A Narrow Window of Opportunity for PBM Reform Action Weekly Advocacy Update

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MANGIONE/MASS: What Do We Want? Healthcare Price Transparency — NOW!

Struggling Americans told political candidates early in 2024 that healthcare costs topped the list of their financial worries.

Congress would do well to listen.

Hospital costs have been nothing short of a gluttonous sinkhole of American wealth.  Not only has inflation in those costs outpaced inflation in college tuition, but the rate of increase has accelerated, even as Americans continue to pay more into the third-party payer system that is supposed to ensure that the costs are “covered.”

In 2019, the Trump administration took an important first step toward solving the conundrum of healthcare costs when it announced an Executive Order—Improving Price and Quality Transparency in American Healthcare. Within months, Health and Human Services announced requirements to implement the executive order.

The order required hospitals to publish an easily readable file of their prices, while group health plans and insurance companies were to provide estimates of out-of-pocket costs and reveal what hospitals and physicians would receive before services were delivered.

When made public, this information would allow Americans and the nearly 55 percent of employers who pay for their employees’ health insurance to become consumers without blindfolds.

Accurate information on prices is essential to the functioning of a sane marketplace.

In case you missed it, American healthcare is not sane.

Despite even the Biden administration doubling down on the penalties for large hospitals not complying with the rules, the overwhelming majority of hospitals and healthcare systems ignored them. As of November, one source reported that only 21 percent are in full compliance.

Why have corporations felt free to thumb their nose at the government in this way?

The reason was obvious. The penalty was either negligible or not adequately enforced.

Then, on December 11, 2023, longsuffering taxpayers and abused patients were tossed a promising bouquet from the House of Representatives in the form of a bipartisan bill (H.R. 5378, The Lower Costs, More Transparency Act) that had originated in the Energy and Commerce Committee. When put before the entire House, the bill passed by a whopping majority of 320-71.

But something was off.

The heavy penalty the bill had originally sought to impose on institutions that failed to comply with the law had been greatly reduced. Things were again being set up to favor non-compliance, just as with that executive order of 2019 and the accompanying regulations promulgated later that year.

Even so, that walloping majority voted the way it did in the face of strenuous opposition from the American Hospital Association and other elements of this country’s increasingly corporatized healthcare delivery system.

An entire year has passed since that huge majority in the House voted as it did.

The Senate has taken no action on the bill.

Nothing has landed on the president’s desk for signature.

And now a window of opportunity is closing fast. A new administration and Congress will soon be distracted and buried by an avalanche of other business, and crises.

But if the current Congress—the Senate and House working together—and the Biden White House can act now, before the holidays, to turn this stalled legislation into law—with the original heavy penalty restored—a major victory will have been won in the war to restore sanity to a deranged healthcare system and its wildly distorted economics.

The incoming administration and Congress will have the wind at their backs in the continuing work to restore sanity to a desperately sick healthcare system.

Continued non-compliance with transparency requirements will be so painful that it will be unthinkable.

America wants, needs, and deserves to have a floodlight trained on the serpentine inner workings of its healthcare system and how it is paid for.

Waste, fraud, abuse, and profiteering thrive in darkness.

Legalized thievery thrives in darkness.

Come on, people!

Cram that senatorial voicemail and email inboxes to let your public servants know what they MUST do.

Drive those servants to move speedily—as in now—to restore the heavy penalty to the law that prohibits skulking in darkness and defying the bipartisan will of the nation’s elected political leadership.

Drive them to deliver that legislation NOW to the President’s desk for signature before the initiative is buried under the inevitable avalanche of new political business that will hit the new administration.

We, the People, demand it.

Marion Mass, M.D. Bucks County pediatrician; co-founder, Practicing Physicians of America; leader in the Free2Care coalition.

Andy Mangione is senior vice president of AMAC Action, the advocacy affiliate of the Association of Mature American Citizens. He wrote this for InsideSources.com.

