# Trump executive order now requires transparency up-front in hospital billing **URL:** \ **Category:** Great Debates\ **Created:** [June 25, 2019, 2:09pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033 "2019-06-25T14:09:15Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [June 25, 2019, 2:09pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/1 "2019-06-25T14:09:15Z")
This might be the first Trump action in a long while that Ds and Rs can support: [Requiring healthcare providers to be more transparent up-front about the prices that they will charge for a procedure prior to actually doing it.](https://finance.yahoo.com/news/trump-order-seeks-disclosure-hospital-142157856.html) Otherwise, in the murky confines of the hospital billing department, they could throw darts at a wall and just as easily charge you $6,000 for your emergency room visit as $750. Oftentimes, one of the most financially terrifying aspects of U.S. healthcare is not knowing in advance how much it will cost, and this will hopefully also penalize providers that charge ripoff prices. However, the change will not be immediately felt; it will likely take years to kick in. ---
**Author:** ![Snowboarder\_Bo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/snowboarder_bo/32/229_2.png) [@Snowboarder\_Bo](https://boards.straightdope.com/u/Snowboarder_Bo)\ **Post date:** [June 25, 2019, 2:10pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/2 "2019-06-25T14:10:32Z")
They have to divulge prices or… what? :dubious: ---
**Author:** ![running\_coach](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/running_coach/32/15836_2.png) [@running\_coach](https://boards.straightdope.com/u/running_coach)\ **Post date:** [June 25, 2019, 2:18pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/3 "2019-06-25T14:18:06Z")
> [@Snowboarder\_Bo](#): > > They have to divulge prices or… what? :dubious: There will be a very [del]firmly[/del] badly worded tweet. ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [June 25, 2019, 2:28pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/4 "2019-06-25T14:28:20Z")
From the linked article: > [@](#): > > But insurers said the idea could backfire, prompting hospitals that now give deeper discounts to try to raise their own negotiated prices to match what high earners are getting. Hospitals were skeptical of the move. > > Trump’s order also requires that patients be told ahead of time what their out-of-pocket costs like deductibles and copays will be for many procedures. > > Little will change right away. The executive order calls for a rule-making process by federal agencies, which typically takes months or even years. The details of what information will have to be disclosed and how it will be made available to patients must be worked out as part of writing the regulations. That will involve a complex give-and-take with hospitals, insurers and others affected. A few bucks exchanging hands, the right Trump appointees heading the right Federal agencies, a little behind-the-scenes deals making with certain medcorps executives…if anything ever really comes of this, it will seem like a proctology exam for all the patients out there, done with an arc-welding glove. ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [June 25, 2019, 2:30pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/5 "2019-06-25T14:30:29Z")
Does anyone else question every step taken during medical care? Maybe the health care providers I deal with think I’m a pain in the ass, but I question everything that happens when I’m being treated/diagnosed/etc. When they wanted to transfer me by ambulance for angiogram/shunt I initially declined until I could speak with my insurance provider. Turns out I wasn’t covered for the ambulance that was idling out front, ready to transport me. I would have been billed around two thousand dollars for the 10 minute ride. I _was_ covered in full for an ambulance from my hometown, an hour away. So, I waited patiently and got a free ride. When I was discharged after my stent, a nurse brought in my morning medications for me to take. I declined, as I had some of the drugs at home and would be stopping to fill the other prescriptions. The nurse initially argued, but eventually one of my doctors heard about the situation and agreed with me. I would have paid significantly more for the hospital-provided drugs (IIRC it was over $10 a pill savings for the 5 drugs). ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [June 25, 2019, 2:52pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/6 "2019-06-25T14:52:08Z")
> [@kayaker](#): > > Does anyone else question every step taken during medical care? Maybe the health care providers I deal with think I’m a pain in the ass, but I question everything that happens when I’m being treated/diagnosed/etc. > > When they wanted to transfer me by ambulance for angiogram/shunt I initially declined until I could speak with my insurance provider. Turns out I wasn’t covered for the ambulance that was idling out front, ready to transport me. I would have been billed around two thousand dollars for the 10 minute ride. I _was_ covered in full for an ambulance from my hometown, an hour away. So, I waited patiently and got a free ride. > > When I was discharged after my stent, a nurse brought in my morning medications for me to take. I declined, as I had some of the drugs at home and would be stopping to fill the other prescriptions. The nurse initially argued, but eventually one of my doctors heard about the situation and agreed with me. I would have paid significantly more for the hospital-provided drugs (IIRC it was over $10 a pill savings for the 5 drugs). I do too. Was in ER a few years ago, challenged the need for various procedures. Was at orthopedist a few months ago, challenged the need for X-ray and MRI (since imaging is scandalously expensive.) Turns out the knee was/is just inflamed, no real damage. ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [June 25, 2019, 3:20pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/7 "2019-06-25T15:20:00Z")
