Like many doctors, I turned to medicine to heal and relieve pain and suffering. However, what I’m seeing today is that more and more people are struggling to pay for the medical care they receive – and many are falling into financial ruin due to exorbitant increases in healthcare costs. A troubling new trend in healthcare consolidation is exacerbating this problem.
As medical costs continue to skyrocket, more and more people are neglecting their care because they cannot afford to see a doctor, undergo a physical, or undergo cancer treatment. In recent years, private equity firms and large, well-financed healthcare companies have increased their stakes in the healthcare sector by acquiring independent medical practices, nursing homes, kidney dialysis providers, physician gastroenterology groups, etc. and then continue to provide medical services – albeit at higher fees. Prices for the same services previously provided by private medical practices are rising.
For example, a patient who requires a Level 3 diagnostic or screening ultrasound and would have paid an average of $250 for that service will now pay $650 for the same procedure performed by and ordered by the same certified and qualified ultrasound technician became a doctor. However, since the doctor is now working under “new management,” the procedure is billed through a code that is referred to as “hospital outpatient clinic” and no longer through the doctor’s office. The cost of a colonoscopy or esophagoduodenoscopy (EGD) increases from $527 to a whopping $2,679, with no improvement in safety or clinical effectiveness.
In one infamous case, a patient paid ten times more for a critical procedure she needed to perform monthly simply because her doctor moved to a different floor in the same building. The hospital that acquired the doctor’s office simply reclassified the new space as a “hospital setting” rather than an “office office setting.” The list of cases could go on and on.
Physicians are deeply concerned about this trend of healthcare takeovers, mergers and consolidations by private equity and other large hospital groups. They raise deductibles and increase premium prices for everyone. Hospitals should not exploit their patients to supplement their already increasing profit margins.
Excessive hospital charges not only burden patients but also have broader economic impacts. The skyrocketing costs are putting a strain on insurance payers, government programs and employers, leading to higher premiums, less coverage and even challenges in maintaining overall health benefits. These financial burdens harm patients and our entire economy.
Fortunately, there are solutions to this growing problem. Congress can protect the public by addressing unfair and unjustified price disparities in health care by passing bipartisan legislation to ensure that patients pay “the same price for the same service.” Doctors and nonprofits are calling on Congress to enact legislation that creates a “universal, location-neutral payment system” for healthcare facilities. In such a system, all health care providers receive equal compensation for the same procedure, resulting in lower health care premiums and cost-sharing requirements for payers and patients.
By reducing these costs, Congress can help encourage more people to receive necessary health care services and reduce financial barriers that often prevent timely care. It is time for our leaders in Congress to act.