Price transparency is Congress’ top bipartisan healthcare priority. The Senate’s Patients Deserve Price Tags Act and the House of Representatives’ Health DATA Act give legislators the chance to make it a reality by requiring upfront prices, including discounted cash and insurance-negotiated rates, across the healthcare system.
American national health expenditures are projected to reach $6 trillion in 2026, nearly 20% of GDP and twice the developed-world average. Americans are working one day in every five to pay for healthcare. The costs of employer-provided health benefits are expected to rise 8% — more than double the rate of inflation — in 2027.
According to the medical journal JAMA, 25% of healthcare spending is waste — including administrative complexity, overcharges, and fraud. By creating a functional, competitive marketplace with billing and payment accountability to known prices, price transparency can return over $1 trillion annually to the productive growth of the public and private sectors, including workers’ wages and family budgets. Empowering consumers and employers to lower their healthcare costs will reduce inflation and improve affordability.
Prices are the lifeblood of a healthy economy, and without them, markets break down and costs rise. Consider the routine price gouging and price variations — sometimes tenfold or more — for identical services that exist under the opaque healthcare status quo. Fraud, spread pricing, and other inflationary billing games proliferate in the dark.
By restoring choice and competition, upfront prices can put downward pressure on costs. Consumers, including employers and unions, could compare and save, paying $2,900 for hernia surgeries instead of $23,000 and $300 for MRIs instead of $3,000. Actual prices protect patients from overcharges and give them peace of mind that routine care won’t lead to debt or bankruptcy.
A transparent marketplace allows employers and unions, which provide coverage for most Americans, to steer employees to the most cost- and quality-efficient care. With actual prices, employers can ensure bills are accurate, honest, and match agreed-upon prices. This power to review bills against prices for accuracy before payment stops overcharges, errors, and fraud.
Honest billing can eliminate the many middlemen that have egregiously paid themselves in the shadows. Insurance can return to its role of affordably protecting families from catastrophic injury or illness.
Businesses can use their health plan savings to expand, hire, and raise wages, generating an enormous economic stimulus. For decades, workers’ wages have been suppressed by rapidly rising health plan premiums. As a result, the true cost of healthcare to the American worker and economy has been obscured.
A recent study from Brown University health economists Christopher Whaley and Daniel Arnold estimates that the Patients Deserve Price Tags Act and Health DATA Act would generate $38 billion in higher wages per year, an average of $1,600 per family of four covered by an employer-sponsored health plan.
Despite spending so much more on healthcare, Americans have a lower life expectancy than their counterparts in other wealthy nations. In addition to substantially reducing costs, price transparency can improve U.S. health outcomes. According to a recent survey, 92% of Americans delay or abandon care because of costs. With financial certainty at known prices, consumers can get the care they need when they need it. Competition will also improve the quality of care. Such well-informed Americans can live longer and healthier lives.
Members of Congress should listen to their constituents’ frustrations with the opaque healthcare status quo and finish what they started when they return from summer recess. The overcharging horror stories that almost every American has under the current predatory billing dynamic should motivate lawmakers to pass the Patients Deserve Price Tags Act and Health DATA Act and fix the American healthcare system.
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Cynthia A. Fisher is founder and chairman of PatientRightsAdvocate.org. Arthur B. Laffer is founder and chairman of Laffer Associates.
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