I had a planned hospital stay a while back, and I asked like a thousand different ways how much it was going to cost me. In the end, I didn’t actually have much of a choice, so I just went in and had the sticker shock after everything was already done. Which really just reinforces to me the stupidity in the phrase, “the U.S. has the best healthcare system in the world!” I hold a high level of contempt for the intelligence of anyone who says and believes this. I do not have any amount of faith that this executive order will address the situation at all. ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [June 25, 2019, 3:33pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/8 "2019-06-25T15:33:29Z")
> [@Ravenman](#): > > I had a planned hospital stay a while back, and I asked like a thousand different ways how much it was going to cost me. In the end, I didn’t actually have much of a choice, so I just went in and had the sticker shock after everything was already done. Yes, getting a straight answer can be difficult, which is why I take it to a fanatical level. Don’t want to tell me what the blood test is going to cost me? Then I refuse to allow the draw. Eventually someone comes by to answer my original question. ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [June 25, 2019, 4:32pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/9 "2019-06-25T16:32:25Z")
> [@Ravenman](#): > > I do not have any amount of faith that this executive order will address the situation at all. Perhaps not, but at least it’s a step in the right direction, and gets the public conversation going. For far too long hospitals and providers have been allowed to get away with this dodginess. ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [June 25, 2019, 5:35pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/10 "2019-06-25T17:35:18Z")
> [@Velocity](#): > > Perhaps not, but at least it’s a step in the right direction, and gets the public conversation going. For far too long hospitals and providers have been allowed to get away with this dodginess. All this has done is given Trump some positive PR, while putting any advancement on the back-burner for years to come. The public conversation was _already_ going on, but now the medcorps know that they won’t have to do anything at all until this all gets sorted out sometime in the future…if it ever gets sorted out at all. ---
**Author:** ![nelliebly](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nelliebly/32/5422_2.png) [@nelliebly](https://boards.straightdope.com/u/nelliebly)\ **Post date:** [June 25, 2019, 5:36pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/11 "2019-06-25T17:36:57Z")
Is this really a big step? When I was scheduled for cancer surgery, the admissions department told me upfront what the hospital charges were, what my insurance would cover, and offered me a discount if I paid then and there. They wanted the money up front. If this isn’t standard practice, it soon will be. Whatever happened to his promise to deliver much lower Rx drug prices? ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [June 25, 2019, 5:42pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/12 "2019-06-25T17:42:36Z")
> [@nelliebly](#): > > Whatever happened to his promise to deliver much lower Rx drug prices? The plan to have Mexico pay for our drugs fell through. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 25, 2019, 5:53pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/13 "2019-06-25T17:53:14Z")
I hope this bill works. But part of me worries because trump supported it that either its inept and incomplete or it’s like the anti tobacco laws the gop have been promoting. They do the opposite of what they say they’ll do. But if it works, then it’s a step in the right direction and I’m glad he passed it . ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [June 25, 2019, 6:10pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/14 "2019-06-25T18:10:20Z")
> [@Velocity](#): > > Perhaps not, but at least it’s a step in the right direction, and gets the public conversation going. For far too long hospitals and providers have been allowed to get away with this dodginess. Sure, just like the infrastructure bill. Everyone’s in favor of it, and it isn’t in the news, so we got that done, right? ---
**Author:** ![Snowboarder\_Bo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/snowboarder_bo/32/229_2.png) [@Snowboarder\_Bo](https://boards.straightdope.com/u/Snowboarder_Bo)\ **Post date:** [June 25, 2019, 6:11pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/15 "2019-06-25T18:11:49Z")
> [@Wesley\_Clark](#): > > I hope this bill works. But part of me worries because trump supported it that either its inept and incomplete or it’s like the anti tobacco laws the gop have been promoting. They do the opposite of what they say they’ll do. > > But if it works, then it’s a step in the right direction and I’m glad he passed it . I don’t think you have a firm grasp of what we’re talking about. This wasn’t a bill. He didn’t sign anything into law. Nothing was “passed”. ---
