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Members of Congress have many legislative priorities to consider while back home in their districts during their summer legislative recess. One piece of legislation would have the biggest effect on Americans: A bipartisan effort to reduce crushing healthcare costs by requiring systemwide price transparency.
The Patients Deserve Price Tags Act, which recently passed a Senate committee, requires hospitals and health insurers to publish their upfront prices, including their negotiated rates by health plan, for all services.
Such meaningful price transparency can protect patients from rampant overcharges, which have caused half of Americans to say they can't afford healthcare, according to new Gallup polling.
Price transparency is supported by 90 percent of Americans of all backgrounds and political persuasions. No wonder it's reportedly Congress's "marquee bipartisan healthcare goal this year." So many of us have been burned by the opaque status quo.
Consider my story. In 2024, I had difficulty walking and was referred to a specialist for a leg muscle biopsy at a local doctor's office. Despite my best efforts, no one could tell me the price. Since I thought I had good insurance, I went ahead with this outpatient procedure that took less than an hour. Thankfully, the results ruled out an untreatable neurological condition.
Then the bills arrived.
First, a $1,059 bill from the doctor who performed the biopsy. This seemed reasonable, so I set up a payment plan. Then, a much larger bill -- $16,531 -- from the big hospital in town, which apparently owns the doctor's office I visited.
Part of this bill was a $4,464 hospital facility fee, even though the procedure could have been conducted in my kitchen. It turns out that big hospitals have quietly been buying up doctors' offices around the country so they can charge significantly higher prices.
There was also an egregious $8,030 charge for pathology.
My health insurance brought the hospital bill down to $3,122, so the total I owe out of pocket is $4,200. I'm still left wondering: What's the point in paying nearly $1,000 in monthly health insurance premiums if I'm left with such a large bill for a routine procedure?
While challenging this outrageous bill, I have gotten the typical runaround: calls go unanswered, false assurances that my bill is under investigation, and rehearsed, insincere responses. I never received a proper explanation from the hospital, which sent my bill to collections, endangering my credit score.
Almost everyone I know has a similar healthcare billing horror story. My son-in-law recently paid a $450 estimate for an outpatient procedure in Atlanta. His final bill was $15,000 after his insurer refused to cover it. It took him 10 months and dozens of phone calls to fix.
Price transparency can rebalance this predatory pricing dynamic by preventing overbilling. Patients could spot wide price variations for the same care, avoid price gouging, choose high-value treatments and benefit from competition.
My health journey is far from over, and I will need to depend on this system in the years ahead. I recently needed a chest X-ray but couldn't get an upfront price that included the mandatory reading from the out-of-network radiologist. I was unwilling to play Russian roulette, so I left.
After some research, I found a price-transparent imaging company that did the scan and radiologist reading for $277, less than my copay alone if I had gone through insurance, not to mention the certain high unknown radiologist charges.
From now on, I want to know what I'm paying for before the bill shows up. The Patients Deserve Price Tags Act would remove this pricing veil holding patients hostage from the care we deserve at costs we can afford.
Kerry Schrader is a retired human resources executive in Hoover, Ala. She wrote this for InsideSources.com.