HEALTH CARE COST: Uninsured Bear Burden of High List Prices
While managed care has "slowed medical price inflation" for itself, UCSF professor of medicine Dr. Philip Alper, writing in a San Francisco Examiner op-ed, asserts that those deals "are contributing to increased price inflation for everyone else," especially the uninsured. Alper argues that the uninsured and those who do not have access to discounts can "expect to face sky-high list prices throughout the health system." The reasons for the high list prices are two-fold. Primarily doctors can offer larger discounts while "protecting their net income" by raising list prices. Also, managed care contributes to high list prices by fostering an attitude that doctors "probably won't get paid nearly what [they] charge," so they lose restraint when it comes to health care costs. Alper charges that health care providers set "painfully high" list prices because they expect that no one will ever have to pay them, or those who will won't have the means to fight back. While conceding that some inflated prices have been caused by decreasing provider reimbursements, he maintains that "patients who aren't under the health organization umbrella are ... pressed to make up the resulting shortfall." With the uninsured walking into a maze of escalating health care costs, "lack[ing] the sophistication to know what measures to take to protect themselves," Alper concludes that the "massive price distortion cannot be healthy for our health care system. A two-tier market that victimizes those who are medically uninsured will not keep our hospitals solvent. It is time to rethink the structure of the medical marketplace" (8/4).
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