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  • Steven Corn

So Much For Price Transparency In The Healthcare System

With very, very few exceptions, healthcare services are the one consumer item that people "buy" without knowing the price. Imagine buying a car and driving it home without knowing the cost of the car or the monthly payments. Then, a few months later, the first bill comes and you realize that you now owe 2-3x more than what you can afford.

The lack of transparency in healthcare services is the reason that medical debt is the #1 cause of bankruptcy in our country today.

So what's the solution? It's obvious. Just make it easier for patients to know the actual costs. Going back to the car analogy, it's easy to see the dealer cost and estimate their discounts from the manufacturer. But it's nearly impossible to do this in a hospital setting.

The Health and Human Services are trying to force hospitals to do just this. The hospitals are fighting back, of course. Their argument is:

The plaintiffs argued that revealing negotiated rates will confuse patients, overwhelm hospitals and thwart competition and said it does nothing to help people understand their actual out-of-pocket costs and what they will owe a provider.

It is insulting that assume that the public is not smart enough to handle this information and will be "confused"!!!

Yet, they are right to a certain extent. Knowing what's covered and approved PRIOR to a procedure is the other 1/2 of the problem. When patients get a surprise EOB or bill saying that something wasn't covered, insurers will always put the responsibility on the patient. However, if you call an insurance company to verify benefits, they will always have a caveat: "We won't know the exact coverage until we receive the bill." This is definitely a problem that needs to be addressed.

In the meantime, the problem price transparency also has to be solved. They both impact medical debt. The solution has to be two-fold.

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