USA TODAY’s story on the difficulties consumers encounter in getting information on health care prices leaves the impression that doctors are unwilling to disclose their prices. In truth, a typical doctor might have 20 or more prices for the same procedure “” because each insurer establishes its own contracted payment amount for a particular service.
So, it is not a simple matter to ask, “How much will this cost?”
An accurate answer usually requires the doctor to research his contract with the patient’s insurer. In many instances, medical practices are not given access to what insurers pay for certain services even during contract negotiations. Lack of transparency between the health plan and the medical practice regarding pricing often makes it impossible for physicians to quote prices to patients.
But the greater problem is that most insurers do not permit doctors to disclose what the insurer pays them. These contractual confidentiality clauses, intended to protect “proprietary information,” act against the best interests of both patients and doctors.
Insurance reform to do away with such prohibitions against disclosure would go far to make the health care market more transparent “” and more price competitive.