Maine Voices: We Must Hold Hospitals and Government Accountable for Health Care Costs



Since ancient times, a fundamental tenet of medicine has been that physicians should “do no harm first” to our patients. Today we must also add “do no harm financially”. The best way to achieve this, and to protect the finances of our patients, is through full price transparency.

The ability to see and compare prices would pave the way for price competition, lowering the cost curve for a change, allowing patients to buy the best value for their healthcare dollar and slow down the unhealthy trend of consolidation in the healthcare industry.

Fortunately, since the first of this year, a new transparency rule for hospital prices went into effect, giving Americans the right to know the price of their health care in advance.

The problem is that many hospitals in our state do not follow federal law. A report released last month by a national nonprofit showed that the vast majority (94.4%) of hospitals, including most of those in Maine, were not following the rule.

They claim they cannot comply because the information is not readily available, which offends the intelligence of the average Mainer. All of these hospitals have multi-million dollar billing systems that can, and do, generate patient and insurance company bills on demand. We all see the price in explaining the benefits we receive – after receiving health care, we cannot come back. Obviously, they know the prices but don’t want to divulge them. There is no reason why, upon request, hospital billing staff cannot enter a particular department’s procedure code (called a CPT code) and display in advance the price charged by the hospital. ‘hospital. If hospitals really cannot do this, perhaps intensive audits of their accounting systems should be carried out.

While doctors are often blamed for rising health care costs, I assure you that we want what patients want. We also want to know the prices, but hospitals and insurers are also keeping us in the dark. It has always been unethical, and now it is criminal.

I wrote to Maine Attorney General Aaron Frey asking him to help enforce the law and hold hospitals to account. To do this, our government must significantly increase the financial penalties imposed on hospitals that do not comply with the rule. Currently, the penalty is only $ 300 per day. Worse, the government has no fine to a single hospital yet for breaking the government’s own rule. What is the use of a toothless law? The fine should be 10 times higher, or $ 300 per day per hospital bed, and be strictly enforced. We also need to eliminate the loophole in the rule that allows hospitals to simply provide estimates, not guaranteed prices. By their complacent inaction, the government is sending the message that these hospitals, most of which are non-profit and therefore do not pay taxes, are above the law. Perhaps the state of Maine should reconsider the tax-exempt status of any hospital system that does not comply with this all-important consumer protection.

We have a long way to go to fix our failing healthcare system, but demanding what is rightfully ours, the right to know the cost of care before we receive a surprise bill, is an essential step. The Mainers deserve nothing less and should demand nothing less.

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