Several new studies show that the vast majority of American hospitals aren't complying with a new federal rule that took effect at the beginning of the year requiring them to post their real prices for care. Actual price information allows healthcare consumers to shop for quality, less-expensive alternatives that can reduce ridiculous healthcare costs burdening patients across Colorado and the nation.
I can speak firsthand about the importance of lowering health-care prices. I have a severe tree nut allergy that causes allergic reactions that can require epinephrine to treat. Earlier this year, I was at a friend's house for dinner. I'm careful to avoid foods that may cause an allergic reaction, but the spaghetti sauce I ate included cashew butter I didn't know about. It triggered an allergic reaction that caused vomiting and throat swelling, restricting my breathing. I was scared of what would happen if my condition worsened, so my friend drove me to the nearest emergency room in Grand Junction.
While there, I was unable to keep my anti-allergy medication down, so the hospital admitted me and put me on an IV to stabilize the reaction. I was briefly treated by a triage nurse and a doctor. The visit lasted about two hours. I was discharged with an EpiPen, a portable epinephrine autoinjector, in case I had a similar reaction in the future.
Because I'm still on my mother's health insurance plan, neither she nor I were worried about the ensuing bill. So imagine our shock when it arrived several weeks later showing that the hospital charged our insurance plan $18,373, of which we owed $4,697 directly. We were in a state of panic.
I demanded an itemized bill from the hospital that finally arrived months later. It indicated that the hospital charged $15,043 for the EpiPen. EpiPens can be purchased at the pharmacy for about $330 for a two-pack, meaning the hospital billed about 100 times more than the market price. As an added insult, the EpiPen the hospital gave me expired in just three weeks, making it virtually useless.
With the help of a patient advocate group, I appealed this outrageous bill. I cited the real price of EpiPens and the lower standard charges on the hospital website for my other care. Recognizing their egregious billing practices, the hospital apologized and waived the bill.
All patients can follow my lead and fight such price gouging by consulting new hospital price lists, which include cash and contracted rates, required by the new hospital price transparency rule. Even better, consumers can view these actual prices before care to enjoy financial certainty and identify high-quality, low-cost care for the overwhelming majority of healthcare spending that's not for emergencies.
Needless to say, if I knew the hospital was trying to charge $15,000 for an EpiPen, I would have refused it in favor of my local pharmacy. Real prices can put patients in the driver's seat of their healthcare decisions, empowering them to generate substantial savings through their choices.
Unfortunately, many hospitals still aren't complying with this rule to post their actual prices. And those that are following it often make their price information challenging to access. I had to download and parse a massive spreadsheet to find my treatment prices.
To make real prices more widespread and consumer-friendly, patients must demand them up front before receiving care. Government officials can also increase hospital compliance with the rule by more robustly enforcing it. Such actions can usher in a transparent marketplace that makes healthcare affordable and accessible, just like all other sectors of the economy where real prices reign.
Mason Kochel is a sophomore at Colorado Mesa University in Grand Junction.