The reporters from the Observer asked Carolinas HealthCare System about that and other questions, which it didn’t answer. Instead the hospital touted its commitment to quality saying, “We work hard to achieve greater value and better care for our patients if these higher charges do occur. The paper printed the response.

In Boise

Reporter Audrey Dutton offered readers a lengthy description of how two hospitals in the Idaho capital—St. Luke’s Health System and Saint Alphonsus Health System—have become giant healthcare machines competing for market share and grabbing more doctors’ practices. In a second piece, she examined the fallout for patients.

How how are prices rising? An analysis of data from Blue Cross of Idaho for common medical imaging procedures revealed the average hospital in the Blue Cross network was charging $110.81 more for a chest X-ray and about $300 more for an MRI than what the service would cost at a free standing clinic. One doctor, who had been in a practice that was sold to St. Luke’s, told Dutton: “Overnight our prices doubled, absolutely doubled”

Insurers said they didn’t actually pay the higher charges. One said their goal was “to pay the same before and after the acquisition.” That leaves the balance up to the patients to pay. The ones with no insurance, who go to out-of-network doctors, or who have coverage that doesn’t count outpatient hospital procedures (which some of these services are) toward the ever-larger deductibles—they have to pay.

What the three newspapers have discovered runs contrary to the goals of the Affordable Care Act, whose very name and legislative premise was to make healthcare cheaper for Americans. If market forces are running contrary to the goals of the law and causing healthcare to become more expensive, that’s one heck of a continuing news story.

Our suggestion: Hospitals claim higher prices are justified because they have to provide costly care for the uninsured. Is the claim justified? Hospitals do collect from uninsured, or insured patients for that matter, often using aggressive techniques. As the Observer reported, they’ve sued thousands of needy patients, often putting liens on their homes and damaging their credit. Do amounts spent on charity and uncompensated care justify the higher prices for services given by hospital-employed doctors?

Related stories:
A Laurel to The Record

The new medical credit racket

What We’re Learning About Hospitals Part 1


Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.