May 28, 2019

Washington's favorite health policy isn't a silver bullet

Illustration: Rebecca Zisser/Axios

Adding more transparency to the health care system's secretive pricing structure is a bipartisan idea that's gotten a lot of interest in Congress and from the Trump administration.

Yes, but: Some experts say transparency alone probably won't do much to lower costs, and could even end up backfiring.

Driving the news: The Trump administration is expected to soon release an executive order mandating the disclosure of health care prices, the Wall Street Journal reported Friday.

  • A new bipartisan Senate bill on health costs also includes several transparency measures.
  • The Health & Human Services Department is also requiring drug companies to include their products' list prices in their TV ads.

What they're saying: Critics argue that the industy's secretive pricing practices support its own bottom line at patients' expense, and causes wild discrepancies in what the same service costs in different places.

  • A recent RAND study found that private insurance plans pay hospitals, on average, 241% of what Medicare pays for the same services — and those rates vary widely from hospital to hospital.

The other side: More transparency could still end up being relatively useless for patients, experts said.

  • "In many cases, patients don’t necessarily know in advance what’s wrong with them and what care they’re going to need, so they don’t know what prices to ask for," the Kaiser Family Foundation's Larry Levitt said.
  • There's evidence that patients don't use the tools already available to them to shop around. And even the prices that providers have negotiated with insurers — which are valuable trade secrets for both industries — don't tell patients their actual costs.
  • "Knowing the underlying cost of a service or drug is unlikely to influence their decision ... since they aren’t paying that price to begin with," Avalere's Chris Sloan said.

Transparency could even lead to higher prices, as providers see what their competitors are getting.

  • "Knowing what concessions everyone is getting or giving can often mean that the low price in the market serves as a floor, rather than a ceiling, in future negotiations and that leads to higher prices over the long term," Sloan added.

The bottom line: At the least, more pricing information could help empower future policymakers.

  • "You’re going to see this jagged mountain range of pricing in the private sector, and it’s going to be pretty darn hard for people to justify it," said John Bardis, a former Trump administration health official. "This is what those who have benefited from opaque pricing practices don’t want to see, because it’s just not defensible.”

Go deeper

Making sense of the UN's climate conference coronavirus delay

Illustration: Sarah Grillo/Axios

The scuttling of November's pivotal UN climate conference is the starkest sign yet of how coronavirus is throwing a wrench into efforts to combat global warming. But like the wider relationship between the coronavirus and climate initiatives, the ramifications are ... complicated.

Driving the news: UN officials announced Wednesday that the annual summit to be held in Glasgow, Scotland, is postponed until some unknown time next year.

Coronavirus dashboard

Illustration: Aïda Amer/Axios

  1. Global: Total confirmed cases as of 9 a.m. ET: 952,171 — Total deaths: 48,320 — Total recoveries: 202,541Map.
  2. U.S.: Total confirmed cases as of 9 a.m. ET: 216,722 — Total deaths: 5,137 — Total recoveries: 8,672Map.
  3. Stimulus updates: Social Security recipients won't need to file a tax return to receive their checks.
  4. Jobs update: 6.6 million people filed for unemployment last week, a staggering number that eclipses the record set on March 26.
  5. Health updates: The Trump administration won't reopen enrollment for ACA marketplaces this year.
  6. National updates: The Grand Canyon closed after a resident tested positive for coronavirus.
  7. World update: Israeli Prime Minister Benjamin Netanyahu re-entered self-quarantine after his health minister tested positive for coronavirus.
  8. What should I do? Answers about the virus from Axios expertsWhat to know about social distancingQ&A: Minimizing your coronavirus risk.
  9. Other resources: CDC on how to avoid the virus, what to do if you get it.

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The weirdest NBA draft ever

Table: Axios Visuals

The 2020 NBA draft was already shaping up to be the weirdest draft in years, and now that the coronavirus pandemic has disrupted the sports world, it could be the weirdest draft ever.

Why it matters: While most drafts have a clear hierarchy by the time April rolls around, this draft does not. There's no reliable No. 1 pick, almost every top-10 prospect has a glaring weakness and the global sports hiatus has shrouded the whole class in mystery.

Go deeperArrow50 mins ago - Sports