Pricing transparency can end the crushing burden of medical debt – InsideSources

The Kaiser Family Foundation recently released a new analysis finding that 100 million Americans have medical debt, or 41% of the nation’s adult population. This crushing debt burden exceeds previous estimates because it includes medical liabilities held through informal loans and credit cards that do not appear in other analyses.

This statement shocks the conscience whatever your political position. This is perhaps the best evidence of America’s predatory health care system and the need for immediate reform to help ordinary families avoid financial ruin. This indebtedness is particularly heavy in times of historic inflation when real wages and the standard of living decline.

Some policymakers point to the widespread financial devastation of health care overload to call for the socialization of health care in a Medicare for All system. Yet there is a much simpler solution to protecting patients against medical debt while expanding access, choice and competition: healthcare price transparency.

Real upfront prices allow health care consumers, including patients, employers and unions, to avoid price increases for more than 90% of non-emergency health expenditures. Accurate pricing allows patients to choose quality and less expensive hospitals and health insurers, to have recourse in the event of over-billing, and to have the peace of mind that their care will not lead to personal bankruptcy.

Under the opaque health care status quo, hospitals and health insurers are blinding patients to prices, then blinding them with huge bills they would often never have accepted in the mail for weeks and months. after care. As a result of this dynamic, the costs of care and coverage have exploded, increasing at more than twice the rate of inflation. Hospitals now charge an average of seven times the cost of care.

Average annual premiums for employer-sponsored family health insurance are $22,221 per year, not including deductibles. This health care overload suppresses employee salaries.

Imagine the outrage if another business, from your neighborhood dry cleaner to your auto mechanic, engaged in such egregious billing practices. Vanderbilt University health economist Larry Van Horn notes, “Even in the darker corners of the market, like payday loans, we don’t require consumers to pay indiscernible prices at ‘advance.

There’s a reason the only industry causing routine financial havoc is also the only one with hidden prices.

When the prices are known, the overcharges, overpricings, billing frauds and debts they cause will come to an end. Hospitals and health insurers that engage in such practices will be bypassed in favor of those that provide quality care at fair prices. Consumers can compare their employer’s plans to alternatives and dismiss outrageous negotiated rates. Competition will reverse exorbitant costs and make prices affordable, as it does in almost every other economic sector.

This pro-consumer, transparent pricing healthcare revolution has already begun. On January 1, 2021, a federal hospital price transparency rule went into effect, requiring hospitals to post their discounted cash prices and all negotiated rates by insurance plan. On July 1, a health insurance price transparency rule comes into effect, requiring insurers to publish their historical claims data and secretly negotiated rates so consumers can access actual, up-front prices wherever they go. receive care.

Unfortunately, the hospital’s rule has been marred by widespread non-compliance. According to a recent study by, only 14.3% of hospitals nationwide follow it. Hospitals deliberately break the law to maintain profit by keeping consumers in the dark. Fortunately, the Department of Health and Human Services finally began issuing fines to non-compliant hospitals a year and a half after the rule took effect. Rigorous enforcement of this rule and the insurance order can make this consumer-friendly vision and price transparency a reality.

When all the prices for health care and coverage are known, patients and employers will not tolerate paying 10 times as much for the same care as the person in the bed next to them. An active and competitive healthcare marketplace will emerge, based on choice and financial certainty. Patients can proactively avoid most cases of medical debt and take control of their health and wealth, ending this national embarrassment.

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