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Career Opportunities in Pharmacy
Trump pushes for new transparency with health care prices — but will it lower them?


NICK SCHIFRIN: National polls show Americans
believe health care prices and drug costs are among their top pocketbook concerns. Today, President Trump took aim at hospitals
and insurers, with executive orders requiring more transparency around what patients actually
pay. But there are questions about the extent to
which the orders will help patients, and whether they could have unintended consequences. The president’s announcement today comes as
the public is increasingly angry about surprise medical bills. Right now, hospitals and insurers keep patients’
costs for procedures as secret proprietary information. Today’s executive order would require health
care providers to disclose before treatment what patients will have to pay. The hope is that patients could shop around
for better prices. Surprise medical bills come when insured patients
are treated at a hospital by a doctor not in the same insurance network. That is what happened to Andrew Haymann, who
was treated by a plastic surgeon for a shard of glass in his ankle at an E.R. He told Megan Thompson of “NewsHour Weekend”
his share of the bill was $5,000. ANDREW HAYMANN, Patient: I’m thinking, there’s
no way I’m going to pay this. This is insane. It’s kind of almost like, whatever, if you
want to call it false advertising, when you get some kind of a crazy bill from someone
who’s not in the network, and you really had no control over the fact that that — that
they would be there. NICK SCHIFRIN: A new study by the Kaiser Family
Foundation found that after treatment at a hospital in 2017, about one in six Americans
were surprised by a medical bill. The order issued by the president today doesn’t
directly address those bills, but it does require hospitals and doctors to disclose
the discounted prices that they are negotiating with insurers. President Trump says true cost transparency
was overdue. DONALD TRUMP, President of the United States:
And there’s no consistency, there’s no predictability, and there’s frankly no rhyme or reason for
what’s been happening for many years. We believe the American people have a right
to know the price of services before they go to visit the doctor. Prices will come down by numbers that you
won’t even believe. You won’t even believe it. NICK SCHIFRIN: So, would these moves help
bring down patients’ costs? We explore that question with Elisabeth Rosenthal,
the editor in chief of Kaiser Health News and author of “An American Sickness” about
the costs of the health care system and its impact on patients. Thank you very much for coming on to the “NewsHour.” When Secretary of Health and Human Services
Alex Azar today previewed the president’s executive order, he said this: “This was one
of the most significant steps in the long history of American health care reform.” Is it? And will it be effective? ELISABETH ROSENTHAL, Editor in Chief, Kaiser
Health News: Well, it’s important. Transparency is good if you get an accurate
estimate of your out-of-pocket costs. You can make consumer decisions in elective
surgeries, elective admissions. So, in that sense, it’s good. I think what’s more debatable is, we know
now that he wants the hospitals to give us the rates that they negotiate with insurers,
which are much less than the list prices. So how will patients use those? And how will that be defined? I think that’s a big question. NICK SCHIFRIN: So that seems to me the key,
right? Will patients, will we get the actual cost
that we will owe after our insurance covers whatever? Or are we going to get something different,
perhaps even what the hospitals owe? ELISABETH ROSENTHAL: Oh, well, that’s a big
question, right? If I go to a contractor and say, I want my
kitchen renovated, and he gives me an estimate of $1,000, and then asks for $5,000, I say
no. You can’t do that in hospitals, because you
have already had the care. NICK SCHIFRIN: These numbers, these values,
the costs that we’re talking about that we pay out of our pockets, these are proprietary. These numbers, the insurers say that they
don’t want to give this up. So they don’t want us to shop around. How bad are they going to fight this? ELISABETH ROSENTHAL: Well, they are fighting
it very hard. And they have actually said, well, if you
release these prices, these insider deals, prices could actually go up, which is very
counterintuitive. But in health care, we often see that if one
person is charging less, and they see that the company next door is charging twice as
much, they will raise the price to that sticky ceiling. It’s called sticky pricing. So it all depends on whether there’s a real
consumer market where we, the patients, or our insurers can really compare prices and
go for the bottom one. NICK SCHIFRIN: And will these executive orders
today, will it create that market? ELISABETH ROSENTHAL: Not in and of itself. It’s a long road before that. I mean, it will help. I think any transparency is good. Technology can help us get us to meaningful
prices and competition. But whether there’s the will to get us there,
hospitals, insurers may not want that out in the open, because, you know, they don’t
really want the market to work here always. NICK SCHIFRIN: And bottom line, why have these
issues become such a pocketbook issue for Americans? ELISABETH ROSENTHAL: Well, a lot of forces
are coming together right now. First of all, a lot of us have high deductible
plans. So we’re paying these bills out of pocket. Another thing is, there are narrower networks. So we’re often more — we encounter more surprise
bills. And another thing is, in the old days, doctors
— I was a physician — we were employed by hospitals. So the hospitals could control what we charge. Now most doctors in hospitals are contractors. That includes the E.R. doctor, the intensive
care doctor taking care of your newborn. And they can charge kind of whatever they
want. And those rates are not apparent until you
get your EOB in the bill. And then you’re stuck, right? You can’t say, oh, well, I would have taken
my baby elsewhere. That just doesn’t make any sense. So whether it can become a meaningful market,
I think it’s really up in the air. NICK SCHIFRIN: Elisabeth Rosenthal, editor
in chief of Kaiser Health News, thank you so much. ELISABETH ROSENTHAL: Thanks for having me.

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