Markets in Everything: Market-Based, Deeply-Discounted Surgery for Cash, Payable in Advance
Here's something rarely seen in U.S. health care - an actual, transparent price list for medical procedures:
| PROCEDURES | TOTAL |
|---|---|
| ARTHOSCOPY | |
| Knee | $3,740 |
| Knee with lateral release or microfracture | $4,510 |
| Shoulder | $5,720 |
| Elbow | $3,740 |
| Wrist | $3,740 |
| Hip | $5,225 |
| Ankle | $3,740 |
| OPEN PROCEDURES | |
| KNEE | |
| Anterior cruciate ligament repair | $7,040 |
| Posterior cruciate ligament repair | $7,040 |
| Medial Collateral Ligament | $6,160 |
| Tibial Tubercle Osteotomy | $6,160 |
| SHOULDER | |
| Open Rotator Cuff Repair | $6,160 |
| Bankhart Stabilization | $6,160 |
| Distal Clavicle Excision | $4,730 |
| ELBOW | |
| Ulnar Nerve Trasposition / Epicondylectomy | $4,510 |
| Wrist/Hand | |
| Carpal Tunnel Release | $2,750 |
| Dupuytrens Contracture | $2,915 |
| Trigger Finger | $2,750 |
| Ganglion Excision | $2,750 |
| ANKLE | |
| Achilles Repair | $5,830 |
| FOOT | |
| Bunion | $4,125 |
| Hammertoe (1) | $2,475 |
| Hammertoe (2) | $2,860 |
| Hammertoe (3) | $3,355 |
| Gastrocnemius Recession | $4,180 |
| Plantar Fasciotomy | $3,080 |
| Neuroma Excision | $2,750 |
| FRACTURES | |
| Closed Reduction and Casting | $1,925 |
| Percutaneous Pinning - finger 1-2 pins | $2,805 |
| GENERAL SURGERY | |
| HERNIA | |
| Inguinal | $2,860 |
| Bilateral | $4,275 |
| Umbilical | $3,190 |
| Incisional | $4,075 |
| Cholecystectomy | $5,665 |
"The Surgery Center of Oklahoma is a 32,535 square foot, state-of-the-art multispecialty facility in Oklahoma City, owned and operated by approximately 40 of the top surgeons and anesthesiologists in central Oklahoma. The facility has been accredited by the AAAHC since 1998 without interruption and has annually provided care to thousands of patients. If you have a high deductible or are part of a self-insured plan at a large company, you owe it to yourself or your business to take a look at our facility and pricing which is listed on this site. If you are considering a trip to a foreign country to have your surgery, you should look here first. Finally, if you have no insurance at all, this facility will provide quality and pricing that we believe are unmatched."
From the FAQ section:
"To keep our prices as low as possible, cashier's checks or cash are the methods preferred. Credit cards and personal checks cannot be accepted. Human resource departments or divisions of self-insured companies can make other arrangements if necessary.
Payment in full is required at the time service is rendered. No payment arrangements can be made. These deeply-discounted prices are otherwise not available."
HT: Paul Harris
37 Comments:
WASHINGTON – A new report shows costs vary as much as 700% for some preventive examinations, and as the federal health care law increases demand for those procedures, it can mean an increase in premiums if employees don't pay attention to those costs.
Over the past year, health plans and self-insured employers began paying for wellness exams — diabetes screening, mammographies, Pap smears and colonoscopies — as required by the law, without charging consumers a deductible or co-payment. But in looking at 15,000 consumers, a research group has found cost differences of hundreds of dollars charged for the same tests. Colonoscopy costs, for example, ranged from $786 to $1,819.
"I wasn't surprised that there was variability, but the degree of variability surprised me," says Doug Ghertner, president of Change Healthcare, which works with businesses to determine costs of health care procedures. ...
Doug Ghertner, Change Healthcare president, says consumers will see a direct correlation between premium increases and their choice of health provider. The "consumer is typically isolated from the cost," he says. "People think they have zero financial responsibility."
