Health Transformation Alliance should do America a favor and also represent all those not insured.

Sir, Rana Foroohar writes: “America has a healthcare market that … has almost no price transparency… is controlled by vested interests (doctors, pharmaceutical and insurance companies) who exert monopoly power against the businesses and consumers they are supposed to service, and is highly fragmented and inefficient.” That results in “that healthcare in the US is the most expensive in the world by about 5 percentage points of gross domestic product” “Employers can help fix American health” March 20.

Foroohar quotes James C Capretta with: “The system would work a lot better if all of us could put pressure on doctors and insurance companies to provide more transparency.”

Absolutely. But I have argued that legislators could also provide much help by simply decreeing that, even though health sector suppliers are to be totally free to fix the prices for their services and products, they should not be allowed to use prices that discriminate excessively.

About a decade go I remember thinking: “If when needing medical services I could be sure being charged the same as my insurance company is, I could almost do without an insurance. What I really cannot do is to expose myself to being billed as an unprotected uninsured Per Kurowski.”

So it could be of great help the Health Transformation Alliance to which Foroohar refers, would, to their 4m employees, manage to add the representation of all the uninsured. That could signify much more for the American health sector than any of all other health and insurance plans being discussed in Congress.

Sir, in the health sector insurance companies is like the insured’s lawyers. But just like those who cannot afford lawyers are given legal assistance, the uninsured also need someone to defend them. 

PS. Here is what I wrote on this to FT back in 2009, when Obama-care was being discussed.

PS. And here what I wrote in 2007

PS. Sir, think of it, if Health Transformation Alliance negotiate only on behalf of its 4 million employees then those that are outside of it all, will find prices even higher.

@PerKurowski

In sovereign debt should not moral and ethical issues be more important than collective and pari passu clauses?

Sir, Robin Wigglesworth discusses bond legalese, like collective and pari passu clauses, and rightly concludes “paying attention to the legal differences is [especially] important when a borrower runs into a brick wall.” “Venezuelan bond small print piques investors’ interest” June 18.

But we citizens would also appreciate that lenders gave some minimum minimorum considerations to what the funds they loaned out were going to be used for, whether the loans were being correctly and transparently contracted, and of the quality of the managers of the proceeds, the governments.

In many cases, like that of Venezuela, if creditors had done so they could easily have concluded they were giving odious credits, and that the government was contracting odious borrowings; and that they better refrain from giving the loans, no matter how juicy the risk premiums.

In a world were legislation against acts of corruption exists it is surprising how little consideration “connoisseurs” give to the moral and ethical aspects of sovereign debt. Very high interest rate risk premiums, is the currency in which the corrupter and the corrupted too often conclude their dirty dealings.

For instance, in Venezuela, though there are serious scarcities of food and medicines, the government sells petrol domestically for basically nothing; and blocks humanitarian international arguing that to allow it would infringe their sovereign right to have exclusive responsibility for the welfare of citizens. And besides the market is well aware of that there are Venezuelans imprisoned for political reasons.

In such circumstances should not lending to Venezuela qualify as odious credit? Should that not also be qualified as part of odious government borrowings?

Should not citizens have a collective clause rights with which they can authorize or not the payment of odious credits and borrowings?

What should a due diligence process for bond issues which proceeds might help finance human rights violations include?

If a corporation suspect of drug trafficking made a bond issue, who would begin by revising the clauses of its legal documentation?

@PerKurowski ©

Tax profits obtained under the umbrella of patents higher, and plough those revenues back lowering medicine prices.

Sir, I refer to Jonathan Ford’s “Pricing of life-saving drugs is put under the microscope” Monday 17.

It is for sure a very difficult and delicate topic that of harmonizing the incentives needed for research to be carried out, with the need of the results of that research ending up being accessible for the general market.

Since open ended (no profit limits) intellectual property rights is the source of much current income inequalities, I have for some time now been suggesting those profits generated under the umbrella of patents, should be taxed at a higher rate than profits obtained when competing completely naked in the markets. 

Perhaps the revenues obtained with such taxes could be ploughed back in exchange for lower prices and thereby help to bridge somewhat the divide between the two objectives.

http://perkurowski.blogspot.com/2014/08/my-current-list-of-prominent-inequality.html

http://perkurowski.blogspot.com/2006/05/human-genetics-made-inhuman.html

@PerKurowski