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Florida's Health Care Cost Markup Among Nation's Highest

A new Johns Hopkins report shows that Florida as the 7th worst health care mark up ratio in the country. WIKIMEDIA COMMONS.
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

A newly released report by Johns Hopkins University, Hospital Prices in the United States: An Analysis of U.S. Cities and States, shows that seven out of ten of the states with the highest health care mark up ratios are in the south - including Florida.

Health News Florida's Daylina Miller spoke with Dr. Marty Makary is a Johns Hopkins surgeon, New York Times bestselling author, and Health Policy Advisor to the Obama and Trump administrations about the report, which featured information published in his book, "The Price We Pay."

Daylina Miller: Your newest report shows Florida has the seventh highest health care market ratio in the country. What does that mean?

Dr. Marty Makary:Well, it means that prices are all over the place. The story that nobody is talking about is that the real problem in health care is that we have complete pricing failures. And we have a crisis of appropriate care in the United States. I mean, imagine going on a travel website, and looking at the price of flights and it just said “to be billed later.” Imagine an airline company said, “We can't give you a price, we don't know if there's going to be a delay. We don't know if there's going to be a cancellation, or if the pilot’s going to experience turbulence. We cannot give you a price because we just don't know what the outcome is going to be.” We'd say that's a dysfunctional marketplace; we'd say a lot of people are getting rich off of the opacity. But yet in health care, that's exactly what we have. People deserve an honest and fair price for their medical care. 60% of medical care in the United States is shoppable. It's elective, and we need to get our act together to get a price so that we can create some efficiency in the marketplace and cut the waste.

Miller: And how can we do that?

Makary: Always asked for a price. Second of all, your bills are negotiable. If you want to fight your bill, we've put on our website 20 ways you can fight or negotiate with your medical price. And businesses are getting ripped off across the country. So number three, if you have a business, renegotiate your pharmacy plan, and renegotiate your insurance, health insurance plan for your employees, use an honest independent broker that's not paid on a commission or kickback basis, which by the way, is the way most brokers are paid. And I outlined many things people can do in the book, “The Price We Pay,” because if enough people rise up and say “enough is enough,” hospitals are going to behave. Doctors, by the way, are fed up as well. I mean, doctors want to redesign care all together by saying, “hey, maybe we've been doing too much.” Maybe five years ago, we were only prescribing 2.4 billion prescriptions, and now it's 5 billion. Disease didn't double in the last five years. But we have a crisis of appropriateness. Isn't the opioid crisis just one manifestation of our crisis of appropriateness? And that problem of our crisis of appropriateness is one of the two root problems of our cost crisis. We can do more in health care to clean up our act. I mean, the current health care costs crisis is our problem. It's not the problem of everyday hardworking Americans.

Miller: What do you hope that people take away from your book and this report?

Makary: I would love to see us change the language. When we talk about medical care, instead of talking about bad debt., let's talk about predatory billing. Instead of talking about the cost of care, let's talk about price gouging. Instead of talking about adverse preventable events, let's talk about medical care gone wrong. Primary Care in the United States is broken, right, 10-minute visits with people rushed and spending time on billing and focusing on throughput. That's for the birds, right? Sometimes, sadly, in America today, people are suffering, not from the disease or illness that brings them to care, but from the care itself, including financial toxicity, which in my opinion, is a medical complication. Billing quality is medical quality. Financial toxicity is a complication and taking care of a patient is taking care of the entire person.

Miller: Dr. Marty Makary is a Johns Hopkins surgeon, New York Times bestselling author, and Health Policy Advisor to the Obama and Trump administrations. Thank you for your time today, Dr. Makary.

Makary:Thanks so much, Daylina, for doing this.

Copyright 2019 WUSF Public Media - WUSF 89.7

Daylina Miller is a multimedia reporter for WUSF and Health News Florida, covering health in the Tampa Bay area and across the state.
Daylina Miller
Daylina Miller, multimedia reporter for Health News Florida, was hired to help further expand health coverage statewide.