28 Nov
Here's a good tip for a Winter cold - throw some lemon sections in a cup, add a teaspoon of honey and some hot water.

Here’s a good tip for a Winter cold – throw some lemon sections in a cup, add a teaspoon of honey and some hot water.

 I am stuck inside with a cold today so thought I might go over this “Fair Healthcare Pricing Act of 2016.” 

http://www.oag.ca.gov/system/files/initiatives/pdfs/15-0101%20%28Affordable%20Healthcare%29.pdf

I’m not a lawyer, but this is mostly plain English. A little repetitive – gotta cover all the bases. I see a limit of 25 percent profit over “costs” and a demand for refunds to patients who are found to pay more than 25 percent over “costs”. The operative word here being, “costs.”  We have to trust the hospital to tell us the true cost of their services?

What I like about this bill is “Public Availability of Charge Setting Methodology.” 

“Public Availability of Charge Setting Methodology. (a) Within 210 days of the end of a hospital’s fiscal year ending on or after January 1, 2018, a hospital shall report the following information to the department: (1) Total patient care expenses; (2) Total private payer patient care expenses: (3) Actual qualifying losses: (4) Qualifying expenses: (5) Reasonable and allowable costs in each of the categories set forth in paragraphs (1) and (2) of subdivision (k) of Section 1339.616; (6) Qualifying reimbursements; (7) Revenues received in each of the categories reflected n paragraphs (1), (2), and (3) of subdivision (l) of Section 1339.616; (8) Total charges; and (9) Any refund made pursuant to subdivision (c) of Section 1339.611. (b) The department shall make the information provided pursuant to subdivision (a) available to the public upon request.”

Now we already have the Patient’s Bill of Rights, which is supposed to be posted in plain sight of any patient who is brought into the hospital. It says, among other things, you can ask what the services are going to cost you – their price – and they have to tell you. That’s how I found out a room at Enloe was about $7,500/day when my husband was sick. I wondered, at what they pay nurses these days, how they could justify that.

 

I found out, prices are already available on the State of California website:

http://www.oshpd.ca.gov/Chargemaster/default.aspx

The Chargemaster is a list of services and prices charged at a hospital. Just type in “Enloe” and you will find information dating back to 2005. Don’t be intimidated – I was confused as to the descriptions given the various services. I just had to look until I saw something I understood. “Boarder” or “Room” obviously refers to a room charge, with different charges for different levels of care.  A “CCU” or “Critical Care Unit” – is listed at $12,883. That’s per day. And that does not include a lot of stuff – read on – some of these charges are per minute.

I did see an item I recognized – a special kind of baby bottle called a Haberman Feeder. The nipple is made to mimic the function of the human nipple, and is supposed to be easier for new babies, particularly those born with any kind of mouth issues or general weakness, to get their nourishment. They also claim to keep babies from swallowing too much air and suffering colic.  I found these bottles on line, priced between $27 and $36. Playtex has similar bottles and sells “starter kits” with five bottles each for about $22.

The hospital charges $66 for one Haberman Feeder.  That’s almost 100 percent mark-up – more if you get the sale price, or say, buy them by gross, like Enloe does. And why not Playtex? Playtex has been making these specialty bottles since before I was born, and offers all kinds of choices ranging in price. Why the spendier bottle, and why nearly 100 percent mark-up? 

This is why we need some legislation to control the prices hospitals are charging. I’ll have to finish reading the whole measure, but so far I like what I’m seeing. 

 

 

 

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