The Revolution That Will Soon Save Your Medical Dollar
NEW YORK ( MainStreet) At the start of 2014, when the Affordable Care Act goes into full swing, these services will be free through Health Insurance Marketplace plans:
- Immunization vaccines
- Screening and counseling for alcohol abuse
- Blood pressure screening
- Depression screening
- HIV screening
- Diet counseling
- Screening for Type 2 Diabetes
In the meantime, California's Fair Pricing Law is demonstrating success: with 97% of California hospitals reporting they offered free treatment to patients at or below the poverty level. Is there a movement toward affordable healthcare brewing?
Maribeth Shannon, who directs the market and policy monitor program for the California Healthcare Foundation (CHCF), says the jury is still out: "We have great opportunities but their success comes down to patients and providers embracing these new opportunities and working together to change the healthcare system."
The California Fair Pricing Law
People without health insurance visiting hospitals are typically bamboozled.
Says the New York Times :
"...uninsured patients also called 'self-pay' patients have effectively no market power at all vis-à-vis hospitals, especially when they are seriously ill and in acute need of care. Therefore, in principle, they can be charged the highly inflated list prices in the hospitals' chargemasters..."
And the Los Angeles Times :
"...there's no consistency to pricing...depending on income level, the uninsured could face anything from full price to discounts of 30% or more."
The California Fair Pricing Law, passed in 2006, is an attempt to reign in these costs and protect the uninsured from paying full price for hospital services.
Within five years, most California hospitals had adopted policies to protect the uninsured from higher fees. Also, the law helps individuals losing more than 10% of their income to medical bills.
Glenn Melnick, professor at the USC Sol Price School of Public Policy and the USC Schaeffer Center for Health Policy and Economics, sees the change as the product of increased accountability: "Once hospitals realize that the whole world's going to learn how they treat low-income people, they become pretty generous." He recently co-authored a study showing the statewide reforms Californians have witnessed since the law was passed.
Shannon says she is hopeful that other States will pick up on the idea to "supplement what's happening under the Affordable Care Act by passing State laws that are more stringent" and "require more from their hospitals than the national law does."
Shannon also finds "the law isn't very prescriptive about what the payment level is," which unfortunately gives hospitals "some freedom to set the limits and the policy in terms of who it would apply to and what the charge amounts would be." She also points out that the law is aimed to only help those living at 350% of the poverty line, while also leaving uncovered consumers stuck paying what Medicare would have.