By Steve Pociask, For The Trentonian New Jersey residents are falling behind and there’s a clear culprit: soaring healthcare expenses. A recent report from the Governor’s Office of Health Care Affordability and Transparency details the growing burden on households. According to one survey from the report, nearly half of all New Jersey respondents delayed or avoided care due to high costs; over a third had difficulty covering their healthcare bills. In 2022, it notes, out-of-pocket medical spending averaged $2400 in NJ, surpassing the national average by 37%, while quality decreased for many performance measures. While there are no silver bullets in an industry as complex as healthcare, one solution that could bring down costs significantly is price transparency. Fortunately, New Jersey Governor Phil Murphy has developed an initiative to address just that: The New Jersey Health Care Affordability, Responsibility, and Transparency (HART) Program. Launched in 2021, the program is designed to slow the rate of healthcare cost growth. While the HART program is a promising start, more needs to be done to hold hospitals accountable. It’s time for New Jerseyans to push for full transparency and ensure healthcare providers live up to their commitments. To understand why transparency is so important, consider first how opaque and frustrating the process is today. Say you go to your primary care physician for a routine checkup. He notices an irregularity in your bloodwork and tells you to go to the hospital within the next week for a colonoscopy. You go to the hospital the next day and sign a piece of paper that guarantees you’ll pay all ensuing charges as a condition of care, irrespective of cost or medical necessity. You have the procedure and return home. At no point in the process were projected costs discussed. 30 days later, a bill comes in for a few hundred dollars for anesthesia. The next week, another bill arrives: two hundred dollars for lab work. Then another one for facility fees. The process continues for weeks. When will it end? And were there cheaper options that the patient was never offered? These questions are never answered, and rarely asked, in a model that leaves patients and often even providers in the dark about the true cost of care. And sometimes the costs are not in the hundreds of dollars but in the tens or even hundreds of thousands of dollars. In a functioning market – for sneakers, or groceries, or home repairs, for instance – prices are listed upfront and consumers can ask for discounts, compare between multiple products or companies based on cost and services provided, and make informed decisions that reflect their budget. But this rarely happens for medical expenses. Not surprisingly, given the opacity around price, overcharging and overtreatment is common, with one study reporting that a shocking 25 percent of U.S. health expenditures are comprised of such costs. Patients play a passive rather than active role in decision-making and then are forced to foot the bill, which may not even reflect the services they were given. But the process is so complicated and obscure that it’s difficult to tell if they are being charged fairly or not. Some existing legislative attempts to curtail obscure pricing already exist – notably, the federal Hospital Price Transparency Rule, which began in 2021. Under this rule, each hospital operating in the United States is required to provide accessible, clear pricing information online about the items and services they provide. But these rules are frequently skirted or ignored altogether. Take New Jersey, for example, where only 41% of hospitals were fully compliant with the federal transparency rule, with many organizations having either missing or significantly incomplete pricing data. It should be no surprise, then, that the rate of healthcare spending per person in the state jumped significantly higher than the national average. To avoid these duplicitous practices, patients need hospitals to provide them with clear, itemized costs before treatment, outlining expected charges and any potential out-of-pocket expenses in an easily accessible format. This transparency would empower people to make informed decisions about their care, shop for the best value and avoid financial surprises that too often burden families. But hospitals won’t do it until voters demand transparency and legislation with sufficient enforcement power is in place. And to be sure, full transparency around cost and quality of service is not always possible. In emergency situations when patients are incapacitated and time is of the essence, providers must do what they think is best for a person’s health. But day-to-day health treatment need not follow the emergency-care model. New Jerseyans deserve to make informed decisions about their care, just as they do in other sectors, especially as healthcare now makes up 20% of the U.S economy. Transparency around pricing is a critical first step in achieving that. New Jersey’s Governor Murphy is moving the state in the right direction with his HART program. The path forward is clear: now is the time to strengthen transparency measures and bolster enforcement mechanisms that ensure good policy is successfully implemented. We need hospitals and medical providers that work for us without charging exorbitant prices. The sooner we demand it, the sooner we can begin to relieve the financial burden on families across the state. Steve Pociask is president and CEO of the American Consumer Institute, a nonprofit education and research organization. For more information about the Institute, visit www.TheAmericanConsumer.org or follow us on X @ConsumerPal.