Empowering patients through price transparency

This article was originally published in the Washington Examiner

By Brett Guthrie

In the first few months of the 118th Congress , the Republican House majority has already delivered wins in holding the Biden administration accountable and advancing solutions to help the public live healthier and longer lives. We have passed a number of important policies, including one finally to terminate the COVID-19 public health emergency , an effort that I was proud to lead. We also moved to end the COVID-19 national emergency declaration and end the one-size-fits-all, federal COVID-19 vaccine mandate on healthcare heroes that has forced thousands of these front-line workers to choose between the COVID-19 vaccine and their jobs.

As chairman of the House Energy and Commerce Committee’s Subcommittee on Health, I am working to deliver solutions that empower patients, crack down on illicit fentanyl, and make healthcare more affordable and accessible. For example, the Health Subcommittee is taking action permanently to schedule fentanyl-related substances as a Schedule I drug and address the flow of these illicit drugs over the southern border. Further, we are leading on banning federal programs from using “quality-adjusted life years,” a metric used arbitrarily to determine the value of someone’s life, and one that discriminates against people with chronic illnesses and disabilities.

Our country’s most formidable healthcare challenges are rooted in ever-rising healthcare costs and a lack of basic transparency. Despite our country spending more than $4 trillion a year on healthcare, or about $13,000 per person, patients are not able to make informed decisions about how and where to spend their money as they can in virtually every other industry.

Not long ago, a constituent contacted me. He was frustrated because he could not find the price to get a routine health procedure done. He had health insurance and was trying to find high-quality care at the best price within his budget. Unfortunately, this is a frustration shared by millions. It can and should be easier for all patients to know costs before they receive care.

Thankfully, there are bipartisan solutions to make healthcare pricing more transparent and the healthcare system easier to navigate for patients. These include the Centers for Medicare and Medicaid Services hospital price transparency rule and the multidepartment transparency in coverage rule, which were initially issued under then-President Donald Trump and continued by the Biden administration. These rules require hospitals to post publicly the prices of hundreds of common procedures on their website in a user-friendly format and require private health plans to disclose information about pricing and what patients are obligated to pay.

This information gives patients, such as my constituent, and employers that pay for health insurance for their employees more bargaining power and some peace of mind to know how much their health procedure would cost ahead of receiving care. Greater enforcement and patient-friendly updates through codifying these important transparency rules would create greater competition among healthcare providers and allow patients and employers to shop around for better healthcare deals.

Price transparency can also provide insight on why the costs of care are rapidly increasing. Exposing prices would help show whether healthcare services are priced correctly and give policymakers a clearer look at the value, or lack thereof, of some of the many steps in the healthcare supply chain.

At the end of March, the Health Subcommittee will hold a hearing on healthcare affordability to examine these price transparency rules and other policies that promote more choices and drive down the costs of care for patients.

Congress should also consider solutions to ensure the public and its employers are getting the best possible deal on their prescription drug benefits. We should build on our bipartisan work to save our healthcare system billions of dollars and make pharmacy benefit managers be more transparent. Shining a light on these middlemen who are making prescriptions more expensive is one important step to bolster competition and allow for affordable new drugs, such as generics and biosimilars, to be made available for patients.

Further, patients, especially seniors, are unnecessarily paying more money for the same service simply because of the location where it was delivered. It’s time to examine carefully the root causes of these inefficiencies that are plaguing patients with higher costs and more confusion. Ultimately, these collective and targeted solutions can more meaningfully reduce the costs of care across the healthcare system.

In our current divided government, I am working on achieving many “first downs” on healthcare priorities that can be signed into law and drive down the costs of care for millions and their families. I’ll work with any colleague, Republican or Democrat, who shares the goal of getting these important policies across the goal line.

Brett Guthrie is a U.S. representative for Kentucky and the chairman of the Health Subcommittee on the House Energy and Commerce Committee.