Hospital and insurers want to keep their pricing agreements hidden from those who must pay those prices, especially those who must pay under the duress of huge costs and the immediacy of the need for medical services.
Hospitals and insurers are gearing up to battle a Trump administration plan that could require the public disclosure of negotiated prices for medical services, part of an effort to lower US health-care costs.
Because price transparency facilitates competition, which in a capitalist, free-market economy helps drive costs down. But hospitals and insurers insist
such a move would force them to disclose prices that would be of little use to consumers, who just want to know what they need to pay out of their pockets, not the full price of the service.
It’s true enough we want that bottom line—so we can shop around—but we also want those intermediate prices so we can get an idea of the markups we’re being expected meekly to accept.
A transition to actual transparency also would be disruptive:
While hospitals fear new demands from insurers to lower prices, insurers could also face price pressures if hospitals that get lower reimbursements demand the higher rates their competitors have won. Also, insurers that have wrangled the steepest discounts may not want those rates exposed to competitors that would then be able to push for similar pricing.
That’s uncomfortable, but it’s also temporary. After a remarkably short time (depending on how piece meal the transition would be vs ripping the band-aid off and being done with it vs something in between), prices would stabilize, consumers would be better off, and hospitals and insurers would be adapted to open competition. Just like the rest of the economy—say home improvement or grocers—is.
Moreover, insurer contracts are complex and hospital systems typically have multiple contracts with each insurer, each with different terms.
“It’s going to be a big lift to actually make this happen,” said Niall Brennan, chief executive of the nonprofit Health Care Cost Institute, who said he applauds efforts to make health-care pricing more transparent. If it does move forward, “It’s going to put a lot of hospital CEOs and CFOs in the hot seat.”
That last is the crux of the matter. Transparency will embarrass some folks. Never mind that the embarrassment often would be unjustified, except in our current professional victim environment. Those CEOs and CFOs, for the most part, were simply doing their jobs in getting the best prices for their companies—and doing their fiduciary duties to their shareholders.
Complexity, on the other hand, might be a valid beef. However, that’s a consideration related to how to implement price transparency; it has nothing at all to do with whether price transparency ought to be implemented.