-- USA Today
The lack of transparency in medical costs is due to insurance, correct? i.e. consumers don't pay attention to prices because costs are covered by their insurance. If so, even in a free market most people would still have insurance and so the problem would still persist, I'd think.
Anyway, I love the transparency. I experienced this first had a month ago when I went to the dentist. They knew I didn't have insurance, so they told me the cost of everything up front before I agreed to any procedures. "Would you like fluoride treatment? If so, that will be $12 extra." During the examination, the dentist discovered two cavities. On my way out, we scheduled another appointment and he printed out an invoice of the cost to repair the two cavities. Refreshing.
employer-provided insurance is a tax-free, spend as you please benefit that is at the core of our dysfunctional health care system that is twice as expensive as any other health care system - in the world.
re: the cost to repair two cavities.
yes...but would you go to a DIFFERENT Dentist to get them filled for 1/2 the price?
and IF you did what would happen between you and your current DENTIST?
Bonus Question: Would you tell your current Dentist that you could get those cavities filled for 1/2 what he charges and ask him to give you a price match?
:-)
Of all the things that are important to people - the one that is often overlooked is your complete medical history.
It's YOUR history but in reality, your doctor or doctors are keeping the complete records and even if you had them all on paper, no Doctor is going to have to the time to pour through a couple hundred pages or more of everything that you've ever been to the doctor for.
All of those things that are offered by those Oklahoma doctors (and much more they do not offer) depends almost entirely on the rest of your medical history which often you have to list on a clipboard in the waiting room and the new doctor has to send for your paper records from you previous doctors, primary care physician, etc.
When you walk into a Doctor's office, look at the room behind the registration window. In most offices, the walls are chock-a-block with folders - paper.
So while your entire life can be represented electronically in Facebook or equivalent and you can pull that info up from just about anywhere with a cell tower, a doctor giving you a quote for an operation is ludicrous unless he/she knows your medical history - which is still often, on paper, at another doctor's office.
Don't think you need your records? Then the operation will likely cost you even more as the doc will have to do more tests and more examinations to get a complete picture of you.
Once we have a system where your medical history is in a standardized (searchable) electronic format that is portable to you - these anecdotal news stories of cut-rate medical procedures are basically bad jokes.
The funny thing is that virtually every other industrialized country in the world has electronic medical records that any doctor, anywhere, with your permission, can access.
Maybe Facebook will provide a new service - "Your Medical Timeline".
:-)
Anyone who wants to see a more robust private market for health care should should standardized electronic medical records.
Once you have your record... on a USB drive or on a remote secure server, you can call the shots on what doc to go to ...what services to buy, where to buy them and how much to pay.
If you owned your own records, you could then require non-disclosure with providers with respect to insurance companies.
right? so the only folks who might know about your conditions would be you and any provider who had signed a non-disclosure agreement when they treated you.
would that work ?
From: http://surgerycenterok.com/pricing.php
A list of what is NOT included in the fee is as follows:
Any diagnostic studies necessary prior to the surgery such as lab, MRI, X-rays, consultations with specialists to determine medical risk/management, physical therapy and rehabilitation.
Any hardware or implants necessary for completion of the procedure (plates and screws, e.g. for orthopedic procedures). This price information will be provided prior to surgery but subsequent to the surgical consultation. Our experienced surgical staff knows with almost certainty what will be needed to complete your surgery and this hardware or implants will be provided to you at invoice cost without any markup whatsoever. Copies of the invoices will be provided to you.
Any overnight stay at our facility. This can be arranged on a case-by-case basis for an additional charge.
Lodging or travel expenses.
Expenses or fees resulting from complications subsequent to the completion of the surgery and discharge from the facility.
------------
I work for a consulting company that negotiates healthcare purchasing contracts, and it is not uncommon at all to see tremendous swings in the pricing of implantable devices. Even between two similar-sized facilities with similar usage volumes, the same pacemaker may cost 20K for Hospital A and 25K for Hospital B. That's just one example, but the margins in this business are huge and hospitals are constantly getting screwed.
