Lawmakers Need to Vote Price Transparency in Health Care

Lawmakers Need to Vote Price Transparency in Health Care

If you go to a restaurant, how odd would it be if you saw the price of an entree listed as "market price"? Health care is the only industry where consumers can't know the product's cost or service before they buy it. This is a bipartisan issue: 87% of Americans want price transparency in health care. If you are one of them, you can help by urging Sens. Pat Toomey and Bob Casey to support the S. 4106 bill.

How many of us have gone into a restaurant and seen the price of an entree listed as “market price”?  Wouldn’t it be odd to order that menu item without first asking for and being told the actual price? So why is it different in health care?

Health care is the only industry where consumers can’t know the price of the product or service before they buy it. Today with more and more Americans on high-deductible health plans, and a growing number unemployed and therefore uninsured as a result of the pandemic, many Americans are footing the full bill for their health care. Because patients don’t know what the price of care is until after they get their bill, they can’t negotiate or even shop for price. Many are receiving bills they could not have foreseen, let alone afford. Significant price variations for the same service further compound the problem.

As an independent rheumatologist, I see many patients forced to make choices that compromise their care because they don’t know what the care will cost. They simply cannot afford to take the financial risk.

A recent poll by Patient Rights Advocate found that 87% of patients want price transparency in health care. Despite today’s political polarization, this is truly a bipartisan issue. When asked whether health-care organizations (insurance companies, hospitals and doctors) should disclose their prices ― including the cash prices that those without insurance pay, and the contracted rates providers negotiate with insurance plans ― 90% of Republicans and 85% of Democrats said yes. Furthermore, 87% of those who support President Trump and 88% of those who don’t also favor increased transparency.

Transparent health-care prices would lead to increased competition and lower costs for patients. Innovations in health care would be rewarded and surprise billing would be reduced.  When consumers can shop for health care by comparing prices, they will not only be in control of their health-care dollars, but they will also be able to avoid getting surprise medical bills.  According to CarePayment, a patient financing company that helps people manage their medical expenses, 64% of patients have avoided or delayed medical care in the last year due to costs.

Patients and employers have a right to know what services will cost before they agree to pay for health-care services they can’t return.

We have a chance to make that happen. A bipartisan senate bill (S. 4106), the Healthcare PRICE Transparency Act, has recently emerged that addresses this very issue.

This bill would require hospitals and insurers to reveal their cash prices and negotiated rates and to make those prices available to patients online in a user-friendly fashion by January. The result would be a functional free market in health care. Price competition would cause hospitals and other providers to lower their costs to attract business, while patients would be empowered to shop for health care and coverage to find the best blend of quality, convenience and cost. Studies show that when patients can see cash prices and shop for health care, their cash prices are on average 40 percent lower than insurance companies’ negotiated rates.

This is why our senators must vote in favor of S. 4106 and make this bill the law. You can help by urging Sens. Pat Toomey and Bob Casey to support this bill and do their part to heal our country.   

Dr. Mark Lopatin is a rheumatologist practicing in Willow Grove, a member of the Association of Independent Doctors and the 2nd District Trustee for the Pennsylvania Medical Society

Source: Bucks County Courier Times

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