Maine Voices: We need to hold hospitals and the government accountable for healthcare costs

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Since ancient times, one of the most important tenets of medicine has been that doctors should “do not harm our patients first”. Today we must also add “do no financial harm”. The best way to do this and protect our patients’ finances is with complete price transparency.

The ability to see and compare prices would usher in price competition that would bend the cost curve down for a change, allow patients to buy the best value for their health care spending, and the unhealthy consolidation trend in the world Slow down the health industry.

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

The problem is, many hospitals in our state do not comply with federal laws. A report released last month by a national nonprofit showed that the vast majority (94.4 percent) of hospitals, including most in Maine, did not follow the rule.

They claim that they cannot do it because the information is not readily available, which offends the average Mainer’s intelligence. All of these hospitals have billions of dollars worth of billing systems that can and do bill patients and insurance companies as needed. We all see the prices in the explanation of the benefits we receive – after we have received medical care, we cannot return. Obviously they know the prices but don’t want to reveal them. There is no reason why the hospital accounting staff could not, upon request, enter the procedural code of a particular service (called a CPT code) and display the price that the hospital charges in advance. If hospitals really cannot do this, then perhaps their accounting systems should be scrutinized.

Although doctors are often blamed for rising healthcare costs, I assure you, we want what patients want. We also want to know prices, but hospitals and insurance companies also leave us in the dark. It’s always been unethical, now it’s criminal.

I wrote to Maine Attorney General Aaron Frey asking him to help enforce the law and hold hospitals accountable. To do this, our government must drastically increase the fines for hospitals that do not adhere to the rule. Currently the fine is only $ 300 per day. Worse still, the government has not fined a single hospital for failing to adhere to the government’s own rules. What good is a law without teeth? The fine should be ten times or $ 300 per day per hospital bed and should be vigorously enforced. We also need to address the loophole in the rule that allows hospitals to only provide estimates rather than guaranteed prices. By complacently inaction, the government is sending the message that these hospitals, most of which are non-profit and do not pay taxes, are above the law. Perhaps the state of Maine should review the tax exemption of any hospital system that does not comply with this very important consumer protection.

We still have a long way to go to mend our broken healthcare system, but demanding what is rightfully ours, the right to know the cost of care before we get a surprise bill, is an essential step. Mainers don’t earn less and shouldn’t ask less.


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