Opinion

Cut Consumer Health Care Costs

As the courts and lawmakers continue to argue about the future of America’s health care system, one thing is for sure: More people today are covered by health insurance than ever before. But what that coverage includes is an entirely different story.

Consumers are facing higher bills, less transparency, bureaucratic nightmares and, of greatest concern, less comprehensive care. Something needs to change.

Consumers are understandably angry and confused. Recent surveys from Ipsos on behalf of Consumers for Quality Care found that Americans are deeply frustrated by unpredictable costs and the lack of transparency in health care.

Two in three Americans struggle with predicting how much they will have to pay for health care when they need it. They fear health care costs even more than they worry about costs associated with retirement, college, housing or child care, and they want more clarity to avoid getting hit with surprise bills and shocking fees.

According to survey respondents, the most frustrating aspects of the health care system are hospital fees and unexpected bills (74 percent), insurance costs like premiums, copays and deductibles (71 percent) and out-of-pocket costs for prescription drugs (64 percent).

Unfortunately, there are too many areas where health care policies are increasing consumers’ out-of-pocket costs, while increasing health care industry earnings. One good example of this is after-the-fact emergency department denials.

Some insurers are instituting policies that would force policyholders to pay for an emergency room visit if the insurer later deems it a non-emergency. Patients are essentially being asked to self-diagnose. As a result, many patients will likely delay or go without emergency care rather than risk being unexpectedly required to pay emergency department costs out-of-pocket.

This isn’t just a problem in the emergency department, however. Hospital care more broadly is the largest single component of total personal health care spending in the United States, and the latest National Health Expenditure data shows health care expenditures grew by 3.9 percent in 2017.

Surprise bills, billing errors and vast swings in average prices for similar tests and procedures are pushing patients into severe financial stress and requiring countless hours on the phone between the bureaucracies of hospital administrators, care providers and insurers. Greater transparency in hospital pricing is essential.

And consumer frustration is not limited to within the hospital walls. New insurance policies in which insurers no longer allow drug copay coupons to count toward patients’ deductibles mean consumers continue to be caught in the middle of industry disputes about price and transparency.

As state legislatures across the country and the new Congress in Washington, D.C., convene, it’s time to do right by patients. A broad, bipartisan majority of voters (77 percent) believed that policymakers were focusing on the wrong things to improve health care in 2018. They want a new approach from politicians to tackle costs and ensure greater clarity in the system. That means shining a light on and reforming policies that strain consumers’ pocketbooks while padding the bottom lines of the health care industry.

The health care industry itself shouldn’t get a pass. Industry can and should reform various practices that needlessly inflate consumer cost, and consumers believe the health care industry has great ability to make changes and to be more transparent about those consumer costs.

The goal sounds simple: higher-quality, lower-cost health care. After years of fights, we know it is not as easy to achieve as it sounds. But today, as in past years, a better health care system remains a priority for the American public. Lawmakers and the health care industry should take heed.

 

The Honorable Donna M. Christensen is a member of the Consumers for Quality Care Board  and retired from the U.S. House of Representatives in 2015 where she served nine terms, and she is the first female physician to serve as a member in the history of the U.S. Congress.

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