President Trump is Bringing Real Transparency to Our Healthcare System
This op-ed was originally published by the McClatchy Company in the Kansas City Star and their other daily newspapers on November 26, 2019.
A few years ago, my doctor told me that I needed to get a routine heart test. Like many Americans, I had a high-deductible insurance plan and, since I hadn't yet met my deductible, I would be paying for the test out of my own pocket. So when I showed up to get the test, I asked how much it would cost.
I was told that price information wasn't available. I persisted, talking to multiple employees of the hospital, and eventually found out the list price was $5,500. But I knew that wasn't the real price — my insurer would have negotiated a lower rate. Eventually, I was told the negotiated price was $3,500.
I was in the private sector at the time, but I had served as U.S. Deputy Secretary of Health and Human Services. I happened to know that one could look up online what the same procedure would typically cost at a doctor's office outside of the hospital system. That cost was just $550.
I knew to ask the price and how to find it because of my experience as the nation's No. 2 health care official. In so many situations, patients end up paying the outrageous prices. In fact, 93% of Americans say they've been surprised by a medical bill in the past year.
President Donald Trump is changing all of this. He's protecting Americans from these kinds of situations, bringing real transparency to our system and putting patients in control.
Last week, we took two major steps toward those goals. First, we finalized a rule to require that, starting January 2021, hospitals will have to disclose in a consumer-friendly manner their negotiated rates for common shoppable items and services, as well as the discounted cash price they're willing to take without insurance. For all procedures, they'll have to post this information on the internet in a format that can be used by third-party tools such as smartphone apps.
Second, we've proposed requiring that insurers provide you with real-time access, via an online tool, to cost-sharing information — estimates of what you would owe for all covered health care items and services. Additionally, we proposed requiring that insurers' negotiated rates for in-network services and historically paid amounts for out-of-network services be made publicly available to consumers, employers, researchers and app makers interested in developing new tools to help customers.
We often hear that health care can't work like any other market, that consumers can't shop among services. In reality, more than 70% of the most common and costly hospital services are shoppable. About two-thirds of consumers say they rank cost as important when they're deciding to follow a doctor's care recommendation. But until now, consumers just haven't had the cost information they need to choose among providers.
To put American patients in control, we're going beyond just price transparency. We're also working to simplify the quality measures that HHS collects, so that they're useful to patients and as simple as possible for health care providers. We're putting you in charge of your own health data by proposing to require the interoperability of health record systems, so you finally have access to your own information at no cost.
Trump is committed to putting patients in control because it's the right thing to do. But it's also the way to deliver better care at a lower cost. For years, everyone has agreed that we need to move to a health care system that pays for value rather than procedures. The missing piece of this, for too long, has been empowering the patient to determine value.
The president has promised Americans a health care system with affordable, personalized care that puts you in control, provides peace of mind and treats you like a human being, not a number. We cannot have such a system without giving patients the information they need to take charge of their own care, and that's what we're delivering.