San Antonio Express-News

Medical price transparen­cy saves families thousands

- By Mike Walls Mike Walls is the executive director of Caring Senior Service of Brazoria County and Revered Texan Hearth & Home.

When my daughter needed surgery for her perforated eardrum, my wife and I didn’t know what to do. We didn’t have insurance and were nervous about how a bill would affect our finances, but taking care of our daughter was our first and highest priority.

We contacted various hospitals and surgery centers to get a sense of how much the surgery would cost, but no one would give us a precise number. I ultimately ended up with two separate “ballpark” estimates: one of $15,000 to $25,000, and one of $30,000 to $40,000.

It seemed like the providers I spoke to were making up numbers and no one was giving me a straight answer. I wasn’t an insurer and didn’t have any power, which meant hospitals and surgery centers weren’t taking my inquiries seriously.

Thankfully, I discovered the Texas Free Market Surgery website and found the cost of the tympanopla­sty surgery my daughter needed. Shockingly, it was only $5,000.

My daughter’s surgery was a complete success.

My family made the choice to shop around for medical care instead of paying for insurance. Over the past 14 years, we have saved money, consistent­ly paying less for bloodwork and standard procedures than the typical copay.

Unfortunat­ely, not everyone can do this because of the complicate­d and opaque nature of the insurance system. I have worked in the health care industry for decades, and sometimes even I don’t understand what is happening.

My family’s experience shows the need for increased price transparen­cy in the health care marketplac­e. When we go to a restaurant, we expect to know the prices before ordering a meal, and there is no reason health care should be different. When a family is about to make a life-altering decision, they deserve to know the price upfront.

Thankfully, a new order — the Price Transparen­cy Rule — went into place on Jan. 1 that requires hospitals and medical providers to publicly reveal their real prices. This rule will lower health

care costs and ensure that families like mine will have a wide array of options when making important decisions.

Price transparen­cy increases flexibilit­y by allowing people to shop around for the specific care they need without worrying about getting hit with surprise bills after the fact. We were always going to get our daughter the best care possible, but it was an immense weight off our shoulders to know her surgery

wouldn’t cripple us financiall­y.

Other families can also save big with price transparen­cy because hospitals and insurers will have to lower their prices to compete with transparen­t providers or face losing business. These savings go directly to families who could use this money to help achieve their financial goals.

Under the new price transparen­cy rule, people also will be empowered to become more invested in their medical care.

Without transparen­cy, there is a wedge between patients and doctors because average Americans are scared of surprise bills; one-third of Americans have avoided seeking treatment because they were worried about being bankrupted by a surprise bill.

Enacting health care price transparen­cy ensures American families don’t have to worry that getting the care they need will push them over a financial cliff.

Increasing price transparen­cy brings together people from all background­s. Americans want to know how much they are paying for care just as they do with every other financial decision that they make.

My daughter was able to have complicate­d surgery at a stunningly low price because of health care price discovery. We are excited that price transparen­cy will be the new normal. Much of the country has struggled immensely because of COVID-19, and price transparen­cy is a tangible reform that alleviates financial pressures on all Americans.

 ?? Brittany Hosea-small / Special to the San Francisco Chronicle ?? Price transparen­cy allows patients to make informed decisions about their medical care.
Brittany Hosea-small / Special to the San Francisco Chronicle Price transparen­cy allows patients to make informed decisions about their medical care.
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