HB 1590, requiring the disclosure to patients and prospective patients of the charges for medical procedures. MAJORITY: INEXPEDIENT TO LEGISLATE. MINORITY: OUGHT TO PASS WITH AMENDMENT.
Rep. Jennifer R Coffey for the Majority of Commerce and Consumer Affairs: The committee understands the intent of the sponsor’s mandate. However, the free market shows that many providers’ offices already provide this information via their financial counselors and the information is also available via the NH insurance dept. website. This bill however, would force employers to make secretaries and health care providers also financial counselors and be put in the position in giving estimates for any possible scenario to the given situation the patient is asking about over the phone. The bill would also have an impact on the cost of doing business and could increase medical care costs. Vote 15-2.
Rep. Andrew J Manuse for the Minority of Commerce and Consumer Affairs: This bill as amended adds medical “list” price disclosure, avoiding all areas where it might interfere with medical care in a responsible manner while still providing pricing indicators that are lacking right now in the industry. The minority thinks this bill as amended attempts to answer all of the raised objections heard in testimony. It avoids insurance contractual concerns by only applying to uninsured people. It removes a requirement to price out emergency or critical care to avoid the risk that unexpected but medically necessary additional procedures won't be provided or paid for. It merely asks for what “retail pricing” would be, and even then only in a non-binding estimate. We heard bipartisan testimony that failure to provide pricing information is a widespread problem and that people are forced to undergo treatment before knowing how much they might have to pay for it. This failure to provide pricing for medical procedures has prevented the free market and competition from being a factor in the industry, and this has contributed to the increase in medical care costs. Medical care is not impossible to price accurately: the animal medical care provided at your local veterinarian clinic often generates a complete pricing report even in advance. Why can't human medical care do the same? We require our automotive mechanics to provide reasonable estimates, and we expect accurate pricing from our restaurants, retail stores, service professionals and most others. Why do we hold medical care immune from this most basic of consumer protections: the right of the consumer to know (even roughly) what a service will cost them before that service is performed on their behalf? The industry and the state currently provides some limited hospital disclosure pricing and requires disclosure of facility costs (i.e., the cost of the room), but we don't require disclosure of other aspects of medical care given, such as how much it costs to provide a pain pill, put on a splint, provide stitches, or put on a band-aid. We have to provide some form of consumer relief mechanism to help battle the high cost of medical care. The few examples of pricing transparency, elective items such as laser eye surgery or plastic surgery, only support the minority's belief of the need for this legislation, and that prices will drop as a result. The free market can help, but only if we stop shielding our medical providers from the same market forces all the rest of us face. Consumers will shop for lower costing care, doctors and others will compete to provide that care, and our poorest will again find themselves able to afford care, instead of having to risk treatment at an unknown price. No longer will patients walk into the doctor's office, unsure what it cost them to walk out, or worse, choose not to walk in at all because of a fear of what the cost might be and risk continuing poor health.
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