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>> on mondays we have a segment called your money when we look at programs by the federal government. this week to look at policy which requires hospitals online. join us for that discussion, serving as their president. good morning. >> good morning. a little bit about your organization. what does it do? who is it supported by and tell us about it. >> sure come a fair health is a national independent not-for-profitit organization. they were created in 2009 to bring transparency and integrity to help insurance information for all stakeholders. we support researchers, government, consumers, industry, using data products and custom analytics and tools to really

appeal back the curtain on the health insurance industry and were supported by those that find value in products and that allows us to make tools available to all consumers across theil country. >> if a person wants to find out how much certain procedures will cost them at a hospital, how transparent is that process? >> well, beginning january 1st , somewhat more transparent. we've been bringing cost information to consumers since early 2010 and it's a journey the whole country is on. it's really health care pricing right now is in the public spotlight. i think january 1st as you know the federal government imposed an obligation on all hospitals to make their standard pricing available for procedures andre services they offer in an online format and to update.yet we likewise make a broad variety

of information to consumers and try to contextualize it. it's sending a signal that they deserve the information and itsl incumbent to really help them travel on this journey. >> expand on what's required by hospitals now and what was different before that? >> sure. so right now what is required is they include pricing for every singles service and procedure they offer to consumers based on non-negotiated prices. standard pricing meaning that which is not subject to a specific negotiation with an insuranceje company. there is no specific format required so that's one of the challenges of the new regulations. for consumers to really make their way through these lists of services, it's a bit difficult to make apples and apples comparison. i think they are signaling that

everyone can start iterating new ways in which to make it more usable, more user-friendly and that's why having a backstop because consumers can take the information that they receive on this individual websites and formulate questions that go into an independent database such asa ours. if you think about it, think about it as a windshield that's really foggy. regulations allow the defroster to be pressed to start really having that missed dissolve. it doesn't necessarily mean that you can find your way. you still need other types of directionsf and information, and signs along the road. that should help consumers. we are sort of at the beginning of this journey, but it is a journey that's been long in coming. >> or the services or what is a

searcher or a stitch or something like that. that's an excellent question. certain procedure codes used to deduce that an more technical languages. consumers will be scratching their head that they should not besc frustrated. they should take those elements on this site and move to a more consumer friendly site and begin to start carrying that information against the information that is contextualize, that is offered in a consumer friendly way. my guess is the feedback that hospitals and the federal government will give some direction on how it can be further shaped. because it's not standardized, nor is that standardized on a hospital website these listings can begs found. consumers may be really sort of walking through the words if you

will looking for trail markets to see where they can find hospital lists. it's going to be chiseled and chiseled because there will be confusion and questions asked. at least now those questions can be asked with the beginning and hopefully will be seeing much more clarity even though this is the beginning of transparency, the goal is to get the tnn clar. >> if you have questions about the policy, but the larger issue of transparency, you want to ask questions of our guests. 2,027,488,000 for those using the for those who didn't eastern and central time zones. in the mountain and pacific time zones. you can always tweet thoughts or questions. the pricing must it's called a charge master if i understand. was this information available could someone go to hospital and say can you give me these prices for these services?

>> some list their pricing of them did it voluntarily. federal governments are not meant to supplant those requirements. they are really meant to embellish what is already in existence. and even without something listed, consumers are able to call their hospital, but the ability to get the t information change from hospital to hospital. >> we saw this reaction from the house built in help association of pennsylvania. i want their initial reaction and what you think about o it. first of all, most times hospitals are paid less than charge rates. the second point was payment rates that are lower, sometimes much lower than charge is and they also add that medicare pays hospitals and what you think about those assessments and factor this into wiki's the doing day-to-day.

>> sure. but that is saying and it's true there are a lot of hospitals that negotiate specific arrangements and those arrangements vary from plan to plan. what this regulation is meant to do and by posting charge master's, the population of uninsured for one. they're not subject to those arrangements. there is also the out-of-network situation. those negotiated arrangements really speak to hospitals and health systems that have agreed to participate in the network and many times those services can be accessed out-of-network. they can be accessed intentionally because they are seeking a particular service and it's important for them to go there. but often times, it is unintentionally out-of-network. so when you think about these regulations and movement towards transparent to you, you have to look at it in the broader

