> Luckily the law isn't an algorithm. Medicine is not perfectly packaged and shrink-wrapped, but a law can be written saying there must be a material basis for

> Luckily the law isn't an algorithm. Medicine is not perfectly packaged and shrink-wrapped, but a law can be written saying there must be a material basis for a difference in price. Let's keep in mind where we are today, which is that price is entirely arbitrary and capricious, and they are allowed to do that. Thats what insurance companies do. Basically their entire work is assigning different value to different care, based on quality metrics, on differential costs for different services, patient populations, etc. But insurance companies can't see how much are you willing to charge as a provider, thus the provider and the insurance are very much adversarial. > EMR coding already provides the basis for establishing a non-discriminatory pricing regime EMR is probably the main reason why upcoding has become a wide-industry practice. EMR allows you to think in how to maximize insurance values which is not the same as medical value, or patient experience. It is also not true that EMR's convolute with pricing matrix's, each insurance has a different negotiated price for different procedures. This happens for a multitude of reasons, and they are all crappy but real. > CVS is selling the same drug, from the same distributor, to different customers at wildly different prices (before an insurance contribution) based on some sort of shell game. Yes, but thats not a price problem, its a principal-agent problem. Insurance should not be covering regular medical services and procedures. It should be used for highly expensive-out of control actuarially sound events. But competition for clients has made it the way it is now since the 1950's. The way to solve that is High Deductible Plans. HDP people really price-shop and put pressure on providers to talk about cash pricing and caps.