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Health Reform, American Style by Hobson Carroll
Today’s health care financing mess requires an American fix. We need a rational solution that recognizes where we have come from in paying and providing for health care in this country, as well as our government, history, culture, economic system and all the other things that define us as a nation. The entire world is struggling with health care financing. Solutions need to be locally relevant, and the United States is no exception. My proposal for reforming core elements in the health care system follows.
Everyone Is Charged The Same Amount
Currently, the same service from the same provider costs different parties different amounts depending on who is paying. This is patently ridiculous for something society has effectively stated is a right, or at least a social utility. We must require all-payer, transparent pricing from providers for their products and services. Each provider is free to set prices as they deem appropriate, but those prices must be the same to all purchasers.
I am referring to a price that represents the true, bottom- line net charge that the provider bills and collects. Payers won’t be able to negotiate with providers for special discounts or pricing concessions for any reason. If a provider agrees to a particular schedule of fees or prices with a given payer, fine. But it then applies to every other payer as well.
This doesn’t mean that insurance benefits must cover whatever the provider charges. Schedules of allowed maximum charges, or networks of providers for which the insurer will cover 100 percent of the provider’s fees, will come into play. Applied against these will be the usual cost- sharing devices of copayments, deductibles and coinsurance.
Provider charges that exceed the insurer’s allowed charge schedule, however, must be balance-billed to the patient and should be treated the

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