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Trump’s healthcare fix should be the norm

Gerald Gianoli

As a physician, I find a lot to like about Mr. Trump’s recently released healthcare plan. No other candidate has brought up price transparency, but it goes to the heart of a true free market in medical care.

I am a third-party-free physician and charge a fee for services rendered, but I have no contract with any insurer or with Medicare. Patients pay me, and my office gives them a claim form to submit to their insurance company for reimbursement. The patients are told in advance, before they even schedule an appointment, how much the visit will cost.

I have to keep my prices competitive, or patients will go elsewhere.

By contrast, ask a doctor or hospital who accepts your insurance how much it will cost for anything (or even ask the insurance company). They will not be able to tell you. They really don’t know. The charged fees, which are multiples higher than what they expect to receive in payment, bear no relationship to what you will ultimately pay. The bottom line: No one knows how much you will owe until about two months after services have been rendered.

What happens when prices are transparent? Price transparency fosters competition, which fosters lower prices and higher quality. Just look at the cost and quality of refractive eye surgery. In the past 10 years the prices have gone way down while the quality has steadily improved.

Obamacare has institutionalized price opaqueness. Without self-payment, there is no source of information about the market price. Prices will rise. And quality will continue to decline, as health insurance plans limit options to whatever hospitals and physicians are “in-network.”

So, the current healthcare market restricts your choice of doctors and hospitals, and prevents you from knowing the price you will pay until after you receive the services.

Transparent pricing should be the norm for all medical services. When transparent pricing becomes the norm, we will see how overpriced services have become inside the insurance-payment system.

Dr. Gerard Gianoli is in private practice at the Ear and Balance Institute.