Say you're in the market to buy a sofa.
You’d probably start by shopping around and finding something within your price range. If you hit up Slumberland and didn’t like their prices, you’d head to Schneiderman’s, and so on.
Now say you needed your tonsils removed. You’d probably head to your doctor, have the thing done and pay whatever they asked you to pay -- no matter how much that happens to be.
Scott Jensen, a Republican senator from Carver County, wants that to change. He thinks every patient should know how much their doctor visits and procedures cost. Which, mostly, they don’t.
“I’m a physician, and I see it every day,” he says. “I see patients shocked by their medical bills.” He says it’s part of the reason he ran for office in the first place.
Jensen is a family doctor with a small clinic in Watertown. If a patient came to him with a sinus infection, he says, they’d probably end up paying less than they would at his daughter’s clinic: a big hospital system in Chanhassen.
That’s because insurance companies broker different deals with different clinics, and a small clinic in Watertown just doesn’t have as much leverage as a big hospital in Chanhassen, nor do they have the facilities fees you get in clinics associated with hospital systems. They get paid less, and in turn, the patient pays less.
But most patients don’t know that, and their infected sinuses are not getting any better, so they’ll go wherever and pay whatever. Even if they did ask Jensen, “Hey, how much money are you going to get for getting all this crud out of my nose,” he couldn’t tell them. He’d be in violation of contract otherwise.
So Jensen wants to remove those gag clauses, and furthermore, he wants patients to be given a list of the 25 most common procedures and 10 most common preventative procedures a clinic offers, and their prices. If the patient doesn’t like them, they can try a clinic down the street, where they might be drastically cheaper. You know, like you would for a sofa, or literally most other things you would buy.
“We need to allow patients to be better consumers of health care,” he says.
Jensen and Rich Draheim, another Republican from Madison Lake, have introduced four bills between them to make health care prices more transparent, and Jensen says they’ve been warmly received across party lines. Jensen gives the proposal better than 50 percent odds of passing in the Senate, but expects lawmakers on the House side will have their own ideas.
The main problem is that there is a large sector that would prefer not to have everyone know what every clinic is charging for an appendectomy: insurance and pharmaceutical companies. Those are two opponents that happen to have excellent lobbyists.
“They control the system, and they’re not interested in letting it go,” Jensen says.
There is also another wrinkle in Jensen’s plan. In a lot of ways, shopping for health care is not like shopping for a sofa, because if you can’t get the sofa, it doesn’t mean you’re going to die. The same can’t be said of cancer treatments. Jensen gets it -- if a person suddenly has chest pains, he says, they’re not going to shop around and compare prices. They’re on the hook for whatever the closest place will charge them.
“On some level, physicians and hospitals charge what the market will bear,” he says. “And the market will bear a lot.”
Obscuring prices through veils of insurance, gag clauses, and general opacity has only allowed medical prices to inflate over the past few decades. Between 1960 and 2013, the health spending share of the GDP has risen from 5 percent to 17.4 percent, and the increase in the human lifespan hasn’t kept up with the change.
Telling patients how astronomically high the cost of their cancer treatments are may not help them in the short term, but Jensen hopes his bill can start to peel back the layers of secrecy that surround medicine and money. If we as a society have agreed that there is a price on human life, we should at least get to see what it is.