Healthcare’s Broken Promise: Patients Kept in the Dark on Costs, Report Finds

The average American family now shells out nearly $27,000 a year for health insurance — more than double what it paid two decades ago. Deductibles have climbed to almost $1,900. Yet for the routine care families actually use, most will pay cash out of pocket before their coverage kicks in. That contradiction sits at the center of a new report from Independent Women, which argues the healthcare system has broken its promise to consumers.

The report, titled “Flourishing Families: An Agenda to Help Families Thrive,” contends that for decades the system has run on a faulty assumption: that health insurance would cover everyday medical care. In reality, most office visits, imaging studies, lab tests, and minor procedures don’t come close to meeting a family’s deductible. That means patients are effectively direct purchasers for a huge share of their care, even as they pay record premiums — a reality policymakers rarely acknowledge, according to the report.

“The healthcare system still treats consumers as though they have no business knowing what care costs,” the report argues.

No Prices Until After the Fact

In almost any other market, consumers know the price before they commit. You wouldn’t board a plane without knowing the fare, or check into a hotel without the nightly rate. But healthcare works differently: patients often discover what a procedure or test will cost only after it’s done, if they find out at all.

There is no single market price for healthcare, and neither payers nor providers have been forthcoming. The No Surprises Act, signed into law years ago, was supposed to require insurers to give patients an advance explanation of benefits so they’d know what they owe before scheduling care. But those provisions still haven’t been fully implemented. Hospitals are also supposed to disclose negotiated rates under federal law, but compliance remains strikingly poor.

The report notes that identical services — imaging, medications, lab work — can vary wildly in price depending on which insurance a patient carries. It calls price transparency a basic consumer protection, not a partisan issue.

Subsidies Aren’t the Answer, Report Says

Some lawmakers and advocates have pushed for more subsidies as the solution to affordability. But the report pushes back, arguing that subsidies largely flow to insurance companies, which respond by hiking premiums and continuing to keep negotiated rates opaque.

“Those subsidies go directly to insurance companies, which return the favor by raising premiums even higher and refusing to provide basic transparency,” the report claims.

Instead of simply funneling more taxpayer money into the system, the report calls for giving families the freedom to act on price information — to compare costs and choose lower-cost options that fit their needs.

Direct Primary Care as an Alternative

One model the report highlights is direct primary care (DPC), where patients pay a monthly membership fee directly to their physician for routine and preventive services, bypassing insurance billing for those visits. When paired with a lower-premium catastrophic plan, DPC can protect against serious illness and hospitalization while saving families money and improving access to care.

The report welcomes recent changes under the Working Families Tax Cuts that allow Health Savings Accounts to cover DPC memberships, calling it a step toward making the option more accessible.

Patients, Not Insurers, at the Center

The report concludes that affordability isn’t about throwing more money at the problem. It’s about restructuring the system so patients are in control — knowing costs upfront, comparing prices, and choosing how to pay for routine care.

“Insurance remains important for protecting against catastrophic illness, but too often it stands between patients and the everyday care they need,” the report states. “Putting patients — not insurance companies — back in control is one of the most important steps policymakers can take.”

The report is authored by Dr. Monique Yohanan, MD, MPH, director of the Center for Better Health at Independent Women. It is part of a series based on the group’s broader family agenda, which emphasizes support for families without relying on direct government subsidies or major tax-code changes.

Source: www.dailywire.com — https://www.dailywire.com/news/the-healthcare-systems-broken-promise