Medical Costs


      As loud and divisive as the presidential campaign has been so far, both parties agree on one thing: health care is one of the top issues concerning Americans.

      And a recent Rasmussen poll found: 59 percent of likely voters consider reducing the cost of health care more important than making sure everyone has insurance, which is the goal of Obamacare.

      But what can consumers to do control their cost?

      These days, it's easy to comparison shop for just about anything, except medical care, one of the most expensive services you'll ever need.

      That gave us an idea. We partnered on a project to try to compare prices of specific procedures.

      We ended up with some incredible results that show it pays to shop around.

      Haller: I was often sent to the wrong place many times.

      Scott Haller played the role of patient in our project. He's a research and programs assistant at the Boston-based Pioneer Institute research group.

      The Institute helped conduct a survey for Full Measure of 54 hospitals in six states: Texas, New York, California, Iowa, North Carolina and Florida.

      Haller: I would call the operator and ask for a cost estimate for an MRI of my life knee without contrast, and basically see where they sent me because it could be one of many different places.

      Shopping around is more crucial than ever with so many consumers paying thousands in cash out of pocket under Obamacare, according to the Pioneer Institute's Senior Fellow, Barbara Anthony.

      Anthony: The reason this is important is because we are now living in an age of high-deductible health plans. It used to be that your insurance coverage would take care of your health care expenses from the first dollar of your expenseswell, that's no longer the case.

      Getting a cost estimate for an MRIa radiology procedure that takes images of the inner bodyshould be simple. But Scott found it was like pulling teeth.

      Haller: The operator would frequently send me straight to the MRI department, who are on the front lines of giving the MRI's and don't actually know anything about the billing. You'd often get the run around. People could be a little bit rude, all sorts of stuff really.

      Getting even partial information on the price of an MRI took up to eleven persistent phone calls.

      Haller: One time I was told to call an 800 number, and got a coal company, who then immediately told me to dial 1-866 instead and that got me to where I wanted to go and they've obviously been through that before but also there were many times where I would leave a message, sometimes multiple messages on the same person's phone and they would just not get back to me after waiting over a week. And sometimes they'd call back and say 'I don't even know why you're calling me.'

      Anthony: In 25 percent of the cases that we called, 25 percent of the hospitals that we called, 14 of them we were actually unable to get final price.

      Sharyl: The Pioneer Institute found hospitals around the country ill-prepared to provide prices to a consumer asking for basic information.

      Fifer: This is a big ship that we're turning as an industry.

      Joe Fifer is CEO of the Healthcare Financial Management Association, which represents many hospital finance executives.

      Fifer: I don't defend the fact that it's very difficult for patients to navigate their way through this that is something that we need to fix. We know we need to fix that as an industry.

      He says what makes it so hard is the complex system set up by the government and insurers using thousands of arcane codes with different fees depending on who's paying the bill: private insurance, the government, or you.

      Fifer: Almost all of these codes have dollars associated with them that are on these charge masters. They really become a part of a calculation to a different payment methodology.

      Sharyl: So you kind of lost me.

      Fifer: I'm sure I did. One good analogy is if you ever go into a hotel room and you look at the charge sticker that's on the back of the door, it's usually some charge that's significantly higher than what you're paying. They probably don't collect that charge that's on the back of the hotel door from anybody. It really means very little. That's kind of like what these hospital charges are like.

      Maybe that's why the prices we did get in our survey were wildly inconsistent and not tied to a city's size or cost of living.

      For example, one hospital in the Los Angeles area charged $400 for the knee MRI. But a hospital in smaller Des Moines, Iowa quoted $3,500 ($3,536). That's eight and a half times as much for the exact same procedure.

      Similar dramatic ranges are found within the same region. In Orlando, one hospital charged as little as $877 totalanother charged close to $2,000 ($1,980) and didn't even include the fee to read the MRI.

      Hospitals in Los Angeles: charged from $400 to $2,800 ($2,850).

      Raleigh-Durham: about a $1,000 ($1,023) to $2,700 ($2,775).

      Des Moines also from about $1,000 ($1,071) to $3,500 ($3,536).

      Dallas and Fort Worth: $500 ($508) to $4,200 ($4,274).

      And the biggest disparity was in the New York City area. The cheapest knee MRI was about $440. Another hospital in the areathe most expensive in the surveycharged $4,500!

      Anthony: I think we called something like 11 hospitals in the New York City region. There was a difference in price of 1,000 percent from the lowest price in New York to the highest price in New York. The point is there are differences and they are huge. And from the research we did, we couldn't figure out what could account for these huge differences in price.

      In a similar study confined to Massachusetts last year, the Pioneer Institute also found "price information difficult to obtain," even though Massachusetts requires hospitals to give it under the strictest transparency law in the U.S.

      And the ranges were equally baffling.

      A dermatologist removing a wart cost anywhere from $85 to $400.

      A routine eye exam at an ophthalmologist went for $80 to $327.

      An adult MRI ranged from $700 at one hospital to more than $8,000 at another.

      Fifer says hospitals are not planning to come up with a single, standard price list that they would all use. But they are working to meet consumer demand to give cost estimates up front.

      Fifer: Internally I would describe it to you is that we're scrambling to be able to develop this capability. But we're probably not moving fast enough for consumers who are all of a sudden, seemingly overnight, sitting their with a multi-thousand dollar deductible health plan.

      Anthony: As a country, we are really lagging behind in terms of health care price transparency for consumers. It is a very daunting task for the average consumer to find out the price of a procedure before obtaining that procedure. We really have a long way to go, I think, all over the country, before we give consumers the tools that they need in order to spend their health care dollars wisely.

      Who proved to be the most easy to get quotes from?

      Dentists and dermatologists possibly because they've always had a lot of patients who self-pay, since insurance often doesn't cover their procedures.

      Also, kudos to Cedar Sinai in Los Angeles, which provided information on the cost of an MRI in just 4 minutes.

      You can see the entire report at