Donald Trump signed an executive order directing Health and Human services to enact regulations that will improve transparency in the pricing of healthcare that we receive. This has nothing to do with health insurance, which is also part of the reason that healthcare costs are so high in this country. Medical malpractice is also a contributing factor to the high cost of medical care. But I have always maintained that we have taken the consumer out of the equation when it comes to paying for the medical care we receive.
Think about your last visit to a healthcare provider, whether it was your primary physician or a hospital. You were basically told how much it was going to cost you out of pocket to cover your deductible or copay. Unless you ask for it, you generally are not given a copy of the entire bill that includes what was being sent to your insurance company. Now we have all had experiences where we have seen the bill and been surprised at how much a ibuprofen capsule costs if you get it in the hospital as compared to your local drug store. But those experiences are not normal.
The last time you went to a restaurant, you were given a menu with the price of each item clearly displayed, unless of course you go to one of those restaurants frequented by politicians and lobbyists. If you have to ask the price then you don't belong there. The last time you bought a pair of shoes online, you were given the price up front. Think about having your car repaired after being in an accident. Even if the insurance company is paying for it, you are given a copy of the estimate up front. You generally review it to make sure everything is being repaired that needs to be repaired plus you're told how much it's going to cost. But not with medical care.
This executive order does not go far enough although it is a step in the right direction. This past week I had surgery at our local hospital. The level of care was outstanding. But on the morning of my surgery as I started registration, I was given a paper to sign. It identified how much I would have to pay to meet my deductible and copay requirements of my insurance. It was not an itemized bill it was just a total amount. Shouldn't they give me an itemized estimate in advance? Then I have the opportunity to ask questions about the procedures or cost.
Why is the Ibuprofen $12 a capsule when I can buy 40 of them at the local drugstore for $15? Why is that flimsy gown $125 when there can't be more than $5 of cloth involved? You get the idea. We do the same thing with contractors or auto body shops, why not with estimates regarding our health care?
Some of you will say I am naive about how the business side of healthcare operates. I can assure you I am not. I have been involved in insurance, specifically in claims where I saw the detailed bills. I saw how much of it can be written off. I also know that hospitals have to price in for writing off bad debt that patients don't pay. That doesn't mean that the costs we are paying are legitimately justified. And it doesn't mean that there aren't other causes driving healthcare costs higher. But by putting the consumer back in the equation our voices can drive change.
It is an undeniable truth of life that the consumer has more power than we actually use. If enough of us are looking at our medical bills in detail and complaining, we can begin to change the way the system works. Transparency drives conversation which drives the identification of the problems and ultimately drives solutions that benefit us.
