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Editorial: Transparency a good place to start in addressing rising health care costs

It’s still weeks till Halloween, but a Bloomberg News story on the Health cover of the Oct. 1 Journal is scary enough to last the season.

Results of an annual Kaiser Family Foundation survey show the annual cost of family health coverage in our country is now upward of $20,000.

That’s right, $20,000. As Kaiser CEO Drew Altman says, “It’s as much as buying a basic economy car, but buying it every year.”

The survey focuses on the medical coverage people get through work – “the main source of insurance in the U.S. for people under age 65.” It points out workers are now contributing an average of $6,000 for just premiums on a family plan – that doesn’t include if they actually have to seek treatment and start shelling out for co-payments, deductibles and the like.

And that’s especially frightening in a rural and largely impoverished state like New Mexico that is struggling to build its private sector. The study also found that “employees’ costs for health care are rising more quickly than wages … and the working poor have been particularly hard-hit.”

And while New Mexico has expanded its Medicaid eligibility and has a state insurance exchange, rising costs mean that for many working New Mexicans, health care coverage is, as Altman says, “just flat-out not affordable.” And it’s certainly not for the small businesses so vital to our communities that struggle to provide benefits. Employers’ costs have risen even more than employees’, according to the report.

Drivers of those costs are as varied as experts and commentators, but it certainly doesn’t help that medical providers have next to no transparency requirements. Patients contemplating procedures often have no idea as to what those services cost – until the bills come weeks or months after the fact and induce a migraine, panic attack or worse.

There’s an unspoken attitude that if you’re seeking medical care, cost should be set aside, pushed onto the back burner. After all, your health comes first. That notion is as out of touch as it is wrong-headed. Of course in a medical crisis, care is priority No. 1. But any medical need short of a life-threatening event should prompt some pocketbook analysis. And you can’t make an informed decision without information.

The lack of medical-cost transparency also means there’s no standardization. An MRI in Albuquerque might cost the same as an MRI in Santa Fe, San Francisco or Seattle – but it more than likely does not. Costs even vary within the same facility, depending on the patient’s insurance, if the provider is in their network, and if there is cost-shifting to cover other patients.

There are a good many other factors to the rising cost of medical care, including the increasing complexity of technology, the high price tag of a medical education and malpractice insurance, and what some would say is permissive regulation of pharmaceutical companies.

It all adds up to a complicated challenge. But a requirement that patients be made aware of the actual cost of procedures is a reasonable place to start to get a handle on the problem. And getting across-the-board price – and then outcome – comparisons for services should provide useful data for solving the more deep-rooted issues plaguing our medical system.

As the Bloomberg New story noted, a single person in 2009 paid an average deductible of $533. This year, that same person on average dished out $1,396. Increases in medical costs continue to outstrip wage growth and prices in the overall economy.

It’s an alarming problem best addressed on a federal level, but New Mexico’s elected officials should step forward with prescriptions to treat this growing financial epidemic that threatens every one of us.

This editorial first appeared in the Albuquerque Journal. It was written by members of the editorial board and is unsigned as it represents the opinion of the newspaper rather than the writers.

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