A new law requires all U.S. hospitals to post their complete price list online in a machine-readable format, such as a spreadsheet, on their own websites.
It is a huge first step towards achieving the transparency consumers require and deserve in fixing our US healthcare system!
The rule, created by the Centers for Medicare and Medicaid Services, is similar to a 2006 California law mandating hospitals share master price lists on a state-run website.
I’m already beginning to see analysis and comparisons with articles starting to appear headlining the vast price differences that is now there in black and white for us all to see.
Of course, hospitals then attempt to defend their pricing, comparing their posted prices to hotel rack rates (which is hurting their reputations even more since we as patients are people – not hotels). But the conclusion, then, is that we can negotiate. The opaque door has finally been pried open and, along with this first step in transparency come a modicum of accountability.
One hospital in the California Bay Area stated that “The amount patients actually pay for hospital services has more to do with the type of insurance coverage they have, than amounts on the chargemaster (master price list).”
Ah, health insurance. I was waiting for a hospital to try to redirect the spotlight back over to insurance, certainly another piece of the shell game, and what they’ve been successfully hiding behind for decades.
But – the gig is up. The door is open, hospitals must now be transparent with their prices, be accountable for their prices, and consumers can now directly negotiate.
We still have a long way to go to achieving the health care system we all want and deserve, but this was a very important first step.
Source: Chris Cumura & James Jackson, January 1, 2019. NBC Bay Area. “New Law Requires All U.S. Hospitals Post Complete Price Lists Online.” Retrieved on 1/30/19 at:
Well, the GOP managed to slip a repeal of the ACA's individual mandate into their new tax law. But will it topple the ACA apple cart?
I doubt it.
Because the individual mandate, designed to "require" young, healthy Americans to buy health insurance never worked. The young, healthy millennials I spoke to just did the math - 5% of their income or a minimum of $695, whichever is lower - and compared that to hundreds of dollars a month to buy insurance they may not use? They just paid the penalty. Or they didn't.
Fact is, the IRS had no real way to enforce the individual mandate. The IRS can’t bill people that didn’t buy health insurance. It can’t garnish their wages, threaten tax evasion charges or report them to the credit bureaus. All it can do is deduct the fine from their tax return. If they have the right amount withdrawn, they won't get a tax refund to deduct the penalty from.
The fear that only those who need health insurance will buy health insurance was already happening.
But let's talk about the real problem here.
An opaque, inefficient health care system with skyrocketing, unsustainable costs.
Health insurance, while not lily-white in their dealings, has nothing to do with this real problem and fretting over young, healthy people buying health insurance will not fix the real problem.
We need a transparent, accountable, affordable health care system.
As I've said before, if health insurance and the government, who are both practicing medicine without a license, stepped aside, and it was just consumers and providers, health care would get fixed in a jiffy!
Gee. How about health insurance companies and the government pitching in with a clear focus on empowering consumers, then staying out of the way!
We've still got a long way to go. I know you're weary - and so am I. But we've got to keep stating that we want consumer-driven health care - now.
Yeah, I just wrote the last post - and bam, Congress got something done - for now. A two year bipartisan deal to pay the cost sharing reduction subsidies. Don't know if it will pass through the full Congress. Trump supports it - for now. He still has his sights set on a full repeal and replace, though, tweaking the Graham-Cassidy-Heller-Johnson bill. And the saga continues... .
Meanwhile, emphasize to your public servants in Washington anything they decide to do needs to empower consumers to drive health care... .
Is anyone else having Deja Vu? It seems to me that Trump has just done what the GOP was criticizing Obama for - unilateral (and illegal?) decision making on health care, slinging that pen on those executive orders like there's no tomorrow.
I seem to recall the GOP suing the Obama Administration for cost sharing reduction subsidies without appropriation approval through Congress - and winning (which was in appeal), because that is not how our government is set up. Appropriations of our tax dollars are supposed to go through the legislative process - one of the differences between a democracy and a dictatorship.
Trump's announcement last Friday that he has signed an executive order to not pay those cost sharing reduction subsidies to insurers, stating his administration is heeding the advice of the Justice Department, may stick, even in light of the lawsuits that are racking up. There is the sticky point that the insurers were promised those payments by a former administration, and changing horses in the middle of the stream may still end up in legal quick sand, but there also is a legal standing.
Now Trump's other health care related executive orders - selling insurance across state lines and the right to purchase health care plans through formed associations, with some other items added in - the jury is still out.
What can you do? I sound like a broken record, I know - but we deserve transparent, affordable, accessible, high quality health care in America, and until we are dealing with those issues, we won't get it. Tell your public servants in Washington that we need consumer-driven health care.
I realize I'm in health insurance, but just imagine what would happen if there were no more health insurance and no more employer health care benefits and no government practicing medicine without a license. Wham! It's all gone. What would happen? We would immediately have affordable health care because it would be back to the providers and the patients - us. Providers, pharmaceuticals, and everyone else in the health care industry could no longer hide behind insurers or employers or the government - they would immediately have to figure out how to provide us with their services at prices we could afford.
Now, I realize health insurance serves an important purpose, but you see my point. Maybe I, health insurance, the government, and employee health benefits need to take a year-long vacation. When we come back, rested and refreshed, bet you the health care industry has figured out how to do or die. Bet you consumers then have the transparency and the quality competitive choices they need to shop effectively for the health care that is right for them.
I repeat - tell your public servants in Washington that we need consumer-driven health care - everyone except doctors need to stop practicing medicine without a license - and they need to put their eye on the right ball - health care transparency, affordability, accessibility, and quality.
Oh, and there's no room for loner cowboys. This is a democracy, for the people and by the people. We want our democratic system honored, respected, and intact. We elected all of you - not just one of you. Stop acting like Washington is a sandbox. Grow up and get 'er done - together.
Rylan Klaseen & Associates
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