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When he returns to duty, President-elect Trump has a chance to fix America’s broken health care system by doubling down on his first-term agenda of providing price transparency for patients.
Instead of protecting American patients, the Biden administration has rolled back or failed to fully enforce basic requirements that patients should know the cost of their treatment before receiving it.
Having finally removed the veil between medical services and pricesTrump can empower patients to buy the right care at the right price, avoid out-of-pocket costs, and give employers and unions a better picture of costs up front so they can optimally design health benefits.
President-elect Trump speaks at AmericaFest on Sunday, Dec. 22, 2024, in Phoenix. (AP Photo/Rick Scuteri)
Recommitting to this reform should be at the top of Trump’s first 100-day agenda.
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Trump’s 2019 executive order to improve price and quality transparency in American health care and the resulting hospital and health insurance price transparency rules provided Americans with real information about the prices of their medical services for the first time. Patients finally have the same information they have about other things they buy, seeing wide price variations of 10 times or more for the same care and looking for affordable services.
Unfortunately, President Biden has been steadily undermining Trump’s transparency rules involving hospitals, insurers and prescription drugs. Hospital price transparency was the first to be implemented and should go the furthest.
While the current administration claims hospitals are in good compliance with the requirements, the information hospitals include is often incomplete. In fact, a new study by PatientRightsAdvocate.org shows that only 21.1% of hospitals nationwide are fully compliant and both publish their discounted cash prices and all negotiated rates by health insurance and the plan.
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Weak enforcement likely contributed to moving compliance in the wrong direction: In February, 34.5% of hospitals were compliant, compared to 21.1% of hospitals found to be compliant this fall. Biden administration has facilitated this non-compliance by refusing to enforce the rules, issuing only 15 fines to thousands of non-compliant hospitals across the country.
The lack of enforcement is linked to administrative actions that undermine these patient protections: The Biden administration allowed hospitals to publish proxy prices, including estimates, algorithms and percentages, instead of actual prices.
There are no consumers shopping around checking algorithms or percentages – they need healthcare prices just like any other service they consume. Only real prices allow consumers to choose the highest quality care at the lowest possible prices and drive competition to reduce inflated costs.
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Assessments do not hold hospitals accountable if they burden patients with inflated final bills. And starting next year, the Biden administration will allow hospitals to continue to hide from transparency requirements, so that hospitals only need to show one type of fee instead of all the contracted rates required for shopping.
Continuing to ignore the needs of patients, the Biden administration has repeatedly delayed President Trump’s demands insurers to provide patients with upfront prescription drug prices and detailed costs through advanced benefit explanations, which patients can use to compare out-of-pocket costs.
Trump can continue his first-term efforts by immediately strengthening and implementing his price transparency rules upon taking office.
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That means reversing the Biden administration’s rollbacks and delays to ensure hospitals must post the actual dollars and cents prices for all their services, and insurers share the information patients need to buy prescription drugs and medical care. And that means consistently issuing financial penalties for non-compliance.
Patients urgently need transparent prices. Under the opaque status quo, US health care spending has grown to 17.3% of the economy, nearly double the developed world average. More than 100 million Americans have medical debtmany of whom face financial ruin due to bills whose base prices were not known. These challenges make any attempt to improve America’s health difficult.
These efforts aren’t just good for American health: A group of 32 bipartisan economists, including Arthur B. Laffer and Steve Forbes, recently sent a joint letter to Congress explaining how system-wide price transparency can divert approximately $1 trillion a year from unproductive health care to the industrial complex into a competitive economy, including workers’ wages and business income.
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A recent poll finds that 92% of Americans are in favor transparency of health care prices. It is clear that Americans of all political backgrounds are sickened by the hidden costs of health care and the huge bills that result from it, which could have been avoided if the prices were known in advance.
President Trump can unite these Americans and improve his legacy by making health care price transparency a reality and introducing an affordable and accountable health care system.
