What is the state of Arizona doing to hold down rapidly rising medical costs? For starters, it is certainly not following its own law about publicizing price comparisons between hospitals.
To provide consumers with "simple and concise" information about hospital charges, state legislation was adopted more than 20 years ago. The act requires the Arizona Department of Health Services, using data submitted on a regular basis by hospitals, to semiannually publish a brochure for geographically proximate facilities. This printed material is supposed to list "average charges per confinement for the most common diagnoses and procedures," and the brochures are to be distributed free of charge through the reception areas of hospitals.
"We haven't produced a brochure for at least 10 years," admits Richard Porter, chief of the Bureau of Public Health Statistics for ADHS. "Because hospital patients never knew their charges since they were (paid for) through insurance companies, we found the brochures had no value to anybody."
To replace the legally mandated but discarded brochures, several years ago, the department established a page on its Web site. Showing standard prices for 29 procedures and services for every hospital in the state, this spread sheet could offer a quick cost comparison between hospitals, at least to the computer savvy.
Unfortunately, the information currently provided on the Web site includes Tucson hospitals which no longer exist, along with some charges that go back more than a decade. The outdated data for University Medical Center and St. Mary's hospitals is seven years old, and for Tucson Medical Center, it comes from 2000.
Porter blames the unusable material on an "internal situation," as well as a fire at a facility where the data was stored. "We have the information," he indicates, "and it should go out on the Web site in the next few months."
Gov. Janet Napolitano's Tucson office did not respond by this story's deadline to a request seeking a comment on this situation. State representative Ted Downing, however, believes it might be time for the Department of Health Services to obey the statute.
"The brochure is a great idea," the central Tucson Democrat says, "and I think somebody (at ADHS) should start reading the law. Supposedly, if the state publishes comparative prices, the cost will go down."
That philosophy recently led the California Legislature to require hospitals there to disclose their prices. Unlike Arizona, which only stipulates a small sample of costs be provided, the California law mandates all prices be made public. To comply, many California hospitals have made their "charge master" costs available.
As a December article in The Wall Street Journal stated: "The California law was intended to make it easy for consumers to see how much certain services would cost. The idea, in part, was to goad hospitals to limit or change their markup policies."
The number of Californians accessing the information, though, has been extremely limited. That same result has been found at some local hospitals.
"I've never had questions about our prices except for our birth package," reports Julia Strange, spokeswoman for Tucson Medical Central. Adds Jim Bands of University Physicians Healthcare Hospital at Kino: "Since we opened in June, we've not had any requests (for price information)." If they did, Bands says, the hospital would make it available.
University Medical Center, though, averages 25 cost inquiries a week, according to a spokeswoman. To answer these questions, the hospital makes its entire fee schedule publicly available. Many of the people trying to find out about costs at UMC are reportedly shopping around for lower prices, even though some of them have health insurance.
This tendency to look for cost savings on medical procedures may become more important as the number of people without any insurance coverage grows. As reported in the Weekly (See "Hospital Check-Up," March 31), the price difference between hospitals can be substantial. With tens of thousands of Tucson residents currently lacking medical insurance, and many others with high deductible policies, potential patients seeking the lowest-priced health care could become much more common in the future.
For last week's article on hospital charges, one local resident attempted to determine the costs for an uninsured person for several services and procedures. Because of the reluctance by some of the hospitals to disclose the data, even though everyone tried to be helpful, he found the process difficult and time consuming.
"For an uninsured person who wants to do this," he says, "there are all kinds of stumbling blocks, and you need a lot of support (from the hospitals). There is a lot of voice-mail and phone tag. The system isn't set up to shop around."
This Tucsonan also isn't sure publishing the cost comparison brochures again would be of very much help. As someone who diligently sought hospital costs, he concludes: "The brochures would only be good to give you a general idea of what a hospital charges. The entire charge master list would be more helpful."