Obviously if you are going in for a procedure requiring an implant, you'd want to receive the most advanced device on the market, and have it implanted by a doctor who stands by that product, but part of the reason for the lack of price parity is that the device makers are so in bed with the docs that a hospital's purchasing staff often has very little leverage in negotiating prices with the suppliers.
Competition - both foreign and domestic.
Note the comments on the left-hand side of the domestic site addressed to Medicare patients. For reference, here is the average cost of knee replacements paid by Medicare in 2008-2010.
Cutting out all third party insurers (whether private or public) seems to be the way to genuinely affordable health care.
Oklahoma Surgery is one of the leaders in transparency. The elements most absent from Healthcare are transparency and competition. At http://medibid.com we have facilities all over the US and overseas too. Here is just a small sample of the cash prices that medical consumers get through MediBid every day http://medibid.com/pages/cash-prices
Last year we saved patients over a million dollars: http://www.medibid.com/pages/one-million-saved
"For reference, here is the average cost of knee replacements paid by Medicare in 2008-2010." -- Ironman
Medicare and Medicaid pay lower rates because these programs shift costs onto the backs of the privately insured. And judging by the price differential in knee sugeries, fairly significantly.
"The report identified the following cost drivers: Increased cost-shifting to private plans as Medicare and Medicaid rates fall further behind the rates private plans pay to providers ..." -- New report finds medical costs to rise 8.5 percent in 2012, The Hill
" ... our dysfunctional health care system that is twice as expensive as any other health care system - in the world." -- Larry
Complete bullshit. Health care in the U.S. is not "twice as expensive as any other health care system - in the world", nor is it "dysfunctional". You continually repeat leftist talking points as if they were grounded in fact. They're not.
Yes, the U.S. spends more on health care than other countries. Why? Because we are both wealthier and freer. Americans can spend as much as they like on their health care, while in many countries peoples options are either restricted, or they are not allowed to purchase private health care services at all. We probably spend more on Ipads, automobiles, movies and restaurant meals than the rest of the world, should government be limiting those choices as well?
What's more, countries with universal health care coverage are on average worse off than the U.S. economically despite the fact that they lean heavily on the U.S. for their defense needs.
As for quality, the U.S. has the highest quality care in the world:
Data assembled by Dr. Ronald Wenger and published recently in the Bulletin of the American College of Surgeons indicates that cardiac deaths in the U.S. have fallen by two-thirds over the past 50 years. Polio has been virtually eradicated. Childhood leukemia has a high cure rate. Eight of the top 10 medical advances in the past 20 years were developed or had roots in the U.S.
The Nobel Prizes in medicine and physiology have been awarded to more Americans than to researchers in all other countries combined. Eight of the 10 top-selling drugs in the world were developed by U.S. companies. The U.S. has some of the highest breast, colon and prostate cancer survival rates in the world. And our country ranks first or second in the world in kidney transplants, liver transplants, heart transplants, total knee replacements, coronary artery bypass, and percutaneous coronary interventions.
We have the shortest waiting time for nonemergency surgery in the world; England has one of the longest. In Canada, a country of 35 million citizens, 1 million patients now wait for surgery and another million wait to see specialists.
The Wall Street Journal
The one thing that we do spend more than anyone else in the world on, and for which we receive absolutely nothing in terms of increased value, is education. And, yet, I never here a leftist scream about the U.S. spending too much on education. Nor do I here them demanding that the education system be overhauled. Oh, that's right, the money spent on education goes directly to their union cronies. Nothing to see here, move along.
" We have the shortest waiting time for nonemergency surgery in the world; "
for everyone? or just certain folks?
Comparison!of!Health!Care!Systems
when you compare health care stats for ALL citizens verses only some citizens, isn't that apples and oranges?
if you wanted to do an honest comparison wouldn't you need to average out the wait times for the folks who had insurance with the folks who had none?
