Health Care Needs Price Tags—but Price Is Not the Same as Value

Sep 2

Key Takeaways

A bipartisan bill led by Kansas Sen. Roger Marshall would strengthen federal health care price-transparency requirements.
Patients should receive useful, advance information about what they will actually owe—not merely access to enormous data files.
Transparency could produce meaningful savings for laboratory tests, imaging and other scheduled services.
Price alone does not identify the best care. Patients also need understandable information about quality, outcomes and clinical suitability.
The bill deserves support, but price transparency should be understood as one reform—not a cure for health care inflation.

Why It Matters

Most Americans would never agree to purchase a car, reserve a hotel room or hire a contractor without knowing the price. In health care, however, patients routinely receive services without knowing what either the provider or their insurer will ultimately charge them.

Sen. Roger Marshall of Kansas is trying to change that.

Marshall and Colorado Democratic Sen. John Hickenlooper introduced the bipartisan Patients Deserve Price Tags Act, designated S. 2355. The Senate Health, Education, Labor and Pensions Committee advanced the bill by a 21–1 vote on July 22, 2026. It has not yet passed the full Senate. Senate HELP Committee⁠

The proposal would strengthen and codify existing federal transparency requirements. Hospitals, ambulatory surgery centers, imaging centers and clinical laboratories would be required to disclose negotiated insurance rates and discounted cash prices. The legislation also addresses itemized billing, employer access to claims data and advance explanations of benefits. Sen. Roger Marshall⁠

Those are worthwhile reforms. Patients should not have to write the health care system a blank check.

But a price tag is only useful if a patient can understand it—and act on it.

Where Transparency Can Work

Many health care services are reasonably shoppable. A patient who needs a scheduled MRI, laboratory test or outpatient procedure may have several appropriate options. Prices for substantially similar services can vary dramatically between facilities, sometimes within the same community.

Making those differences visible could encourage patients, employers and insurers to direct care toward lower-cost providers. It could also force high-priced facilities to explain why their services cost more.

Transparency may be especially useful for patients with high deductibles and for employers that finance their workers’ health plans. Employers cannot negotiate intelligently when insurers and third-party administrators restrict access to claims and pricing data.

Marshall’s legislation appropriately recognizes that health care transparency is not exclusively an individual consumer issue. Employers, unions and health plans need usable information as well.

Where the Grocery-Store Analogy Breaks Down

Marshall compares health care prices to price tags at a grocery store. The analogy makes the problem easy to understand, but health care is not an ordinary retail market.

A shopper can choose between two brands of cereal with relatively little risk. A patient cannot always determine whether two surgical procedures, hospitals or specialists are clinically equivalent.

Emergency care is not realistically shoppable. Neither are many complex episodes involving multiple clinicians, facilities, laboratories and medications. Patients may also be limited by insurance networks, geography, transportation, referral patterns or the availability of specialists.

Even when patients can choose, they often rely on their physicians to recommend where a test or procedure should be performed. That is reasonable. Health care decisions involve clinical judgment, not merely consumer preference.

Transparency can improve the market, but it cannot transform every patient into a purchasing agent while that patient is sick, frightened or in pain.

A Price Is Not the Same as a Patient’s Price

Publicly posting negotiated rates is valuable for accountability and research. But most patients do not want to download a machine-readable file containing thousands of billing codes and payer-specific rates.

They want a straightforward answer:

What is this care expected to cost me?

That calculation may depend on the patient’s insurer, network, deductible, coinsurance and remaining out-of-pocket maximum. Meaningful transparency therefore requires accurate, patient-specific estimates delivered before scheduled care.

The estimate should also describe what is—and is not—included. A quoted facility price may exclude the radiologist, anesthesiologist, pathologist or another clinician whose separate bill arrives weeks later.

The best price tag is an understandable estimate of the entire episode of care, including the patient’s expected responsibility.

Price Must Be Paired With Quality

The least expensive service is not necessarily the best value. Neither is the most expensive.

A meaningful comparison should include both price and understandable measures of quality. Depending on the service, that might include complication rates, repeat-procedure rates, readmissions, patient experience or adherence to accepted clinical standards.

Patients should not be expected to choose the cheapest provider without knowing whether the care is effective and appropriate. Conversely, health systems should not be allowed to imply that a higher price automatically reflects superior care.

Price transparency answers, “What does it cost?”

Value requires another question: “What am I receiving for that price?”

My Perspective

As both a podiatrist and a patient, Sen. Marshall is right about the underlying principle: people deserve to know what health care will cost before they receive it whenever that is reasonably possible.

The Patients Deserve Price Tags Act deserves serious consideration and passage. Its bipartisan support is encouraging, particularly in a Congress that struggles to agree on meaningful health policy.

But lawmakers should resist presenting price transparency as a complete solution to rising health care costs. Transparency supplies information. It does not eliminate market consolidation, limited provider competition, complex insurance rules, administrative waste or the practical inability to shop during an emergency.

Price tags will not fix everything. They can, however, expose unjustified price differences, strengthen employer purchasing and give patients greater control over genuinely shoppable care.

That would be real progress—as long as the information is understandable, patient-specific and paired with meaningful measures of quality.

Further Reading: https://www.marshall.senate.gov/newsroom/press-releases/senators-marshall-hickenlooper-introduce-legislation-requiring-price-transparency-in-healthcare/

Paul Wilson