Trump Moves to Force Hospitals, Insurers to Disclose Prices

By | June 25, 2019

  • June 25, 2019 at 7:21 am
    OpPolaResearch Bear says:
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    Hooray for POTUS Trump! This is an act only Socialist Communists digging in their heels on ACA could object to, and will bring lower costs and optional treatments to the attention of healthcare consumers. It is one of the elements of ‘HEALTH CARE SPPECIFICCS’. It seems someone in the Trump Administration is paying attention to the numerous suggestions sent to them by the public, as well as common sense/ economic principles.

    If you believe Amazons’ success is due to price transparency and multiple seller markets (vs. a SINGLE SELLER), this EO makes sense and is defensible against criticism by ACA supporters.

    • June 25, 2019 at 4:46 pm
      Agent says:
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      Hey Pharma, disclose your drug prices. Hey Hospitals and Doctors, disclose what you are charging for services as well. Put the Consumers first for a change.

      • June 25, 2019 at 4:53 pm
        Rosenblatt says:
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        I agree with Agent

  • June 25, 2019 at 9:02 am
    Captain Planet says:
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    I think full disclosure of pricing is a good thing. I do have a question, though. So, before I have a surgery or anything more than minimal done, I can always get my out of pocket estimate from my insurance carrier. My doctor or his/her assistant will call the carrier for me, then call me. Is this not the case for everyone? I’m guessing before the passage of the PPACA, there were probably some nefarious carriers out there who wouldn’t. But now, with pre-x covered, no lifetime limits, the carrier doesn’t have any costs or reasons to hide estimates. Has anyone out here been denied an estimate before having some work done?

    • June 25, 2019 at 12:01 pm
      Rosenblatt says:
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      Estimates from insurance companies solely for in-network vs out-of-network coverage & deductible/copay amounts, yes. However, I’ve never had a doctor give me his/her estimate of their actual charges.

  • June 25, 2019 at 11:47 am
    KP says:
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    Good call Mr. President. Folks who don’t have insurance or ridiculously high deductibles will benefit from this.

  • June 25, 2019 at 11:59 am
    Rosenblatt says:
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    I think this is a great move and I applaud President Trump and whomever is working for him to see this through (disclaimer: I still expect Agent, Bob & Craig to claim I never give credit when credit is due to Trump).

    However, I think there’s one aspect here that is being overlooked. These are just estimates and anyone who has ever had surgery (let alone emergency surgery) knows the doctors can very easily increase the bill by using out-of-network anesthesiologists. I’ve never seen a patient have the ability to choose their anesthesiologists, only the doctor/surgeon. This is a huge step in the right direction, but the estimates are sure to be low when all is said and done and the patient will still end up paying more than they originally expected.

    • June 25, 2019 at 1:06 pm
      Craig Cornell says:
      Hot debate. What do you think?
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      Right. You support it but have serious reservations. Unlike when Obama ordered the hospitals to do this.

      Let the perfect be the enemy of the good, right Rosenblatt? This is LONG overdue, something liberals said wouldn’t work because Americans aren’t capable of shopping prices (liberal arrogance about how smart they are and how stupid Americans are).

      What liberals never acknowledge is the power of the market, even for health care. I don’t look at prices at Walmart, but enough people do to keep Walmart honest, and so i benefit because the prices come down as a result of a few people keeping an eye out.

      The same thing is about to happen in health care. It worked for Safeway and Whole Foods, who first mandated published prices, and employee/patient satisfaction went way up.

      (Watch all the Dem. candidates for President sell out to the hospitals and criticize this move. “Trump did it?
      Well then it’s stupid.”)

      • June 25, 2019 at 1:37 pm
        Rosenblatt says:
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        “You support it but have serious reservations”

        Yup. I am in favor of something while SIMULTANEOUSLY being cautious of the resulting (and potentially unintended) risks.

