For decades, the political and media class has told Americans that the only way to fix health care is with more government—more mandates, more regulations, and more spending.
What has that approach delivered? Skyrocketing costs and unaccountable bureaucracy. Inflation-adjusted national health care spending has more than doubled since 2000. As a result, over 100 million Americans have medical debt, and many avoid care altogether for fear of financial ruin.
It’s time we tried something different. If we want to reduce costs and create a pro-consumer system, then we must restore the free market, which works in every other sector of the economy.
That starts with one basic principle: Americans deserve to know the price before they buy. That’s the simple, powerful idea behind the Patients Deserve Price Tags Act, a bipartisan bill I recently introduced with Sen. John Hickenlooper, D-Colo.
Our bill finally requires actual, upfront prices across the health care system, including discounted cash and negotiated insurance rates (not unaccountable estimates). It requires that health plans offer an Advanced Explanation of Benefits, so patients know their out-of-pocket responsibility before care.
This real price information protects patients from overcharges, empowers employer health plans to choose quality, less expensive care, and unleashes real market competition to drive down costs.
The legislation ends the opaque status quo where giant hospital systems, health insurers, and middlemen overcharge without consequence. Nearly every American has a billing horror story: $2,400 for basic lab tests, $8,400 for a biopsy, or $660 for a five-minute telehealth visit. Our bill gives Americans the prices they need to choose affordable alternatives.
Most Americans get coverage through their employer. But those health plans have been stuck with rising costs that eat into worker wages and take-home pay. According to the Kaiser Family Foundation, the average employer-sponsored health plan now costs $24,000 a year—a 50% increase over the past decade. And a JAMA study shows premiums as a share of total compensation have more than doubled since 1988.
Our bill gives employers the tools to reverse this trend. It gives them access to the claims data that their third-party administrators often withhold. That means they can finally audit their plans for spread pricing and overbilling. It also exposes the vertically integrated relationships of health insurers, third-party administrators, and Pharmacy Benefit Managers, allowing employers to stop kickback schemes that inflate costs behind the scenes. The ensuing savings can be shared with workers through lower premiums and higher wages.
The impact of systemwide price transparency would be enormous. Economists project it could save the U.S. up to $1 trillion a year, redirecting unproductive health care spending to the productive private economy, including business earnings and workers’ wages.
The Patients Deserve Price Tags Act is a pro-worker, pro-consumer, pro-market reform. It opens the door for tech companies and AI to aggregate price data into simple shopping tools, bringing health care into the 21st century like every other part of the economy.
It’s no surprise that price transparency enjoys overwhelming bipartisan support. A recent Marist poll found that 94% of Americans want to see actual prices before receiving care.
This legislation will bring transparency, accountability, and trust back to health care, values long missing from a system distorted by government overreach, corporatism, and cronyism. When prices are known and competition is unleashed, costs come down, quality goes up, and a functional, pro-consumer marketplace emerges.
Let’s pass this legislation and finally give the free market a chance to work in health care.
Roger Marshall is a Republican senator from Kansas.
Reprinted with Permission from The Daily Signal – By Sen. Roger Marshall
The opinions expressed by columnists are their own and do not necessarily represent the views of AMAC or AMAC Action.
Health care delivery in this country is a sham. Keep your doctor if you want is now a joke as your primary care provider acts as a gate keeper sending you to more and more specialists and subspecialists. This eats up my time, produces disjointed care, and repetitive testing that never gets looked at. I am so fed up with my healthcare that I no longer really care what happens to me. If I didn’t look at results and do my own research, I am not certain where I’d be. This is the cause of the poor outcomes in the US despite the highest spending in the world.
The insurance companies need to take part of the blame for the crazy health care in this country of ours. I sometimes feel like I receive better care from a provider if I skip the insurance company. Those companies are For Profit, Not for My Health.
I agree with the “price tags,” but something must be done to get the lawyers out of the picture, also.
I had a doctor who misdiagnosed me and kept having me take the same tests over and over again till I refused if he wouldn’t do different tests. The definition of insanity comes to mind!
My twins were born in 1970, dr. Levy did it free of charge, single deliveries were 1,200, when one of them needed a cast on her foot 3 years later, I paid the doc 70 bucks and home we went. Sounds like a fantasy, what happened in those 50 years ?
Great Start. Transparency. However, everyone gets a cut of the monetary pie, except the patient. In our litigious society, the lawyers drive costs higher. As a new retiree, 68..it is terrifying to think that medical is soaring even as some markets have too few doctors. We pay for top Classic Medicare. We have saved well, but it is a black hole on the budget sheet. It is not what it used to be at all.
As an old person, I remember when I could go to a doctor get a check-up or get a diagnosis and a prescription and pay for it out of my pocket! The insurance companies and government-provided or assisted medical plans have caused the costs of any kind of medical care to explode…and the dental costs are the same. What we need to do is get rid of the huge amount of fraud in these systems and yes, show the public what EVERY cost is charged to their account in and out of insurance plan.
This is also how the costs for college got so outrageous!! Government loans and we know how that turns out!
I have spent about 50 years in our current sickness care system (you do not attempt to get care if you are healthy), both as a provider (technician and admin) and of course as a patient. My problem with forcing the industry to advertise it’s cost for providing care is I do not believe that enough patients will be able to understand what they are being billed for even after it is spelled out in great detail by the providers. Individual knowledge of “health” is probably one of the last things that we are taught as a population and our ignorance shows when we try to access care for something that is bothering us. If an Xray of your leg is $190 and an MRI of the same leg is $300 which do you choose to have done and what are you asking the exam to show you or your provider? And don’t compare our system with the Canadian system as I was continually bombarded by patients from Canada looking for care in the US, because they could not get it in Canada.
Cover ALL HC costs A-Z
I’m hoping Artificial Intelligence arrives as fast as possible. Imagine getting diagnoses from multiple sources in a few minutes instead of waiting for an appointment with a doctor trained in India decades ago.