On the Third Hand: Prices

The truth is that, even for U.S. patients with a rough idea of how their health insurance is supposed to work, finding either the full discounted price or the patient’s share of the bill can be next to impossible.

Providers’ office managers use provider network agreement confidentiality provisions to justify refusing to give patients anything other than names, ranks and provider ID numbers.

If a plan provides a cost estimation tool, the estimate usually comes with many footnotes warning the patient that the estimate has no relationship with reality.

On the one hand, some states have found that health care pricing transparency laws have had little effect on health care costs.

See also: N.H. Prices Resist Sunshine

Some antitrust experts have suggested that price transparency requirements may backfire and help providers increase costs.

See also: Panel Considers Health Price Disclosure Proposals

On the other hand, patients’ current lack of access to care price information is a slap in the patients’ face. Policymakers, providers, employers and insurers all want to blame as many of the patients’ bills on the patients as possible. But, even when patients might have some ability to shop based on price, they still have a terrible time getting the prices.

On the third hand, providers will blame carriers for the problem, and carriers will blame providers.