Without the individual consumer of medical care making dollar expenditure decisions we cannot have truly 'control' medical care costs. Those 2,700 pages of ObamaCare are only the begining of the morass governmetn medical care will become. There aren't enough fingers to fill up the porous dike that governments erect.
My prescription for health care is for our government to tax us enough to give everyone a stipend to buy a Health Care Savings Account and a Catastrophic Policy and give our citizens the actual medical care decisions. Then the things that Prof Perry shows us, walk-in clinics, etc will be used to the extent that they are indeed useful.
the big issue with any kind of health care is the ability to buy it if you have health issues.
Medicare allows anyone to buy it.
All universal access in other industrialized countries allows anyone to participate regardless of conditions.
The States could require this of insurance companies instead of the Fed/ObamaCare but so far very few states do even though many do it for car insurance.
Not sure who would/could require insurance companies to offer nationwide plans instead of state plans but portability between states and between jobs is also an important thing for people.
Between insurance availability to anyone and portability, the "market" in the US seems not inclined to offer much and that and things like that ...implemented at the same time the Part D Medicare was - would have preempted ObamaCare.
ObamaCare basically came about because no legislators were willing to deal with the insurability and portability issues since the time of Clinton and Reagan.
The GOP keeps threatening to Repeal and REplace but so far the "replace" part still does not deal with the availability of insurance to everyone and the portability issue.
Insurance is effectively tied to employers. This often keeps people in a job they don't like or want and if their insurance was portable, their job mobility would free them to pursue more, better opportunities including working in small business and start ups.
"if you wanted to do an honest comparison ..." -- Larry
The very last thing that leftists want is an honest comparison, just look at the "fact" sheet that you linked to. Almost every metric on that sheet is skewed in some way to make the U.S. system look inferior to the government run systems of other countries when, in fact, the U.S. is far superior.
Let's take infant mortality. The reason that the U.S. has higher infant mortality figures is that we apply life saving care to far more premature infants many of whom do not survive the first year of life, but are counted as "live births". Other countries, like France and Japan classify such babies as stillbirths, which aren’t counted. Once you have adjusted for that, the gap disappears.
Life expectancy: After adjusting for variables such as race, educational achievement, crime rates, etc. the overall life expectancy "at birth" gap disappears. What's more significant is that as you go farther out on the age curve, where medical care becomes more of a factor, U.S. life expectancy exceeds these other countries despite the fact that Americans tend to suffer greater incidents of illness.
What about that bogus "47 million" uninsured figure that your source uses? As Investors Business Daily pointed out a couple of years ago when the health care debate was raging the "47 million uninsured" figure constantly used by leftists was a myth:
One of the shocking things in the Census Bureau's report this week on poverty and health care in America is that so many well-to-do people can easily afford health care, but choose to go without it.
The median household income, according to the data released this week, is $48,200. You might be surprised to discover that 38% of all the uninsured — that's almost 18 million people — have incomes higher than $50,000 a year. An astounding 20% of all uninsured have incomes over $75,000. These are people who can afford coverage.
Drilling even deeper, one finds that fully 27% of all the uninsured in the U.S. — that's 12.6 million people — aren't even citizens ... another 20% or so is uninsured only for a couple of months a year. As TV journalist John Stossel recently noted, as many as a third of all those eligible for public health programs don't even bother to apply.
Once you whittle it down, you start to realize that the number of hard-core uninsured who are citizens is in fact fairly small ...
And on, and on ...
But, like I said, the last thing a leftist wants is an honest comparison.
'ObamaCare basically came about because no legislators were willing to deal with the insurability and portability issues since the time of Clinton and Reagan." -- Larry
Obamacare came about because the left rightfully sees socializing the nations health care system as essential to the imposition of socialism generally. Period.
LOL, market unfulfilled:
Financing arrangements for people getting surgeries at this place.
:^D
>>> Obamacare came about because the left rightfully sees socializing the nations health care system as essential to the imposition of socialism generally. Period.
+1.
