[Congressional Record Volume 152, Number 19 (Wednesday, February 15, 2006)]
[House]
[Page H304]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        HEALTH CARE TRANSPARENCY

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Texas (Mr. Burgess) is recognized for 5 minutes.
  Mr. BURGESS. Mr. Speaker, Americans, American patients, are 
fortunate. They have access to the greatest health care system in the 
world. But for many, the cost to access that care is prohibitively 
high. So it is ironic, Mr. Speaker, that the world's largest free 
market economy, government control and lack of true market forces have 
led to diminished sophistication among medical consumers and increased 
health care costs.
  Dr. Uwe Reinhardt, a professor of political economy at Princeton 
University, frames the problem by stating: ``To move from the present 
chaotic pricing system toward a more streamlined system that could 
support genuinely consumer-directed health care will be an awesome 
challenge. Yet without major changes in the present chaos, forcing sick 
and anxious people to shop around blindfolded for cost-effective care 
mocks the very idea of consumer-directed care.''
  A lack of transparency has created a system where customers don't 
have the ability to hold providers accountable. We have reached a point 
where even doctors and nurses and other providers have difficulty in 
being cost conscious, because nobody really knows what anything costs 
any more. In a system like this, cost increases are a given.
  Mr. Speaker, there is no bigger proponent of medical health savings 
accounts than myself. A little less than 10 years ago when the Archer 
Medical Savings Accounts were first made available, I went out and got 
one. I think it is a good method of providing health insurance, 
particularly for those young Americans who want to be entrepreneurs 
that Chairman Dreier was just talking about. But right now there is a 
problem, because there is a lack of transparency in the system; and 
that opacity in the system prevents them from being good consumers.
  A more transparent pricing system would help give providers and 
patients more control over their health care dollar, but there are 
great incentives for providers to keep consumers blindfolded. For 
instance, every year hospitals normally raise their price list for 
services. Because hospitals can increase their net revenue by raising 
their list prices, this provides them the incentive to increase their 
list prices.
  But hospitals also negotiate a discount in payments for patients 
covered by certain health plans, and these discounted amounts are not 
always available to individuals who may be interested in self-pay, such 
as the holder of a health savings account.
  Additional breakdowns of hospital operating costs and how that 
impacts billings would be essential information to a consumer trying to 
select the lowest-cost provider. Since this information is obscured, 
the consumer can exert no pressure on a hospital to implement rational 
pricing structure.
  What happens when pricing information becomes available to consumers? 
The results can be dramatic. When the Medicare prescription drug 
discount card was introduced in 2004, seniors could log on to 
Medicare.gov and see cost comparisons of what drugs cost at area 
pharmacies. I would submit that Lasik surgery and plastic surgery are 
the other such examples when transparency is brought to the 
marketplace.

                              {time}  1915

  Some health plans are getting into the transparency game. Aetna 
health plan has initiated a pilot project in Cincinnati, Ohio, that 
gives enrollees information on what doctors charge and gives enrollees 
the ability to take action before services are performed. This type of 
information is vital to hold providers and plans accountable for what 
they charge and what the patient pays.
  Giving new consumer-based coverage options like health savings 
accounts the opportunity to plug into a fully transparent system, it 
gives consumers information on cost, price and quality and would 
transform the American health care system in a radical manner, 
providing care for more Americans both rich and poor. Patients with 
portable health care dollars that can be paid at the point of service 
are extremely attractive to most health care providers who otherwise 
normally have to wait for an insurance company to process a claim and 
remit the payment sometimes months or even years after a service has 
been rendered. To attract the business of these patients who are 
willing to pay cash at the time of delivery, providers could list their 
charges, competing for business on price and quality.
  With nearly 3 million now enrolled in health savings accounts to date 
and the number growing daily, health care providers and hospitals would 
be wise to allow transparency to pervade the system and ride the coming 
consumer wave.
  Now, Congress can play a role in leveling the playing field in favor 
of the health care consumer. HSAs should be supported or made more 
attractive to consumers by increasing their portability and maximizing 
the tax benefits of these accounts. Congress has already established 
several quality reporting programs that are available to the public. 
The same should go for medical costs. There is no reason to continue 
the system of opacity in medical pricing.
  Congress should take the lead in developing a collaborative approach 
with all provider stakeholders to make the costs more transparent to 
consumers.
  The Greek dramatist Sophocles said that, ``wisdom outweighs any 
wealth.'' The American health care system needs a healthy dose of 
wisdom; and consumers can deliver, given the chance.

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