        Insurance example: I am in favor of our insurance company expanding into coastal areas, but I’m cautious about it due to CAT’s being able to impact a large number of our insureds if we expand in concentrated areas and don’t spread out our risk enough.

        If you can’t understand this concept, I don’t know why you’re here on IJ in the first place because that logic is inherent in the way carriers write business and attempt to project loss their exposures.

        • June 25, 2019 at 1:49 pm
          craig cornell says:
          Hot debate. What do you think?
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          Because you tried to claim you were “praising Trump” and then predictably went on to criticize his proposal. Can’t have it both ways.

          • June 25, 2019 at 2:01 pm
            Rosenblatt says:
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            Seriously Craig? I explained 1 thing that I thought could be an unintended consequence of the proposal, while still making it clear that I approve of the proposal taken as a whole.

            If you ever had surgery (or had a family member need surgery) and took the time and effort to schedule it with an in-network doctor, only to find out when the bill comes that the doctor used an out-of-network anesthesiologist, you wouldn’t be arguing here – you’d understand this is a valid concern.

            Not everything is black and white.

          • June 25, 2019 at 2:23 pm
            SWFL Agent says:
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            I believe you can have it both ways. Rosenblatt just did. This move to display prices is a step in the right direction but it’s only one step of what I hope will be many. The healthcare industry is a for profit money making machine that the Gov’t, regardless of party, as yet to figure how to rein in. I’d bet on the multiple layers of health industry executives over Gov’t bureaucrats every time. The sole practice of posting prices may not control costs after add’l services/treatments are added, emergency care is rendered, and/or no other competition exists. Just asked a car dealer how many people pay more than MSRP.

          • June 25, 2019 at 3:51 pm
            Rosenblatt says:
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            Thanks, SWFL. I’d give you an up-vote, but I don’t vote on this site.

      • June 25, 2019 at 3:51 pm
        Agent says:
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        Craig, I am sure glad Yellowstone is on opposite of the Democratic debates.

    • June 25, 2019 at 3:49 pm
      Agent says:
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      Rosenblatt, you should have stopped after the first paragraph, but your Progressive ways would not allow it.

  • June 25, 2019 at 1:21 pm
    Caldude says:
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    This makes sense for elective surgery. Need repair work on my meniscus, check out the rates. Have a heart attack? Not going to check Uber Ambulance and Amazon Doctor to make a decision and drive out of the way to save money.

    • June 25, 2019 at 1:52 pm
      craig cornell says:
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      Why not? If the difference is double in price but the ratings on the doctors is the same, why WOULDN’T you want to know? Geez. I hope you didn’t buy your house this way: “well, this neighborhood is good, so who cares how much the house costs. . .”

      • June 25, 2019 at 2:20 pm
        Nebraskan says:
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        I think Caldude was using a heart attack as an example of an “emergency” situation. They sort of just happen with no warning, and most likely someone isn’t going to stop and shop rates while they are on the floor dying.

        I’m fairly confident in saying your apples to oranges comparison of house buying is moot.

        • June 25, 2019 at 2:52 pm
          Captain Planet says:
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          Exactly, Nebraskan – emergency situations are quite different. They don’t allow enough time to do pricing research. But, generally speaking, I do like the fact they will have to disclose prices. If nothing else, there could be some general information sharing by word of mouth.

        • June 25, 2019 at 5:34 pm
          Craig Cornell says:
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          Nonsense. Think it through. With published prices, if someone gets an outrageous bill after a heart attack, they can then check to see what others would have charged.

          Once their friends and neighbors find out which hospital is the rip-off artist, people WILL change their providers.

          That’s what happens now in advance: people change providers all of the time to save money on premium. Once they can save on out-of-pocket expenses, they will look in advance at those charges too.

