Is Health Care Price Transparency Working?

Hospitals started posting the list prices for their procedures and supplies on their websites on Jan. 1 in response to a federal requirement, which aims to improve price transparency in the health-care system. 

But critics say that hospital list prices — called chargemasters — don’t translate to patients’ out-of-pocket costs, can confuse consumers, and may not move the needle in price transparency. 

The majority of Americans who have public or private insurance don’t pay the chargemaster prices. However, if you’re uninsured or out-of-network, you could be billed for the full list price.

First, let’s have an honest conversation about what's really going on here. The crisis with healthcare isn’t and never has been accessing. Federal law dictates you can’t be denied needed healthcare period. The crisis has been the cost of healthcare. The reason we have a crisis with the cost of healthcare is the lack of transparency and the general inability for the average consumer of healthcare to know what the actual costs of healthcare will be and the resulting lack of competition in the marketplace. In other words, health insurance is and has been the greatest obstacle to transparency and thus the number one driver of unsustainable costs.  

Health insurance doesn’t equal healthcare. Insurance is the literal antithesis of healthcare for tens of millions of Americans (46 million approx..) who can’t afford to meet their deductibles to use the insurance after they’ve paid for the policies. That’s 46 million consumers of the insurance products at an average of $8,500 per policy that’s never used. Think there’s an incentive for the status quo? That’s why you have to take the cynical reaction by the establishment with a grain of salt.  

The existing model allows for opaque pricing and accountability without consumer price transparency. This allows medical service providers to not have to compete on specific market-based competition (based on prices and quality of service/outcomes) like all other industries and it’s a great business model for the health insurance companies for the previously cited reasons. The loser in this deal is you. Don’t be dismayed by the negativity being projected by the establishment. Instead, take advantage of the pricing information made available and don’t be afraid to ask questions.  

The overwhelming majority of Americans would benefit from a model in which all non-catastrophe care is paid for out-of-pocket direct with the medical service provider with insurance being reserved only for true emergencies as is the case with virtually all other insurance products. The existing bureaucracy in healthcare wasn’t created overnight and it won’t go away that quickly either but remember that establishment embraced the ACA and what happened to your healthcare costs? They’re wrong this time too becoming more informed is the important first step. 


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