To the editor:
I read your article “Health Care Sticker Shock,” outlining hospital costs and seemingly encouraging people to “price shop” for their health care. As a consumer I can appreciate looking for bargains, but as a nurse in the Indianapolis area with some management experience, I would like to offer an “insider” perspective on this issue.
First of all, what you listed were the Medicare charges for specific diagnoses. There are a great many variables that factor into how these charges are determined, not the least of which is that some hospitals, usually teaching and specialty centers, receive more than other hospitals in the same area to support their programs.
At the same time, smaller local hospitals without the advanced equipment needed for more complex testing and treatment receive less. Other factors that influence these charges can include the complexity of the procedures performed and cost-of-living indicators in a given region. For example, New York City, Chicago and San Francisco receive more for the same procedure than similar hospitals in Indianapolis. That said, the amounts listed, as you pointed out, are not anywhere near the actual amounts collected.