitals often collect margins from their patients with private insurance, argues The Wall Street Journal. It highlights that, according to economic studies, they tend to choose to increase rates instead of reducing costs and inflate prices when they can. Nor are higher fees likely to mean better treatment.
“We have found no evidence that price is a great sign of quality“The publication quotes Michael Chernew of Harvard University School of Medicine.
The US healthcare system is the most expensive in the world. Only in the hospital sector are they spent annually $ 1.2 trillion in the country. Regarding expenses in medicine in general, in 2018 it was estimated which were equivalent to 20% of the US GDP.
The data analyzed by the journalists was released by the hospitals as a result of an order from the previous US President Donald Trump, which took effect on January 1.