Better Late Than Never (Editorial)

This issue’s front-page story on practical effects of the Patient Protection & Affordable Care Act on hospital finances reveals that private insurance carriers have been demanding price concessions from hospitals. Anecdotally, we’ve heard of the same demands being made of other providers, particularly specialty physicians groups.

Because we are not part of the health care industry, merely consumers of medical care either directly or indirectly through our insurance policies, this news is both encouraging and infuriating.

We’re encouraged that insurers are demanding that we, the ultimate payers, get the best possible prices for medical services. This, among other things, could help explain why health care price inflation was kept to 1 percent between July 2012 and July 2013 — miraculously lower than general inflation — and suggests that there will be more cost containment in the future, at least in the near term.

It’s infuriating, however, to be presented with fresh evidence that our insurance carriers haven’t always bargained hard with our money. And there really can be no other way to look at the situation. Insurers are demanding and getting price concessions that they didn’t demand (and therefore didn’t get) in the past. Medical care inflation could have been reined in earlier, at least to some extent.

We’ve seen evidence of this before. Perhaps it’s impolite to drag up ancient history, but before Arkansas’ “any willing provider” legislation finally took effect in 2005, St. Vincent Health System offered to undercut Baptist Health’s pricing by 10 percent in order to get on Arkansas Blue Cross & Blue Shield’s list of preferred providers, but ABCBS wouldn’t give that cost-saving option to its customers.

It is very hard, nigh unto impossible, for health care consumers to negotiate on price. For one thing, we have no frame of reference for what a procedure or service should cost. It is gratifying to know that the insurance gatekeepers are doing a better job of that — but what took you so long?