**Author:** ![doreen](https://avatars.discourse-cdn.com/v4/letter/d/858c86/32.png) [@doreen](https://boards.straightdope.com/u/doreen)\ **Post date:** [June 25, 2019, 6:31pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/16 "2019-06-25T18:31:55Z")
> [@kayaker](#): > > When they wanted to transfer me by ambulance for angiogram/shunt I initially declined until I could speak with my insurance provider. Turns out I wasn’t covered for the ambulance that was idling out front, ready to transport me. I would have been billed around two thousand dollars for the 10 minute ride. I _was_ covered in full for an ambulance from my hometown, an hour away. So, I waited patiently and got a free ride. I feel like I’m misunderstanding something here - or was a matter of the ambulance out front not accepting your insurance and it was just a coincidence that the covered ambulance was based in your hometown ? ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [June 25, 2019, 6:35pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/17 "2019-06-25T18:35:42Z")
> [@nelliebly](#): > > Is this really a big step? When I was scheduled for cancer surgery, the admissions department told me upfront what the hospital charges were, what my insurance would cover, and offered me a discount if I paid then and there. They wanted the money up front. If this isn’t standard practice, it soon will be. You’re fortunate. For many other Americans, the response they get from Billing to “How much will this cost?” is tantamount to a snort, “Who knows? Could be a hundred or a million.” ---
**Author:** ![iamthewalrus\_3](https://avatars.discourse-cdn.com/v4/letter/i/258eb7/32.png) [@iamthewalrus\_3](https://boards.straightdope.com/u/iamthewalrus_3)\ **Post date:** [June 25, 2019, 6:37pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/18 "2019-06-25T18:37:49Z")
> [@nelliebly](#): > > Is this really a big step? When I was scheduled for cancer surgery, the admissions department told me upfront what the hospital charges were, what my insurance would cover, and offered me a discount if I paid then and there. They wanted the money up front. If this isn’t standard practice, it soon will be. I think that is an atypical experience. In my experience, it’s very hard to get actual numbers from anyone. And even when the medical provider or the insurance provider tells you numbers, they’re always disclaimed as basically “for entertainment purposes”, with the suggestion that you read your insurance policy. So you basically have to be a lawyer to figure out what you might be charged. Then you start getting bills and spend hours on the phone and shuffling paper around because My experience: A few years ago my health insurance stopped covering eye exams, and I called the optometrist I had been going to to find out what their cash prices were. I was quoted “somewhere between $180 and $400”. That’s quite a range, I said, how does it get narrowed down. It depends on the tests the doctor runs. Can I see a price list for the tests? No. When my daughter was born, someone filed some paperwork incorrectly (not me) and it screwed up insurance coverage for like 4 things in the first month of her life. After lots of emails and calls, three of those were covered, but the fourth was genetic testing required by the state of CA. Person I called at the insurance company said it wasn’t covered. My employer’s insurance broker (who I had enlisted to pester the insurance company until they fixed their other mistakes) said it wasn’t covered, and that it was common for insurance to not cover it. I pointed out that just two years earlier, our insurance (a different company) had covered it, and it seemed odd to me that the CA insurance regulators would be ok with insurance not covering state-required testing. They were adamant it wasn’t covered. I submitted it anyway. Insurance covered it. No one has any fucking idea how this stuff works, even the (ostensibly) professionals involved. ---
**Author:** ![Snowboarder\_Bo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/snowboarder_bo/32/229_2.png) [@Snowboarder\_Bo](https://boards.straightdope.com/u/Snowboarder_Bo)\ **Post date:** [June 25, 2019, 6:46pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/19 "2019-06-25T18:46:54Z")
> [@Velocity](#): > > You’re fortunate. For many other Americans, the response they get from Billing to “How much will this cost?” is tantamount to a snort, “Who knows? Could be a hundred or a million.” That is the only answer I have ever gotten from a hospital regarding any cost of anything. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 25, 2019, 7:13pm UTC](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033/20 "2019-06-25T19:13:37Z")
> [@Snowboarder\_Bo](#): > > I don’t think you have a firm grasp of what we’re talking about. > > This wasn’t a bill. He didn’t sign anything into law. Nothing was “passed”. Don’t talk down to me because you’re too neurotic to understand verbal nuance. I know what an executive order is. [Next page](https://boards.straightdope.com/t/trump-executive-order-now-requires-transparency-up-front-in-hospital-billing/836033.md?page=2)