Wyden: Let Americans know health care costs before visit

Senate Finance Committee Ranking Member Ron Wyden, D-Ore., announced Wednesday a new proposal to help Americans learn what they will have to pay for health care services before going to see a health provider.

Speaking at Health Datapalooza 2019, Wyden said the proposal would require health insurance companies and Medicare to share data on the cost and quality of health services with patients, and allow doctors to compare prescription drug costs to find the best deal.

“It is almost impossible to find a part of the American economy where it is harder to get reliable information than health care,” Wyden said. ” Today I’m announcing a new proposal to get millions of Americans better information about their health costs in a simple way . Health care is different than going to a grocery store, but it’s time to pull back the curtain so consumers can get a price check on ‘Aisle Health Care.’ ”

A one-page description of the proposal can be found here. Legislative text will be released at a later date.

Wyden’s full remarks, as prepared for delivery, can be found below:

I’m going to start off with what I believe is the basic challenge facing America when it comes to health care data. Our country is experiencing a tsunami of health care consumer data, pushing and pulling every health care decision. You have to be a health care Houdini to make sense of it all. Doctor’s offices have it. Hospitals have it. Insurers have it. Pharmacies have it. The government has it. Increasingly, our smartphones and smartwatches have it. The list goes on. Americans want that data to help them get better care and better costs, and they want it to be protected from thieves and rip-off artists.

So let’s start with a basic proposition: it is almost impossible to find a part of the American economy where it is harder to get reliable information than health care. You’ll hear all kinds of excuses for maintaining the status quo, mostly from special interests:

“The sticker price is not the real price.” “Patients won’t understand it – it’s too complicated.” “Every provider charges something different.”

In a nation that spends more than $3.5 trillion a year on health care, people ought to have easier access to information on the cost and quality of what they’ll have to pay.

Today, I’d like to describe a new proposal for millions of Americans to get – and more simply – better information about their health care. The proposal has three parts.

First, when deciding about your health care, it all starts with making it easier for consumers to find out how much their care will cost, from A to Z. Second, because quality is intertwined with cost, this proposal allows people to compare providers by quality in addition to price. Third, because prescription drugs are the fastest growing part of American health care spending, this proposal will include a fresh strategy for empowering patients and their doctors to get the best deal for prescription drugs.

Here’s a little more detail on each part.

Here’s how it works for the more than 200 million Americans who get their health care through Medicare or a health insurance company: they can make one call or go to one place online and find out how much they will have to pay for any service or procedure. You may be wondering if this is doable, but the fact is health insurance companies and Medicare already have this pricing data. It’s time to stop playing keep away from paying customers and taxpayers.

It will let consumers search for more than an individual service – people ought to know how much the whole deal costs. For example, not just your knee surgery – that won’t give you the whole picture. There’s the MRI, the post-surgery care, and the physical therapy. It’s essential that people see the whole cost of treating an ailment, not just a slice.

Americans don’t just want affordable care, they want the highest quality care. It doesn’t do someone much good to get cheap treatment that’s lousy, because they’ll just end up needing more care later. We also don’t want patients unknowingly throwing good money after bad care. That’s why including data on quality collected by Medicare or health insurance companies is so important for those comparing their care options, and they’ll get it the same way they get information about costs.

Now let’s talk about prescription drugs, because that’s another area where Americans are getting clobbered by high costs. I’ve led the fight in the Senate to lower list prices for unaffordable prescription drugs, to shine a bright light on the patents and pricing schemes that are protected like Gollum with his ring, and to hold Big Pharma accountable when they are gouging people with price increases that are unjustified. I’m optimistic that Congress will take real action this year.

Here’s another step in the right direction: giving doctors and their patients access to drug cost information during the appointment. Today when you go to your doctor, you get a prescription and you’re on your way to the pharmacy with zero idea of what’s ahead. You don’t know what your bill is going to look like, if the lowest cost drug was prescribed, or whether you can get a better deal at a different pharmacy down the street. Under my proposal, doctors can tell their patients about all the options so they can, together, choose the best deal for them. This builds on current federal electronic records policy so that when a physician logs on to prescribe a medicine, they’ll have a simple way to discuss alternatives.

Here’s my bottom line. In a grocery store, you can get a price check for a can of peas on Aisle Two. Health care will never be like that. You aren’t going to look up the price of fixing your broken leg when you’re already in the ambulance heading to an out-of-network hospital. But it ought to be a lot easier for people to get information when you have to buy health care when it’s not an emergency. It’s time to pull back the curtain and get the equivalent of a price check on “Aisle Health Care.”

Before I close I want to briefly talk about privacy. I have proposed a new law to deal with privacy in the online world. In health care we have HIPAA, which has done a good job to protect the personal information of patients. At the same time, health care companies handle vast amounts of information and need to be under the same legal jeopardy should they fail to adequately safeguard it. A leak of health care information like what we’ve seen from retailers, governments, and credit services would be devastating, the folks responsible for holding your information should behave accordingly, and be subject to serious legal consequences if they fail to do so.

As advocates of using data to improve people’s lives you all understand the potential for aggregate health care data to contribute to significant public health breakthroughs. I want to work with you to ensure that these privacy protections are iron-clad while allowing for research aimed at improving the health of all Americans.

As far as this proposal, let’s put this conversation in the “to be continued” column. I’m counting on all of you who are interested in this effort to work with me in the coming weeks to make health care as painless as possible for Americans that continue to be frustrated with the way the system is today. Empowering consumers to learn about the prices they pay is an important start to bringing transparency to a market that is out of whack.