"States urgently need to change their regulations to limit hospital prices for out-of-network emergency care." This is the conclusion of an informative op-ed in the New York Times by a researcher at the Schaefer Center for Health Policy and Economics and professor of public policy at U.S.C. Glenn Melnick, "Limit Hospitals' Pricing Tower" p.A23 (New York Times, Monday, September 10, 2018).
Here's why.
Here are the figures he reports from California's experience with hospital charges for mandated emergency room care:
- Between 2002 to 2016, total emergency room charges billed by hospitals reached a record $386 Billion, an increase of $263 Billion during that time.
- The number of patients admitted to emergency rooms during that time did not increase. It stayed the same. Only the charges increased.
- Most states mandate hospitals to cover emergency room care. Most states also apparently mandate that your health insurance plan will cover emergency room visits regardless of whether they are in your network or not. During that same period of 2002 to 2016, hospitals charged your health insurance plans amounts which increasingly "grew from $6,900 per day to over $19,500 per day." Recall that there was no increase in the number of patients during that time, only in the charges billed by hospitals during that time.
"Capping billed charges at 125 percent of contracted prices would keep hospitals from exploiting their E.R. advantage." Reportedly Maryland is trying this approach.
Solutions are certainly welcome, and not just in Maryland or California. These increased health insurance charges are paid by increased health insurance premiums. The idea that it is not necessary for people to have health insurance coverage that covers their health, because everyone can go to an emergency room without consequences, is not reality. It isn't even true.
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