Q: Does secrecy contribute to health-care costs?
A: Sticker-shock for health-care in the United States has been a growing concern for decades. From prescription drugs to lab tests, durable medical equipment, outpatient surgery, and hospital stays, Americans increasingly feel they pay through the roof for medical care.
As chairman of the US Senate Finance Committee, I’ve worked to bring transparency to the policymaking tables to expose wrongdoing, increase accountability, drive up quality, and drive down costs. Specifically, I support anti-kickback and sunshine laws that protect tax-payers and put patients first. My open-payments law created a federal database that requires health-care providers to disclose financial payments from pharmaceutical companies and medical device manufacturers. Last year I secured expansions to include nurse practitioners and physician assistants.
When health-care providers prescribe medication or recommend a particular therapy or treatment, consumers ought to know about financial relationships between them and the industry. For decades, a veil of secrecy has shrouded increasingly-complex pricing-arrangements negotiated between doctors, hospitals, insurers, and benefit managers. For tax-payers who underwrite subsidized insurance and foot the bill for public health-care programs, and patients who pay steep out-of-pocket costs for medical care, improving transparency in the US health-care system is a big deal.
It’s a policy goal worth the growing pains it will take to get it right. Unraveling the whole ball of wax to make pricing information user-friendly for consumers is a tall order. The bottom line is clear. Americans are fed up with the secrecy that allows soaring health-care costs, sky-high prescription-drug prices, and surprise medical bills to keep climbing.
Q: What reforms are underway to improve price transparency in US health-care?
A: I’m glad to see the Trump administration continue its efforts to bring transparency to the murky pricing-system in the health-care marketplace. So far this year, it has required hospitals to post list-prices for their health-care services and announced regulations for drug companies to disclose the list-price of prescription drugs in television advertisements. I’ve re-introduced bipartisan legislation I wrote with Senator Dick Durbin that would require pharmaceutical companies to list prices of drugs in direct-to-consumer ads.
President Trump in June also signed an executive order to pull back the curtain on secrecy so consumers and taxpayers have a better understanding about the prices they’re paying for services provided. In the coming months, the US Department of Health and Human Services will roll out federal rules to help unleash free-market forces and drive down costs. Like doctors who take the Hippocratic Oath, it’s important policymakers take care to first, do no harm, and to avoid unintended market-distortions.
For example, mandating price disclosure on negotiated rates should not be leveraged by providers and insurers to collectively bid up their rates. That would defeat the utility of transparency to help bring accountability. Clear, meaningful information should be used to help boost competition, drive innovation, and drive down prices. Unleashing government interference willy-nilly is the wrong remedy to solve soaring prices. That’s why I’m working to steer market-driven reforms that put patients in the driver’s seat and put the brakes on secrecy. Price-disclosure should help root out cost-shifting and expose artificially-inflated prices that grow the tax-payer tab and gouge consumers. Secrecy provides cover for insurers, providers, drug companies, and benefit managers to milk the rebate system and pad their bottom lines. For too long, patients and tax-payers have been caught in the middle.
The debate on price-transparency can be a game-changer in the health-care marketplace. Consider how the retail landscape has changed for consumers in the market to buy a car. Many buyers can get a better price because they can research and compare information on what price would be reasonable to pay. It should be no different in health-care. Transparency brings accountability and better prices. Getting the rules right on price-disclosure is important to help make health-care more affordable for more Americans and the tax-paying public.
