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Jeanne Pinder: What if all US health care costs were transparent?
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In the US, the very same blood test can cost $19 at one clinic and $522 at another clinic just blocks away -- and nobody knows the difference until they get a bill weeks later. Journalist Jeanne Pinder says it doesn't have to be this way. She's built a platform that crowdsources the true costs of medical procedures and makes the data public, revealing the secrets of health care pricing. Learn how knowing what stuff costs in advance could make us healthier, save us money -- and help fix a broken system.
Jeanne Pinder - Journalist
Jeanne Pinder asks why it's so hard to make sense of US healthcare bills -- and suggests what we might do about it. Full bio
Jeanne Pinder asks why it's so hard to make sense of US healthcare bills -- and suggests what we might do about it. Full bio
Double-click the English transcript below to play the video.
00:12
So, a little while ago,
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members of my family
had three bits of minor surgery,
had three bits of minor surgery,
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about a half hour each,
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and we got three sets of bills.
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For the first one, the anesthesia bill
alone was 2,000 dollars;
alone was 2,000 dollars;
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the second one, 2,000 dollars;
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the third one, 6,000 dollars.
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So I'm a journalist.
I'm like, what's up with that?
I'm like, what's up with that?
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I found out that I was actually,
for the expensive one,
for the expensive one,
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being charged 1,419 dollars
for a generic anti-nausea drug
for a generic anti-nausea drug
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that I could buy online
for two dollars and forty-nine cents.
for two dollars and forty-nine cents.
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I had a long and unsatisfactory
argument with the hospital,
argument with the hospital,
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the insurer and my employer.
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Everybody agreed
that this was totally fine.
that this was totally fine.
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But it got me thinking, and the more
I talked to people, the more I realized:
I talked to people, the more I realized:
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nobody has any idea
what stuff costs in health care.
what stuff costs in health care.
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Not before, during or after
that procedure or test
that procedure or test
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do you have any idea
what it's going to cost.
what it's going to cost.
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It's only months later that you get
an "explanation of benefits"
an "explanation of benefits"
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that explains exactly nothing.
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So this came back to me
a little while later.
a little while later.
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I had volunteered for a buyout
from the New York Times,
from the New York Times,
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01:23
where I had worked for more than
20 years as a journalist.
20 years as a journalist.
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I was looking for my next act.
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It turned out that next act
was to build a company
was to build a company
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telling people what stuff costs
in health care.
in health care.
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I won a "Shark Tank"-type
pitch contest to do just that.
pitch contest to do just that.
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Health costs ate up almost 18 percent
of our gross domestic product last year,
of our gross domestic product last year,
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but nobody has any idea what stuff costs.
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But what if we did know?
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So we started out small.
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We called doctors and hospitals
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and asked them what they would accept
as a cash payment for simple procedures.
as a cash payment for simple procedures.
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Some people were helpful.
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A lot of people hung up on us.
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Some people were just plain rude.
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They said, "We don't know,"
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or, "Our lawyers won't
let us tell you that,"
let us tell you that,"
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though we did get a lot of information.
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We found, for example,
that here in the New York area,
that here in the New York area,
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you could get an echocardiogram
for 200 dollars in Brooklyn
for 200 dollars in Brooklyn
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or for 2,150 dollars in Manhattan,
just a few miles away.
just a few miles away.
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New Orleans, the same simple blood test,
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19 dollars over here,
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522 dollars just a few blocks away.
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San Francisco, the same MRI,
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475 dollars
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or 6,221 dollars just 25 miles away.
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These pricing variations existed
for all the procedures
for all the procedures
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and all the cities that we surveyed.
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Then we started to ask people
to tell us their health bills.
to tell us their health bills.
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In partnership with public radio station
WNYC here in New York,
WNYC here in New York,
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we asked women to tell us
the prices of their mammograms.
the prices of their mammograms.
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People told us nobody would do that,
that it was too personal.
that it was too personal.
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But in the space of three weeks,
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400 women told us about their prices.
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Then we started to make it easier
for people to share their data
for people to share their data
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into our online searchable database.
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It's sort of like a mash-up of Kayak.com
and the Waze traffic app for health care.
and the Waze traffic app for health care.
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(Laughter)
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We call it a community-created
guide to health costs.
guide to health costs.
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Our survey and crowdsourcing work
grew into partnerships
grew into partnerships
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with top newsrooms nationwide --
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in New Orleans, Philadelphia,
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San Francisco, Los Angeles,
Miami and other places.
Miami and other places.
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We used the data to tell stories
about people who were suffering
about people who were suffering
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and how to avoid that suffering,
to avoid that "gotcha" bill.
to avoid that "gotcha" bill.
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A woman in New Orleans saved
nearly 4,000 dollars using our data.
nearly 4,000 dollars using our data.
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A San Francisco contributor
saved nearly 1,300 dollars
saved nearly 1,300 dollars
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by putting away his insurance card
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and paying cash.
