$10,000 for a colonoscopy? To fight the rising costs of health care, we need more transparency

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Frankly, we’re all paying through the nose until we find ways to reduce spiraling health care costs for the hundreds of thousands of state workers in New Jersey, many of whom have been hit by double-digit hikes in their wages. last year.

That’s not just money out of their pockets, but also the pockets of state taxpayers, who take the brunt of the hit — meaning premium increases of more than 20 percent for some workers. Local and county governments and schools face the same problem and have less wiggle room: They’re being forced to lay off workers because these dramatic price increases are breaking their budgets.

We need to find ways to fix this. On Friday, a final vote is expected from Senate President Nicholas Scutari to allow more than one insurance provider to administer public employee health insurance programs. He hopes this will create more competition to help control health care costs.

It wouldn’t hurt to add another provider; We’ve had more than one in the past, including Horizon and Aetna. But it is not clear how much it helps. The associations are correct: what this draft is missing is clarity. We want to make hospital rates public to help us negotiate better, and beyond this bill, we need to really look at how we can control health care costs in New Jersey.

Some states, such as Montana, Oregon and California, have set limits on what they pay for hospital care based on the price paid by the federal Medicare program, a proposal worth serious consideration. Our state legislature should hold a hearing.

“The real issue and driver behind the rising cost of health care plans is hospital costs, because hospital costs are increasing dramatically,” said Kevin Brown, 32BJ SEIU state director. While his union doesn’t have a dog in the fight for this particular bill, it is part of a coalition of unions and advocates that, like New Jersey Citizens Action, a consumer advocacy group, cares deeply about the issue and formed the policy group. “A Coalition for Affordable Hospitals”.

They mention that for some mysterious reason, hospital cost inflation is much higher than other areas of healthcare. “From 2008 to 2023, hospital price inflation was 100%, while for other medical services and restaurants it was only 50% over the same period,” Brown said, citing data from the National Bureau of Labor Statistics.

“Inflation for health insurance is driven by increases in utilization, costs to cover services, and inflation. However, these changes do not fully account for the large increase,” according to a report by the New Jersey Policy Outlook think tank. However, it can cost state and local governments hundreds of millions of dollars each year.”

And with little transparency, it’s hard to say exactly how much government employees are paying for healthcare at various hospitals. Last year, 32BJ released a report using member billing data to compare prices for procedures at various hospitals in New York City, and found that some were paying too much. You can pay up to $10,000 for an outpatient colonoscopy at New York Presbyterian or just $4,000 at Mount Sinai. Big difference.

We also need to look closely at the cost of our hospital. Scutari said what advocates are asking for “goes beyond the intent of the bill” and that requiring public disclosure of hospital costs complicates the law. “I think there’s been some pushback on the question, and the bill doesn’t intend or intend to do that,” he told us this week.

But we can’t have a meaningful discussion about affordability without getting real about the cost. Kathleen Bennett, CEO of the New Jersey Hospital Association herself said, “Achieving affordable quality health care is a priority for all of our member hospitals and requires a deep and honest conversation about the many factors that drive costs. Undeniably, the prices set by hospitals are one of these factors. So why don’t people watch them?

Beyond that, finding ways to better manage and reduce these costs could result in significant savings for public employees and taxpayers, New Jersey Policy View argues.

About 54,000 people enrolled in our state’s health benefits in 2015 — including school employees — and NJPP senior policy analyst Brittany Hollom-Trundy. Last year’s report. However, spending increased by about $417 million.

“Hospital costs account for a large share of insurance costs, potentially costing state and local governments hundreds of millions of dollars each year,” she wrote.

New Jersey has an office created by Gov. Murphy to curb health care cost growth through data-driven analysis and recommendations. But advocates complain that it lacks real enforcement powers.

It is time for the Legislature to step in. As premiums continue to rise, we can no longer rely on one-time repairs. Let’s find a more permanent solution.

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