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#Stop hospitals from keeping their prices secret

#Stop hospitals from keeping their prices secret

Health costs are one of America’s biggest problems. They decimate family incomes, drive Americans into bankruptcy and demoralize citizens. Americans have come to expect hefty bills for the simplest of hospital visits. But there is a solution — price transparency — and it isn’t too late to enact it as part of the next coronavirus-relief package.

Patients don’t know what they are paying in advance, because hospitals and insurers work to hide this information. In June, nine US senators introduced the Health Care PRICE Transparency Act. The bill compels hospitals and insurers to provide accurate cost estimates and to publicly reveal how they calculate rates. By doing so, it would offer our people a decent measure of certainty in turbulent times.

For years, we’ve heard stories of surprise bills and inflated, unaccountable costs destroying ­patients financially. The COVID-19 pandemic has created a devastating cascade of such cases.

Consider what happened to Melissa Szymanski. Melissa went to a Hartford, Conn., hospital with COVID-19 symptoms. Bizarrely, the hospital denied her a test. ­Instead, as she told my organization, “I received an EKG, chest X-ray, flu test, urine-pregnancy test and IV fluids. My diagnosis: potential COVID.”

The hospital charged her $3,200 for five hours in the emergency room, and she had to spend weeks fighting fraudulent, improperly coded bills that her insurance company refused to accept as COVID-related — because she never actually received a test. As Melissa says, “it shouldn’t have to be this hard. If I knew the price in advance, I would be informed and able to decline tests that are ­unnecessary.”

No wonder the American people want health-care price transparency. Surveys show that 90 percent of Americans support the government requiring hospitals and insurance companies to ­reveal their discounted, cash prices and negotiated rates.

Melissa’s only option was to spin the wheel and play a game of health-care-cost roulette. Americans all too often pay for health care with a blank check, and we all know someone who expected to be billed a few hundred dollars, only to be charged thousands or tens of thousands.

There is no reason why health costs should be secret. We expect price transparency at gas stations and when paying rent, but hospitals and insurers have tricked us into believing we can’t have it for medical bills.

A murky price model enables price-gouging, overbilling and waste. Hospitals deviously pass on these costs to powerless, often unsophisticated patients via bills weeks after treatment.

In addition to ensuring basic fairness, price transparency would drive down systemic costs — one of the bipartisan goals of US health reform for decades. A similar process has played out in other industries, as innovators like Travelocity and Carfax have improved the travel and used-car industries. Customers can compare alternatives and choose the product and services best fitting their needs and budget.

Larry Van Horn, a Vanderbilt University health economist, found that discounted cash prices across our country, even in the same facilities, are on average 39 percent lower than the insurance-negotiated rates. It’s downright bizarre. Being able to choose care at transparent cash prices could save the average family of four $11,000 a year on health costs, according to Van Horn and other experts.

Critics of price transparency claim it is almost impossible to compare prices amid health emergencies. But that ignores the power of what economists call proxy shoppers: Allowing even a small slice of consumers to shop around can keep prices low for ­everyone. Only a fraction of drivers need to shop around for gas to keep prices low and honest — why not for health?

Naturally, there is opposition — from profiteering special interests: hospitals and insurers who gorge themselves financially by charging ridiculously high prices to the detriment of their consumers. These companies invest millions of dollars in lobbying and in lawyers to maintain the status quo — and their profits.

Amid a devastating health and economic crisis, there is no justifiable reason to reject this no-cost solution to protect all Americans from outrageous hospital bills and crippling medical debt.

Cynthia Fisher, a life-sciences ­entrepreneur, is chairwoman of ­PatientRightsAdvocate.org.

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