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There are a lot of people
who are going to in-network hospitals
who are going to in-network hospitals
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and getting out-of-network bills.
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And then there was the hospital
that continued to bill a dead man.
that continued to bill a dead man.
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We learned that thousands of people
wanted to tell us their prices.
wanted to tell us their prices.
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They want to learn what stuff costs,
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find out how to argue a bill,
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help us solve this problem that's hurting
them and their friends and families.
them and their friends and families.
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We talked to people who had
to sell a car to pay a health bill,
to sell a car to pay a health bill,
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go into bankruptcy,
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skip a treatment because of the cost.
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Imagine if you could afford the diagnosis
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but not the cure.
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We set off a huge conversation about costs
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involving doctors and hospitals, yes,
but also their patients,
but also their patients,
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or as we like to call them, people.
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(Laughter)
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We changed policy.
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A consumer protection bill
that had been stalled
that had been stalled
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in the Louisiana legislature for 10 years
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passed after we launched.
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Let's face it:
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this huge, slow-rolling
public health crisis
public health crisis
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is a national emergency.
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And I don't think government's
going to help us out anytime soon.
going to help us out anytime soon.
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But what if the answer was really simple:
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make all the prices public all the time.
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Would our individual bills go down?
Our health premiums?
Our health premiums?
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Be really clear about this:
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this is a United States problem.
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In most of the rest
of the developed world,
of the developed world,
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sick people don't have
to worry about money.
to worry about money.
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It's also true that price transparency
will not solve every problem.
will not solve every problem.
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There will still be expensive treatments,
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huge friction from our insurance system.
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There will still be fraud
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and a massive problem
with overtreatment and overdiagnosis.
with overtreatment and overdiagnosis.
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And not everything is shoppable.
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Not everybody wants
the cheapest appendectomy
the cheapest appendectomy
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or the cheapest cancer care.
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But when we talk
about these clear effects,
about these clear effects,
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we're looking at a real issue
that's actually very simple.
that's actually very simple.
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When we first started calling for prices,
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we actually felt like
we were going to be arrested.
we were going to be arrested.
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It seemed kind of transgressive
to talk about medicine and health care
to talk about medicine and health care
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in the same breath,
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and yet it became liberating,
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because we found not only data
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but also good and honest people
out there in the system
out there in the system
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who want to help folks
get the care they need
get the care they need
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at a price they can afford.
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And it got easier to ask.
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So I'll leave you with some questions.
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What if we all knew what stuff cost
in health care in advance?
in health care in advance?
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What if, every time
you Googled for an MRI,
you Googled for an MRI,
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you got drop-downs telling you
where to buy and for how much,
where to buy and for how much,
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the way you do when
you Google for a laser printer?
you Google for a laser printer?
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What if all of the time and energy
and money that's spent hiding prices
and money that's spent hiding prices
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was squeezed out of the system?
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What if each one of us could pick
the $19 test every time
the $19 test every time
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instead of the $522 one?
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Would our individual bills go down?
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Our premiums?
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I don't know, but if you don't ask,
you'll never know.
you'll never know.
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And you might save a ton of money.
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And I've got to think that a lot of us
and the system itself
and the system itself
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would be a lot healthier.
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Thank you.
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(Applause)
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ABOUT THE SPEAKER
Jeanne Pinder - JournalistJeanne Pinder asks why it's so hard to make sense of US healthcare bills -- and suggests what we might do about it.
Why you should listen
Lifelong journalist Jeanne Pinder is founder and CEO of ClearHealthCosts, a digital media startup that demands price transparency from the US healthcare system. After taking a buyout from the New York Times, where she worked for more than 20 years, she won a Shark Tank-style competition with her ClearHealthCosts pitch and hasn't looked back.
Since its founding in 2011, ClearHealthCosts has won a slew of journalism grants and prizes and has reported on and crowdsourced health price data in partnership with prestigious newsrooms in New Orleans, Philadelphia, Miami, San Francisco, Los Angeles, New York and elsewhere. This work has won numerous journalism prizes -- a national Edward R. Murrow award, a Society for Professional Journalists public service gold medal and a spot as a finalist for a Peabody Award, among others.
Pinder and the company have won grants from the John S. and James L. Knight Foundation, the International Women's Media Foundation, the Tow Center for Digital Journalism at Columbia University, the Tow-Knight Center for Entrepreneurial Journalism at the CUNY Graduate School of Journalism and others.
Previously, in her native Iowa, Pinder worked at The Des Moines Register and the Grinnell Herald-Register, a twice-weekly newspaper that her grandfather bought in 1944.
Pinder speaks fluent but rusty Russian. In a previous lifetime, she lived in what was then the Soviet Union, a place almost as mysterious as the US healthcare marketplace.
Jeanne Pinder | Speaker | TED.com