OPINION: Price transparency is the bipartisan health care solution

Health care reform is once again a top priority in Congress. Recently, President Donald Trump announced his health care plan that would finally require meaningful hospital and health insurance price transparency.

Yet price transparency isn't a partisan issue. The Biden administration also supported this policy solution, as does over 90% of the American public. For good reason. Upfront prices can protect patients from overcharges and reverse runaway costs.

Almost everyone has a story of being blinded to health care prices, then blindsided by massive bills that arrive long after care.

Consider mine. After experiencing abdominal pain, my primary care physician told me that I needed hernia surgery. It wasn't urgent, but since I'm a mountaineer, I wanted it taken care of so I wouldn't have to worry about complications while in a remote area.

Despite the procedure being scheduled, outpatient and relatively straightforward, I couldn't get an upfront price. Finally, I received an estimate for $3,500 the day before my surgery and paid it promptly in full.

The surgery was successful, but then the bills came. They arrived piecemeal — one from the hospital, one from the surgeon, one from the anesthesiologist — more than a dozen in total. I would decline service in any other industry that priced and billed this way.

I paid the first couple in good faith, but then, as they kept on coming, I held off, worried I was being taken advantage of. In total, I received over $10,000 in bills. That doesn't include additional costs my insurer paid. The combined topline amount was supposedly $161,000. Ridiculous.

When I began disputing the charges and requesting explanations, I got the classic runaround. I couldn't reach anyone with decision-making authority on the phone. Emails went unanswered. Disputing the bills became a second job. It was overwhelming. 

Eventually, I was told the bills would be sent to collections and destroy my credit if I didn't pay them. That threat hits hard when you're a small business owner who depends on good credit. I had no other choice but to settle for $7,500, more than twice my original estimate. I have no idea what my insurance company actually paid.

This opaque system seems designed to exploit the power differences between hospitals and patients. It operates under the assumption ordinary folks will just give in to this predatory billing behavior. 

Indeed, one of my best friends, dying of cancer eight years ago, told me he didn't want to spend his final weeks fighting billing errors and overcharges. He told his wife to simply pay every bill, even though he knew some were duplicative and inaccurate.

Upfront prices would put patients on a level playing field, allowing us to shop for the best value, spot wide cost differences for the same care, and budget rather than pay with a blank check. We could hold hospitals accountable for price gouging and enjoy financial peace of mind. Competition would put downward pressure on costs just like in every other part of the economy.

Hospitals and health insurers already know their prices, including the detailed negotiated rates for each plan. What reason do they have to hide them other than to facilitate profiteering?

Patients understand that prices may vary depending on personal circumstances or complications, but hospitals and insurers should provide this detailed information in advance. Not unaccountable estimates provided only when insisted upon by the patient.

Price transparency's overwhelming popularity means it's one of the few health policy solutions that can survive political partisanship. Yet it's powerful enough to dramatically improve affordability and accessibility. Legislators from both parties should unite around it.

Mark Gregory is a small business owner in Albuquerque.