There have been many outrages in the last century, but in that list would have to be the cost of medical care. Both political parties blame each other, and there is plenty of fault to go around. Every once in a while, there are band-aid solutions such as getting a particular drug company to lower the prices on some important pharmaceutical. Other times, the government simply picks up the tab, and consumers ultimately pay in higher taxes and higher prices.

What is missing in the medical healthcare field is full disclosure about pricing and costs. In my time on Pennsylvania’s Patient Safety Authority, and in numerous other endeavors involved in the medical field, I have always been amazed by how little information the medical community really gives about costs, and the basis of their charges.

Recently, a close relative of mine had a very minor procedure whereby a device was implanted in her skin which measures her heartbeat rate. The information is remotely received in order to know whether additional care should be rendered to the patient.

The tiny device, not much different than an Apple air tag, was charged at $16,810. The surgery to implant the device just below the skin, which took approximately 10 minutes, was $4,674. The surgical bill was $836. The grand total was $22,320. This is merely the “submitted charge.” This is not what will be paid by Medicare. This was the bill from Blue Cross.

Where does Blue Cross get these cost figures from? Did they receive a bill from the doctor, the hospital, and the medical supplier? Unquestionably, the answer is “yes.”

The patient, not surprisingly, was outraged. “No wonder medical healthcare insurance is so expensive in this country,” she said. She is absolutely correct.

One of the legislative solutions which I have trumpeted for well over 25 years is to turn patients into consumers. In some states, the complication rate for particular procedures is published. It is required to be made known to the public as a matter of law. There is no uniformity in this regard.

The federal government, through its constituent agencies, should require that every hospital and healthcare facility in the United States which provides medical care list its complication rate in the 10 most frequently performed procedures. Consumers will choose the safest option, and this will cause the outliers to clean up their act.

Take infections for example. It has been widely written that approximately 10% of patients who go into hospitals will wind up with a hospital acquired infection. The cost of fighting those infections is the single highest cost of medical care in the United States. The drugs and antibiotics used to fight hospital acquired infections are astronomical in costs, not to mention the hospital and medical care that must be rendered to the patient. All of this gets billed to insurance, the government or to the consumer.

Hospitals bill outrageous amounts of money, presumably because somebody is billing them. The insurance companies pay a fraction of what is owed, and Medicare pays even less. Sometimes the patients get billed for the excess, and other times the amount goes unreimbursed. This system is nuts. Who would do business that way and get away with it?

What we need to do is have full disclosure about what hospitals charge for procedures, medications, even aspirin. What do they charge, and do they have different charges based upon whether an individual is paying as opposed to the federal government or an insurance company. There should be one price for everyone. That should be required by law. One price for everyone, whether it is a big insurance company like United Healthcare, United States of America, or Joe Schmo down the block.

There should also be an obligation for the hospital to reveal what it has paid for the product or service that it is charging for. Hospitals know what these amounts are because they have sophisticated computer systems, and they are well aware of what they are paying for products, pharmaceuticals, medical devices, and “yes,” even salaries. A doctor who charges $836 or $10,000, is being paid by that hospital. The hospital knows what their cost really is for that procedure or the care rendered by a particular doctor.

Full disclosure as to what hospitals charge; the same charge for all; and publication of the actual cost of all services and products will drastically reduce the cost of medical care in this country. That reduction in the cost of medical care will be passed on to insurance companies and must be passed on to the consumer as well.

If hospitals were required to publicly and periodically list their complication rate; infection rate; charges on a uniform basis; and the cost to the hospital, we would have a completely different structure for medical care in the United States of America.

Will any of these proposals pass? The answer is absolutely not. Keep in mind that pharmaceutical companies like Johnson & Johnson have sales of more than 92 billion dollars a year. The medical healthcare industry, the pharmaceutical companies, and hospitals in general are without question the single most significant industry in this country. They are the tail wagging the dog.

No solution that the Democrats or Republicans come up with is going to reduce medical care except the proposals listed here. What the Republicans and Democrats will eventually come up with, when the public demands it, is government handouts and increased taxation to the public. The Democrats will scream that billionaires should pay the healthcare bill, and Republicans will make a big fuss over costs imposed by Democratic mandates. They are both wrong, wrong, wrong. They are protecting Big Pharma, the hospital industry, and a way of doing business which is wholly unprincipled.

It is time to pass the legislation suggested here, and this author intends to write it and submit it at both state and federal levels. We will call it the: “DOMB,” Disclosure of Medical Billing.

This will cover not only proper disclosure of medical billing practices, but also medical errors and complications in hospitals.

How many people know that in Pennsylvania, for example, the Patient Safety Authority, by law, collects information about unanticipated medical events throughout the state on a regional basis? Yet, none of that information on individual hospitals which Pennsylvania collects is made publicly available. The Patient Safety Authority is supposed to publish and give to the Pennsylvania Legislature a “report” about medical events. Has anyone ever seen that in the public? Even where there are full disclosure bills, they are either unreadable, generally not made available, or wind up in somebody’s trash bin.

We can and should do better. This is a capitalist democracy. We must utilize the benefit of what it means to be capitalists, to provide the kind of information that consumers want and need to make informed choices. The time is now!

It may not be Domb, but it is the correct thing to do.

Clifford A. Rieders is a board-certified trial advocate in Williamsport.