By Fraser Cobbe

There is ample evidence to suggest the battle for health care transparency for consumers is going to be a long struggle. The Federal Government under the previous administration passed a series of regulations designed to make hospital and insurance carrier prices transparent to the public. The current administration is moving forward with implementation. As health care consumers and patient advocates, we need to continue to support their efforts.

The New York Times had a piece in August that discussed the data being made public for the first time as hospitals comply with the Federal Regulations. That data illustrates the wide variation in the price of services that insurance companies have been able to negotiate with hospitals for patients receiving the same services. The headline of the story was their inability to negotiate favorable rates with some hospitals and health systems that leave patients “getting prices that are higher than they would if they pretended to have no coverage at all”.

Given patients are footing the bill for a much larger percentage of the overall cost of care through increasing co-payments, consumers deserve to know how much they have to pay for health care services and whether their insurance company is negotiating favorable terms on their behalf or not.

Yet compliance with the hospital transparency rule that took effect in January has been extremely low and efforts remain afoot to prevent this sort of data from ever seeing the light of day.

Bloomberg Law reported that 94.4% of hospitals haven’t met one or more of the requirements since the hospital transparency rule took effect January 1, 2021, according to a survey conducted by Patient Rights Advocate.

The Wall Street Journal also recently reported that “the U.S. Chamber of Commerce and the Pharmaceutical Care Management Association have filed separate lawsuits to block portions of a federal rule mandating that insurers and employers disclose prices they pay for health care services, the newest legal challenges to the health care price transparency rule.”

The significant impact of health care debt on American families is well documented. We should no longer tolerate the veil of secrecy that surrounds the price of health care services. A transparent marketplace will enhance competition, drive up quality, and lower costs for all to benefit.

Fraser Cobbe, Executive Director, Dade County Medical Association, can be reached at fcobbe@miamimed.com.