American healthcare did a fuckery

A trillion prices can’t be wrong.

My fellow Americans, I regret to inform you that our beloved health insurance industry has done a major fuckery. I know this is hard to believe, given the probity and honor we associate with our fine insurance companies, but the evidence is incontrovertible.

Back in 2019, the Trump administration ordered insurers and hospitals to start disclosing their prices, despite tens of thousands of comments filed by employers, insurers and hospitals objecting to the proposal.

This is one of those pox-on-all-your-houses/you-can’t-get-there-from-here situations. The Trump admin wanted to continue the fiction that the blame for America’s worst-in-class health care was the result of bad market dynamics. Without transparency on pricing and service, employers can’t shop for plans, hospitals can’t know if they’re getting a bad deal from insurers, and sick people are denied information needed for effective bargaining.

That’s all true, as far as it goes. The stubborn, remarkable opacity of American health-care pricing is an enormous source of mischief. Two patients receiving the same procedure, medicine or service might see bills that are thousands of dollars apart, at the same hospital, delivered by the same personnel.