John James: Hospital prices are a confusopoly

WASHINGTON - People drive out of their way to fill up with cheaper gas. They check different websites for the best price before making an online purchase. They price compare before buying a flight.

So why do they blindly pay whatever it costs to get a non-emergency medical procedure?

They do it because hospital prices are confusing and hard to find. And as a result, patients can end up paying hundreds or thousands of dollars more for the exact same services with the same level of care, with the same billing codes.

That's the argument Rep. John James made during a Congressional committee hearing Wednesday while urging lawmakers to pass his "Patients Deserve Price Tags" legislation (H.R. 5582), which will help people save money and lower health care costs by requiring hospitals to clearly label prices.

"The idea behind this legislation is simple," said James, R-Shelby Township. "It will make it easier for patients to price compare when getting medical treatment so they can pick the lowest-cost option, just like they do in every other aspect of their lives."

James has also argued that hospital prices are difficult to navigate on purpose.

"Dilbert Cartoonist Scott Adams had a term for this kind of system: Confusopoly. He called it that because the friction that makes it difficult to shop around is by design," James said during an April 21 hearing.

"Patients Deserve Price Tags" was part of the "Lower Cost, More Transparency" legislation the U.S. House of Representatives approved last term. It passed the House on a wide bipartisan basis of 320 to 71, but it died in the Senate, which was controlled by Democrats at the time.

This term, there is an identical version of James' bill in the Senate that has 10 Democrat and 10 Republican senators as co-sponsors, meaning one-fifth of the Senate is already on board.

"Passing this bill again in the House should be a no-brainer. We can and we must get this done," James said.

The Department of Health and Human Services issued a rule in 2020 requiring health care providers to clearly label prices so that patients can make informed decisions about where to get treated. But under the Biden administration, that rule was not enforced.

In 2025, President Trump issued an executive order to "Make America Healthy Again", which included an April 1 deadline for health care providers to comply with existing-but-unenforced price transparency rules.

On Tuesday, HHS Secretary Robert F. Kennedy Jr. announced that the grace period has ended, and that the Trump administration is enforcing hospital price transparency. James' "Patients Deserve Price Tags" legislation will make that change permanent and provide a stronger enforcement mechanism.

James had expressed concern about this issue to Kennedy in an April 21 committee hearing.

James represents Michigan's 10^th Congressional District, which includes portions of Oakland and Macomb counties.