>>> Not sure who would/could require insurance companies to offer nationwide plans instead of state plans but portability between states and between jobs is also an important thing for people.
This would be the Fed, and ONLY the Fed, and that is pretty damned "DUH".
That they've made no effort to encourage portability across state lines says a lot about how much they want to "solve" this short of single-payer universal government-run health care. It would lead to a huge cost decrease for a number of reasons, as the pool sizes would get much larger, and the nature of the care offered could be extended/lowered to match the price point desired by the purchaser.
Another thing that ought to occur is to sever the link between employment and health care, which is always a problem for those without Japanese-style cradle-to-grave employment, as it regularly "resets" the "pre-existing" condition list. This is just a tax issue -- remove the tax exemption from employers and provide the same for the individual buying their own insurance, either directly or through a collective (which would assist in providing lower care by replacing the "bulk" negotiations of the employer with the bulk negotiations of an insurance collective).
geeze... oh bloody and I AGREE on 2 things?
zowee!
here you go...the solution to health care:
5 charged for taking teen's kidney in return for iPhone, iPad
Q: What is "Type II medical malpractice"?
A: We all know about "medical malpractice." It's when appropriate medical care is administered inappropriately. I call this Type I medical malpractice. In "Worried Sick" I repeatedly illustrate another form of medical malpractice, the practice of doing the unnecessary very well. This Type II medical malpractice demands recognition and expunging as much as Type I medical malpractice. No one would argue. But you will learn in "Worried Sick" that some of the most technologically sophisticated and expensive interventions, interventions for which a great deal of training is required and about which there is exuberant institutional pride, interventions to which you and your neighbor are likely to submit are shining examples of Type II medical malpractice.
"Don't think you need your records? Then the operation will likely cost you even more as the doc will have to do more tests and more examinations to get a complete picture of you."
You are missing the point. The Surgery Center of Oklahoma performs surgeries only. When you go to them for surgery you have already been tested, examined, and diagnosed as needing a certain surgical procedure, for instance a Distal Clavicle Excision, if your doctor has concluded that that's the correct repair for the shoulder problem you are suffering from.
You wouldn't likely show up at the Surgery Center with a shoulder pain and ask them for that procedure.
Your primary care doctor, who is not a surgeon, and wouldn't do your surgery in any case, has determined that you require that procedure, and would other wise admit you to a hospital and arrange for a surgeon.
So no, the Surgery center will not need your 4000 pages of medical history, but will rely on your doctor for instructions on any special concerns based on your medical history.
"if you wanted to do an honest comparison wouldn't you need to average out the wait times for the folks who had insurance with the folks who had none?"
No. What is measured is the time from scheduling a non emergency surgery, until the time it's performed. Who pay's for it, or how, isn't the issue.
If a procedure is never scheduled, for whatever reason, you can't include those folks in the measurement.
" If a procedure is never scheduled, for whatever reason, you can't include those folks in the measurement. "
even if those folks need the procedure?
"Anyone who wants to see a more robust private market for health care should should standardized electronic medical records."
The problem isn't lack of a private market, but lack of a free market.
"Once you have your record... on a USB drive or on a remote secure server, you can call the shots on what doc to go to ...what services to buy, where to buy them and how much to pay."
Perhaps on an RFID chip implanted in my arm. All my medical records could be added to the National ID
Some folks are recommending.
No, i'm not serious about that.
"If you owned your own records..."
I do own my own records.
"...so the only folks who might know about your conditions would be you and any provider who had signed a non-disclosure agreement when they treated you."
Medical providers are already forbidden by law to disclose medical information about you without your signed consent. The trouble is that your consent is often given in a form that allows the doctor to disseminate that information to anyone they think should have it.
"My prescription for health care is for our government to tax us enough to give everyone a stipend to buy a Health Care Savings Account and a Catastrophic Policy and give our citizens the actual medical care decisions. Then the things that Prof Perry shows us, walk-in clinics, etc will be used to the extent that they are indeed useful."
You have citizens?
Your prescription is a terrible idea, Norman.
