Wednesday, November 7, 2018

The $48,000 allergy test

A recent posting on Kaiser Health News epitomized much of what is wrong with health care in today's America. An English professor in the California state university system went to Stanford University's outpatient clinic for help with a rash that she thought might be due to a cream she had been prescribed. She had 119 tiny plastic containers taped to her back and ultimately learned that she was allergic to a variety of things, including the ingredient in her cream. All well and good until she saw that Stanford had billed her insurance company for $48,329! This included $848 for the time she spent with the doctor and $399 for each of the 119 small samples taped to her skin. The "usual and customary" charge in the San Francisco Bay area for this is $35 per sample. Why so much? Stanford, as a prestigious institution, has a lot of clout when it comes to negotiating with insurers. They know that many companies want access to "the best" and so drive a harder bargain than smaller hospitals. The insurer paid Stanford at their negotiated rate of $11,376 - still 3-4 times what they would have paid an allergist in private practice for the same service. We need single payer, where the payer and not the provider are in the driver's seat. Read more in my book, Prescription for Bankruptcy.

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