Donald Signs EO Mandating Price Transparency from Healthcare Services

Sounds good.

DaisyDay said:

Two good things in a row! This and not bombing Iran. Donald may be on a roll.

Click to expand...

Nobody ever gives me any credit for not bombing Iran.

iow, now one can know for certain of the impending bankruptcy prior to receiving care.
One will not have to wait until the bill comes afterwards.
oh goody.
Perhaps those who can't afford it will merely opt to forego care. That'll help.

FenderTL5 said:

iow, now one can know for certain of the impending bankruptcy prior to receiving care.
One will not have to wait until the bill comes afterwards.
oh goody.
Perhaps those who can't afford it will merely opt to forego care. That'll help.

Click to expand...

It's looking in the right direction.

PeachyKeane said:

It's looking in the right direction.

Click to expand...

It'll be fine for elective care issues.
I tend to think it'd be completely useless in emergency or catastrophic events. However, I'm willing to listen/learn.
i.e. Your loved one is (having stroke/heart attack/involved in a car crash/diagnosed with cancer/breaks an arm... etc.) so you do a little research on the costs in order to decide on whether to get care or not.

While this sounds like a good idea from a very simplistic view, it will be a costly implementation for doctors and hospitals.

DaisyDay said:

WaPo: Trump signs executive order to compel disclosure of health-care prices

This can only help while we are awaiting his Obamacare replacement.

Two good things in a row! This and not bombing Iran. Donald may be on a roll.

Click to expand...

Agreed! It's nice when Trump can nail some things correctly.

comana said:

While this sounds like a good idea from a very simplistic view, it will be a costly implementation for doctors and hospitals.

Click to expand...

There is always some devil in the details. But honestly medical pricing is so opaque and confusing that IF the Republicans want to make it a "free market system" they would be REQUIRED to support and even vote for funding for this sort of thing. It is irrational to have a system that we are told is a market-based system (a truly horrible concept for healthcare), but if that's how we are playing it we MUST know pricing systems.

If it shows something bad then maybe, just maybe, people will realize what many economists already know: healthcare is NOT a normal market good. It requires a very different system than what we are trying to implement these past hundred or so years.

FenderTL5 said:

It'll be fine for elective care issues.
I tend to think it'd be completely useless in emergency or catastrophic events. However, I'm willing to listen/learn.
i.e. Your loved one is (having stroke/heart attack/involved in a car crash/diagnosed with cancer/breaks an arm... etc.) so you do a little research on the costs in order to decide on whether to get care or not.

Click to expand...

This is PRECISELY why healthcare is NOT a normal market good. These are issues that NO ONE in their RIGHT MIND is going to or would even be capable of making "comparison shopping" decisions.

FenderTL5 said:

iow, now one can know for certain of the impending bankruptcy prior to receiving care.
One will not have to wait until the bill comes afterwards.
oh goody.
Perhaps those who can't afford it will merely opt to forego care. That'll help.

Click to expand...

People already do that. If we make the corporations tell us WHY we must be bankrupted for healthcare then maybe it will spur a significant change in our national view of this system.

But really there's NO WAY for Conservatives who want a market-based healthcare system could do anything BUT support this initiative.

This EO certainly has the correct intent. Credit to Trump for that.

That being said, it is going to be complex and difficult for health care providers to implement. I think the solution heads this direction, but not accomplished this way.

Who knew health care could be so complicated?

I have been on CF for so long, that I automatically think "EO" stands for Eastern Orthodox.

Gracia Singh said:

I have been on CF for so long, that I automatically think "EO" stands for Eastern Orthodox.

Click to expand...

... that's what first caught my attention as well.

carlv_52 said:

There is always some devil in the details. But honestly medical pricing is so opaque and confusing that IF the Republicans want to make it a "free market system" they would be REQUIRED to support and even vote for funding for this sort of thing. It is irrational to have a system that we are told is a market-based system (a truly horrible concept for healthcare), but if that's how we are playing it we MUST know pricing systems.

