美国国家公共电台 NPR A Tough Negotiator Proves Employers Can Bargain Down Health Care Prices

 

STEVE INSKEEP, HOST:

One woman found a way to attack high health insurance prices. And that's news because it's hard for any one person to do. If you go to the hospital, the hospital charges your insurer, which passes the cost on to you. And it's hard to negotiate¹ a better price in that system. Marshall Allen of the nonprofit newsroom ProPublica has been investigating high health insurance costs. And he has the story of a woman who used her power to hold them down.

Hi there, Marshall.

MARSHALL ALLEN: Good morning, Steve.

INSKEEP: Who is this woman?

ALLEN: We're talking about a 68-year-old grandmother named Marilyn Bartlett. And Marilyn Bartlett took over the Montana employee benefit plan in 2014. And when she took over the plan, which covers about 30,000 state employees and their families, that plan was in deep trouble. It's self-funded, so the employer² paid all the health care bills. And it was projected to lose about $50 million in the coming years and basically³ go broke.

INSKEEP: So the classic⁴ situation here that people in all sorts of insurance arrangements face where they're basically told health care is really expensive, gets more expensive every year. And we're short of money. We need more from you.

ALLEN: Exactly. And if people hadn't noticed, the cost of your health care benefits is rising. There's about 151 million of us who get our health care benefits through our employers⁵. And part of the problem is our employers have been deferring⁶ to the medical industry when it comes to the cost of health care. And so the industry keeps raising the cost. And basically, those costs keep getting passed on to the workers.

INSKEEP: What did Marilyn Bartlett do differently?

ALLEN: She had spent 13 years working in the insurance industry, and so she knew a lot of the games. She was also kind of a math nerd who knew how to follow the money. And so working with her team, she compared what her plan paid each hospital in the state - the bigger hospitals - to what they were paid by Medicare. And Medicare publishes its prices. And so she could see that her health plan was paying hospitals in the state anywhere from two times what Medicare gets paid to five times what Medicare gets paid.

INSKEEP: Wow. And so she said that was too much.

ALLEN: It was too much. I mean, the plan was going broke. Her charge was to get things under control. And so she had to do some really hardball negotiating⁷. And what she decided⁸ to do, which is kind of a revolutionary idea in the health care world, is she decided to set her own prices and set the plan's prices. Now in this case, she had some leverage⁹. And actually, all employers have this leverage because the health care industry really does need our money. So she said, look; you hospitals that are at five times the Medicare rate, you're going to need to bring your prices down to about twice the Medicare rate.

INSKEEP: I wonder if hospitals simply had to accept that. I'm thinking that in Montana, there can't be all that many hospitals. There surely would be a hospital that would just say, listen; our price is our price.

ALLEN: It took some hardball negotiating. She threatened to go public with the price variation¹⁰ and expose the high-priced hospitals. She called in the union to campaign against a hospital that was holding out, and they had a whole campaign statewide. They sent hundreds of postcards and made phone calls to the hospital executives¹¹ and leaders. And eventually, all the hospitals signed on. And the plan saved about a million dollars a month just from the reduced hospital prices.

INSKEEP: Is there a lesson here for employers of all sizes that if they put in the time, they can get the leverage to hold down what is paid for hospital and other medical costs?

ALLEN: Marilyn would say absolutely, yes. Her message really to employers is you need to push back. You need to read the fine print in your contracts. You need to demand to know where the money is going and why the costs are so high. Get an itemized explanation for all of the expenses. And when you do that, you know, you may need to - the smaller employers may need to join together with other small employers to increase their leverage. But they can bring down the prices.

INSKEEP: Marshall Allen of ProPublica, thanks very much.

ALLEN: Thanks so much, Steve.

1 negotiate   

v.洽谈，协商，谈判，顺利通过，成功越过

参考例句：

• I'll negotiate with their coach on the date of the match.我将与他们的教练磋商比赛的日期问题。
• I managed to negotiate successfully with the authorities.我设法同当局进行了成功的协商。

2 employer   

n.雇用方，雇主

参考例句：

• My employer deducted ten pounds from my wages this week.我的雇主从我本周的工钱中扣除了十英镑。
• His monthly salary is paid into the bank by his employer.他的月薪由雇主替他存入银行。

3 basically   

adv.基本上，从根本上说

参考例句：

• His heart is basically sound.他的心脏基本上健康。
• Basically I agree with your plan.我基本上同意你的计划。

4 classic   

n.经典作品；adj.经典的，一流的；古典的

参考例句：

• The novel is regarded as one of the classic works.这篇小说被公认为是最优秀的作品之一。
• The football match was a classic.那场足球比赛堪称典范。

5 employers   

雇主( employer的名词复数 )

参考例句：

• Employers must consider all candidates impartially and without bias. 雇主必须公平而毫无成见地考虑所有求职者。
• The onus is on employers to follow health and safety laws. 雇主有义务遵行健康安全法。

6 deferring   

v.拖延，延缓，推迟( defer的现在分词 )；服从某人的意愿，遵从

参考例句：

• Recently, the Supreme Court has focused on an additional reason for deferring to administrative agencies. 最近，最高法院强调了尊重行政机构的另一种理由。 来自英汉非文学 - 环境法 - 环境法
• Think of it as deferring part of the compiler's job to runtime. 可以认为这是将编译器的部分工作延迟到了运行时。 来自互联网

7 negotiating   

n. 谈判 动词negotiate的现在分词

参考例句：

• They were coerced into negotiating a settlement. 他们被迫通过谈判解决。
• We want to get all the parties back to the negotiating table. 我们想把有关各方拉回到谈判桌上来。

8 decided   

adj.决定了的，坚决的；明显的，明确的

参考例句：

• This gave them a decided advantage over their opponents.这使他们比对手具有明显的优势。
• There is a decided difference between British and Chinese way of greeting.英国人和中国人打招呼的方式有很明显的区别。

9 leverage   

n.力量，影响；杠杆作用，杠杆的力量

参考例句：

• We'll have to use leverage to move this huge rock.我们不得不借助杠杆之力来移动这块巨石。
• He failed in the project because he could gain no leverage. 因为他没有影响力，他的计划失败了。

10 variation   

n.变化，变动；变体，变种；变奏(曲)

参考例句：

• The prices for food are subject to variation.食品的价格可能变更。
• The air flow will have some variation of angularity.风的流向将有一定程度的变化。

11 executives   

（公司或机构的）经理( executive的名词复数 )； （统称公司或机构的）行政领导； （政府的）行政部门； [the Executive][美国英语]（美国政府的）行政当局

参考例句：

• They have taken measures to equate the salaries of higher civil servants to those of business executives. 他们采取措施使高级文职人员的工资和企业管理干部的工资相等。
• He disregarded the advice of his executives. 他对主管层的建议置若罔闻。