AMAC Action Update: Victory for New York Parents

AMAC members once again rose to the occasion to stop government intrusion into their daily lives.

This time, they thwarted a state takeover of public schools in New York. Governor Kathy Hochul tried to pull a fast one and issued an emergency regionalization order that would have stripped local school districts and parents of their control over their children’s education and placed all public schools under the jurisdiction of a regional superintendent appointed and controlled by Governor Hochul.

Teachers, administrators, and local superintendents would have been forced to answer to these regional superintendents who also would have had the final say over curriculum and other school policies. Accountabilities to parents would have been effectively eliminated! This order by the governor would have been mandatory!

This is where AMAC’s New York members come in. The week of Thanksgiving, they responded to an AMAC Action call-to-action and contacted Governor Hochul directly with over 900 messages to demand that she rescind her order. The governor responded to this outpouring of opposition by reversing the mandatory element of her order and made district enrollment in her program optional.

This is a huge victory for New York parents and another example of extreme government overreach.

Click here to watch AMAC Action Senior Vice President Andy Mangione spotlight a major win for parents in NY!

Meetings

December 9 Chapter Meeting: WI-05 Delegate Scott Kosteretz hosted the chapter meeting and annual Christmas party for AMAC members in the 1st, 4th, and 5th Congressional districts of Wisconsin. Brett Galazewski, 1st Vice Chair of the Milwaukee County GOP, gave a legislative update for Wisconsin and a post-election analysis.

Action ☆ Academy 

Can You Pass the U.S. Citizenship Test?

To become a naturalized citizen, immigrants must pass the citizenship test by correctly answering 6 out of 10 questions correctly. 90% of applicants pass the test but only 36% of U.S. adults can! And even more shocking, merely 3% of American public high school students! Test your knowledge with PragerU’s Citizenship Test. Want to get better educated? Go to PragerU and learn from their vast collection of videos. PragerU is a 501(c)(3) nonprofit that promotes American values in short educational videos for people of all ages.

Term of the Week: Federal Reserve

Federal Reserve System, central banking authority of the United States. It acts as a fiscal agent for the U.S. government, is custodian of the reserve accounts of commercial banks, makes loans to commercial banks, and oversees the supply of currency, including coin, in coordination with the U.S. Mint. The system was created by the Federal Reserve Act, which President Woodrow Wilson signed into law on December 23, 1913. It consists of the Board of Governors of the Federal Reserve System, the 12 Federal Reserve banks, the Federal Open Market Committee, and the Consumer Financial Protection Bureau (CFPB), which was authorized in 2010 by the Dodd-Frank Wall Street Reform and Consumer Protection Act (the CFPB assumed some functions of the former Consumer Advisory Council, which existed from 1976 to 2011). There are several thousand member banks.

(Britannica, The Editors of Encyclopaedia. “Federal Reserve System.” Encyclopedia Britannica, 13 Dec. 2024, https://www.britannica.com/money/Federal-Reserve-System. Accessed 13 December 2024.)

Class for November and December

Economics 101: The Principles of Free Market Economics

Economics is ultimately about making choices. Learn about economics and how the American Founders believed that economic freedom and property rights are rooted in the natural competition and cooperation of human beings. They believed that the best economic system should consist of private property and be allowed to operate freely. Learn more in Hillsdale College’s free online course Economics 101: The Principles of Free Market Economics. This 10-session course includes lessons on supply and demand, the “information problem” behind the failure of central planning, the rise of macroeconomics under the influence of John Maynard Keynes, and the 2008 financial crisis.

Quote of the Week

REAL ID was sold to conservatives as a way to prevent people who are here illegally from traveling or using taxpayer resources. It’s fairly obvious now that was a ploy to take more of your civil liberties. The next scam is national E-verify. Will you fall for it?

― Thomas Massie, U.S. Representative (KY-04)

Fight to save the America we love! If you’d like to become a volunteer AMAC Action Delegate, please contact us at (855) 809-6976 or [email protected].



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