Patients should know the cost of their care

As Canadians we live in a privileged country where almost all of our healthcare is paid for by our taxes.  The two recent articles in the New York Times and JAMA highlight the absurdity in the US where prices are so fluid and nebulous.

The original idea for this comes from my friend, another anesthesia resident.  The idea is this:

Patients should be given an itemized bill with all the costs for the care they’ve received, and the final sum they have to pay – zero.

This provides transparency of healthcare costs to the end-user and taxpayer, to the healthcare workers who are being paid by and also utilize and spend healthcare money, and may allow everyone to find opportunities to reduce cost.

I don’t think anyone in our hospitals really know how much money every device/implant, medication, or test costs the system.  Some of these costs would be incredibly difficult to calculate, but some would be fairly simple I would think.  For us, have the prices of items printed on their storage, so we know how much that IV blood set, 4×4 gauze, vial of atropine, bottle of sevoflurane really cost. Surgeons should know the costs of their implants and single-use devices, sutures, staplers, etc.

Of course, there will be people arguing that we should not be constrained by the costs but by the necessity of the intervention, and we should be doing what we think is “best” for the patient. However, I would argue that we should all know the costs to the system and to not forget that we are also managers of the healthcare system. We must be cognizant not to bankrupt the future for the benefit of the present.

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