by Tracey Owens
Ohio state legislators are putting the finishing touches on bipartisan legislation to make healthcare more affordable and accessible. This week, state representatives and senators are working in conference to negotiate the final text of hospital price transparency legislation each chamber has passed versions of. They must pass this vital patient protection before the legislative session concludes at the end of the week, and Gov. DeWine must sign it into law.
Like many Ohioans, I learned about the importance of upfront hospital prices the hard way. After experiencing intense abdominal pain last year, my physician told me I needed umbilical hernia surgery — a four-hour outpatient procedure at a hospital in Barberton. The surgery was a success, and I wasn’t overly concerned about the cost because I have good insurance through my husband’s union job.
But then the bills came. The hospital charged $14,437, of which my insurance paid $11,640, leaving me on the hook for $2,797 out of pocket. I was shocked. My husband and I pay $14,000 a year in premiums for our health insurance (not including the premiums his employer pays).
What’s the point of this massive annual cost if we can’t get the care we need covered? Sadly, American health coverage doesn’t protect you from medical debt.
This bill seems to be a clear case of price gouging. According to Sidecar Health, the average outpatient hernia price in Ohio ranges from $5,220 at a surgery center to $7,495 at an outpatient hospital. According to MDsave, the average cost is $6,441. In other words, the hospital I attended charged me around double the average cash price.
Since there’s no way I can afford this bill, the hospital put me on a payment plan. For the last 17 months, I have paid $115. Earlier this year, the hospital inexplicably added $715 to my outstanding balance — a surcharge I’m powerless to fight.
Price transparency, as articulated in the Ohio legislation, empowers patients to avoid such outrageous healthcare costs and choose affordable care. It goes without saying that if I could have had access to hospital prices beforehand, I would have never agreed to this surgery at this hospital. I would have shopped for a quality, less expensive alternative.
Price transparency levels the power imbalance between the healthcare industry and patients. It forces hospitals to compete over price and quality, just like everywhere else in the economy, putting downward pressure on costs.
Employers and unions can use hospital price disclosures to structure higher-value group health plans and share the savings with employees in the form of lower premiums and higher wages. According to the National Federation of Independent Business, small businesses have cited the rising cost of healthcare as their biggest problem for the last 38 years.
There’s no reason why hospitals have to wait until after care is provided to disclose prices on bills that arrive weeks or months after care. Ohio’s legislation simply requires them to post their prices upfront.
However, the House version is stronger because it requires actual prices in dollars and cents. The Senate bill, by contrast, allows hospitals to post mere estimates. Estimates don’t protect patients from final bills that are far higher, and they make it almost impossible to shop around for the best value. Conference negotiators must include the stronger House language in the bill’s final version that goes to Gov. DeWine’s desk to be signed into law.
Signing this bill into law will help prevent more people from falling victim to the predatory healthcare system like I did. It will finally reduce outrageous state healthcare costs.
– – –
Tracey Owens is a resident of Norton, Ohio.
