A year after a federal appeals court upheld a government regulation requiring hospitals to publish their prices — a rule rooted in the 2010 Affordable Care Act, fought tooth and nail since, then finally advanced during the Trump administration after legal challenges failed — the institutions are flouting the mandate. In a report this month, PatientRightsAdvocate.org found that just 14% of 1,000 randomly selected hospitals nationwide were in full compliance. In New York state, just two of 22 were. In New York City and Long Island, none of 12 were.
That contempt for consumers is supposed to result in penalties of up to $2 million a year. Bring on the transparency or bring on the fines.
As anyone who’s ever asked for an itemized bill after being treated and discharged can attest, trying to make sense of it all can make you sick all over again. Hospitals negotiate wildly variable rates with different insurers, and also have a discounted cash price for those who pay upfront. But for years, many of those institutions have done everything in their power to keep the numbers fuzzy or hidden, lest those who actually pay for the services — insurers and ultimately patients and their employers — start asking why one provider charges double another for the same knee replacement or colonoscopy or C-section delivery, with no meaningful difference in quality.
Americans’ blindness on who charges what and why is one of the big reasons health care costs here are twice those in comparable countries. Every time they grow, they take a bigger bite out of wages.
No, shopping around on a medically necessary procedure isn’t the same as hunting down the best deal on a TV — there are all kinds of reasons price sensitivity will always be different in health care — but the only way to begin to build a more functional marketplace is by telling the people who pay the bills what costs how much and why so the informed scrutiny can begin in earnest. There’s no second opinion.
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