AMAC In The Media / Opinion / Politics

Fighting for Transparency in Health Care

health careLast June, President Trump issued an Executive Order instructing his Health and Human Services Department (HHS) to create a rule that would require hospitals to disclose the prices for medical services they negotiate with insurance companies, in addition to the cash prices they accept for specific procedures. These “shoppable” medical services include those that are commonly offered by multiple providers. The Executive Order’s intent is to equip patients with the information they need to empower them to shop for health care services much in the same way they do for every other purchase they make throughout their lives. 

The information would be accessible electronically in an easy-to-read format and allow for patients to compare the real prices for their care, not an estimate, average or out-of-pocket cost. They would then be able to make informed decisions based on cost and quality of care.

Imagine knowing the cost for a knee replacement from hospitals in your town before having the surgery. Further imagine the impact this kind of pricing transparency would have on the cost of the procedure. Hospitals would actually compete with each other for your business and we all know how competition benefits consumers. How about having the option to choose a cash price for a service if it’s cheaper than an insurer-negotiated price? Gone would be the days of receiving health care only to find out its true cost after you’ve been treated. This transparency would also protect patients from the predatory “surprise billing” business practice where hospitals invoice patients, again, after they’ve received treatment, for an exorbitant sum from an “out-of-network” provider from whom they had no choice in receiving care.

AMAC – Association of Mature American Citizens recently joined an Amicus Brief with other patient advocacy groups supporting the President’s price transparency initiative. The brief argues that, among other things, hospitals routinely disclose prices in their explanation of benefits statements (EOB). So, their prices are not truly “secret”, they’re just disclosed after it’s too late for patients to have a choice in more cost-effective care. One would think that this disclosure in the EOB would negate any First Amendment argument.

Price transparency in health care is a vastly popular issue among Americans, regardless of their political persuasion. According to a Harvard-Harris poll, 88 percent of Americans, including both Democrats and Republicans, say they support government mandates for hospitals and insurance companies to show their prices.

Hopefully, the Court will recognize how price transparency in health care leads to a competitive environment for medical services and drives down costs for Americans. If it sides with the amici and grants HHS’s motion for summary judgement, AHA’s case would be dismissed and the transparency rule will stand. And a positive step towards meaningful health care reform will be taken.

Reprinted with Permission from - Townhall by - Andrew Mangione

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Dean Brittain

Transparency would go a long way in allowing patients to make good decisions based on full knowledge of the costs and benefits of which provider to choose.
Another example of President Trump’s efforts to help all American citizens.

Frank S.

So long as insurance companies, big-pharma, hospital administrators, lawyers, politicians, many doctors, and all the “middle-men” with their hands in the cookie jar continue to make outrageous money in this scam we call “health care,” we’ll never drive down the costs in any meaningful way. Certainly there are lots of wonderful people in the health care industry today, but there are also a huge number of blood-suckers. We must identify these people and call them out. Transparency and the open free market is the only way to go. And you think its bad now? Wait until the left has their way!

J. FARLEY

I’AM AFRAID THAT THE COURTS WILL SIDE WITH THE DEEP STATE , KEEP AMERICANS IN THE DARK SO THEY CAN FORCE CONSUMER
TO WANT GOVERNMENT RAN HEATH CARE , DO YOU THINK THERE WILL BE PRICE TRANSPARENCY —NOT ONLY NO BUT HELL NO.
TRUMP/PENCE 2020
GOD BLESS DONALD J. TRUMP
GOD BLESS AMERICA
GOD BLESS THE NRA
SAVE AMERICA VOTE REPUBLICAN

Brenda Blunt

ALL legal American citizens should know in advance what they are paying for. This also includes Congress. There are too many middle people involved and that is why prices are up along with CEOs thinking they need an eight digit salary.

JohnH

How much is liability insurance & lawsuits adding to cost of medical care??????? A lot I would bet. We need tort reform!!!!!!!!!!!!!!!!!!!!!!!!!

