Tackling America’s giant hospital bill

THE HEALTH-CARE system in America has long suffered from two grave problems. The first is that not enough people have reasonable access to medical treatment if they fall ill. President Barack Obama tackled this with his landmark reforms in 2010, which succeeded in extending coverage to some 20m Americans who previously lacked insurance. Mr Obama cut a deal with America’s powerful health-care lobbies and built a grand coalition for reform that included hospitals, insurers and Big Pharma. The law was passed after an epic battle in Congress.

Unfortunately, since that success the second problem—exorbitant costs—has spiralled even further out of control. Health spending has risen from 17.3% of GDP before Obamacare was passed to 17.9% today. The average figure for rich countries is 9%. Now President Donald Trump is aiming to slay the monster. On November 15th he announced plans to require hospitals and insurance firms to disclose the true prices they charge. More transparency is a vital step in ending the health-care racket. But the plan will not work unless there is also a drive to boost competition in rigged local hospital markets.