“Price transparency” is a phrase used by politicians right and left to oversimplify real problems with health-care costs, access and delivery in the United States. This fall’s campaigns for state and federal offices should move beyond that social-media meme to a debate that respects the public’s ability to comprehend.
Republican candidate for governor Tom Tiffany has made health care price transparency a campaign pillar, calling for rules to require hospitals, pharmacies and other health-care clinicians to give upfront cost disclosure for many patient procedures. He sees it as encouraging a free-market approach to controlling costs.
As a member of Congress, however, Tiffany was not always “free market” when it came to health care. He voted to protect federal tariffs that could raise drug prices by
$600 per household once fully implemented. Tariffs have also raised the cost of medical supplies, such as catheters and IV bags, by 15%.
Like most Republicans, he voted against extending Affordable Care Act tax credits. As a result, health care systems swallow more uncompensated care as rising premiums cause people to drop insurance coverage. It’s more akin to cost shifting than free-market economics.
Tiffany’s opponent in the general election is Democrat David Crowley, a two-term Milwaukee County Executive. While he has not called for health care price transparency, he has urged an expansion of Badger Care, the state-federal state program that offers full-coverage Medicaid for low-income adults and children.
Crowley wants to “open Badger Care enrollment to any household that wants it, using federal Medicaid matching funds to cover portions of cost.” He would do so by using “a sliding scale premium based on income, with targeted subsidies for small businesses, farmers, gig workers, single parents and college students.”
He would also “make Badger Care comprehensive” by including dental, vision and mental health care. Crowley should explain how to pay for such a dramatic expansion – and tell clinicians how they can handle the surge in patients.
None of this is to suggest health care is without serious cost problems. Solving them in whole or part would help Wisconsin’s economy become more efficient.
Nearly half of all U.S. hospitals don’t turn a profit, mostly those not affiliated with a large system. Uncompensated care – which means not getting paid for helping some poor people – is a related dilemma. Government insurance is underfunded and operational costs are rising. That includes administrative costs, which might be easier to cut if there weren’t so many regulations to meet.
“Roughly 60% of hospitals make some margin. Approximately 40% lose money,” said Scott Becker, a Chicago-based analyst who spoke in Wisconsin recently as well as during a 2025 Wisconsin Technology Council conference.
There’s more: Adopting cutting-edge research saves lives and relieves suffering, but it rarely comes cheap. Mega-mergers add to the problem if they reduce competition. The U.S. population is aging and more people of all ages have chronic conditions, such as cardiovascular disease and diabetes, that require ongoing care. Preventable medical errors are costly from a readmission perspective, if nothing else.
Workforce shortages are a major issue for hospitals, clinics and nursing homes alike. It starts at the top and works its way down health care’s supply chain.
There are serious shortages of specialists and sub-specialists, in large part because it takes so long and costs so much to train them.
Shortages are no less severe in nursing, where not enough people are earning degrees and it can take too long to do so. New nurse training methods include accelerated nursing degrees, competency-based tracking and simulation technology to cut timelines to 18 months or less.
Producing more workers is a major reason why the Universities of Wisconsin will ask for $90 million in the next state budget to accelerate training for 35,000 health professionals.
Health care “price transparency” is very difficult when the system is opaque for many reasons, some of its own making and some due to overlapping private and public overseers and payers.
Complexities don’t stop politicians from applying simple bumper stickers to the rear of their campaign vans. Wisconsin’s economy needs a health-care debate that helps patients, businesses, workers and clinicians alike.
Still is past president of the Wisconsin Technology Council. He is an adviser to Competitive Wisconsin Inc., a non-profit public policy group.
