hospital transparency, medical debt, healthcare in the United States

Hospitals Gone Wild

Ideas and Issues

July 8, 2021

New Orleans       

Our team of ACORN and LNRTC researchers and interns from Tulane have been reviewing the price lists posted by hospitals in Texas, Louisiana, and Arkansas to satisfy new HHS regulations.  It’s not a pretty story, but we’re still vetting the data and compiling the report, so this is not a sneak preview except in one regard, and that is confirming some of what the Wall Street Journal found in a special report looking at the same kind of data nationally.

The Journal noted that in using “…data compiled by Turquoise Health Co, a pricing-transparency startup.  At least 44% of the country’s roughly 4900 short-term, rural and children’s hospitals hadn’t published data that complied with the January rule as of June 18…”  I don’t think it’s a spoiler alert to share that our team looked at all of the hospitals in the three-state area and found that was the case pretty much across the board.  Not a high as 44% from our early review, but certainly over 30% when we looked at all private, nonprofit, and other facilities in the area.  Knowing that there is a federal regulation that your hospital association held up in court for years until finally throwing in the towel after constant legal defeats so that the regulation could finally go into effect, doesn’t give a hospital an excuse to just not bother.  They all should have been good and ready.  In our experience, this is pretty typical of hospital impunity and their refusal to be accountable to almost anything but their view of their own divine status.

Ok, you may think that’s a minor point, but it’s part of a larger pattern.  The real meat of the Journal piece was based on looking at 1500 hospitals where they could see both pricing and the amounts paid by either the insured or uninsured.  Be ready for this, because this is where we go from impunity to something closer to profiteering on the poor.

Breaking the hospitals down into groups and looking at one simple procedure, chest x-rays, they found that there were 586 hospitals that charged cash customers in the top 25% of all patients.  281 were in the third 25%.  336 were in the second 25%, and only 249 were in the bottom 25% of pricing.  The math is simple.  Way more than 50% of the hospitals charged cash customers without insurance in the top half of their price brackets, underlining the reporters’ conclusion that “many hospitals charge their highest pries to uninsured people paying cash.”

We’ve asked this before, and we’ll keep asking this of hospitals and other health care providers:  what happened to “do no harm?”  And, when is the government and the rest of us going to say “enough!”, and do something about it?