context. right now in addition to thisti regulation, there are over 20 states right now trying to design statute that address the surprise out-of-network situation or the bills consumers receive for emergency services, which they often planned for by virtue of the fact it's an emergency. everyone recognizes it is unfair for unintentional audit network services such as those that may be rendered by an anesthesiologist or pathologist that might be providing services in an in network hospital and so therefore if you take the consumer out of the equation and hold them harmless to what they wouldd otherwise pay, nowadays how do you reimburse a hospital to that service. those conversations are happening in parallel to the listing of these. so just, they often do receive less than what is on their charge master even from medicare

or from a plan, but that really does not address the question of the uninsured or out-of-network situation. >> our guest is with us from fair help.word. we have calls lined up for you. our first one comes from oklahoma city. this is joe. you're on with our guest. ahead. >> hi, guys. we've had a lot of debates over health care for decades and decades. at the end of the day, the american people, which is 350 million strong has really been on the extreme shorthand of the stick, where pharmaceutical companies have literally just gouged it down to the last penny. for-profit insurance companies have basically collected all sorts of premiums, made massive profits in at the end of the day we are really being smashed by

the health care system. my question for your guest when i hear people, on i can respect their opinions, i understand the idea of transparency and costing. my question is because you never know who funds the people and they sometimes will have a nice name, but quite often the funding for companies like this and organizations like this are coming from the very people that like our system. my question for the guest is do you support a national health system where we finally bring 300 dirty million people into one big risk pool. everyone pays a little extra in taxlt and we actually have healh care that is accessible. not people going all my gosh if i go to the doctor i don't know if i'll be able to make my rent this month. >> collar, thank you. >> thank you for that question.

we talked about when it was created in 2009, but let me give you more background on not and i think it will help answer the question the caller washe askin. there were a number of questions and complaints that were raised in newrk york state about conflicts of interest that were perceived to be in data used to help support decision-making of the insurance d industry. thee data being is who's being generated by a company so whether the data were in fact flawed or not really wasn't the issue. the investigation then ended because everyone agreed even with the appearance of a conflict of interest there would be a lack of trust in the kind of informatione being taught about in the data being circulated. so is specifically created to be independent,be neutral, unbiased

to support all stakeholders in the system. this is a very fragile ecosystem. were all the routes are connected under the ground is not one single tree. our task, our mandate was to disseminate information that cat be trusted and allow everyone whether it's a plan, academic researcher, government official to exhale. we are unbiased and what policies should be adopted. our goal is to provide ingredients for sound decision-making so people can use the data that we offer to understand. we have over 27 billion health care claims in a repository. the largest in the country. that is data. our goal is to take people out on the glassom bottom boat and t

them determine and rearrange or suggest policies or ways in which the ecosystem could be battered. it's important to build a trust tr information that dancing different types of policies and that's what we're poised to help. this is kristina. >> thank you for letting me speak to you. i'm retired rn and believe me different doctors do different things and do great things are for differently. my problem with this whole idea of posting prices is health care is not like buying a microwave, tv. you know what features you'd like. health care is quite different. whether you have a cardiac problem or if you have diabetes

or a complication that arises. soso the consumer, it all sounds wonderful. health care in finding out what's wrong with you. you have no way to judge so you can make a better decision. thank you very much for listening. >> host: collar, thank you. just go that such an excellent point and you're right. health care is her usual, which is how we found ourselves in the situation we are in today. it has a lot of different practices. quality is a big condition as well. it's also critical a to what the ultimate cost should be. so you're right that there's soo many different ingredients as to what makes a procedure in the cost of the procedure.

we are learning the recognition that when insurance models really required more or less out-of-pocket costs on the part of the consumer, they suffer while the employers and plans and health systems would make the different arrangements about what those prices should be. but now it's high deductible health plans and changing reimbursement models and consumer has been plucked from the chorus line is now the star of their own insurance play in their own health care play, but they have no line. they're been asked to add live in these doctors offices without knowing what the cost will be. you're totally correct and that will be embellished with quality information and are adjusting it based on comorbidities and they should notit be penalized becaue

someonee and giving any replacement. they have diabetes or hypertension. there will be additional cost to someone just presenting in a more similar manner. so i think what this is as mentioned earlier the beginning of this journey. it should be appended with information about frequency and the patient's condition. but winning the starting point and consumers are hungry for being give them some direction so they can start adding begin to plan for what this cost may be. >> why is there such a wide range of prices when it comes to a procedure? >> guest: that's a very common question. you can imagine with 27 billion claims we seeiz tremendous disparities and we organize our data into 493 different discrete geographic markets really trying to capture the medical heartbeat

