Patients have a right to know what health care is going to cost

“For far too long, people have had no idea what they’re going to pay if they walk into a hospital.” So said Xavier Becerra, President

Joe Biden’s nominee for Health and Human Services secretary, at his recent confirmation hearings. “The American people are entitled to know what they’re buying.”

This commitment to health care price transparency from the nation’s presumptive highest health care official is welcome news for American patients, who have been forced to contend with a broken system where prices generally aren’t known until bills show up weeks and months after treatment. As a result of this bizarre pricing dynamic, visiting the hospital resembles roulette, where patients can only hope and pray that our ensuing bills won’t be ruinous.

If confirmed, Becerra can revolutionize American health care by enforcing and building upon a price transparency requirement that took effect at the beginning of this year.

Under the opaque status quo, nearly all Americans have a health care billing horror story. Consider mine: Two years ago, I had a bad case of bronchitis.

When I woke up one morning having trouble breathing, I called my physician, and he told me to visit urgent care. I went to a facility operated by Saratoga Hospital, and a physician assistant performed a 20-minute exam and chest X-ray to check for pneumonia.

I didn’t have pneumonia, and I

recovered shortly after with the help of an asthma inhaler. But a few weeks later, I received my bill, which took my breath away once more. The price of the visit was over $850, with the X-ray alone costing about $420. Because of my high-deductible health insurance plan, I was on the hook for the entire charge.

I challenged the bill, but the hospital representative told me it reflected my evaluation for “eight body systems,” including a psychiatric evaluation and cardiovascular exam. For bronchitis? The rep explained that New York state’s routine doctor’s office question, “Do you feel safe in your home?” constituted my psych exam, and the assistant’s quick stethoscope use amounted to a cardiovascular test.

With patients paying with the equivalent of a blank check, such overbilling is rampant. The Department of Justice notes that routine doctors’ visits and lab examinations are especially vulnerable to upcharging. According to a 2019 JAMA study, waste — including overbilling — makes up roughly 25 percent of American health care spending.

Help is on the way. This year, a new HHS rule took effect requiring hospitals to post their real prices, including their discounted cash and secret negotiated rates. This information will empower patients to shop for better-value alternatives for the roughly 90 percent of health care spending that’s not for emergencies. If I knew beforehand that my X-ray would cost $420, I would have gone to a less-expensive imaging center.

Compare my bill to the transparent prices at Walmart Health in Georgia, where an office visit is just $40, a chest x-ray varies between $24 and $41, depending on the number of views, and a 45-minute counseling session (if I wanted one) is just $60 for a new patient and $45 thereafter. These cash prices are about 90 percent less than the prices I paid, and they provide patients with peace of mind that they won’t incur additional surprise bills.

Hospital compliance with this rule has been spotty. For instance, Saratoga Hospital now lists its standard charges, but these are confusing, difficult to access, and not “all-in” prices.

By working to increase hospital compliance with both the letter and spirit of this rule, Becerra can help transform American health care into a pro-consumer system that grants patients like me real, up-front prices. Such transparency will hold hospitals accountable by allowing patients to easily remedy upcharging if our bills do not match — a process that’s currently extremely convoluted and often requires a lawyer.

It’s our health. It’s our money. And as Becerra noted recently, it’s our right to know real prices.