re: Trump to force Hospitals to disclose their prices

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Dude the insurance companies negotiate the price with the hospital.

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The hospital sets prices. It then negotiates discounts to various insurance companies off those set prices. In the case of obamacare insurance companies, those negotiations are increasingly with one insurance provider.

Price disclosure could be based on nondiscounted fee, average negotiated fee, or suboptimally it could be formulated/extrapolated per facility based on CMS billing data. Any or all of those, and could be basis for reasonable approximations..

What good would it do?

Well, for example if one hospital runs a series of Family Medicine Clinics predominantly using MDs while the another hospital system employs Nurse Practitioners or rotating providers for the same or higher charge, a patient might want to know that in advance. Especially if there is copay exposure.

If one facility outsources path or lab results to an uncovered provider while another does not, charge differentials could be significant. Patients should be apprised of that cost in advance.

But a significant benefit would arise in the fact most hospitals are run so inefficiently that the individuals who are actually generating charges have no clue as to what is expensive and what is not. Ask a surgeon the cost differential between two fairly interchangeable sutures --- often he'll have no clue. Ask an RN cost differential between two IV cannulas -- same thing, no clue. Ask an administrator the cost of not having enough clean up crews for an OR, they might well respond "the fewer the better". . . . ie not a clue. Nor in many (most) cases do facilities have good insight into innumerable cost sinks. Much of that would become apparent and therefore addressable with price transparency.

From an insurance end, if two facilities charge significantly differently, yet insurance does not pass those potential savings to patients, folks should know that.

Forcing price determination and direct interfacility numbers publication would change the dynamic.

If you need personification here, look no further than our own illustrious BamaAtl. The poor guy picks up a check twice a month without so much as a hint of a clue as to what his employer actually charges for his services or what actual costs he is imparting.

Bottomline, our current third payer structure places considerable distance between care and patient charge. As a result inefficiencies go unrecognized, innovative cost-reduction opportunities are lost, and the system hemorrhages money.