The Biden administration and Congress are addressing the escalating costs of health care and health insurance by extending the Affordable Care Act (ACA) subsidies into the pandemic era in the United States. Inflation reduction law. However, simply transferring the increased costs to taxpayers does nothing to address the unsustainable basic health care crisis. In fact, increasing subsidies makes it easier for health insurers to increase and stabilize premiums record profits. Major insurers have already announced plans to increase ACA disbursement premiums by up to 15 to 20 percent Next year.
The best way to bend the health care cost curve and make care and coverage affordable is through system-wide health care price transparency. Actual pre-pricing allows consumers to choose high-quality care at the lowest possible price. Real prices enable patients to avoid hospital price hikes and get the care they need at prices they can afford, expanding access and equity. Pricing transparency reveals significant price differences for the same care, even in the same hospitals.
a Hospital price transparency rule which entered into force on January 1, 2021 and Health Insurance Price Transparency Rule which came into effect on July 1 this year, could usher in a competitive and pro-consumer healthcare market. Unfortunately, New study By PatientRightsAdvocate.org (PRA) found that only 16 percent of US hospitals comply with the rule requiring them to post their cash and discounted health insurance rates online, in a single file, per procedure and plan.
The Biden administration can make this rule a reality for consumers and unleash the health care affordability revolution by promoting compliance through strong and timely enforcement.
The PRA study found that most of the 2,000 hospitals examined did not publish all payer negotiation fees “clearly linked to the names of each third party payer and plan” as required. America’s largest hospital system, HCA Healthcare, which 59 billion dollars In revenue and $7 billion in profit in 2021, it has a zero compliance rate.
This opacity prevents the consumer from choosing. It prevents tech developers from collecting prices in consumer-friendly web apps like Kayak or Expedia. It also hinders the competition that makes the prices of goods and services affordable in almost every other economic sector.
Hospitals and insurance companies blind consumers to actual prices, and then blanket them with huge bills they’ve never agreed to, after weeks and months of care. This opaque dynamic allows US hospitals to charge a medium seven times the cost of their care. Last year, Los Angeles Times mentioned On leaked hospital pricing practices, he revealed automatic price margins of 675 percent. Her health care expenses a plus At more than double the rate of inflation each year for the past two decades.
as a result of, 64 percent of patients delay care for fear of financial ruin, and 100 million Americans have medical debts. a New mini documentary The New York Times profiles ordinary patients bankrupted by this predatory healthcare system. «I’ve had these procedures done, and now I’m getting the prices?» One patient says. “It seems to be the opposite way of doing things. Prices should have been first.”
The Biden administration could bolster hospital compliance through aggressive and rapid enforcement of the rule. So far, she has Only two hospitals are fined Among the thousands who do not comply. However, these two hospitals soon became compatible and published model price files, which is indicative of the strength of enforcement. The administration could replicate this success by fining other non-compliant hospitals on the spot, starting with 101 that the PRA report found had not bothered to publish the price list.
When all hospitals publish their actual prices, consumers can enjoy peace of mind that their care will not lead to bankruptcy. They can choose to pay $300 for an MRIinstead of 3000 Dollarsor $6000 for a cesarean delivery, instead of $60,000.
Employers who provide coverage For most Americans, they can direct their employees to higher-quality, lower-cost care and share the resulting savings in the form of higher salaries, helping workers weather historical inflation. When prices are known, no business owner will have to pay 10 times what their competitors pay for the same care, even in the same hospital.
Policymakers looking to make health care affordable should note: System-wide price transparency can actually reverse the runaway costs of health care and health insurance, rather than simply transferring those costs to taxpayers. The Biden administration should be commended for its efforts to increase access to health care. But now affordability must be addressed. Strict and timely implementation of the hospital price transparency rule can significantly reduce costs through selection and competition and bring «affordable cost» back into the Affordable Care Act.
Cynthia A. Fisher is a life sciences entrepreneur, founder and president PatientRightsAdvocate.orgfounder and former CEO of Viacord.