It is no mystery that health care costs and insurance premiums are spiking higher than Americans can afford.
Two factors -- lack of industry transparency and burdensome government regulations -- have created an environment that allows hospital systems to charge double, triple or more than what other providers are charging for the same health care products and services. Patients are paying the inflated price both financially and emotionally, to the detriment of their health, as medical entities charge more for a lower quality and quantity of care.
Patients needing swift, emergency care are often shocked to see the bill after treatment. Pricing data reveals that the cost for the same procedures at the same hospitals varied by an average range of 10.7 times in 2023 when comparing insurance plan negotiated rates. Prices at different hospitals in the same state varied an average range of 31.3 times for the same procedures when comparing hospitals and insurance plan negotiated rates.
If the cost of gasoline in the same area varied as much as the charges for medical procedures do, consumers would pay $535 to fill their tank when it might cost them $50 at a nearby station. Such a wide discrepancy in gas prices would quickly put the stations that gouged customers out of business. Why do hospital systems continue to get away with inflating prices and hiding the cost of care until after treatment is delivered?
Perhaps unsurprisingly, overregulation is also artificially driving up the cost of health care. President Barack Obama's implementation of the Affordable Care Act, for example, still has cascading effects on the medical industry. The national average monthly premium paid in the individual market more than doubled from $244 to $558 between 2013, the last year the insurance market was unaffected by the Affordable Care Act and 2019. In 2025, those on the Federal Employees Health Benefits Program are projected to experience the largest health care premium increase in more than a decade.
To address the skyrocketing costs and plummeting quality of health care, Solidarity HealthShare uses a reference-based pricing, or RBP, model when reviewing medical bills and negotiating payments with medical providers on behalf of our members. We have found that RPB ensures access to affordable care for members and can save them as much as 60% compared with traditional health insurance policies.
This model saves money in ways that traditional insurance and most other health-sharing ministries do not. If more ministries and traditional insurers were to use RBP, more Americans could access the high-quality care they need at far lower cost.
RBP works by carefully reviewing individual provider bills and negotiating with the provider fair and reasonable prices that are free from unnecessary fees and price gouging. Solidarity, for example, bases this negotiation in reference to what Medicare would pay for the procedure in the geographical location it was received. The benefits to this method -- exceptional savings and eliminated waste -- greatly outweigh the downside that negotiations can delay the sharing of health care costs among members.
Bad policies and bad actors that exploit our broken health care system and force Americans to compromise their health and their finances must not continue to go unchallenged. Reference-based pricing addresses waste and price gouging at the source, assuring our nation's leaders that if they took similar steps to demand fair and reasonable health care pricing, we'd soon see a more efficient and effective American health care industry that delivers higher-quality care.