CMD's Wendell Potter to Appear on Bill Moyers' Journal

Wendell Potter makes a number of good points, but he has thrown in with people whose objectives are to collectivize the economy, and they are just as bad as those Potter "blew the whitstle" on. Instead of having the government grab control of 1/6th of the economy as proposed by the idiotic 2700 pages of legislation known colloquially as "ObamaCare," if we had the moral courage to take ONE STEP AT A TIME, we should be able to agree on any number of BASIC elements, among them portability, intrastate competition,TORT REFORM, private carriers having "assigned risks" divided up among them for those who otherwise would not be able to get coverage, etc.

Anyone who has ever seen an EOB where their carrier settled a bill (including your copay) for 22% of the "sticker price" billed (that is, with 78% "written off") knows that free markets have not worked because we don't HAVE free markets. We have providers and carriers engaged in a tug-of-war that leave patients (i.e., the party for who they are supposed to be Hippocratic oath-bound angels of mercy and financial intermediaries, respectively) out in the cold. The best cure for 2700 pages of complexity is frequently simplicity; we can solve THAT one with ONE SIMPLE LAW, the morality of which is self evident. To wit:

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The purpose of this Act is to promote free market competition in order to retard inflation of health care prices.

(1) Any health care provider shall be free to set its own prices for any given service and to change such prices at will (but not more frequently than daily),

AND

(2) each health care provider shall be required to charge the same amount to all its patients for each particular service delivered on the same date, regardless of whether or by whom the patient’s care is insured.
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One insurance and economics professor told me that carriers "deserve" discounts for the "tremendous volume" they bring providers. I asked him what financial intermediary "deserves" anything at the expense of the principal party it serves; I asked what medical bill is not billed INDIVIDUALLY to one "customer" (the patient). No one buys 500 kidney transplants at once to get a "discount!"

Under the two simple rules stated above, providers would be at liberty to set their own prices (the absence of which killed HillaryCare). They would also assume responsibility for setting their rates high enough to cover a reasonable profit and some bad debt experience, along with the cost of collections. Carriers would have to LIST their payout rates for all medical service codes in the contract BEFORE they sold the policy to an end user. Patients need to be financially responsible for any balance left over. THIS IS HOW ANY OTHER FREE MARKET WORKS WITH INSURANCE PLAYING A FINANCIAL INTERMEDIARY ROLE.

While other elements (portability, etc.) are needed, they will ultimately fail to provide real reform WITHOUT these rules to rationalize pricing fairly. Further, these two rules in a truly free market would do more to contain inflation in healthcare (and make insurers competitive) than all the other elements added together.

Why NOT do this? And why not do it FIRST?

NOTES:

A. It is immoral to allow the shell game of artificially inflated “Sticker Prices” for health care. In an industry supposedly motivated by altruism and the Hippocratic Oath, it is simply unjust to coerce people into cartels of insurance coverage (whether public or private) and systematically prevent disclosure of real prices – which is exactly what the present system does on nearly every “Explanation of Benefits” form. Whether CIGNA or AETNA pays the bill should make no more difference to either the provider or the patient than the races or religions of doctor and patient.

B. The dishonest quotation of fictitious and exorbitant “Sticker Prices” with phony discounts or write-offs applied to them deprives Americans of the competitive effects of genuinely free markets, and should be banned as collusion by federal anti-trust laws.

C. The call to fix prices (as in HillaryCare) or coerce employers to provide care as a fringe benefit (ObamaCare) distorts the competitive effects of an otherwise free market, and should be discouraged, if not banned outright as illegal.

D. A common objection is “what about those who don’t pay anything?” The truth is, people who are taxpayers and those who are insured are paying for them NOW. Truth in pricing would use free market mechanisms to (1) identify such costs, and (2) bring competition among providers to bear in containing such costs in a way that is not done effectively now.

E. Real honesty in pricing will employ free market competition to bring about more reform in health care in one year than all efforts WITHOUT such honesty can in a decade.