The Hidden Game Behind Hospital Pricing - and Why It’s Time for Transparency

By Pearly Chen, Co-Founder & CEO of Openbook Health

If you’ve ever tried to understand a hospital bill, you’ve probably felt confused, angry, or defeated. You’re not alone. Even healthcare insiders can’t make sense of it - and that’s by design.

In America’s healthcare system, patients are asked to shop blindfolded. Prices for the same MRI can range from $350 to $3,200 depending on which door you walk through, yet the system keeps patients - and employers footing the bill - in the dark.

As Mark Cuban recently put it, “Insurance companies structure deductibles to be unaffordable, making most care unaffordable. Carriers have no financial responsibility. They just keep the premiums.” He’s right. The system wasn’t built to serve patients or providers. It was built to preserve opacity - because opacity protects profits.

The Triple Hit of a Broken System

Here’s how this plays out every day:

1. Patients can’t afford care. High deductibles and surprise bills leave families delaying treatment, rationing prescriptions, or skipping care entirely.

2. Providers get squeezed. They’re underpaid, undercut, and buried in administrative burden — forced to hire armies of billers and lawyers just to get reimbursed.

3. Insurers win both ways. They collect premiums while offloading risk onto patients and providers, exploiting a system too complex for anyone else to navigate.

The result? Everyone loses — except the middlemen.

When Prices Are Hidden, No One Wins

A system this dysfunctional isn’t sustainable. It’s not just unfair - it’s economically irrational. Healthcare now represents more than 20% of U.S. GDP, yet even large employers often have no idea what they’re truly paying for.

Employers think they’re buying care. In reality, they’re buying complexity.

And that complexity hides billions of dollars in waste, markups, and misaligned incentives.

What Transparency Makes Possible

At Openbook Health, we’re building a future where anyone - patient, provider, or employer — can see what care actually costs and what quality they’re getting.

Our mission is simple but radical:

Bring sunlight to healthcare prices so everyone can make informed decisions.

We analyze the newly public hospital price files and turn them into an intuitive, searchable tool that compares real prices across hospitals and procedures. What used to take hours of detective work now takes seconds.

It’s not just about fairness — it’s about power.

Because when people can see clearly, the game changes.

Where We Go from Here

Transparency alone won’t fix everything, but it’s the foundation for reform. Once people know the truth, employers can demand fairer contracts, patients can make smarter choices, and innovative care models - from direct contracting to value-based care - can actually scale.

We believe healthcare should work like any other marketplace: clear prices, trusted quality, informed choice.

It’s time to stop playing a rigged game and start building an open one.

If you believe in this vision — whether you’re a patient, employer, or healthcare innovator — explore the Openbook beta today at https://app.openbook.health.

Together, we can make healthcare make sense.