Current Healthcare Proposals Not Good Enough


By Tomer Shoval

Despite increased attention to healthcare issues and changes in the lead-up to next year’s presidential election,  neither would-be Democratic candidates nor the Trump Administration have put forward solutions that actually move the needle today on the core issue: medical care, regardless of health insurance, is not affordable for the vast majority of Americans.

This focus on the cost of care is no surprise given that healthcare affordability is the number one concern for Americans, according to a recent Gallup poll. Yet, many of these policies ignore recent SHED data that shows many people cannot find $400 cash in an emergency, placing the average health insurance out-of-pocket deductible of nearly $1500 squarely out of reach. Even newly announced CMS changes that require providers to disclose what they pay for delivering care do little to address this healthcare affordability gap.

Imagine a potential car buyer unable to compare vehicles based on cost. Weeks after choosing a car only by available options and from a dealer she liked, she would receive a bill from the manufacturer, another from the tire company, and a third from the dealership. After tallying the invoices and realizing the total cost was out of reach, only then could she request a payment plan. Without knowing her financial obligation upfront, she could be stuck with dangerously high monthly bills that put her at risk of repossession. 

This is the precarious state of healthcare today. We have an unassailable cost issue with no real solution in sight. Americans are being forced to make tough choices about paying for care or skipping it altogether – last year people borrowed $88B for medical expenses while 44% skipped a test or treatment because it was not affordable.

But beneath the rhetoric, the pain of that cost can be mitigated in the near term if regulators and/or providers commit to addressing two key elements: transparency and affordability. This reflects the two questions most often asked by patients about a hospital visit: “How much do I owe?” and “How am I going to pay?”

By ensuring that all patients understand and can compare their actual financial responsibility ahead of time, then giving them reasonable ways to afford payments over time without damage to their credit score, we can put quality medical care within reach for everyone. 

This financial relief does not require an overhaul to the health system. It is possible today by heeding the advice of objective counsel and borrowing technologies and policies from adjacent industries like financial services, travel and retail. 

Hospitals and policymakers that create self-service scheduling and payment systems akin to booking one’s own airfare both return control to patients and lower their own cost centers. Retail technologies make it possible for hospitals to provide instantly available up-front pricing on a phone or online based on each patient’s insurance (or lack thereof). And data analytics tools used extensively in financial services enable hospitals to provide personalized payment plans based on a patient’s financial circumstances and health insurance. 

Instead of slapping on Band-Aids or arguing about campaign trail slogans like “Medicare for All,” healthcare providers have both an opportunity and obligation to take control of the wheel now. By delivering on promises of transparency and affordability today, they can get out in front of inevitable regulatory change tomorrow while making patients happy and boosting their own bottom lines in the process. 

As the founder of the patient financial care movement, Simplee CEO Tomer Shoval is committed to making medical payments affordable for everyone.