of those markets. and there is a lot of diversity. sometimes it's explained by differences in standards of living come in different communities cost of employment. for example rural communities where you're trying to attract positions and facilities to open. they may want facility whether it's a pet scan for other types of technologies. some may be market trends and leaves now but itio those disparities are made quite clean. we've already been doing that on her website, but now it's down to the hospital level. this is an opportunity for people to ask questions and ask one versus another why are you charging x versus y for this procedure and there may be very legitimate reasons are unfortunately maybe also because of the lack of the apples to apples comparison, but at least

again there's a starting point to these conversations. >> the pricing scale if they have to go to an emergency room rather than another hospital visit. >> well, that is the big concern here with emergency services. if it is a true emergency, you are not shopping for lowest cost of course. that is why there's so many states right now in some states already new york and connecticut already protect consumers against bills for emergency services that might be out of network and that is why based on those two states there are conversations going on all aroundnd the country and actors also national legislation that has now been introduced by a bipartisan team of senators in the house is picking up the issue as well. this is truly a issue protecting consumers against emergency

services are outerce of networkt you are not in the position to know before hand. >> in maryland, hello. >> can you hear me? >> go ahead, you're wrong. [inaudible] my first point is people don't understand how insurance works. insurance is supposed to make you bankrupt. they are going just one time a year. $3200 not particular. and then -- [inaudible] it's important to understand in your picking up a plan with $6500, it's really not going to work for you, but it will make sure that you don't go bankrupt if something big happens. thank you.

>> that is such an excellent point that you raise. we commissioned a national consumer survey about people's understanding of insurance principles. that level of awareness is quite low and in fact over 75% of respondents say they wish they had been given of course either in high school or in college that explained the basics covered the fundamentals of health insurance. they feel like they're being pushedel into that and now were particularly individuals 26 and older are coming off of their parents plan again is really a challenge to understand what those principles are. we in the meantime offer health insurance 101 on her website because we don't presume any knowledge on the part of the consumer. it's a very complex area. people don't understand basic

terms that premium, co-pay and adaptable. high deductible health plans are becoming quite common right now and people don't really understand implications of the plan design and it's critical to take ben insurance card and try to understand what are the elements that are governing that level of insurance because bankruptcy is not unusual and people are really having financial challenges, which again makes things the launch of these regulations. >> robert albert with the trump administration wants people can go online and find a price for the various services, what other costs have to be considered that maybe will not be listed online. >> well, interestingly, the requirement is that all services and procedures offered by the institution be listed. but that can be a challenge for consumers, whichme is why we've tried to go out of her way to explain to consumers the concept

of episodes of care or bundle d yments. what we have learned in our research is if a consumer is going to have a procedure, let's tunnel surgery, they are thinking of the surgery cost not necessarily that anastasia or radiology or other costs associated with it in the three-dimensional type of view and that is where consumers have to be right now to help them understand all the different components and while all of them are on the site, and they may be in a very disjointed way so there are free resources available to start nurturing that awareness ofwa the fact its not just one service they should be thinking about all the other ancillary costs so they can appropriately prepare for their procedure. >> up at the requirement by the federal government, what is the

penaltyfo of this information isn't available? just go right now i'm not aware of the penalties associated. i have not seen them articulated i think there is a sense that the hospital will move to compliance with the end we are already seeing that happen right away. thursday, i give it a on the part of hospitals, and they already started moving down this path. it will be interesting to see what extent there is a need and what the penalties would be. housecoat (202)748-8000. (202)748-8001 for the central and pacific time zone. new york is next. go ahead. >> caller: good morning. what i really take objection to the use of the term consumer. i am an attorney and there is no

way anyone -- i'm sorry -- can determine what their coverage is once they've been through a major health and said that. i went through -- my husband had stage four beasts all non-hodgkin's lymphoma. thankfully i was employed in hot andr employer policy that was somewhat decent at the time also they continually were reduced over time. one thing that was of particular concern to me was watching the annual cap and the lifetime cap come down before obamacare. i think most citizens in this country do notns understand that obamacare eliminated those caps. the risk that they have if they have a band-aid policy that is

going to pay 100,000, 200,000 they don't realize they could be looking at a million dollars worth of treatment. i got caught with a hospital. i had a world-renowned oncologists treating my husband thankfully i did this correctly and saved his life. it ultimately did not -- the second incident i went through with him. i did get caught the first time because we had to receive extremely strong chemotherapy and he had to have a port. the only surgeon available and the hospital to put a port in and remove that port was out of network. so iso got hit with a $10,000 charge to put the poor dan and a $10,000 charge to take the poured out. as my husband advocated fighting

