Medical product and service prices should be fair, reasonable and non-discriminatory. But, they aren't. The current system of negotiated health care prices ensures inevitable inequity. Large insurers, who have the most negotiating power, pay the lowest prices and thus shift costs onto smaller insurers and the uninsured. Thus, small insurers often subsidize their larger competitors while the uninsured, who are often those who can least afford medical care, pay the most since they have the least negotiating power. The current system is also anti-competitive in that it encourages consolidation of hospitals into larger groups with greater pricing power.
Many see the creation of single-payer systems or government rate-setting as solutions to medical pricing inequity. But, after many decades of fighting, Vermont is still the only state with even the beginnings of a "single-payer" system and of over 30 states that once regulated prices, only Maryland continues to do so today. It is time that we look for strategies more likely to bring fair, reasonable and non-discriminatory pricing to our health care system.
While it is easy for the radical right to condemn single-payer or rate-regulating systems as "socialism" or worse, it strikes me that it would be much harder for them to explain to their constituents what evil lies at the root of a requirement for "Fair, Reasonable and Non-Discriminatory" pricing.
I've written a "Request For Comments" which explains why the current system of negotiated prices inherently results in inequitable pricing and which proposes that New York State adopt a requirement for Fair, Reasonable and Non-Discriminatory (FRAND) pricing. I would very much appreciate any comments that you might be able to provide on how I could improve this proposal, either in substance or in form. Please consider reading and commenting on: https://googledrive.com/...
The essence of my proposal is that we should move to a system in which all providers of medical products and services are required to quote a single price for all payers, whether they be insurers or individuals. This is often referred to as "competitive pricing" and would result in "Equal Pay for Equal Work."
