What's the true cost of health care? - KMSP-TV

What's the true cost of health care?

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TAMPA (FOX 13) -

Most people shop for the best price when they're looking for goods and services like a new car or perhaps lawn service, but what about medical care?

"It's all bound by insurance," said Sharon Cannella of Tampa, who believes there's no need to shop around.

Darren Riopelle told us that he agrees. "You just have to know what your deductible is."

But there's a true cost that most people never see, and this summer, the federal government published the data. The Centers for Medicare and Medicaid Services compared the cost of the 100 most common inpatient services and 30 common outpatient services for different states and hospitals.

LINK: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/

Dr. Adam Levine, who spent 12 years practicing as a physician and now works as a lawyer in the area of health care and administrative law, reviewed the data for FOX 13.

"The numbers make no sense," he said.

The government database is designed to help unravel the mystery behind medical billing, but Levine, who founded the Florida Legal Advocacy Group and is also an adjunct professor of law at Stetson, thinks it explains very little and raises plenty of troubling questions.

"There's no connection between the quality of care you are given and the amount of money the hospital is going to get."

Levine looks at the significant price variations from state to state, hospital to hospital, and procedure to procedure, and is left scratching his head at the seemingly random costs of service as well as the reimbursement the hospital is paid by Medicare.

"If it really costs $98,000 for a procedure, why is the federal government only paying $21,000? If it's really $21,000, maybe we should bill that and get paid honestly."

Levine points out that Tampa General receives more government reimbursement for uncomplicated pneumonia then surrounding Bay Area hospitals. TGH spokesman John Dunn offered this explanation:

"Tampa General is different than surrounding hospitals in the area in that we're a teaching hospital and we also treat a disproportionately high number of uninsured and underinsured patients."

Dunn says the federal government takes that information into account in the payment formula. But why is the full price for a procedure so much higher than the reimbursed rate?

"You kind of look at it like the sticker price of a car; it's a starting point but nobody really pays sticker price for a car," explained Dunn.

So we now know names and numbers, but how the newly released information will be used in the health care debate down the road is still a mystery.

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