American parents have different dreams for their children. A parent of a child with cancer has only one cancer patient.
When my son King was diagnosed with leukemia in 2016 at just two years old, my heart was broken and the world was changed. I quit my job to be his caregiver because his wife pays for health insurance through her employer. This is a full-time job that includes doctor appointments, hospital visits, and managing the side effects of years of daily chemotherapy and steroid treatment.
Even with health insurance, the financial costs of his treatment are enormous. The never-ending bills and ever-growing debt is itself a disease. The financial pain is even worse for families like mine who earn too much to qualify for government assistance. My wife’s salary was seized to pay off the debt. The stress exacerbated the autoimmune condition.
If we could afford the legal costs, we would file for bankruptcy. Nearly one in four U.S. adults with family medical debt or cancer has declared bankruptcy or lost their home, according to a poll. About two-thirds spent less on household essentials.
One solution that will help families like mine, and all patients blinded by exorbitant costs, is transparency in healthcare prices. Knowing the actual price will help you protect yourself from overpriced treatments and help you choose treatments at fair market prices.
For someone with a fixed income, dealing with a life-threatening or chronic health condition can always be a financial burden. However, setting an upfront price will at least prevent financial ruin.
The Shin family, clockwise from left: King, Shameza, Michael, Messiah, Faith.(Courtesy of Michael Singh)
If it becomes possible to purchase cheaper medical supplies, it will be possible to extend the pre-deductible period of medical insurance and smooth household finances. But in the typical model, we’re often blind to clear prices, and thousands of dollars’ worth of pre-deductible expenses all fall in January. We have no choice but to deposit these bills on our credit cards and watch the interest accrue.
In 2016, King was billed about $200,000 for two weeks in a New York City hospital and related tests and treatments, most of which were minor. If I had known this high fee prior to care, I would have compared the fees of other facilities and selected a less expensive alternative.
As with many commercial insurance plans, after you reach your deductible, you are responsible for paying 20% of your additional medical expenses until you reach your out-of-pocket limit. The difference between paying 20% coinsurance for treatment that costs $5,000 versus paying $1,000 determines whether our family will go into more debt.
As anyone familiar with the U.S. health care system knows, the same treatment can vary wildly in price. A recent JAMA study found that prices hospitals charge for brain MRIs on commercial insurance plans range from $1,024 to $3,197. A California woman found that having the same three blood tests at different locations cost her more than 800% of the difference. And a 2020 Employee Benefits Institute report found that insurance costs for chemotherapy are nearly twice as expensive as when it’s given in a hospital versus a clinic.
Price transparency allows you to choose cheaper options. This also makes it possible to find a cash price that is lower than the out-of-pocket cost.
More broadly, price competition in health care is necessary to reduce the overall prohibitive national health care spending, which accounts for nearly 20% of America’s Gross Domestic Product. Clearly publishing up-front prices also puts hospitals and health insurers accountable for overcharging and forces them to cut costs to retain customers, reducing out-of-control monthly premiums. There is a possibility.
Even in today’s partisan climate, policy makers should unite to enforce and enforce these price transparency rules and make them work for the general public. It is a basic American right to know the price before receiving service.
Medical price transparency is not the ultimate dream for my family. But it will certainly help while we work towards it.