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Price transparency needed for medical services

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I recently attended a forum in Helena to discuss the high cost of health care and workers compensation insurance in Montana. Other legislators and concerned citizens in Montana were also in attendance. We had several great speakers join us, some via teleconference and others in person. One of the speakers in attendance was Representative George Kiser from North Dakota. Representative Kiser discussed North Dakota’s workers compensation system which is called Workforce Safety and Insurance (WSI). WSI has the lowest cost rating for workers compensation premiums among all 50 states. Montana’s workers compensation premiums are 2.5 times higher than North Dakota’s premiums. Montana has the 11th highest premiums among all 50 states. 

Representative Kiser presented an overview of North Dakota’s workers compensation system. On the surface, it seems North Dakota’s benefits for employees are better than Montana’s benefits and the cost of administering their system is much lower than ours. Workers Compensation was established to benefit injured workers, yet in Montana it seems our system is plagued with higher costs and lower benefits. There has to be a way to create a better worker’s compensation system in Montana ... If North Dakota can do it, so can we. I will continue to investigate and review North Dakota’s system with the goal of developing some ideas to present to the 2017 legislature in order to improve Montana’s worker compensation system.

We also had several speakers address the high cost of healthcare insurance, which is a direct result of the high cost of medical services. Rarely as a consumer do you know the cost of medical procedures. This lack of transparency in pricing makes it very difficult for consumers to make financially prudent healthcare decisions. We had examples of a hysterectomy costing anywhere from $8,000 to $25,000, sometimes more. Patients with healthcare insurance are generally more concerned with their deductible than the cost of care, and they have no incentive to consider price when comparing healthcare providers. Even if a patient had an incentive to find a low cost provider, it is very difficult to find pricing information for medical procedures. Price transparency could help lead towards competition, leading to lower healthcare expenses and ultimately lower health insurance rates. One great example of price transparency is the Surgery Center of Oklahoma. You can review their website at and find the cost of many procedures. It was reported that some insurers were sending patients to Oklahoma and paying for the flight and accommodations because of the savings and quality of care. 

We also discussed companies that review and audit medical and prescription drug bills. Many find substantial billing errors. A State Senator from Maryland discussed their healthcare system, which includes price transparency and one bill for the same amount for all providers. So whether you are on Medicare, Medicaid, private insurance or self-pay the price for a procedure is the same for everyone. 

Our healthcare system is broken and the recent changes from Obamacare have not made many significant cost savings. Soon, the Montana State Auditor will be announcing the insurance rate increase for Obamacare coverage for individuals on the exchanges and most, if not all, of the increases will be in the double digits, having significant impacts on ratepayers. 

I will be working on healthcare issues with other legislators and concerned citizens prior to the 2017 session. I believe one of our first priorities should be price transparency for all medical services. 

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