NCPA - National Center for Policy Analysis


September 9, 2005

With many employees paying more for health insurance -- and getting less coverage -- patient advocates are encouraging consumers to do some shopping around. But hospitals, clinics and laboratories don't always make that easy, says the Wall Street Journal.

  • Physicians, while open to their patients' preferences, often recommend specific centers for diagnostic testing without first considering the price, say experts.
  • At the same time, doctors connected with hospitals often prefer in-house testing for easy access to radiologists and other specialists who handle the results.

The Journal examined the difficulty some consumers face in shopping around for medical procedures, as well as the wide discrepancy of prices for medical services. Researchers compared the charges for a lower-lumbar spine magnetic resonance imaging test and a routine mammogram at "a dozen diagnostic-testing facilities in the New York City area. Charges for MRIs ranged from $950 to $1,600, while charges for mammograms ranged from $155 to $280.

According to the Journal:

  • Physicians do not usually consider the price of medical tests or procedures when recommending specific centers or hospitals, despite the variance in price, and doctors connected with hospitals often prefer in-house testing.
  • Medical facilities often do not always quote accurate prices for tests or procedures.

Additionally, quoted rates were often pre-negotiated rates, which are rates paid by uninsured patients. Negotiated rates, paid by insured patients, were not always available because they are often negotiated after the procedure has been performed, says the Journal.

Source: Loretta Chao, "Shopping for the Best Medical Prices," Wall Street Journal, September 8, 2005.

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