- The Washington Times - Thursday, March 8, 2018

The Trump administration will push the American health care system to let consumers know the true costs of medical services, giving them more say in decisions that emphasize “value over volume,” Health and Human Services Secretary Alex Azar told insurers Thursday.

Mr. Azar noted that the federal government has been pushing for quality care for years with only slim results but said it is convinced it can harness technology to give consumers more power and access to their records.

“This is no time to be timid. Today’s health care system is simply not delivering outcomes commensurate with its cost. President Trump knows it, and the American people know it too,” he said in prepared remarks before a policy conference held by America’s Health Insurance Plans.

The secretary said providers need incentives to become more transparent and that consumers should know the costs of procedures before they undergo them.

He said he once confronted hospital employees over a cardiac stress test that cost $5,500 in a hospital but $550 in a doctor’s office.

“Imagine if you have to order before knowing what anything costs — indeed, before ever seeing the menu. And once your bill finally does arrive, not only are you paying for your appetizer, entree and dessert, you get a surprise bill from the pastry chef, too, who turns out to be out of network,” he said. “No one would ever put up with such a system.”

He lauded UnitedHealth Group Inc., a major insurer, for cutting through the “thicket of negotiated discounts” for middlemen by passing on drug rebates to consumers at the point of sale instead of using the money to bring down premiums across its pool of customers.

Mr. Azar’s speech signaled that the department is looking to translate Mr. Trump’s government shake-up philosophy into the health care markets.

“This is the stake in the ground. This is making clear that under President Trump, this is the direction we’re going,” he told reporters at HHS. “Now, the job will be for us to run the processes here to fill that in.”

The secretary said the administration will use the nation’s public insurance programs — Medicare and Medicaid — to test models that tie payments to quality. Spending on the programs totaled over $1 trillion in 2016, creating a wide playing field for innovation.

But Mr. Azar promised the change wouldn’t be heavy-handed.

“We may be the only one who has sufficient market concentration and power to be the first mover, to make change,” he said.

Mr. Azar said his drive for quality dates back to his tenure in HHS under President George W. Bush.

The Obama administration emphasized quality over quantity in its health care reforms, though Mr. Azar suggested Thursday that too many strictures on the private sector made it difficult to innovate. Yet sweeping changes to the way the sector delivers health care will require some degree of federal intervention, he said, “perhaps even an uncomfortable degree.”

“That may sound surprising coming from an administration that deeply believes in the power of markets and competition,” he said. “But the status quo is far from a competitive free market in the economic sense of the term, and health care is such a complex system that facilitating a competitive, value-based marketplace is going to be disruptive to existing actors.”

Mr. Azar said White House senior adviser Jared Kushner, who leads the Office of American Innovation, will help the government launch Blue Button 2.0, which will urge app developers to design programs that let patients easily access and understand their health records and claims data.

Mr. Azar said Mr. Kushner, the president’s son-in-law and owner of a broad portfolio at the White House, has been “constructive and helpful.”

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