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Good letter. Many of these suggestions could actually be taken from the agendas of the Employers’ Forum of Indiana. Yes, Indiana needs to invest more in public health (and education, infrastructure and the like). Yes, we need more transparency around the prices and practices of pharmaceutical companies, PBMs, insurance companies and private-equity-owned medical groups. And yes, new benefit structures are emerging such as tiered and narrow networks, reference-based benefits, centers of excellence and bundled payments.
But, as evidenced by the very high prices Hoosiers pay for hospital services, the market has not to date worked effectively. Gag clauses and other contractual provisions between providers and insurers have slowed the introduction of new payment models discussed above and prohibited insurers from publicly disclosing provider prices. This highlights the essential role of government in promoting transparency and fair competition. So, let’s applaud the hospitals for their expressed interest in transparency and value improvement. Let’s also give a shout out to our legislators for investing the time and energy necessary to understanding the importance of transparency and anti-competitive contractual structures to the proper functioning of a market.