MANGIONE/MASS: What Do We Want? Healthcare Price Transparency — NOW!

Struggling Americans told political candidates early in 2024 that healthcare costs topped the list of their financial worries.

Congress would do well to listen.

Hospital costs have been nothing short of a gluttonous sinkhole of American wealth.  Not only has inflation in those costs outpaced inflation in college tuition, but the rate of increase has accelerated, even as Americans continue to pay more into the third-party payer system that is supposed to ensure that the costs are “covered.”

In 2019, the Trump administration took an important first step toward solving the conundrum of healthcare costs when it announced an Executive Order—Improving Price and Quality Transparency in American Healthcare. Within months, Health and Human Services announced requirements to implement the executive order.

The order required hospitals to publish an easily readable file of their prices, while group health plans and insurance companies were to provide estimates of out-of-pocket costs and reveal what hospitals and physicians would receive before services were delivered.

When made public, this information would allow Americans and the nearly 55 percent of employers who pay for their employees’ health insurance to become consumers without blindfolds.

Accurate information on prices is essential to the functioning of a sane marketplace.

In case you missed it, American healthcare is not sane.

Despite even the Biden administration doubling down on the penalties for large hospitals not complying with the rules, the overwhelming majority of hospitals and healthcare systems ignored them. As of November, one source reported that only 21 percent are in full compliance.

Why have corporations felt free to thumb their nose at the government in this way?

The reason was obvious. The penalty was either negligible or not adequately enforced.

Then, on December 11, 2023, longsuffering taxpayers and abused patients were tossed a promising bouquet from the House of Representatives in the form of a bipartisan bill (H.R. 5378, The Lower Costs, More Transparency Act) that had originated in the Energy and Commerce Committee. When put before the entire House, the bill passed by a whopping majority of 320-71.

But something was off.

The heavy penalty the bill had originally sought to impose on institutions that failed to comply with the law had been greatly reduced. Things were again being set up to favor non-compliance, just as with that executive order of 2019 and the accompanying regulations promulgated later that year.

Even so, that walloping majority voted the way it did in the face of strenuous opposition from the American Hospital Association and other elements of this country’s increasingly corporatized healthcare delivery system.

An entire year has passed since that huge majority in the House voted as it did.

The Senate has taken no action on the bill.

Nothing has landed on the president’s desk for signature.

And now a window of opportunity is closing fast. A new administration and Congress will soon be distracted and buried by an avalanche of other business, and crises.

But if the current Congress—the Senate and House working together—and the Biden White House can act now, before the holidays, to turn this stalled legislation into law—with the original heavy penalty restored—a major victory will have been won in the war to restore sanity to a deranged healthcare system and its wildly distorted economics.

The incoming administration and Congress will have the wind at their backs in the continuing work to restore sanity to a desperately sick healthcare system.

Continued non-compliance with transparency requirements will be so painful that it will be unthinkable.

America wants, needs, and deserves to have a floodlight trained on the serpentine inner workings of its healthcare system and how it is paid for.

Waste, fraud, abuse, and profiteering thrive in darkness.

Legalized thievery thrives in darkness.

Come on, people!

Cram those senatorial voicemail and email inboxes to let your public servants know what they MUST do.

Drive those servants to move speedily—as in now—to restore the heavy penalty to the law that prohibits skulking in darkness and defying the bipartisan will of the nation’s elected political leadership.

Drive them to deliver that legislation NOW to the President’s desk for signature before the initiative is buried under the inevitable avalanche of new political business that will hit the new administration.

We, the People, demand it.

Marion Mass, M.D. Bucks County pediatrician; co-founder, Practicing Physicians of America; leader in the Free2Care coalition.

Andy Mangione is senior vice president of AMAC Action, the advocacy affiliate of the Association of Mature American Citizens. He wrote this for InsideSources.com.

Reprinted with permission from DV Journal – By Marion Mass and Andy Mangione

The opinions expressed by columnists are their own and do not necessarily represent the views of AMAC or AMAC Action.