Health and Human Services Secretary Michael Leavitt spoke to the American Health Lawyers Association on June 26th. One of his topics was the need for transparency in the pricing of healthcare. He stated that for the duration of this administration, one of his top priorities would be promoting the need for healthcare providers to fully disclose their pricing to the public. The text of his comments is not yet up on the HHS website but I expect it will be sometime soon.
We hear a lot along these lines nowadays. It is odd to me that there is so much talk about the need for providers to fully disclose their pricing arrangements when, at the same time, health insurers so often do a terrible job at providing information to consumers about how the cost of medical treatment will be split between the insurer and the insured under a health insurance policy.
For example, many health insurance policies state that if an insured goes to a non-preferred provider, the insurer will pay only the amount a preferred provider would accept and the patient is responsible to pay the difference between that amount and the billed charge. So you would assume that an insured can call up the insurer and find out what the preferred provider payment for any given procedure is? Dream on. Getting information about the specific amount of that payment before the procedure occurs so the insured can shop around is next to impossible. Insurers view it as proprietary information. Unlike what is happening to providers, I don’t see anyone pushing insurers to open up their records, even for their own insureds.
Insurer stonewalling is especially offensive when there is a direct contractual relationship between the insured and the insurer. That creates more of a duty to be openhanded with information than any relationship between a healthcare provider and the public at large.