February 18, 2013--Money? At a Time Like This?

Many years ago my first mother-in-law unexpectedly and very prematurely died.

The family had made no plans for such an eventuality, thinking they could deal with it well into the future. But according to Jewish tradition, the services and burial needed to occur quickly, within a day or two.

Though I was deeply saddened by her death (she had a beautiful and blithe spirit), I was not as grief stricken as her immediate family and thus stepped forward to offer to take care of the funeral arrangements.

How to do so? I was quite young and had no experience with such matters. And, where they lived in New Jersey, there were only a few choices of funeral parlors, and so I went to the one closest to their house.

I quickly learned that there are many costs associated with funerals, from renting a chapel to arrangements for car service and, then, for more basic things such as embalming, cosmetology, and the purchase of a coffin. I selected a plain one since I knew that would have been what she wanted and also, quickly, had learned that caskets can be, and are very expensive and theirs was a cost-conscious family.

The funeral director, with appropriate solemnity, added everything up and it came to what seemed to me a staggering sum. So I asked, "Can you do a little better on the price?"

He looked across his desk at me as if he were the grieving party and in a hushed voice said, "How can you think about money at a time like this."

I think, I hope I mumbled back, "Well, aren't you?"

But what could I do? Shop around? Not easily in those circumstances. And so I signed the necessary papers.

I was reminded of this terrible time when reading recently in the New York Times about a revealing study of the cost of medical procedures. Specifically, the costs associated with hip replacement surgery.

A senior at George Washington University in St. Louis, pretending she was calling at the behest of her grandmother, attempted to speak with appropriate people at 100 hospitals in all 50 states to see how much such an operation would cost because, she told them, her grandmother didn't have health insurance. Since the operation, fictional though it was, was not urgent, she informed the people she spoke with that she was, in effect, doing some comparison shopping.

Astonishingly, only half the hospitals could provide estimates despite repeated calls, and the estimates they offered ranged wildly from $11,100 to $125,798.

Unlike me, when I was "shopping" for my mother-in-law's funeral, the student, Jaime Rosenthal, balked at some of the highest fees and a few of the hospitals offered to lower the cost. Not unlike what they do when they attempt to fully bill an insurance company, which, in turn, agrees to pay only a percentage of the bill (often attempting to pass the difference along to the patient--their insuree).

The Times quotes Jamie Court, the president of the California-based Consumer Watchdog, who said, "If one hospital can put in a hip for $12,000, then every hospital should be able to do it. When there's 100 percent variation in sticker price, then there is no real price. It's about profit."

What if, as Jamie Rosenthal found, there's a 1,000 percent variation? Clearly, it's no longer about profit, it's about greed.