Today in Massachusetts, physicians cannot get paid unless they belong to an organization that negotiates their rates with the insurers. These negotiating entiti

Today in Massachusetts, physicians cannot get paid unless they belong to an organization that negotiates their rates with the insurers. These negotiating entities are like unions but not really. If the insurer and the organization disagree, the insurer simply goes to a different organization to make a contract. Prices were not publicly available so each negotiation resulted in a different fee schedule. On top of that, insurers invent different 'products' with different amounts of 'coverage' for different premiums. Each of these 'products' had their own negotiation, their contracts, and their own subset of physicians who chose to participate. So what do these organizations do for the cut that they take? They reduce the burden of the insurers so they dont have to negotiate with each individual provider. Hospitals are an entirely different system. They have much more negotiating power and if an insurer has a customer that goes to a hospital emergency room outside of their contract, the insurer has to pay outlandish rates. So it is in the insurer's interest to make a deal. They achieve this by inventing different 'products' with different amounts of 'coverage' for different premiums. Each of these 'products' had their own negotiation and their contracts. Price transparency is the first good thing that has been mandated. However, this misses the mark. The focus is the patient, not the insurer, the hospital or the physician. Accordingly, patients should be allowed to submit their explanation of benefits and their bills-this is the data that reflects the true cost of healthcare. All of the numbers provided by hospitals, insurers and physicians has been massaged and buried in a forest of minutiae.