Transparent pricing is literally the least we can do to improve US health care

There are very few actions or aims of the current administration of the United States Executive Branch with which I agree, but one such rare alignment won a legal victory this week when Judge Carl J. Nichols ruled against the insurance-dominated medical establishment in favor of American patients.

The U.S. District Court ruling agrees with the White House that it is reasonable to force medical service providers to publish a full accounting of negotiated prices for their services. Disclosing the price a patient would pay if s/he elects to pay cash will also be required.

Insurers say their negotiated prices are their own secret treasures to share with providers, and that we—the consumers, the patients, the worried loved ones—don’t deserve to know what they are. I say that insurers offer so little value relative to the enormous fees paid to them that their wishes are irrelevant and a distraction from the goal of almost all Americans to have better health care with fewer going bankrupt to pay for it.

I believe that the administration of the U.S. medical care system could be improved in almost every way. That said, cost transparency requires no bipartisan agreements on contentious issues such as rationing of care or how much in dollars a government owes each citizen in the provision of health care.

Price transparency will cost almost nothing save a few hours of administrative work by hospital staff. Typing up and publishing these lists will take a minuscule fraction of the labor hours currently spent on insurance billing. In exchange, and, for the first time in decades, cost-conscious consumers of health care—the ill, the injured, the infirm—will have at least a passing chance to vote with the pocketbook by taking business to more efficient providers. Continue reading

Systems should serve people, not the other way around

AC/DC put it succinctly in the title of their song, “Who Made Who?” Later in the song, the lyric “who turned the screw” fits the thesis I’d like to explore pretty well, too.

From the Merriam Webster definition of System

“d : a group of devices or artificial objects or an organization forming a network especially for distributing something or serving a common purpose 

Systems surround us, especially the designed networks rapidly replacing naturally occurring phenomena that might once have been the primary driver of human choices. Weather systems can still pack a punch, but a typical modern person on a typical day can live almost completely oblivious to heat, cold, and moderate precipitation.

It is man-made systems that increasingly dictate to the people who use them. The financial system, health care systems, your cellular provider’s system, our highway system: how much of modern life could continue unimpeded without these conveniences?

A question I’ve found myself asking far too often of late is this:

When did the systems humanity designed become master of almost every human action?

Not simply “who made who?”, then, but also “who’s in charge here?”

Continue reading