Hospital pricing has drawn increased scrutiny from parties within and outside the healthcare industry as patients experience higher out-of-pocket costs.
Hospitals consider a confluence of economic, political, geographic and social factors when setting prices for healthcare services, making it difficult for officials to explain variance in hospital prices.
Below are seven statements from hospital and industry professionals that illustrate the complicated and politically fraught dialogue surrounding hospital prices.
1. "The chargemaster is complete nonsense that really doesn't matter — unless you are an uninsured person and you're getting these huge bills driving you toward bankruptcy. The biggest irony of the U.S. healthcare system is that only the uninsured — often people who don't have a lot of money — are the only ones the hospital expects to pay these incredibly inflated prices!"
— Robert Laszewski, president of Health Policy and Strategy Associates.
From "Hospital Prices No Longer Secret As New Data Reveals Bewildering System, Staggering Cost Differences" via The Huffington Post (May 2013)
2. "Hospitals are self-fueling, ever-expanding machines. There is an infinite amount of stuff to buy — amenities, machines, new wings, higher salaries, more nurses. If you pay hospitals more, they spend it. If you pay them less, they adjust. The only way to pay less for healthcare is to pay less for healthcare."
— James Robinson, economist and professor of health policy at the University of California, Berkeley.
From "As Hospital Prices Soar, a Stitch Tops $500" via The New York Times (December 2013)
3. "We [hospitals] cannot be compared to an independent doctor who can just overtly select who they see. We take everybody. That requires cost-shifting that is so emblematic of this industry."
— Joe Piemont, former president of Carolinas HealthCare System in Charlotte, N.C.
From "Prices soar as hospitals dominate cancer market" via The Charlotte Observer (April 2015)
4. "There's more price transparency and quality transparency regarding a refrigerator than there is about your heart surgery."
— John Toussaint, MD, CEO of ThedaCareCenter for Healthcare Value in Appleton, Wis.
From "Why some health systems aren't systems at all: Q&A with Dr. John Toussaint, CEO of Thedacare Center for Healthcare Value" via Becker's Hospital Review (April 2014).
5. "We lose money on 60 percent of what we do, and we actually generate a margin on 40 percent of what we do. In aggregate, hopefully, we break even or have a 1 or 2 percent margin at the end of the year. The things that we get overpaid on allow us to do the things that we get underpaid on."
— David Torchiana, CEO of Partners HealthCare in Boston.
From "Partners CEO makes his pitch" via CommonWealth Magazine (April 2016).
6. "Although many factors influence [hospital] pricing, it is clear that inadequate competition between providers contributes significantly to this variation."
— Liam Sigaud, analyst at Maine Heritage Policy Center.
From "Study Finds Wide Disparity in Maine Healthcare Costs" via Maine Center for Economic Policy (April 2016).
7. "Hospitals face economic pressures of all sorts. Overhead is a huge piece of it [pricing], as well as types of services. If one hospital has a trauma unit and a burn unit, it'll have a higher cost structure than one that doesn't have that high level of specialty services."
— Jan Emerson-Shea, vice president of external affairs for the California Hospital Association.
From "Two halves of California have wide gap in health costs" via The Sacramento Bee (September 2015).
8. "There is no method to this madness. As we went through the years, we had these cockamamie formulas. We multiplied our costs to set our charges."
— William McGowan, former CFO of the University of California Davis Health System in Sacramento.
From "The Pricing of U.S. Hospital Services: Chaos Behind a Veil of Secrecy" via HealthAffairs (January 2006).