Health

Dems, Republicans Press Medical Industry To Post Market Prices

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Robert Donachie Capitol Hill and Health Care Reporter
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A patient advocacy group with the backing of a conservative billionaire, is lobbying Congress to pass a simple, bipartisan piece of legislation that would force doctors, hospitals and others within the medical industry to publicly list prices for their goods and services online.

PatientsUSA is trying to push legislation that would require nearly every entity within the health care industry to “publish cash prices by July 1, 2018 at the point of sale and on the internet notwithstanding any existing government regulations.”

The bill would be the first step in helping solve one of the more pervasive problems many argue is at the heart of skyrocketing health care costs: There is no legitimate, market listed price for goods and services in the sector. Instead of being set by normal market forces like supply and demand, health care prices in America are set behind closed doors by federal regulators and insurance providers.

“PatientsUSA is an attempt to get the patient a seat at the table with the insurance, hospital and drug companies, and there are other features of the healthcare delivery system which we would intend to reveal step by step,” Foster Friess, a conservative billionaire, told The Daily Caller News Foundation.

Since billing rates are not set and publicly listed, the industry — hospital systems and insurance companies — is essentially able to prey on patients at their most vulnerable state.

Take the cost of sending a simple blood test to a laboratory for analysis: The cost of that one blood test can range from $10 to $400 at the same lab. The differing rates for the same blood tests causes the system to waste an enormous amount of money. For instance, Medicare paid $910 million more than it would have if it had paid the rates of state Medicare plans and private insurers in 2011, according to a 2013 report by the Department of Health and Human Services’ Office of Inspector General.

What people do experience when they try to ascertain what the market rate will be for a given health care service is rather disappointing. Typically, they will be met with one question: What insurance do you have?

The new bill would give consumers some idea of where they could go to receive the best possible price for whatever their need might be, like the case is with virtually any other good or service.

Democratic Rep. Ed Perlmutter of Colorado and GOP Rep. Mike Gallagher of Wisconsin put forth a similar piece of legislation in May 2017, but it hasn’t made much progress.

PatientsUSA and its supporters are planning a press conference in early February to advocate for their proposal.

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