When he returns to office, President-elect Trump has the opportunity to fix the broken American health care system by doubling down on his first-term agenda of delivering price transparency for patients.
Instead of protecting American patients, the Biden administration rescinded or failed to fully implement the very basic requirements that patients should know the cost of their treatment before they get it.
By finally removing the veil between medical services and prices, Trump can empower patients to shop for the right care at the right price, avoid overcharges, and give employers and unions a better idea of the costs in advance so that they can optimally design health benefits.
Recommitting to this reform should be at the top of Trump's first 100-day agenda.
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Trump's 2019 executive order improving price and quality transparency in American health care and the resulting hospital and health insurance price transparency rules provided Americans with actual price information about their medical services for the first time. Patients finally have the same information that they do about the rest of the things they buy, spotting wide price variations of 10 times or more for the same care and shopping around for affordable services.
Unfortunately, President Biden steadily undermined Trump’s transparency rules involving hospitals, insurers and prescription drugs. Hospital price transparency was the first implemented and should be the furthest along.
While the current administration claims high compliance from hospitals, the information the hospitals include is often incomplete. In fact, a new study by PatientRightsAdvocate.org shows only 21.1% of hospitals nationwide are fully compliant and both posting their discounted cash prices and all the negotiated rates by health insurance company and plan.
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The lackluster enforcement has likely contributed to compliance moving in the wrong direction: in February, 34.5% of hospitals were compliant, compared to 21.1% of hospitals found compliant this fall. The Biden administration has facilitated this noncompliance by refusing to enforce the rule, issuing only 15 fines on the thousands of noncompliant hospitals nationwide.
The lack of enforcement is coupled with administrative actions which undermine these patient protections: The Biden administration has allowed hospitals to post price substitutes, including estimates, algorithms, and percentages, in lieu of actual prices.
No consumer shops around checking algorithms or percentages – they need prices for health services like any other service they consume. Only actual prices allow consumers to choose the highest quality care at the lowest possible prices and unleash competition to reduce inflated costs.
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Estimates don't hold hospitals accountable if they saddle patients with inflated final bills. And starting next year, the Biden administration will let hospitals continue to hide from transparency requirements so that hospitals only need to display a single type of charge instead of all negotiated rates required to shop.
Continuing to neglect patients’ needs, the Biden administration has repeatedly delayed President Trump's requirements for insurers to provide prices for prescription drugs and detailed costs to patients ahead of time through an Advanced Explanations of Benefits, which patients can use to compare their out-of-pocket costs.
Trump can follow through on his first-term efforts by immediately strengthening and enforcing his price transparency rules upon taking office.
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That means reversing the Biden administration's rollbacks and delays to ensure that hospitals are required to publish actual prices in dollars and cents for all their services and insurers are sharing the information patients need to shop for prescription drugs and medical care. And it means consistently issuing financial penalties for noncompliance.
Patients urgently need transparent prices. Under the opaque status quo, American health care costs have ballooned to 17.3% of the economy, almost twice the developed world average. More than 100 million Americans have medical debt, many of whom face financial ruin from bills whose underlying prices weren't known. These challenges aggravate any attempts to improve American health.
These efforts aren’t just good for American health: A group of 32 bipartisan economists, including Arthur B. Laffer and Steve Forbes, recently sent a joint letter to Congress explaining how systemwide price transparency can redirect approximately $1 trillion annually from the unproductive health care industrial complex to the competitive economy, including worker wages and business earnings.
A recent poll reveals 92% of Americans support health care price transparency. It's clear Americans of all political backgrounds are sick of hidden health care costs and ensuing enormous bills that they could have avoided if prices were known in advance.
President Trump can unite these Americans and burnish his legacy by making health care price transparency a reality and ushering in an affordable and accountable health care system.
