The transparency imperative.

Steven Brill’s “Bitter Pill” Time cover story (1) shed disturbing light on the lack of price and quality transparency in U.S. health care. He reveals that many stakeholders in the health care system profit from concealed price and quality information, including poor-performing and highpriced insurers, providers, and suppliers (1). All of us are harmed through higher premiums and less-effective competition. Most important, patients may inadvertently place themselves at higher risk for injury or unwittingly pay more for poor-quality services. The Patient Protection and Affordable Care Act (ACA) made significant albeit preliminary efforts to collect and disseminate price and quality data. More action is essential, by shifting the basis of competition from structural market power to delivery of better value. To achieve this, we propose the transparency imperative: All data on price, utilization, and quality of health care should be made available to the public unless there is a compelling reason not to do so. The transparency imperative is part of the foundation for a post-ACA health care system that achieves better quality and cost control.