When Dr. Hans Rechsteiner saw the appendectomy bill for one of his patients, he couldn’t believe the total was $12,500, more than seven times Rechsteiner’s $1,700 fee for doing the surgery.
The other charges included $4,000 for the operating room, $3,000 for anesthesia and $2,500 for the recovery room, all for what Rechsteiner said was a 15-minute procedure.
Rechsteiner discussed the bill with his colleagues at the Tri-County Medical Society in northwest Wisconsin. They decided doctors don’t speak out enough about ways to reduce medical costs.
They passed a lengthy resolution calling for dramatic health care reforms — saying, for example, that “overbuilt” hospitals “should be allowed to fail” and patient deductibles should be set as a percentage of total bills, not a particular amount, so patients have more incentive to shop around.
The group, which includes 75 doctors in Barron, Burnett and Washburn counties, published the resolution Jan. 15 as a half-page ad in the Wisconsin State Journal. The doctors were seeking the attention of lawmakers and statewide medical organizations, said Rechsteiner, a general surgeon in Spooner.
“The hope was to shine a light on the problem and increase public awareness so the appropriate people could bring this under control,” he said. “It’s a bit of a pipe dream, but that is our goal.”
Rechsteiner, citing articles this past year in Time and The New York Times that have explored the high cost of health care, said the medical industry is like the oil and meatpacking industries of a century ago. The Affordable Care Act is getting more people insurance but doing little to address soaring health care costs, he said.
“All these years later we have another industry that’s just plain gouging,” he said.
The eight-part resolution also calls for tort reform, price transparency, a ban on doctors profiting from facilities they own and the creation of a public service commission-like body to ensure that 95 percent of health insurance premiums are used on medical care.
Rick Abrams, CEO of the Wisconsin Medical Society, said he agrees with parts of the resolution but believes other parts are “light on facts and depth.”
Doctors should be able to own facilities if they disclose such relationships, and transparency about the quality of care is at least as important as about price, Abrams said.
“Cost is not value,” he said. “Cost plus quality is value.”
The Wisconsin Hospital Association’s PricePoint system makes some hospital charge data publicly available. The Wisconsin Health Information Organization is expected to make quality and efficiency ratings for primary care doctors at 600 clinics public in February.
Rechsteiner, like many doctors, believes a single-payer system — such as extending Medicare to everyone — is the best solution. “I think the whole thing would pay for itself,” he said.
His patient’s $12,500 appendectomy bill, like most medical bills, was a “sticker price.” As is typical, the patient and his insurer paid less. However, “what’s paid is still a crime,” Rechsteiner said.
He acknowledged the complexity of the situation, however, when I asked if he supports Spooner Health System’s plan to build a replacement hospital — which could arguably add to health care costs.
“I’m not happy about it, but I don’t blame the people who manage the hospital because we have to compete,” he said.