A No-Deal Brexit

The Wall Street Journal opined earlier this week that, in the words of the piece’s subheadline,

A no-deal crash out of the EU may be the best outcome now.

The rest of the thing was a string of rationalizations of why this is true, but the heart of the matter is that subhead.

In fact, though, a no-deal departure always has been the best outcome.

A priori because that’s what the Brits voted for in their referendum—they wanted their sovereignty and control of their own borders back. Full stop.

In retrospect because Brussels has acted in bad faith, solely to punish the Brits for their effrontery, ever since. EU leadership, lately in the person of Donald Tusk, has acted in echo of Jacques Chirac’s slam on eastern European nations:

It is not really responsible behavior. It is not well brought-up behavior. They missed a good opportunity to keep quiet.

There’s no reason at all for the Brits to talk further with the EU regarding the terms of Great Britain’s departure for freedom.

Update: Yesterday, the British Parliament voted against a no-deal Brexit and in favor of going to Brussels and beg for more time to negotiate. What happened to the courage that led Great Britain to build a globe-spanning empire?

Fortunately, Parliament’s move is non-binding. We’ll see whether Prime Minister Theresa May has the courage required to stay with the scheduled date for British departure, currently 29 March.

Medical Services Price Transparency

Hospital and insurers want to keep their pricing agreements hidden from those who must pay those prices, especially those who must pay under the duress of huge costs and the immediacy of the need for medical services.

Hospitals and insurers are gearing up to battle a Trump administration plan that could require the public disclosure of negotiated prices for medical services, part of an effort to lower US health-care costs.

Because price transparency facilitates competition, which in a capitalist, free-market economy helps drive costs down.  But hospitals and insurers insist

such a move would force them to disclose prices that would be of little use to consumers, who just want to know what they need to pay out of their pockets, not the full price of the service.

It’s true enough we want that bottom line—so we can shop around—but we also want those intermediate prices so we can get an idea of the markups we’re being expected meekly to accept.

A transition to actual transparency also would be disruptive:

While hospitals fear new demands from insurers to lower prices, insurers could also face price pressures if hospitals that get lower reimbursements demand the higher rates their competitors have won. Also, insurers that have wrangled the steepest discounts may not want those rates exposed to competitors that would then be able to push for similar pricing.

That’s uncomfortable, but it’s also temporary.  After a remarkably short time (depending on how piece meal the transition would be vs ripping the band-aid off and being done with it vs something in between), prices would stabilize, consumers would be better off, and hospitals and insurers would be adapted to open competition.  Just like the rest of the economy—say home improvement or grocers—is.

Moreover, insurer contracts are complex and hospital systems typically have multiple contracts with each insurer, each with different terms.
“It’s going to be a big lift to actually make this happen,” said Niall Brennan, chief executive of the nonprofit Health Care Cost Institute, who said he applauds efforts to make health-care pricing more transparent. If it does move forward, “It’s going to put a lot of hospital CEOs and CFOs in the hot seat.”

That last is the crux of the matter.  Transparency will embarrass some folks.  Never mind that the embarrassment often would be unjustified, except in our current professional victim environment.  Those CEOs and CFOs, for the most part, were simply doing their jobs in getting the best prices for their companies—and doing their fiduciary duties to their shareholders.

Complexity, on the other hand, might be a valid beef. However, that’s a consideration related to how to implement price transparency; it has nothing at all to do with whether price transparency ought to be implemented.