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OPINION

The Prescription to Cure Hospital’s Latest Patient-Gouging Scheme? Site-Neutral Pricing.

The opinions expressed by columnists are their own and do not necessarily represent the views of Townhall.com.
spukkato/iStock/Getty Images Plus

Mass consolidation is the cancer of our time as advanced technology has allowed mass consolidation on a scale that makes 1980s-era mergers and acquisitions seem quaint by comparison.

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Hedge funds buying up housing is creating a nation of 21st century serfs. New media consolidation has led to increased political polarization. The Biden administration’s abuse of our national security apparatus wouldn’t be possible if it were still as fragmented as J. Edgar Hoover designed it to be. 

The more power that’s consolidated in the hands of the very few, the more problems it creates. This is why Republicans have championed states’ rights over federal power, attacked globalist groups like the World Economic Forum and the United Nations, and opposed efforts to nationalize the health care industry. 

With that last one, the effects are particularly nasty, as medical consolidation hits sick or hurt people when they’re already down. In recent years, big hospital systems have been buying up small physician-owned practices, allowing them to jack up already high prices for routine services. 

What medical megacorps do when they buy up physician practices is rebrand them as “hospital outpatient facilities.” The hospital system that now owns the practice is legally entitled to bill as though the care was received in a hospital, allowing them to charge higher prices to either Medicare and commercial insurers or patients themselves, who routinely face increased costs by hundreds or even thousands. 

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You might think nothing of it when you see a different logo on the door, but your eyes will pop out of their sockets when you see the bill. For example, for an epidural injection in a lumbar or sacral region, Medicare pays out $740.88 when it’s performed in a hospital outpatient department, but just $255.89 in a physician’s office. 

That’s just one example of how hospitals drive up prices when they buy up doctor-owned practices; others include the average cost of an office visit increasing from $118 to $186; ultrasounds more than doubling from $164 to $339; and the price of biopsies skyrocketing from $146 to $791.

As mentioned earlier, this kind of consolidation is why Republicans have always opposed so-called “free” health care when Democrats promise it from the federal government. Mass consolidation creates monopolies, which Republicans like Teddy Roosevelt and Ronald Reagan always knew were a threat to free markets rather than an intrinsic feature. 

Our whole byzantine health care system has become so complicated there’s no easy answer to fix it, but for this kind of price gouging there is. 

Congress has the opportunity to pass a bipartisan solution that rebukes hospitals’ price gouging with legislation to expand “site-neutral payments” in the Medicare program. This means hospitals couldn’t charge patients more for services based on where they receive them. This would save patients, employers, and taxpayers billions every year. 

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The consequences of these increases have been devastating. In addition to the irrefutable economic damage of Bidenomics, medical debt is suffocating the country – to the tune of more than 100 million Americans. Of those, 59 percent said some of the bills that led to their debt were from a simple lab fee or diagnostic test. Indeed, the services most eligible for site-neutral payments are the top source of medical debt, including lab fees, diagnostic tests, and everyday doctor visits. 

Site-neutral pricing would legislate greater parity in health care pricing, regardless of the location. According to the Committee for a Responsible Federal Budget, this could save Medicare $150 billion, slash health care costs for Medicare beneficiaries by $90 billion, and save employers and consumers in the commercial market $140 billion.  

Mass consolidation is a cancer of our time, and site-neutral payment policies are the chemotherapy to destroy its effect on our health care system. 

 

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