The doctor will see you later

OPINION:

Do you remember the name of your childhood doctor? He remembered your allergies without checking a screen. Your mom would call the office, and the doctor would see you the same day. His office was probably a few rooms tucked into a brick building, and he ran it himself. You weren’t a “case.” You were a patient.

Today, that kind of doctor is quietly disappearing replaced by an impersonal system where you repeat your medical history to someone new and brace yourself for the bill that follows. Nearly 74% of doctors are now employed by hospitals, and some are employed by health insurance companies. This shift isn’t just eroding the doctor-patient relationship; it has created regional monopolies and driven up costs.

I’ve treated patients in my allergy and asthma practice for over 30 years. When my patients needed a sinus CT scan, if I referred them to a private doctor-owned radiology practice, the patient paid around $300 for the scan. If I referred them to a hospital-owned practice, an identical scan cost $2,500 or more.

Once a hospital acquires a medical practice, prices increase an average of 45%. Patients typically see the same doctor with the same equipment, yet they are paying more for it.

Hospital prices are also not uniform; rather the variation between prices is staggering. In one case, a Wisconsin patient saved $1,095 simply by choosing between two hospitals located 30 minutes apart.

Hospitals are not necessarily villains in this story. Most struggling private practices sell because they are drowning in debt and administrative burden. Doctors now spend two hours on administrative tasks for every hour they spend with patients. Arguing with insurers about the care patients need has become a second job. But there is no question that it is difficult or impossible to compete when one’s competitor is paid dramatically more for the same service. And patients are the real losers in this dysfunctional system.

And lack of transparency is an enormous problem. While you’re sitting in the exam room, your doctor often cannot see in real time which prescriptions or procedures your insurance will actually cover. If he could, he could discuss your options with you, and you could decide on your care plan together. Instead, doctors are forced into lengthy phone calls with insurers or slow “fax-only” processes that are designed to stall rather than deliver care while patients often get worse while they wait. This administrative burden pushes private practices to the brink and has driven many of them into hospital employment or early retirement.

For many small practices, selling to a hospital feels like the only way to survive. And when competition disappears, prices skyrocket.

Patients deserve access to care when they need it: without delays, and without having to choose between medical treatment and groceries or childcare.

During his first term, President Donald Trump began tackling unreasonable administrative hurdles that drive consolidation. Since returning to office, he has pressured insurers to provide clear, timely information about drug and procedure denials so patients can access care without unnecessary delays. To make this progress permanent, Congress must pass the Improving Seniors’ Timely Access to Care Act. This bipartisan bill would require insurers to communicate claim issues electronically, reducing approval delays and allowing doctors to focus on care instead of paperwork.

But reducing administrative burden is only half the solution. Because consolidation has already reduced competition in many communities, price transparency can restore some competition and empower patients to shop around for the best price.

Also during his first term, President Trump signed the No Surprises Act into law, which required hospitals to post clear, upfront prices so patients could compare costs for non-emergency care. Unfortunately, President Joe Biden refused to enforce Trump’s price transparency law, and 45% of hospitals didn’t comply. If the price transparency rules had been fully enforced, analysts estimate that it could have saved patients, employers and insurers up to $80 billion by 2025.

After returning to office, President Trump signed an Executive Order directing stronger enforcement of his price transparency law. In January, Congress passed stronger price transparency reforms, led by my colleagues on the GOP Doctors Caucus.

We cannot undo consolidation overnight, but we can insist on policies that restore competition, demand transparency and reduce the administrative overload that is suffocating private practices and driving up costs.

It’s not too late to return to a system where moms don’t hesitate to call the doctor out of fear of a devastating medical bill and one in which the doctor remembers your name.

• Rep. Bob Onder has represented Missouri’s 3rd Congressional District since 2025. He is vice chair of the House Education and Workforce Committee’s Subcommittee on Health, Employment, Labor, and Pensions and is a member of the GOP Doctors Caucus.