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.

EU Should Make Concessions?

That’s British Minister Theresa May’s plea to Brussels.

…the decisions that the European Union makes over the next few days will have a big impact on the outcome of the [parliamentary] vote. …  [L]et’s not hold back. Let’s do what is necessary for MPs to back the deal on Tuesday.

The EU functionaries have been playing you for a fool for a year and a half. This is confirmed by the EU’s chief Brexit negotiator, Michel Barnier:

EU commits to give UK the option to exit the Single Customs Territory unilaterally….

Don’t beg, Prime Minister; aside from denigrating the British people, it won’t be effective.

Just take Great Britain out of the EU and into the sunlight of sovereignty on schedule, deal or no deal.

An Experiment in Progressivism

This one has the advantage of being live and current. The Progressive-Democratic Party has extended its control over the State of California.  The results accumulating from the several years of Progressive-Democratic dominance (now outright control) are these.  California has

  • the highest welfare numbers (a third of all Americans on welfare live in California)
  • the largest contingent of illegal immigrants
  • a burgeoning homeless population
  • onerous regulations on business and private property
  • mediocre public schools
  • high income taxes (the highest marginal rate is 13.3%) and sales taxes
  • a yawning gap between rich and poor
  • its own summer blend of expensive gasoline
  • bedraggled and crowded roads
  • a widely mocked high-speed rail boondoggle

Sadly, it doesn’t get any better than that for California.  Or for our United States if the Progressive-Democratic Party makes further gains in 2020 or beyond.

French Tax, Tax, Tax

Now the French have decided to add another tax on American multinationals—a 3% “digital-services” tax on companies that do “targeted advertising or run[] a digital marketplace,” a tax aimed in particularly at Alphabet’s Google and Amazon.com.

Finance Minister Bruno Le Maire:

These giants use your personal data and make a significant profit from it, without paying their fair share of tax[.]

This, though, is a conflation of two separate issues, cynically done in order to obfuscate the French government’s drive for ever higher taxes and never lower spending.  It may well be that “these giants” take advantage of personal data for the sake of profit.  Whether that particular profit should be taxed especially, though, is a tax matter, not a data use/abuse matter.  Especially coming, as it does, against the backdrop of the government’s men continuing to decline to say how much is companies’ (or rich folks’, come to that) fair share.

Tax, Tax, Tax

The Progressive-Democrats want more.  It’s almost like an OPM addiction.

Now they’ve proposed the Wall Street Tax Act of 2019, which is intended to charge traders and investors a price for the privilege (apparently) of investing in economic products.  Their bill would

impose a tax on the purchase of most securities—including stocks and bonds—and on transactions involving derivatives. The tax would be about 0.1% of the value of the security or 0.1% of all payments made under the terms of a derivative contract.

Because Progressive-Democrats just can’t get enough of our money.

And this from Senator Brian Schatz (D, HI) who intends to introduce a similar bill in the Senate, citing the need to discourage “risky, volume-based trading.”

Because Progressive-Democrats Know Better than us petty citizens how to invest or trade.

Cutting spending, on the other hand, is utterly inconceivable to Progressive-Democrats.  After all, they also know how to spend our money better than we do.