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Wednesday, November 4, 2020

ANALYSIS/OPINION:

We live in a world with instant access to information through our computers, smart phones and even our watches. Set your phone up with the right apps and you can instantly know the amount of money in your bank account, the time it will take to drive to work, your child’s grades, the price of a pound of bananas at the grocery store, and if you left your front door unlocked. 

But when it comes to your No. 1 priority — the health of you and your family — the information superhighway has yet to reach you. This roadblock has created deep dysfunction in America’s health care system. 


Critics claim President Trump has no health plan. But the truth is, for nearly four years, the president has been methodically implementing a comprehensive plan that finally addresses the underlying problems in America’s health care system to deliver lower costs, better care and more choice.

A central piece of this plan uses free market principles — the same principles that reliably drive innovation across every industry — to create a system in which providers are competing for patients on the basis of cost and quality. This begins with giving patients the price information they need to make sound decisions with their doctors.

Clear pricing is particularly critical to ensure providers compete to deliver lower costs. Yet, insurers and providers work hard to keep patients from seeing prices before they receive care. Instead, prices come afterward when patients receive their Explanation of Benefits, often even when patients haven’t yet met their deductible and must pay the full negotiated price. 

Mr. Trump has stood strong against these special interests over the past four years and has been implementing a health plan that puts patients first. 

Every patient has a right to know the price of their care upfront. Anything less is unacceptable. 

Just last week, the administration unveiled the most consequential part of the president’s health care plan and finalized a rule to once and for all make health care pricing information transparent to the 200 million Americans who rely on private health coverage. Combined with a rule that applies to hospitals that goes into full effect on Jan. 1, 2021, this policy represents an unprecedented level of price transparency that will benefit consumers and drive down health care costs. 

These price transparency rules build on several other important policies to empower patients with the information they need to be intelligent consumers. That involves not just price but also quality. We’ve unveiled the first-ever Medicaid & CHIP Scorecard to provide much-needed transparency on how well Medicaid is serving its beneficiaries, as well as Care Compare, making it easier for patients to research the quality of care between different health care providers and facilities before receiving care.

Access to health records is another key piece of information patients need. Incredibly, after the previous administration spent $36 billion on electronic health records, patients still rely on faxes and, in many cases, must pay extra to retrieve their own health record from their doctor. 

This is plainly intolerable in this information age. That’s why the president has required all qualified health plans doing business in Medicare, Medicaid and the federal exchanges to allow patients to access their personal health care claims data electronically. We have also penalized doctors and hospitals for hoarding health information and restricting access to patient records and instituted additional requirements for health IT companies to ensure that every patient can access their medical record. Altogether, nearly every American will gain access to their health data under these initiatives.

Disappointingly but perhaps unsurprisingly, massive hospital conglomerates have gone to court in their attempts — so far unsuccessful — to cling to their privileged position and keep patients in the dark. Only time will tell if insurance companies will resort to the same tactics to keep their prices hidden. 

But what’s beyond doubt is that the special pleading of the big players in the health care system will never dissuade this president from fighting for ordinary patients. When it comes to lowering costs, improving care and increasing choice for the American people, nothing less will be sufficient.

• Seema Verma is administrator of the Centers for Medicare and Medicaid Services (CMS).


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