On Wednesday the Senate HELP Committee advanced the Patients Deserve Price Tags Act, 21 to 1.
Roger Marshall of Kansas and John Hickenlooper of Colorado wrote it, with twenty-two cosponsors. It would require hospitals, ambulatory surgery centers, imaging centers, clinical labs and insurers to publish negotiated rates, costs and cash prices on a monthly basis, with real penalties for failing to. It would also guarantee employer health plans access to their own claims data and bar third-party administrators from restricting it.
The American Hospital Association says it has serious concerns about administrative burden.
Of course it does.
Why that objection does not survive contact
I have spent the past year building health-records infrastructure — consent layers, authorization scopes, the plumbing that decides who sees what about a patient and under what conditions.
It taught me something I did not expect: the technical difficulty of publishing a price is roughly zero.
Hospitals already know their negotiated rates. The numbers are in a contract. They are in the claims system. They are in the chargemaster. Producing them monthly in a machine-readable format is an afternoon of engineering and a decision.
The burden objection is not an engineering objection. It is a business-model objection wearing an engineering costume.
The strongest thing said in that room
Rand Paul cast the only no vote, and his argument deserves an answer rather than a dismissal.
His position is that the problem is not opacity but that prices are fixed. Medicare and Medicaid rates are set by federal formula. Publishing a number nobody is free to change, he argued, does not change the situation.
He is partly right, and supporters should say so instead of talking past him.
Where rates are administered, disclosure is informational rather than competitive. Nothing gets bid down.
But that is not the whole system, and Hickenlooper supplied the answer: more than 180 million Americans are covered by employer plans, many of them self-insured. Those employers pay claims with their own money and in many cases have no idea what they are paying for.
That is not a fixed-price market. That is a market whose buyers have been blindfolded — which is why Hickenlooper's description of the industry as an aggregated monopoly lands.
One number to treat carefully
Marshall told The Epoch Times the bill could cut a family's healthcare costs by as much as a thousand dollars a month.
Treat that as a campaign figure until somebody scores it. The honest case does not need it.
The honest case
In every other transaction an American makes, the price is knowable before the purchase. You know what the flight costs before you board. You know what the car costs before you sign.
Healthcare is the only sector where standard practice is to render an irreversible service and mail the number afterward.
That is not a market failure. A market requires prices. What we have is not a failing market — it is not a market at all.
This bill is the floor, not the ceiling. Pass it and keep going.
Disclosure: NeuraWeb Global Inc., of which the author is founder and CEO, builds health-records and consent infrastructure. That work informs the technical claims above and represents a commercial interest in the underlying subject.
Add your perspective
Left: transparency without price caps just tells you what you cannot afford, and the real answer is coverage. Right: Paul is correct that federal price-setting is the disease and this treats a symptom. Center if you think the claims-data provision matters more than the posted-price provision.
