TL: How far can transparency go to move the needle?
SB: It can only go so far. It’s good that chargemaster prices have now been made public by Medicare. Knowing what hospitals charge insurance companies would also go a long way. There’s no reason why a state can’t disclose those charges. Once you have that information, that’s good. But it’s only the beginning of the conversation. Transparency and skin-in-the-game is a way to begin the conversation, but it’s not the answer. Until patients have leverage—which they never will—you’re not going to change medical pricing. The only way to control medical prices is how every other country does it. The market can’t work without government regulation.
TL: What are the shortcomings of the Affordable Care Act, in your view?
SB: It nips at the edges but doesn’t address the basic problem of the cost of healthcare. It deals with who pays the costs, not what the costs are. The law passed precisely because it doesn’t solve the problem
Healthcare reporters who are in New York on June 11 are invited to the New York chapter meeting of the Association of Health Care Journalists, at which Steven Brill will speak. It will be held at 6:30 at the office of the New York State Health Foundation, 1385 Broadway.