If it shows something bad then maybe, just maybe, people will realize what many economists already know: healthcare is NOT a normal market good. It requires a very different system than what we are trying to implement these past hundred or so years.

Click to expand...

I agree that our approach to healthcare is not working. And this order will not fix it.

It would be simpler to enact Medicare for All which would have transparent pricing built right in. Right now anyone willing to do a little research can find out what a procedure will cost and what their share will be if currently enrolled in Medicare.

Standardized pricing is just more practical and cost effective than trying to implement a system that requires all providers and hospitals to purchase and manage (read more overhead/employees) a Chargemaster system and provide estimated costs to to any patient or prospective patient (based off their individual insurance plans) on demand.

I also believe that the cost information provided in this way will not bring the satisfaction of “comparison shopping” that healthcare consumers are imagining it will. It can lead to more anxiety and frustration when trying to find the right facility and or doctors to provide the care they need when overwhelmed with cost sheets and coordination of care. Also noting that cost does not necessarily equal quality.

Thinking about this a little more, this should not be the sole responsibility of the hospital/provider, but in reality the cost information should be made available by the individual’s insurer.

In the case of a planned procedure a member should be able to call the insurance company and ask what is payable to the facility and provider as well as what their personal cost share is.

Doctors, hospitals, and all their staff already have enough to do without the added task of trying to build an estimated cost based on negotiated discounts for each and every plan they accept.

comana said:

While this sounds like a good idea from a very simplistic view, it will be a costly implementation for doctors and hospitals.

Click to expand...

It may be a little overreach, but more transparency is needed. The “Chargemaster” is a combination of a bad joke and an accounting trick.

comana said:

Thinking about this a little more, this should not be the sole responsibility of the hospital/provider, but in reality the cost information should be made available by the individual’s insurer.

In the case of a planned procedure a member should be able to call the insurance company and ask what is payable to the facility and provider as well as what their personal cost share is.

Doctors, hospitals, and all their staff already have enough to do without the added task of trying to build an estimated cost based on negotiated discounts for each and every plan they accept.

Click to expand...

Actually EOB’s do provide a lot of the type of information. But it doesn’t help those people paying cash nor does it help before hand.

cow451 said:

Actually EOB’s do provide a lot of the type of information. But it doesn’t help those people paying cash nor does it help before hand.

Click to expand...

I am a medical biller and I field calls from confused patients daily. Adding more information for them to decipher will not help most of them. EOBs are already a mine field of confusion most patients.

It is rare that one understands that providers are paid on a fee for service basis when billing their insurance, meaning they are going to break down a visit and bill anything they did separately where allowed. I can’t imagine what stress would ensue in trying to costs compare even a routine exam with recommended screenings.

Now for cash pay it should be fairly simple to get an estimate because the providers I bill for always bundle all services for cash pay visits. Patients pay up front at time of service and no other charges will be billed unless something unexpected is diagnosed leading to unplanned tests, etc., and of course they will be given an estimate prior to agreeing to said additional tests/procedures so still no surprises.

comana said:

I am a medical biller and I field calls from confused patients daily. Adding more information for them to decipher will not help most of them. EOBs are already a mine field of confusion most patients.

It is rare that one understands that providers are paid on a fee for service basis when billing their insurance, meaning they are going to break down a visit and bill anything they did separately where allowed. I can’t imagine what stress would ensue in trying to costs compare even a routine exam with recommended screenings.

Now for cash pay it should be fairly simple to get an estimate because the providers I bill for always bundle all services for cash pay visits. Patients pay up front at time of service and no other charges will be billed unless something unexpected is diagnosed leading to unplanned tests, etc., and of course they will be given an estimate prior to agreeing to said additional tests/procedures so still no surprises.

Click to expand...

Definitely the idea should be to make things simpler. Perhaps having standardized EOBs and bills would go a long way. Hospitals in particular like to hide charges and resist itemized statements.
Sooooo.... the things I’d like to see
1. Standards for simplicity to help consumers understand EOBs
2. Do away with the Chargemaster
3. Standards for patient bills similar to #2