as hard as i could to save his life, the last thing in the world i was at that time was a consumer. as a lawyer, as a professional i can tell you if you come to me with a set of facts, i cannot tell you given the complexities i may encounter in your case at the cost is ultimately going to be. >> i appreciate your story and telling you respect it. go ahead. >> sure, your husband was very lucky to have you as his advocate. one of the main drivers really behind the organization was a woman, a cancer survivor who had breast cancer and had challenges really mounting for her because she was also receiving care for multiple clinicians come in many him out of network. it was dizzying for her as she was trying to care for her on

condition and really take care of her family at theta same time in that story was presented to the attorney general's office. in the challenges they face. i totally agree with health care is different from the earlier callers say that there's so much complexityit to health care and knowledge toasters or tvs. it's so personal and so stressful dealing with literally life-and-death situations. the last thing you want to compound would be financial complexity and those insurance principles.il i think while we're all not position, were all patients if you will and advocates on behalf ofs patients.

and really try to keep the focus where it should be on the care and treatment in the well-being of a particular patient and not clinical setting. this is a challenge. >> dillon, south carolina. >> yes, hi. good questions and comments. one i would like you to address free care. and basically get free care. not always something in emergency. a lot of times it's for headaches or for things like that. this sends a beam cost shifting on the people who do have insurance so you have very high cost. so what should we do about that. i think people need to have skin in the game. they have to pay something because i have seen people come back day after day after day to

the er for getting their prescriptions refilled. it's crazy. the other thing it seems like we are heading towards just catastrophic care like you mentioneddea earlier. people should have insurance for catastrophic care and they should have to pay because that's the only way it seems the system's going to work. >> we will leave it there. thanks. >> ray. so what i indicated earlier about those interdependencies in the health care system and there is cost shifting under way. so here it and it unravels they are. the emergency room has been used for far more than two emergencies, which is why were singing it sure revolution going in place of service. what were seen as the emergence

of a new set of health care venues spirit urgent care centers, and literary, and latour is an estimate retail clinics,mi tele-health, to realy start allowing in a sense the air out of the balloon about pressure in the emergency room because there's a lot of non-emerging positions presentinge. there. partly because of convenience or maybe office hours not availabln to some. and so, that is starting to shift a bit and we are seeing a decrease in emergency room utilization towards urgent care setting and some of these other outposts because if you go there for something that's not emerge in, emergency rooms becauseer ty are open 24 hours have sophisticated equipment and technologies it is an expensive operation to run and therefore if someone is unable to pay, those costs have to get absorbed somewhere. it would be fascinating to track this sort of revolution going on

in these new venues because that is starting to change. >> robert thalberg, serves as their president. fairhope.org is the website. thank you for your time. >> i think the u.s. companies, the best of them tend to be ph driven, research driven aiming for a.i. to be a breakthrough. ..

>> it is focused on immediate usage and montization, and i think those approaches are more business driven. >> watch the communicators tonight at 8:00 eastern, on c-span 2. >> here's a look at our prime-time schedule on the c-span networks. starting at 9:00 p.m. eastern, on c-span, a discussion on war and the use of social media. at 8:30 p.m., on c-span 2, massachusetts republican governor charlie baker delivers his inaugural address to lawmakers in boston. and at 7:30 eastern, on c-span 3, panelists mark the 50th anniversary of the civil rights movement in northern ireland.

>> sunday on q&a, the author and columnist james grant. >> i make my living by writing about markets and something called grants, interest rate observer, which is much too expensive for some of the people out there. i think the trouble lies not so much in wall street as wall street is what it is. it's been a name either -- it's been mostly an infamous name, i would say, mostly in american history; right? but i think what we ought to be more on our guard about are the institutions in the federal government that are validly benign in their intentions. the federal reserve for example, the department of the treasury, the securities and exchange commission, these institutions set up as benefactors for the

public. increasingly they are not so. >> author and columnist james grant, sunday night at 8:00 eastern on c-span's q&a. next, policy experts examine current relations between the u.s., japan, and south korea. this panel focused on the role of soft power and the media. the event is hosted by the international student conferences and a foundation. it is an hour and 15 minutes. >> good morning. [inaudible]. >> i'm excited to be here to discuss issues relevant to the u.s., japan and south korea relations. it is not often that experts are put together on a washington panel. [inaudible] >> -- i w