Why not tax us enough to give everyone a stipend to buy food?
Or maybe rent? Rent is important. How about taxing us enough to give everyone a stipend to pay rent?
@ Che is dead; I agree with most of what you say, but you say obamacare is a socialist system, and I say it is pure fascism. Hillary care was ot be socialism. Medicare is socialism, medicaid is socialism, but obamacare is fascism.
an individual mandate is fascism?
so every other industrialized country in the world from England to Japan to Australia to Singapore are fascist?
Social Security and Medicare Part A are an individual mandate, right?
If we had a system where free riders did not get benefits - food stamps, housing vouchers, medicAid, etc... maybe the individual mandate would not be required but the only countries that I know that do not have such individual mandates are 3rd world or 3rd world like.
are there any advanced countries that do not have individual mandates for health care?
"even if those folks need the
procedure?"
You are measuring wait time. Period. Schedule procedure- get procedure. How much time elapsed in between?
Someone needing or not needing something is a different issue. How much time would you add for someone who never schedules a procedure, their entire life?
Your link to
"Comparison of Health Care Systems" didn't even address the question you asked.
"5 charged for taking teen's kidney in return for iPhone, iPad"
Exactly what point are you trying to make with that? that there are unscrupulous people in the the world? Check: that there are stupid people in the world? Check:
Keep in mind that that kid received something between 1 and 2 years pay for that kidney.
"You are measuring wait time. Period. "
we're measuring how many people get health care that need/want it and how long it takes.
how many people in these other countries that need treatment never get it?
when we say our system is "better", it's not better for everyone whereas the comparative stats that we use for other countries DOES include everyone.
So we're cherry-picking our comparative data and ignoring the folks who are not covered and have to go to ERs to wait or other public assistance.
"So we're cherry-picking our comparative data and ignoring the folks who are not covered and have to go to ERs to wait or other public assistance."
Since it appears you have lost track, here's the quote you responded to:
"We have the shortest waiting time for nonemergency surgery in the world; "
Please remember what it is you are arguing.
As I explained before, if people seek treatment and get it, their wait time is measured. Who pays for it or how it's paid for isn't part of the issue. If they don't seek treatment or don't get treatment when it's recommended, there is no wait time to measure.
Who is or isn't covered, and who does or doesn't need treatment but doesn't get it, for whatever reason, is a different issue, and worthy of discussion, but it's not a proper response to the statement "We have the shortest waiting time for nonemergency surgery in the world; "
Incidentally, the emergency room is designed to handle emergencies, and you won't get non-emergency surgery there. You will have to go to the Non-Emergency Room to get your non-emergency surgery scheduled. Then we can measure the wait time.
"Other public assistance" covers a lot of ground, but has no bearing on how long people wait for non-emergency surgery.
It goes like this:
Have complaint > seek medical treatment > get diagnosis > schedule proceedure > wait - tick, tick, tick > get procedure done.
The statement you quoted and responded to, refers to that wait time only.
It doesn't include time between "have complaint" and "seek medical treeatment", nor the time between "get diagnosis" and "schedule procedure". Get it?
www.medibid.com is great. You get the market working for you personally every time you make a bid request.
This is an excellent comment. I have seen these stats in Sally Pipes work. The uninsured rate is all hype and no substance. It is a "crises" used by the left to increase government power. We do not need more government in health care we need less. www.medibid.com is the type of market response needed to the health care issues. An open and transparent market.
Larry,
You did not read my post. I said that obamacare is fascism, I did NOT say the individual mandate is fascism. If you don't understand, that's OK, but do not pretend that I said somehting I did not. Re-read my email, then if you have any honest questions ask
larry g says: "if you wanted to do an honest comparison wouldn't you need to average out the wait times for the folks who had insurance with the folks who had none?"...
No only the insured wait times should count...
They are after all footing the bill for themselves and of course for those who are leeching off of them, the folks without health insurance...
In fact how much shorter would the wait time be if only those who were paying their own way were in the waiting room?
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