Price Transparency (or lack thereof) in Healthcare

Recently my head almost exploded over a price quote from the great big gigantic medical center (GBGMC) across the street. I have surgical privileges at the GBGMC but do almost all of my surgery cases in my office ambulatory surgery center (ASC). My ASC is fully certified, much more convenient and private for patients and much more affordable. But it took a few phone calls yesterday to the GBGMC to realize how much more affordable my ASC was for private pay patients.

I have a prospective tummy tuck patient who is a little borderline for doing in my ASC because of her age and a few medical issues. I would kind of like to do her in the GBGMC with an overnight stay.

My patient care coordinator spent two days trying to get a tight price estimate for the 4 hour tummy tuck. So here are the 4 different quotes we got from various employees of the GBGMC for facility fee which means the use of the operating room. These quotes did not include anesthesia and do not include my surgeons fee. Are you ready? $41,650, $53,550, $70,000 and $90,000. I am not making this up. Anesthesia costs were real steal at about $13,000. Hmmm – that means the anesthesiologist is charging way, way more for the anesthesia than I am for the surgery. And the anesthesiologist provides zero follow up care.

Now these prices are just mind blowing but the other thing that drives me nuts is that we got 4 different quotes. How on earth can a patient budget for surgery when the price could vary by over 100%?

So does the GBGMC really rake in $90,000 for a 4 hour surgery. Well, maybe from a private pay patient who happens to be a member of the Saudi royal family, but never from an insurance company. You see, the GBGMC charges this but the insurance companies have cut a deal with the GBGMC and they pay a steeply discounted rate. This, gentle readers, is one of the things that is really, really dysfunctional in our heath care system. Nobody really knows how much things really cost, unless of course you are paying out of pocket at a clinic like mine where we put everything in writing and I even post price ranges on this website.

As for my sweet patient who, by the way, is not a member of the Saudi royal family. I think I will do her in my ASC and have her hire a home nurse for a day or two. Geeze, for the facility fee of the GBGMC, we could hire a home nurse for a year!

Thanks for reading and when you go in for a medical procedure, ask how much it is going to cost. This will not be a welcome question but I think the more pressure applied to the health care industrial complex for price transparency, the more likely we will see a change in how the big business of health care is done.

Thanks for reading and follow me on Instagram @sowdermd and @breastimplantsanity. Dr. Lisa Lynn Sowder