By Jane Norman, CQ Healthbeat Associate Editor
October 28, 2010 -- If Republicans take over the House it could mean some movement on mandating greater disclosure of prices charged by doctors, hospitals, and other health care providers. It's a favorite suggestion among members of the GOP as a way to keep rising health care costs in check and a possible source of bipartisan legislation with sympathetic Democrats.
"For individuals and families to shop for their health care, they must have a better sense of what they are expected to pay—and what they are getting for their money," says Republican Rep. Paul D. Ryan in the section on health care in his "road map" proposal. Ryan is the frontrunner to be Budget Committee chairman if the GOP captures the House. "Making data on the pricing and effectiveness of health care services widely available is critical to the success of an effective health care marketplace," Ryan says.
Interest in the issue has been bipartisan but it has been strongly pushed by Republican Rep. Michael C. Burgess of Texas, a physician who would be a key player on health issues in the Energy and Commerce Committee next year. He said in an interview that the medical pricing idea probably will be the subject of congressional hearings if the GOP wins the House.
Three bills aimed at price transparency were introduced in the current Congress, one by Democratic Rep. Steve Kagen of Wisconsin (HR 4700), another by Burgess with Democratic Rep. Gene Green of Texas (HR 2249), and a third by Republican Rep. Joe L. Barton, who wants to regain the Energy and Commerce chairmanship (HR 4803). There wasn't any companion legislation in the Senate.
Burgesss said that he had strong support from outside groups for his approach. "Like it or not, that is important," he said. The Burgess-Green proposal would mandate that state Medicaid programs require hospitals to publicly disclose prices and estimated out-of-pocket costs for services.
Barton would require private and public health plans to provide enrollees with information on covered items and services. He would also require hospitals and ambulatory surgical centers to disclose costs for the services they typically perform.
Democrat Frank Pallone of New Jersey, chairman of the Energy and Commerce Health Subcommittee, held a May 6 hearing on the three proposals but didn't push further action. Burgess and Green's bill also was incorporated in initial Democratic health care proposals, aides to Burgess said.
Pallone said he likes the transparency concept but experts have cautioned that lawmakers should proceed carefully because purchase of medical treatment "is not like going out and buying a TV or a new car." Patient choice is limited by insurance plans and patients may not want to go against a doctor's wishes to find a lower price, Pallone said.
But Republican Rep. John Shimkus of Illinois said it's impossible to find out what medical services cost and patients rarely find out the true cost of health care services. "Without this information we take the power away from consumers and prevent a market based system from functioning," he said.