Stan

The same issue with prescription drug prices. The pharmacy in not able to quote the co-pay amount until prescription is filled, but not before that. Pharmacy benefit managers are running the show in great secrecy.

Old Silk

These people advertise their hospitals and other facilities, as does big pharma. They are businesses, and truth in advertising applies to them too.

tony d willIiams

That would be wonderful. We were visiting my son in Phoenix, Az. Our youngest, CP, open spine, unable to speak, low motor control and a Grand mal disorder began to seize over & over. He was taken to hospital B. They never worked on him while I was in the room. I left mornings to go to a hotel to sleep for a couple hours. Whenever I fell asleep in his room they woke me up. I provided our insurance info to them. A rep from our insurance called and said to let hospital B do whatever they needed to do. This surprised me as Kaiser has sent a plane to bring my son and I back to our home hospital before. When we left I was handed a massive bill, not itemized. Seems they did a lot when I wasn’t there. I fed him through hs G tube when… Read more »

James S

As a retired physician I have watched Corporate America take total control of the health care system with the attitude that if we all increases prices corporate medicine benefits. They have been looting the system for 30 plus years. Forcing hospitals, pharmacies, drug companies, medical device companies and medical clinic companies to disclose prices ahead of service provided would greatly limit the current abuse and place competition into the system.

Press ONE for English

I’m not sure what to think about this. The article makes many good points, and there are undeniable benefits to price transparency. But there’s a flip side as well. The article says, “…and we all know how competition benefits consumers…”. This is certainly true if you are talking about cans of beans. One can of beans is much like another, and if you can get the beans for a buck instead of two it is a win. But doctors are not alike. Hospitals and surgery centers are not alike. Procedures are not alike, either, although they may seem so to those of us (like me) who are largely clueless about most medical specifics. I’ll throw in the old adage, “you get what you pay for”. It is pertinent here. I will tweak the article’s quote to offer another truth: “We all know how competition leads to cost cutting, cutting corners,… Read more »

WillieBDare

All this transparency is all good and great, but the hospital bill doesn’t cover the doctors bill. If you are going to require the hospitals, then you need to include the doctor’s charges, otherwise listing the hospital bill is deceptive.

Li Ryder

I do not believe hospitals are chosen bAsed on price of surgery. I believe they are chosen based on one’s surgeon affiliated hospital. All the physicians with I have had surgery were connected with a particular hospital or hospitals. None did surgery wherever I wanted to go. Often the surgeon is chosen because of a particular affiliation with a reputable hospital.

Steve

Hospital transparency should be no different than at an automotive repair shop. Would you have repairs on your car and hope not to receive a double or triple bill when the mechanic is finished

JohnH

A lot of insurance companies have a list of doctors that network with them.. My insurance/bill shows hospital cost for xxx and then it shows the amount that insurance will pay for this xxx procedure. Seems like the insurance companies are already putting pressure on costs of medical care. If you go out of network or do not have insurance, you might be at the mercy of ??? but you should try to negotiate a payment plan that you can meet

Stephen Lykins

Since the hospitals don’t want price transparency, require them to pay the additional charges for out of network doctors when the patient is otherwise in network!

JohnH

I wonder if Trump is still considering his statement of “buy prescription drugs from Canada if US producers do not drop price”. Sort of goes against the buy America grain

Dennis

Using the EOB argument for disclosing prices is a non-starter. It’s nearly impossible to determine prices from this document. The only thing you get from EOB’s is what insurance companies are willing to pay, which is much less than the “charge.” No transparency at all.

Margaret portman

BeRst health ins supplement after medicare???

My major med is going up 150%.
Suggestions??

Chuck

One of the few industries that do not disclose prices for their services. Then when a person that has Medicaid they just pile on the cost because they know they will get paid. Between Medical and politicians they are putting the shaft to the American public. How did this start? Industries paying off politicians to pass laws that benefits their bottom lines. Definitely time for term limits for all politicians including federal judges!!

Gery Ratterman

Since I carry medical insurance should it be the responsibility of the insurance companies to shop for the best prices? They are paying the bill.