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 the Rich

Of course, tax the rich, but tax everyone else, too.  The latest get (the) rich quick scheme, this one offered by Alan Davis, The Leonard and Sophie Davis Fund President and ex-founder and CEO of Conservatree Paper Company, though, falls into the same trap that all the other Progressive-Democrat schemes—Senator Elizabeth Warren’s (D, MA) wealth tax, Senator Bernie Sanders’ (I, VT) estate tax expansion, and Congresswoman Alexandria Ocasio-Cortez’ (D, NY) 70% marginal tax—do.  What Davis is proposing is

a 10% surtax on the earnings (including both income and capital gains) of the top 0.1% of taxpayers

That’s the sucker trap.  Not singling out the rich for extra taxing, but maintaining the special treatment of capital gains, other than within his surtax.

Why should capital gains—or debt interest or any other form of income, or expense—get special treatment?  That’s just the social engineering distortion of our tax code that’s so badly counterproductive for our economy.

In 2007, the last year before the Panic of 2008, from which we’ve only begun a serious recovery over the last couple of years, we Americans earned $17.8 trillion dollars from all sources: wages and salaries, interest payments, dividends and capital gains, gambling earnings, pass-throughs from small businesses, and so on, and we paid, in aggregate, $1.15 trillion dollars in taxes on that income.

Of those taxes, the top 10% of us paid 70% while the bottom 50% of us paid little to nothing.

Take the social engineering out of our tax code.  Charge a flat 10% tax on all income regardless of source, and charge it to all who have income.  Americans will spend their money where they deem fit, not where Government dictates, and businesses will allocate their money according to sound business decision, not according to Government “desires.”

That will suitably tax the rich, as well as all of us.

Set our economy free.