          • June 26, 2019 at 8:46 am
            Captain Planet says:
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            Craig,
            Perhaps to some degree but prices fluctuate, they are not stagnant. And, if one hospital finds it is losing money, and as long as healthcare is a for-profit business which I don’t see changing anytime soon, then they will raise prices. So, what may be true for someone who had a heart attack back in January may not be true today, for example. Carriers do it all the time, they find their first quarter or half of the year isn’t going as planned, so they reforecast with a new plan, which includes changing rates and or terms/conditions.

        • June 25, 2019 at 5:41 pm
          OpPolaResearch Bear says:
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          Nope. Although individual instances of emergencies will not result in price shopping, doctors and hospitals who/ which POST their rates will eventually see their business rise or drop, depending on their rate levels relative to other doctors / hospitals. In a time-lagged effect, doctors and hospitals with higher than average costs will (have to) lower their rates to remain competitive for non-emergency treatments, and thus for all of their business.

          • June 26, 2019 at 11:09 am
            Rosenblatt says:
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            ” In a time-lagged effect….” (begin sarcasm) That’s excellent. Dear everyone — do not have an emergency medical condition anytime soon because the longer you can wait, the cheaper it’ll be. Thinking of having a stroke or heart attack in 2019? Stop it. Don’t do it until 2022.

          • June 26, 2019 at 6:19 pm
            bob says:
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            “Also, comments that are part of extended and repetitive squabbles between two and/or among small cliques of commenters are also inappropriate use of this forum.”

            You’re aware this includes your tendency to use people’s quotes as you’ve done for months, and you seem to be repeating with Andrew’s, correct?

      • June 25, 2019 at 3:00 pm
        Agent says:
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        Craig, the Doc in a Box operations are doing quite well since they offer services much lower in cost than hospitals for every day illnesses and accidents. Hospitals are famous for ordering every test in the books and then misdiagnose the actual condition. Result: Much higher cost.

    • June 27, 2019 at 1:47 pm
      Jax Agent says:
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      Well duh, Caldude, if you’ve been smushed in a car accident and you’re bleeding out, that’s a whole different matter. smh

  • June 25, 2019 at 8:49 pm
    Andrew G. Simpson says:
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  • June 25, 2019 at 11:35 pm
    Billing clerk says:
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    After I had (perforated) appendix surgery (emergency) I went to the billing department and sat down with one their clerks. They called several departments to see if all the procedures I questioned were actually performed — they were quite accommodating. But when they tell you,”the surgeon is on the way,” you’re not going to sit there ask for their chargemaster.

  • June 26, 2019 at 11:21 am
    jsmooth says:
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    I’m all for pricing being disclosed across the board. I cannot tell you how many medical bills I’ve had that were an extreme amount more than what I was told by the hospital. When getting my MRI’s (have to twice per year because of Cancer) the hospital had me set have it done with them. After digging a bit, I found they were FOUR times more expensive than the local outpatient MRI place. The difference is they didn’t have the overhead the hospital does. I save a small fortune by using the outpatient place. If you don’t dig deep and do the research on your own, you could be hit with a massive co-pay or the 10% – 20% your insurance will not cover. Having the prices available for everyone gives the patient an opportunity to shop around. Medical procedures are expensive enough without being gouged by the hospital because of their “overhead”.

    The more you learn about healthcare in the USA, the more sickened you become. Ask your doctor how Chemo is bought and sold, and who profits off the sale the most? It’s your chemo doctor. I went through it and had it explained. They do not simply make money off your illness and treating it. They can make a small fortune depending on which treatment you get, which is completely their choice. I would like to think they are all about the healthcare, but when money is involved, are they all 100% on the up and up?

    • June 26, 2019 at 1:26 pm
      Captain Planet says:
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      That’s right, jsmooth – this is why we are seeing more and more Americans seeking medical tourism. Sucks having a profit motive between me and my well-being. They’re spending time on their new yacht boasting about while you’re crunching your budget trying to determine how you can afford your next treatment.

