Author: Aurelie Chuong, Treasurer - [email protected]
Last October, when I was advised to have surgery, I decided to google “laparascopy” and “laparotomy” in order to figure out what those procedures were as well as how much they would cost. I was covered by health insurance but I wanted to figure out the “out-of-pocket” costs (e.g. deductible and percentage for which I would be responsible) so that I had an idea of much of a hole in my wallet I would be digging. I remember seeing that a laparascopy, a minimally invasive procedure using a surgical robot, cost anywhere between $1,700 and $5,000 [1], and that a laparotomy, an invasive surgical procedure, would cost anywhere between $5,000 to $15,000 [2] (and that is not even including room & board or drugs at the hospital). The first reaction I had was an anxiety attack because in addition to worrying about my health, I now had to come up with a way to pay for a procedure that, in retrospect, saved my life. Then, the question of “Why is there such a big difference?” arose in my mind.
I forgot about the topic as I focused on recovering from two major surgeries but I was reminded last week when listening to NPR where they did a story about making health care prices public [3]. Taking their example, let’s say you are in the market for a coffee maker. As a consumer, you can find out exactly how much it is at your favorite retailer; however, finding out the exact costs of a medical procedure is not so easily available. That is where Center for Improving Value in Health Care, or CIVHC, comes in. Born in Colorado, CIVHC “envisions a system where clear and open communication between providers, consumers, businesses, health plans and government is the standard for exceptional, state wide health care” in order to“contain costs and ensure better value for health care received” [4]. CIVHC collects Colorado costs of health services by obtaining “receipts from the parties that pay the bills: insurance companies, Medicaid and Medicare, mostly” into an “all payer claims database”[3], where maps and reports are available to everyone for “health care price and service comparison” [5]. According to NPR, Colorado is one of eleven states that have worked towards making health care costs public, but CIVHC still has a long way to go since there are limitations to using Medicare data [3].
Just to put numbers in perspective, in 2012, Medicare spent $580 billion, Medicaid $416.8 billion, private health insurance $930.6 billion, and out-of-pocket $320.2 billion, and it is projected that “[h]ealth spending is projected to be 19.9 percent of GDP by 2022” [6]. In 2011, the U.S. ranked third in the world in highest percentage of GDP spent on health [7]. Specifically for ovarian cancer, the costs of prevention was calculated to be $88,993 per years of life saved (YLS) compared to $787 million per YLS for cancer treatment (surgery and chemotherapy) [8, 9]. In short, with the rise in chronic diseases, if we, as a community, do not act, these healthcare costs will only increase. While public health focuses on disease, injury, and disability prevention, CIVHC is making its strides in standardizing the cost of medical services, so that hopefully soon, we will able to shop for health care services just as easily as for a coffee maker [3].
References
[1] “How much does laparoscopy cost?” Cost Helper Health, Cost Helper, Inc. <http://health.costhelper.com/laparoscopic-surgery.html> Accessed Oct 2013.
[2] “How Much Does a Laparotomy Cost?” HowMuchIsIt. <http://www.howmuchisit.org/laparotomy-cost/> Accessed Oct 2013.
[3] “Elusive Goal: A Transparent Price List For Health Care.” National Public Radio Health News. <http://www.npr.org/blogs/health/2014/02/12/276001379/elusive-goal-a-transparent-price-list-for-health-care> Accessed 19 Feb 2014.
[4] Center for Improving Value in Health Care (CIVHC). <http://www.civhc.org/> Accessed 25 Feb
2014.
[5] Colorado All Payer Claims Database. CIVHC. <https://www.cohealthdata.org/#/home> Accessed 25 Feb 2014.
[6] “National Health ExpenditureProjections 2012-2022.” Centers for Medicare and Medicaid Service. <http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/proj2012.pdf> Accessed 25 Feb 2014.
[7] “Health expenditure, total (% of GDP).” The World Bank. <http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?order=wbapi_data_value_2011+wbapi_data_value+wbapi_data_value-last&sort=desc> Accessed 25 Feb 2014.
