Opinion

Want to Lower Healthcare Costs? So Do Doctors.

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Posted: Oct 19, 2020 12:01 AM
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Want to Lower Healthcare Costs? So Do Doctors.

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The increasingly high cost of health care continues to rank as the top issue among American voters. But let’s get one point clear: Doctors aren’t the problem. In fact, for the most part, they’re on your side.

Although lumping doctors into the overall problem of health care costs is natural, physicians have little to do with the price of health care. Hospitals and insurance companies set the prices, yet doctors often get the blame. Heck, insurance companies and Medicare tell doctors what their services are worth, not the other way around. How would lawyers, or accountants, or car makers like to be treated that way?

Overall, doctors want what you want:

- They want to be able to tell you the price of your health care. (But they don’t know either.)

- They want care to be affordable and accessible.

- They want the middle players ? hospital administrators, insurers, the government, data trackers, private equity ? out of the exam room.

- They don’t want to order unnecessary tests or do unnecessary procedures, or rush through their appointments with you in order to meet their employers’ quotas.

- They want to return health care to a relationship between the doctor and the patient.

Unfortunately, many in the health industry don’t share those goals because they profit excessively from the system as it is, and they fear the one change that would make all of the above possible -- healthcare price transparency.

Right now, a law is in play that would require both hospitals and insurance companies to disclose their cash and secret negotiated prices online, in an easy-to-access format. However, those with the most to lose, who profit from keeping patients and doctors in the dark, are vigorously opposing this effort.

Special interests and bought-off lawmakers have doubled down to protect the status quo as if it were, well, Fort Knox. Indeed hospitals and insurance companies spend hundreds of millions of dollars lobbying Congress to make sure their secret negotiated prices stay hidden.

If our health care system had real price transparency, you and your doctor could know the price of care ahead of time, so you could choose the best care at the lowest cost, the way you shop for cars, or houses, or groceries. Competition would enter the market causing costs for care and coverage to tumble down fast, making care affordable and accessible.

Once hospitals have to compete on price, they would need to make changes to bring their costs down. They would have to reduce their administrative glut along with their appetite for acquiring medical groups and converting independent doctors into employees, which dramatically raises prices. When hospitals own medical groups they use their increased market power to get higher payments from insurers. Hospitals also layer in facility fees, added costs that add zero value and that independent doctors don’t charge but that can drive up the cost of care five-fold.

As consumers’ value-driven choices steer them toward independent practices, acquiring medical groups would become less lucrative for hospitals. Market monopolies would unwind as hospitals found it to be more profitable to release their employed physicians from their contracts. Independent practices would increase and flourish.

This change would drive the middle-players out of the exam room and let doctors practice without corporate interference.

Finally, if we had complete price transparency, doctors would be happier. Most doctors didn’t go to school for 12 years after high school to be told by someone with half the formal education which knee replacement device to use, how many stents to put in a week, how many tests to order, and how many patients to admit to the hospital. Price transparency is the doctor’s ticket to freedom, and the patient’s ticket to empowerment.

This is our chance to make all that happen. We have two shots: One is through the courts. Last year, after President Trump issued an executive order for health care price transparency. In response, the hospitals sued. Last June, the hospitals lost their case in federal court. They are appealing the decision.

Our second hope is through the legislature. The Healthcare PRICE Transparency Act (SB 4106) requires hospitals and insurers to reveal all their prices online, in an easy-to-read format by January. If Congress votes on another stimulus package, that would be the place to drop in that bill. Not incidentally, this would cost taxpayers nothing.

If healthcare price transparency becomes part of the next stimulus package or the government wins its case in court, Americans and their doctors could celebrate the beginning of a free market health-care system, one we have long been denied.

Marni Jameson Carey is the executive director of the Association of Independent Doctors (www.aid-us.org), a national, nonprofit, nonpartisan trade association based in Winter Park, Florida, working to stop health-care consolidation and lower health-care costs.