Many Nebraskans visit their doctors or check into the hospital without a clue as to how much their visit — or the procedure or the tests they get — will cost.

The Legislature’s Health and Human Services and Banking, Commerce and Insurance committees took a couple of hours Friday to listen to the benefits and problems associated with health providers and insurers providing cost estimates to consumers.

It’s a hot topic across the country. In March, the Bush administration announced the goal of making more information available to consumers on price and quality of health services, hoping to create more “free-market” principles in health care.

Others assert a consumer doesn’t purchase chemotherapy in quite the same way she would purchase a Toyota. There’s no Kelley Blue Book for health services. And she wouldn’t select a surgeon in the same way she would a plumber.

A person needs a trusting relationship with her doctor, said Sen. Gwen Howard of Omaha. For many people, cost is secondary.

Many hospitals today compete based on aesthetics rather than costs.

Sen. Joel Johnson of Kearney, chairman of the Health and Human Services Committee, said even though senators have no pending legislation, they are interested in what’s happening with health care pricing in Nebraska and whether state residents have access to costs.

Per capita health care costs in America are among the highest in the world, and millions of Americans go uninsured every year. By 2015, health care is expected to account for 20 percent of the U.S. economy, said Fred Schuster, regional director for the U.S. Department of Health and Human Services.

There’s no place on the world leader board for a country that can’t control its health costs, Schuster said.

One way to get a grip on costs is to allow consumers access to the costs charged for doctors, technicians, hospital care, treatment centers, rehabilitation and laboratory services before they purchase care.

“Nothing but good comes from people knowing the costs,” Schuster said.

And Nebraska could be a leader in the area of making health care costs transparent, he added.

Johnson said that as insurance programs have grown over the past 60 years — with people aware only of the insurance premium they pay or the co-pay at the doctor’s office — individual responsibility in keeping costs manageable has been lost.

A disconnect exists between consumers and those who actually pay the bills.

Joann Schaefer, the state’s chief medical officer, said she doesn’t know of a physician unwilling to give a patient information about costs. Primary physicians in particular become directly involved with their patients’ ability to pay.

But she asks that health providers not be held to unreasonable standards when providing cost estimates.

Nebraska hospitals recognize the importance of heightening consumers’ awareness and understanding of health care, said Kevin Conway, vice president of health information for the Nebraska Hospital Association, and the knowledge of pricing and quality is a component of that.

State law requires hospitals to make available the charges associated with the 20 most common diagnoses.

Alegent Health, with nine hospitals in the Omaha area and Schuyler, has embraced the notion of transparency in both quality and pricing, said CEO Wayne Sensor.

In 2005, the hospitals began publishing reports on their quality scores. And on the company’s Web site, consumers can click on a service called “My Cost,” which guides them through a series of questions that delivers costs for any one of 500 procedures, based on a person’s individual health care plan. It also can tell the person their co-pay, deductible and out-of-pocket costs.

As of last week, 23,000 had used “My Cost” to find prices for specific procedures, Sensor said.

The Nebraska Hospital Association is in the process of developing its own Web site that would enable consumers to review information on hospital charges. But consumers need to know what to expect from other providers, as well as insurance companies, Conway said.

“Only when the consumer can make a choice on what is the best value to them based on recommended treatment, expected outcomes and financial implications will we have transparency,” Conway said.

Reach JoAnne Young at 473-7228 or jyoung@journalstar.com.