SHAC, hospital pricing and student health care

Almost two weeks ago, the Centers for Medicare & Medicaid Services released a revealing set of data about the prices charged by hospitals for various inpatient procedures. The database catalogs the top 100 most-billed discharges, ranging from seizure treatment to cardiac arrest, across the U.S.

Almost two weeks ago, the Centers for Medicare & Medicaid Services released a revealing set of data about the prices charged by hospitals for various inpatient procedures. The database catalogs the top 100 most-billed discharges, ranging from seizure treatment to cardiac arrest, across the U.S.

Readers will be shocked to find the enormous disparities in costs between hospitals within just a few miles of each other.

For example, following admission to Legacy Good Samaritan Medical Center for chest pain, one can expect an average bill of $13,517. This is a rather large difference when one considers the same admission conditions are billed at $8,456 at Providence St. Vincent Medical Center in Beaverton.

According to the executive director of the Center for Student Health and Counseling, Dr. Dana Tasson, “Hospitals need to be more transparent about their pricing so that it’s less of a mystery and people can make informed choices.”

Tasson added that “[hospital] pricing has lost its meaning.”

Tasson emphasized that the mission of SHAC is to provide health care for any student who enters its doors. Additionally, it considers the current state of the health care system and works to make it as affordable as possible for students, he explained.

This translates to yearly negotiations between the university and health insurers to find the lowest-cost provider with the widest doctor network for PSU students, in order to mitigate the extreme price variation that the pricing data shows, Tasson said.

A question that arises within the Portland State community is what this data, and health care reform, means for students.

The most tangible way many students feel the cost of health care is at the beginning of every term, when they see a $560 fee for health insurance on their student account (unless they submit a waiver showing they have similar or better insurance elsewhere).

While there is grumbling about being forced to purchase a product some may not want or need, Tasson pointed out that by switching to this system PSU is providing a service to its students while keeping their out-of-pocket expenses to a minimum. This is in addition to funding SHAC operations, which provide services ranging from primary health services to advocacy and outreach and more.

Tasson explained that when people are insured they don’t end up paying the “rack rate,” or full price, that an uninsured patient would pay.

“The students that are really falling prey to that variance in pricing are students who aren’t insured, because it’s the uninsured, at the end of the day, who pay those rack rates,” he said. “So that’s one reason we feel it’s so important to have a student insurance program, so that we can use our buying power to get the student the best deal possible.”

Neal Wallace, a PSU professor of public administration, feels that the state of the current health care system is at fault for putting the university in the unenviable position of filling holes in the social safety net.

Specifically, many students attending the university in the past could be categorized as underinsured or uninsured, and unless the university and the students were prepared to turn a blind eye to the suffering of their peers, providing insurance and health care was a necessary measure.

“In a world of universal coverage, you don’t need universities doing insurance and health care provision,” Wallace said.

“Now, with…[the Affordable Care act], students, many of which are undergraduates, [who] might be of an age to get on their parent’s insurance have gotten more insured. But for younger ages who typically have been uninsured or underinsured in the sense that they have to pay a lot out of pocket, this kind of price variation can have a huge impact.”