Though the current system does not include insurance differences, it’s a step in the right direction.
After a new federal regulation that went into effect on Jan. 1, hospitals are required to post documents online that show the cost of each treatment that they have available. This process was created by the U.S. Department of Health and Human Services as a step to providing knowledge to patients about the pricing of healthcare in America. In a statement about the new regulation, the department said, “We are concerned that challenges continue to exist for patients due to insufficient pricing transparency.”
This new regulation seeks to close the information gap and make customers aware of their health care bills. However, the system in place is not completely accurate due to varying post-insurance costs, outcomes of treatment and potential necessity of outside physicians. The resulting inaccuracy has the potential to be more of a hindrance to customers than a benefit. In addition, some argue that health care pricing is difficult to properly understand so a generalized federal regulation will not properly explain the data.
Though the system is currently flawed due to its lack of explanation of the procedures involved, it will be able to provide basic information about the current pricing and enable policy improvements down the road.
One of the small solutions that could help the current health care pricing plan is requiring a better explanation for each procedure. For example, an article by the Oklahoma Watch found that the most expensive item on the list provided by Integris Baptist Medical Center is “ECMO OR TRACH W MV<96 HRs OR PDX EXC FACE, MOUTH & NECK W MAJOR.” To the average patient, this string of letters is useless, providing no real information about what the medical treatment entails. Due to the downloadable data format required by the government, it is understandable that the description is required to be short to fit into a tiered list. But the problem of industry jargon could be solved by hospitals providing a quick explanation of the procedures involved in another downloadable document. An explanation would provide the necessary information for customers seeking the pricing of medical treatments. The current way these are phrased removes the whole intention of transparent health care pricing. By hiding the information in unintelligible industry terms, health care companies provide no real benefit to any potential patient and merely acquiesce to the intent in loose terms. While the descriptions currently provided may be difficult to understand, the lawsuit provides good information about the current problems that people face in the healthcare industry. An advocacy group known as Oklahoma Council of Public Affairs provided a statement on the issue through its president Jonathan Small: “The posting of the master pricing list could reveal how ridiculous [the health care pricing system] is, it is not going to provide anybody information on a large scale, but it could expose how idiotic and insane health care pricing has become.” The current federal regulation may not provide the necessary information in its first attempt, but it illuminates the issue. It provides the first stepping stone for future policies that will help further bridge the gap between the healthcare industry and the consumer.