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You're right (well, the opposite complaint would be that doctors and pharmacies are banning insurance companies from offering cheaper alternatives, but I think I get what you mean) I merged two problems in my head - the three big pbms (all owned by insurance companies) refusing to stock certain brands making it either expensive or impossible for doctors to prescribe them and insurance companies banning doctors from telling patients they could get their meds cheaper without using insurance.
I chuckled. But anyway, what I meant (as you probably know) is the insurance company banning doctors/pharmacies from using more expensive alternatives. Dubbed "step therapy" or "fail first", the insurance companies were saying that you had to have the patient try a cheaper alternative first, and only if/when that didn't work would they cover the more expensive drug. I'm sure there are nuanced arguments on both sides of this, and I don't have a dog in that fight. Probably sometimes one approach is good; probably sometimes the other approach is good. Not worth getting involved from the outside.
I agree that lack of price transparency here was a problem. At a cursory look, I would agree with the goals of the Patient Right to Know Drug Prices Act that they cite, which fixed this problem. All we need to do is take that same name, swap in "Medical Services" for "Drug" in the title, and perhaps we can work out a text that can fix more of this price transparency nightmare.
I was kidding, but I appreciate the clarification anyway. But man the prkdpa didn't fix this problem any more than the anti kickbacks statute fixed the problem of doctors taking kickbacks for prescribing certain medications.
Well, of course it didn't fix all of the problems with pricing in the industry. The industry has amazing lobbyists. All they could do is fix the one very very narrow problem of insurance companies banning doctors from telling patients they could get their meds cheaper without using insurance. Similarly with the anti-kickbacks. The laundry list of exceptions is phenomenal, and it's questionable whether they even conceptualized the problem correctly in the first place.
I'm generally skeptical of regulation. It's usually ineffectual, produces unintended outcomes, and gets ground up by lobbying efforts to protect entrenched interests. It would be my last resort as a tool to improve price transparency in medical services. However, at this point, I'm pretty much out of other ideas for how to accomplish it. If you have any, I'm all ears. Absent that, I am at the point where I would support as minimally-scoped of a regulation as is possible to say some version of, "You just have to give them a good faith price estimate for services that you're planning to do before you do them (subject to the caveat of situations where informed consent is otherwise infeasible)."
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