[8] Drescher, C. W., Hawley, S., Thorpe, J. D., Marticke, S., McIntosh, M., Gambhir, S. S., & Urban, N. (2012). Impact of Screening Test Performance and Cost on Mortality Reduction and Cost-effectiveness of Multimodal Ovarian Cancer Screening. Cancer Prevention Research, 5(8), 1015-1024. doi: 10.1158/1940-6207.capr-11-0468
[9] Yabroff, K. R., Lamont, E. B., Mariotto, A., Warren, J. L., Topor, M., Meekins, A., & Brown, M. L. (2008). Cost of Care for Elderly Cancer Patients in the United States. JNCI Journal of the National Cancer Institute, 100(9), 630-641. doi: 10.1093/jnci/djn103
Last October, when I was advised to have surgery, I decided to google “laparascopy” and “laparotomy” in order to figure out what those procedures were as well as how much they would cost. I was covered by health insurance but I wanted to figure out the “out-of-pocket” costs (e.g. deductible and percentage for which I would be responsible) so that I had an idea of much of a hole in my wallet I would be digging. I remember seeing that a laparascopy, a minimally invasive procedure using a surgical robot, cost anywhere between $1,700 and $5,000 [1], and that a laparotomy, an invasive surgical procedure, would cost anywhere between $5,000 to $15,000 [2] (and that is not even including room & board or drugs at the hospital). The first reaction I had was an anxiety attack because in addition to worrying about my health, I now had to come up with a way to pay for a procedure that, in retrospect, saved my life. Then, the question of “Why is there such a big difference?” arose in my mind.
I forgot about the topic as I focused on recovering from two major surgeries but I was reminded last week when listening to NPR where they did a story about making health care prices public [3]. Taking their example, let’s say you are in the market for a coffee maker. As a consumer, you can find out exactly how much it is at your favorite retailer; however, finding out the exact costs of a medical procedure is not so easily available. That is where Center for Improving Value in Health Care, or CIVHC, comes in. Born in Colorado, CIVHC “envisions a system where clear and open communication between providers, consumers, businesses, health plans and government is the standard for exceptional, state wide health care” in order to“contain costs and ensure better value for health care received” [4]. CIVHC collects Colorado costs of health services by obtaining “receipts from the parties that pay the bills: insurance companies, Medicaid and Medicare, mostly” into an “all payer claims database”[3], where maps and reports are available to everyone for “health care price and service comparison” [5]. According to NPR, Colorado is one of eleven states that have worked towards making health care costs public, but CIVHC still has a long way to go since there are limitations to using Medicare data [3].
Just to put numbers in perspective, in 2012, Medicare spent $580 billion, Medicaid $416.8 billion, private health insurance $930.6 billion, and out-of-pocket $320.2 billion, and it is projected that “[h]ealth spending is projected to be 19.9 percent of GDP by 2022” [6]. In 2011, the U.S. ranked third in the world in highest percentage of GDP spent on health [7]. Specifically for ovarian cancer, the costs of prevention was calculated to be $88,993 per years of life saved (YLS) compared to $787 million per YLS for cancer treatment (surgery and chemotherapy) [8, 9]. In short, with the rise in chronic diseases, if we, as a community, do not act, these healthcare costs will only increase. While public health focuses on disease, injury, and disability prevention, CIVHC is making its strides in standardizing the cost of medical services, so that hopefully soon, we will able to shop for health care services just as easily as for a coffee maker [3].
References
[1] “How much does laparoscopy cost?” Cost Helper Health, Cost Helper, Inc. <http://health.costhelper.com/laparoscopic-surgery.html> Accessed Oct 2013.
[2] “How Much Does a Laparotomy Cost?” HowMuchIsIt. <http://www.howmuchisit.org/laparotomy-cost/> Accessed Oct 2013.
[3] “Elusive Goal: A Transparent Price List For Health Care.” National Public Radio Health News. <http://www.npr.org/blogs/health/2014/02/12/276001379/elusive-goal-a-transparent-price-list-for-health-care> Accessed 19 Feb 2014.
[4] Center for Improving Value in Health Care (CIVHC). <http://www.civhc.org/> Accessed 25 Feb
2014.
[5] Colorado All Payer Claims Database. CIVHC. <https://www.cohealthdata.org/#/home> Accessed 25 Feb 2014.
[6] “National Health ExpenditureProjections 2012-2022.” Centers for Medicare and Medicaid Service. <http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/proj2012.pdf> Accessed 25 Feb 2014.
[7] “Health expenditure, total (% of GDP).” The World Bank. <http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?order=wbapi_data_value_2011+wbapi_data_value+wbapi_data_value-last&sort=desc> Accessed 25 Feb 2014.
[8] Drescher, C. W., Hawley, S., Thorpe, J. D., Marticke, S., McIntosh, M., Gambhir, S. S., & Urban, N. (2012). Impact of Screening Test Performance and Cost on Mortality Reduction and Cost-effectiveness of Multimodal Ovarian Cancer Screening. Cancer Prevention Research, 5(8), 1015-1024. doi: 10.1158/1940-6207.capr-11-0468
[9] Yabroff, K. R., Lamont, E. B., Mariotto, A., Warren, J. L., Topor, M., Meekins, A., & Brown, M. L. (2008). Cost of Care for Elderly Cancer Patients in the United States. JNCI Journal of the National Cancer Institute, 100(9), 630-641. doi: 10.1093/jnci/djn103