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Trump Administration Edging Toward Forcing Hospitals to Publish Rates Negotiated With Insurers

U.S. health care costs hit a record $3.65 trillion in 2018. It’s the highest by far in the developed world, according to the Organization for Economic Co-Operation and Development.

With such pressure on consumers, you might assume they would become practiced shoppers, demanding to know costs and effectiveness up front. But details are generally difficult to get. Even as a law signed by Donald Trump make explicit hospital list prices available starting January 1, 2019, it has been next to impossible for the average person to decipher them, with tens of thousands of obscure descriptions. The law only applies to hospitals—not doctors or clinics.

But an even bigger problem is that list prices are only the starting point of bills. Insurers demand and get contractual discounts and then have different levels of coverage, depending on plans. Two people, even with similar sounding insurance, could pay significantly different prices for the same procedure by the same care provider. Move between facilities and the differences multiply.

But the Trump Administration seems to be edging toward what would be a radical degree of transparency, according to the Wall Street Journal. The Department of Health and Human Services has asked for public comment on whether patients should get real pricing—know the discounted costs from all involved providers—ahead of treatment.

This would allow everyone—patients, their employers, and policy makers—to see exactly what pushes prices up so high. With this level of information, if presented in an understandable way, patients could make choices that could put significant downward pressure on prices.

“It’s an effort by the president to help put Americans back in control of price data,” Dr. Don Rucker, national coordinator for health information technology at the Department of Health and Human Services, told the Journal.

The industry would likely balk. The reason the information is now secret is because it represents competitive advantages that few in the industry will want to give up.