      • June 26, 2019 at 3:58 pm
        Craig Cornell says:
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        The profit motive drives innovation. That’s why you see almost no new medical ideas coming out of Single Payer countries. No body cares to bother. Want to see all our Pharmeceutical jobs head to China? Vote for Bernie.

        It is the greed of doctors and hospitals that drives our high prices. Remember, the AMA endorsed Obamacare because their high prices weren’t going to be touched. And so prices went up after Obamacare was enacted, just as conservatives predicted (“families will save $2,500. per family” Obama promised. Did YOU believe him?)

        • June 26, 2019 at 4:11 pm
          Captain Planet says:
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          I am an active participant in an innovative champions group – it’s about solutions, not necessarily profit. But, if you make the right solutions for those you are trying to serve, the ROI comes naturally, of course. You can have innovation without the profit motive, I can name all sorts of volunteer opportunities where innovation has been implemented. Though, I will agree with you, for some, profit is the motive to innovate.

          Didn’t believe that would happen but I did believe my double digit increases I saw year after year, upwards of 25% more than once, would slow down. And, I was right. What’s more, I have pre-x covered and no lifetime limits. I even had 2 years in a row under ACA when my rates were flat – unheard of prior to ACA. In order for what Obama said to be even close to be true, he needed each state to have their own exchange. Most conservative states squashed that just because the top of the house said don’t be in favor of our own healthcare reform solution because now there is a Democratic President. Otherwise, they would have been all about the Heritage Foundation’s plan that was put in place by Democratic leadership (and previously tested by Romney in his own state).

          • June 28, 2019 at 8:33 am
            jsmooth says:
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            I understand what you are saying Captain Planet. While I am not in favor of government Healthcare, it would need to be done on a nation-wide level with each state having their own exchange to make it work. The largest hurdle is when only the people truly needing healthcare sign up, like me. It throws the pricing out of whack as there just aren’t enough healthy people signing up for the plans to offset the costs. I have looked into whether or not I think it would be sustainable if everyone were on the plan. I think it could be, but the question I have is how will the care be? Will certain people be denied medications because of their cost, or because their situation isn’t dire? I compare it to a Sales vs. Underwriting meeting. In Sales, we want it all. Send us your worst policyholders and we’ll write them if the premium is there. In Underwriting, especially when running a temperature, you hear more that we need to be more selective and there isn’t always an acceptable rate for the risk. Politicians are the Sales people. The Actuaries running the numbers for the exchanges would be the Underwriters. Without someone, at some point, making certain the numbers remain workable, it would be a wreck. If they (Politicians) could explain exactly how they would prevent people being denied necessary healthcare, I think we would have a national healthcare system put into place. My doctor had said his concern is what about the people who do not “need” a medication, but it makes life livable to have it? No pun intended, but Viagra is an example. This isn’t medically necessary, but it’s used by a lot of people. Same for various skin creams that help with itching, burning or whatever. Some are hundreds of dollars. They aren’t “necessary” but promote a much happier/healthier life.

  • June 26, 2019 at 4:08 pm
    Hoosierone1 says:
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    It is interesting to finally see the comment section light up like never before. Only our nation’s health care system is possibly second to our problems at the border that our elected officials fail to take care of. With all of the problems California has with sleeping homeless persons and needles on the sidewalks that workers have to step over, local politicians wanting homeowners to put up tents in their back yards to help the situation and providing free health care to illegals….. It was refreshing visiting Gatlinburg the last couple of days visiting a couple of stores one run by the Queen and the other by her spouse, lettin me know up front being gay. They lived in Malibu and explained they got sick and tired of having to live with the disgust. My Trump 2020 Keep America Great hat came with great enthusiasm explaining how admittedly she voted for Hillary but now has seen the light with Trump, What is happening with trying to dump Trump either before or after he is elected again is disgusting, so any Trump haters here on this site can let your dislike votes roll. In the meantime, take a look! Tom Fitton: Cleaner Elections in CA & the Nation as a Result of Lawsuit–1.56 Million Inactive Voters!



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