President Trump signed an executive order Monday afternoon to bring transparency to hospital and physician fees.
Trump signed the order surrounded by physicians from the Docs4PatientCare Foundation (D4PCF) in the Oval Office. The order aims to provide transparency in the cost and pricing of the nation’s healthcare system by showing prices to patients.
The D4PCF, a healthcare organization composed of physicians with hands-on, practical knowledge of the American healthcare system, met Trump’s order with excitement.
“The executive order will provide immediate action and immediate relief to patients” Dr. Lee Gross, president of D4PCF, told Newsmax hours before participating in the signing at the White House.
In a dramatic shift, the order will also allow patients to use their Health Savings Accounts for direct primary care in hopes of strengthening the relationship between the physician and their patients without disruptions from third-party actors or insurance companies.
Without exception, the physicians who spoke to Newsmax prior to the signing ceremony at the White House agreed the executive orders were a “major step in working around” the Affordable Care Act.
They also agreed that this step toward deregulation of healthcare is set to disrupt advocates of Medicare for All, — poised to be a hot topic for discussion in the Democratic presidential debate later this week.
Many candidates at the debate are certain to underscore the view that healthcare is a right for Americans, rather than a choice.
The vision of future healthcare championed by some Democratic presidential platforms was not shared by the physicians who spoke to Newsmax.
“Medicare for All will be the ultimate loss of transparency,” Dr. Katarina Lindley of Brock, Texas, told Newsmax.
“If we’re ever going to fix the prices [of medical services], we have to know what [the prices] are,” said Dr. Chad Savage of Brighton, Mich.
Regarding a lack of transparency in healthcare prices, Savage said “what you don’t know can hurt you.”
He added that the overall goal of the executive order is to expand choices of physicians for Americans to lower healthcare costs, and that this issue is “uniquely bipartisan.”
But insurers said the idea could backfire, prompting hospitals that now give deeper discounts to try to raise their own negotiated prices to match what high-earners are getting.
Trump's order also requires that patients be told ahead of time what their out-of-pocket costs like deductibles and copays will be for many procedures.
Little will change right away. The executive order calls for a rule-making process by federal agencies, which typically takes months or even years. The details of what information will have to be disclosed and how it will be made available to patients must be worked out as part of writing the regulations. That will involve a complex give-and-take with hospitals, insurers and others affected.
Consumers will have to wait to see whether the results live up to the administration's promises.
"For too long it's been virtually impossible for Americans to know the real price and quality of healthcare services and the services they receive," Trump said at the White House. "As a result, patients face significant obstacles shopping for the best care at the best price, driving up healthcare costs for everyone. With today's historic action, we are fundamentally changing the nature of the healthcare marketplace."
Health and Human Services Secretary Alex Azar told reporters earlier that the order "will put patients in charge and address the drivers of high healthcare costs...increasing choice and competition."
Lack of information on healthcare prices is a widespread problem . It's confusing for patients, and experts say it's also one of the major factors that push up U.S. costs. The same test or procedure, in the same city, can cost widely different amounts depending on who is performing it and who is paying the bill. Hospital list prices, which are available, don't reflect what they actually get paid by insurers and government programs.
The health insurance industry said disclosing negotiated prices will only encourage hospitals that are now providing deeper discounts to try to raise their rates to match the top-tier facilities. "Publicly disclosing competitively negotiated proprietary rates will reduce competition and push prices higher — not lower — for consumers, patients, and taxpayers," Matt Eyles, head of the industry group America's Health Insurance Plans, said in a statement.
While the prices Medicare pays are publicly available, private insurers' negotiated rates generally are not. Industry officials say such contractual information is tantamount to trade secrets and should remain private.
Azar pushed back against that argument, saying insurers do ultimately disclose their payment rates when they send individual patients an "explanation of benefits." That's the technical term for the form that patients get after they've had a procedure or seen the doctor.
"Every time one of us goes to a hospital, within a couple of weeks there arrives an explanation of benefits that contains the list price, the negotiated price, and your out-of-pocket cost," Azar said. "This is not some great state secret out there." He said "that information is out there, it just needs to be presented to patients at the right time, in the right format, so it can help drive decision-making for them."
Trump's executive order also calls for:
- expanded uses for health savings accounts, a tax-advantaged way to pay healthcare bills that has long been favored by Republicans. Coupled with a lower-premium, high-deductible insurance plan, the accounts can be used to pay out-of-pocket costs for routine medical exams and procedures.
- a plan to pull together the government's various healthcare quality rating systems for hospitals, nursing homes, and Medicare Advantage plans, improving reporting of information to consumers.
- more access by researchers to healthcare information, such as claims for services covered by government programs like Medicare. The data would be stripped of details that could identify individual patients.
Clare Hillen is a sophomore at George Washington University, and a summer intern at the Washington, D.C., bureau of Newsmax. The Associated Press contributed.
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