The Era of Healthcare Price Gouging Must End
Patients across the nation have reason to hope for a healthier future, one at a lower, more equitable and more transparent price-point to boot.
Mere days after the U.S. Department of Justice launched an investigation into UnitedHealth Group’s ethically problematic billing practices, the Trump administration issued an executive order to empower “patients with clear, accurate, and actionable healthcare pricing information.”
In conjunction, these actions are set to revitalize American healthcare and put patients first like never before.
UnitedHealth’s billing practice is just one symptom of an oversized, bureaucratic healthcare system that has put profits over patient health for far too long. The company has been diagnosing patients in such a way that it triggers extra payments into Medicare Advantage plans – plans owned and overseen by the insurance giant itself. It works like this: insurers get lump-sum payment from the government to handle their enrollees’ benefits. When patients are diagnosed with certain conditions, payments to their insurers increase.
Under UnitedHealth’s framework, patients are being price-gouged with every visit to their doctors’ offices. Billions of Medicare records reveal that UnitedHealth-employed doctors boasted large upticks in profitable diagnoses after they joined UnitedHealth’s Medicare Advantage plans. UnitedHealth’s Minneapolis branch went so far as to train physicians in the area to report their lucrative diagnoses to the company, including ones that they deemed uncommon. These doctors were also paid bonuses to suggest conditions to patients that garnered large insurance payments, showing without a doubt that Big Healthcare has little concern for the patients it claims to serve.
Price gouging vulnerable patients doesn’t stop with UnitedHealth. Our federal government has spent $1.45 trillion in taxpayer money on Medicaid and Medicare alone in 2023 – double the Pentagon’s budget. After the Affordable Care Act went into effect, the cost of private health insurance skyrocketed for the average American, more than doubling between 2013 and 2019.
By circumventing federal mandates, the U.S. hospital system too is making the cost of basic care even more unbearable for patients, especially the infirm and those already struggling to make ends meet. Nearly 80 percent of American hospitals refuse to comply with commonsense rules requiring them to post the cost of care online for all patients to see well in advance of receiving treatment. By not clearly displaying prices upfront, hospitals and other health companies are able to charge whatever they want, causing many patients and employees to delay necessary medical treatment out of fear of unknown costs or else pay steep prices due to these hospitals’ shameful misconduct.
It should be no surprise that 92 percent of people say they support efforts by the federal government to require hospitals and health insurance companies to provide the actual cost of treatments rather than just estimates.
Trump’s executive order to restore healthcare price transparency comes not a moment too soon. It aims to make “meaningful price information available to patients to support a more competitive, innovative, affordable, and higher quality healthcare system” by ensuring hospitals comply with the law. Going forward, it’s the administration’s order that “machine-readable file with negotiated rates for every single service the hospital provides” be available to all those who are tired of healthcare sticker shock.
We at Solidarity HealthShare are hopeful that the Trump administration will continue to revamp the healthcare sector with transparency and accountability, and we are already taking steps to work alongside the Department of Government Efficiency and Health and Human Services on this important issue. The era of fraud and abuse from our health providers must end. And ethical, affordable care must soon become the standard of care for all patients.
Chris Faddis is president of Solidarity HealthShare, a health care sharing ministry guided by the moral teachings of the Catholic Church that negotiates directly with providers to ensure delivery of high-quality and affordable, life-affirming health care for the more than 46,000 members it has served since 2016.
Patients across the nation have reason to hope for a healthier future, one at a lower, more equitable and more transparent price-point to boot.
Mere days after the U.S. Department of Justice launched an investigation into UnitedHealth Group’s ethically problematic billing practices, the Trump administration issued an executive order to empower “patients with clear, accurate, and actionable healthcare pricing information.”
In conjunction, these actions are set to revitalize American healthcare and put patients first like never before.
UnitedHealth’s billing practice is just one symptom of an oversized, bureaucratic healthcare system that has put profits over patient health for far too long. The company has been diagnosing patients in such a way that it triggers extra payments into Medicare Advantage plans – plans owned and overseen by the insurance giant itself. It works like this: insurers get lump-sum payment from the government to handle their enrollees’ benefits. When patients are diagnosed with certain conditions, payments to their insurers increase.
Under UnitedHealth’s framework, patients are being price-gouged with every visit to their doctors’ offices. Billions of Medicare records reveal that UnitedHealth-employed doctors boasted large upticks in profitable diagnoses after they joined UnitedHealth’s Medicare Advantage plans. UnitedHealth’s Minneapolis branch went so far as to train physicians in the area to report their lucrative diagnoses to the company, including ones that they deemed uncommon. These doctors were also paid bonuses to suggest conditions to patients that garnered large insurance payments, showing without a doubt that Big Healthcare has little concern for the patients it claims to serve.
Price gouging vulnerable patients doesn’t stop with UnitedHealth. Our federal government has spent $1.45 trillion in taxpayer money on Medicaid and Medicare alone in 2023 – double the Pentagon’s budget. After the Affordable Care Act went into effect, the cost of private health insurance skyrocketed for the average American, more than doubling between 2013 and 2019.
By circumventing federal mandates, the U.S. hospital system too is making the cost of basic care even more unbearable for patients, especially the infirm and those already struggling to make ends meet. Nearly 80 percent of American hospitals refuse to comply with commonsense rules requiring them to post the cost of care online for all patients to see well in advance of receiving treatment. By not clearly displaying prices upfront, hospitals and other health companies are able to charge whatever they want, causing many patients and employees to delay necessary medical treatment out of fear of unknown costs or else pay steep prices due to these hospitals’ shameful misconduct.
It should be no surprise that 92 percent of people say they support efforts by the federal government to require hospitals and health insurance companies to provide the actual cost of treatments rather than just estimates.
Trump’s executive order to restore healthcare price transparency comes not a moment too soon. It aims to make “meaningful price information available to patients to support a more competitive, innovative, affordable, and higher quality healthcare system” by ensuring hospitals comply with the law. Going forward, it’s the administration’s order that “machine-readable file with negotiated rates for every single service the hospital provides” be available to all those who are tired of healthcare sticker shock.
We at Solidarity HealthShare are hopeful that the Trump administration will continue to revamp the healthcare sector with transparency and accountability, and we are already taking steps to work alongside the Department of Government Efficiency and Health and Human Services on this important issue. The era of fraud and abuse from our health providers must end. And ethical, affordable care must soon become the standard of care for all patients.
Chris Faddis is president of Solidarity HealthShare, a health care sharing ministry guided by the moral teachings of the Catholic Church that negotiates directly with providers to ensure delivery of high-quality and affordable, life-affirming health care for the more than 46,000 members it has served since 2016.
