The Infuriating Lottery of Healthcare Prices
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Even within a single state, the cost of an MRI might vary by hundreds of dollars.
One popular strain of healthcare article considers how a common medical procedure costs X in the United States and Y in Germany (or Japan or France or Brazil), with the foreign figure being tantalizingly low by comparison. The explanation is usually that Germany (or wherever) caps how much providers and drug-makers can charge, and the U.S. does not.
The U.S. might be expensive when it comes to healthcare prices, but it's far from monolithic. While someone in Stuttgart might pay as much as their cousin in Hamburg for an x-ray, the same cannot necessarily be said of two people in, say, Madison and Milwaukee.
A new report out from the Health Care Cost Institute shows that the price of a given procedure can vary widely within a single state. In Wisconsin, for instance, how much people pay out-of-pocket for cataract-removal surgery has a range of $989. In each of nine states that the nonprofit examined, out-of-pocket charges for other common, elective procedures varied by hundreds of dollars.
Variation in Out-of-Pocket Prices for Procedures in 2013
Keep in mind that these are out-of-pocket charges—that is, what people actually paid. The discounts providers give to various insurance plans don't apply to this data. The fact that there is so much variation in out-of-pocket costs suggests that doctors and hospitals often charge wildly different amounts.
HCCI also found that co-pays are on the rise: Nationally, out-of-pocket medical spending among adults who had job-based insurance rose 6.9 percent, from $662 per person in 2012 to $707 in 2013.
The HCCI study authors suggest that to save money, consumers should shop around before they settle on a doctor for a big operation or diagnostic test. Most insurers (and some states) offer ways for people to look up their expected costs for various procedures. That might not be possible in an emergency situation, though, which is exactly when someone might need, say, a knee MRI.
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