Sunday, August 10, 2008

General Hospital pricing resembles an Egyptian bazaar

In a Sunday News "In my opinion" article, Amish shop operator S. S. Stoltzfus states that "...in the past, many folks with large hospital bills, especially those with hospital insurance plans, would meet with the hospital bookkeepers and offer a cash payment; most always the settlement would be 50 to 60 percent of the total bill."

Stoltzfus observes"Why the big mark up in billings? Doesn't seem like good business."

"Good business" it may well be. The question is whether it is "fair business."

It would appear that one of the reasons is to over charge those of us with co-pay hospital insurance, an observation NewsLanc has made in the past. If the invoice ("Costs") amounts to $10,000 and the policy calls for the health insurance provider to pay 80% ($8,000) and the individual to pay 20% ($2,000), the insurer receives a 40% to 50% discount on its share and pays say $5,500 instead of $8,000. But the individual is required to pay 100% of his or her share, which amounts to $2,000.

So the so called "Costs" are not shared 80 / 20. In all likelihood, the ratio is 65 / 35 and the individual is paying about $700 too much.

NewsLanc does not mean to impugn the integrity of the managers of LGH. We recognize they are not running an ordinary business. Rather there are valid social and pragmatic issues to be considered.

On the other hand, we don't think LGH should be pricing like a used car lot!

NewsLanc maintains that LGH, a public and not-for-profit institution, should provide greater transparency concerning its policies and practices and encourage greater public input and overview pertaining to how it operates and what it does with its earnings.