Why Trump’s health care price transparency rules will reignite America’s economy: Art Laffer

In a historic win for all Americans on Thursday, President Trump issued a final rule requiring health insurers to post the prices they have negotiated with hospitals, medical facilities, and doctors. Under this rule, health care consumers, including employers sponsoring workplace coverage, can finally know prices before they receive care. This action will increase competition, lower prices, and save American families money.

Combined with the Trump administration’s already finalized hospital price transparency rule, which requires hospitals to publish the secret rates they negotiate with insurance companies as well as the cash payments they will accept, Thursday’s announcement will usher in a transparent health care sector with less need for the middlemen that have capitalized on patients’ misfortune.

Once these rules delivering complete health care price transparency take effect (January 1, 2021 for the hospital rule and one year later for the insurance rule), we can expect our economy to come roaring back, and our beleaguered health care system to rebound as well.

Knowing the real prices of health care and coverage beforehand will be a huge boon for all Americans–patients, workers, employers and taxpayers.

HEALTH INSURANCE FOR MILLENNIALS, GEN Z, MOST LIKELY TO BE AFFECTED BY PANDEMIC

Together the rules will unleash a real market in health care, usher in competition and choice, dramatically lowering the costs of care and coverage. Fewer dollars going to health care and more going to wages, jobs and small businesses in our local communities will help boost our nation’s economic recovery.

When complete health care price transparency is in place, patients, consumers, and employers will be able to better shop for health care, and high-tech innovators will eagerly develop tools to help consumers access and compare prices. Better informed buyers of health care will take advantage of the huge price variation that exists in the current, opaque market.

For instance, a recent study from the respected RAND Corporation found employer-sponsored plans are paying hospitals two-and-a-half times more than Medicare pays for the same procedure. Since almost all hospitals accept Medicare, those government rates are by definition “acceptable,” which means hospitals are price-gouging workers and employers, and growing rich at the expense of the middle-class.

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Insurance companies are no better, reaping huge profits as health care costs have soared. The average premium for an employer-provided family health insurance plan in 2020 jumped to $21,300–a 55 percent increase over a decade earlier. During that same time, deductibles more than tripled.

Last year I co-authored a study with health economist Larry Van Horn, it found that cash prices are, on average, 39 percent lower than the insurers’ negotiated rates for the same care. Throughout the country, businesses have saved 30 to 50 percent on health care costs by directly contracting with price transparent doctors and medical facilities, leaving insurers out of the equation.

It’s time to disrupt

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Stephen Colbert: Mike Pence Is ‘America’s Spare Tire’

“That’s right, the coronavirus is spreading through the Coronavirus Task Force. But don’t worry, the White House is now forming a task force to figure out what went wrong with the task force.” — JIMMY FALLON

“Seriously, it doesn’t instill a lot of confidence that the head of the Coronavirus Task Force’s office got the coronavirus. It’s like if the Avengers got mugged.” — JIMMY FALLON

“As far as we know, the virus cannot be transmitted between humans and poodles so he should be OK.” — JIMMY KIMMEL

“Yep, the only place the coronavirus is rounding the corner is in the halls of the White House.” — JIMMY FALLON

“Meanwhile, when Pence saw he was trending online, he was like, ‘Oh, no — do I have another fly on my head?’” — JIMMY FALLON

“That’s right, Pence will continue to campaign, ’cause not even Covid can stop people from seeing the electricity and raw sexual magnetism that is Mike Pence in person.” — JIMMY FALLON

“We wish them all a speedy recovery, of course we do, both from the virus and from thinking it was ever a good idea to work for Mike Pence.” — JAMES CORDEN

“Despite all of this, Pence himself still has not tested positive because even the virus isn’t interested in Mike Pence.” — JAMES CORDEN

“It’s like the coronavirus won the Super Bowl, except it already made trips to Disneyland and the White House.” — JIMMY FALLON

“In response this weekend, the White House dispatched chief of staff and last boy picked for the white pride kickball game, Mark Meadows. Yesterday, Meadows went on CNN to reassure a worried nation that you’re on your own.” — STEPHEN COLBERT

“The White House’s new plan to stop the virus is to stop trying to stop it.” — JIMMY KIMMEL

“Interesting, so the plan is to just let coronavirus spread freely throughout America? It’s interesting how zen Trump’s people are about this, you know, because with an immigrant child who came over the border, they’re like: ‘Zero tolerance! One is too many! We have to deport!’ But with a virus that’s killing hundreds of thousands of Americans they’re like: ‘Look, man, the virus is just trying to make a better life in our lungs. Who are we to stop it?’” — TREVOR NOAH

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Covid-19 Live Updates: Harrowing New Surge Rages Across America’s Heartland


New reported cases by day in the United States

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Source: New York Times database of reports from state and local health agencies

See maps and charts showing Covid-19 cases around the country »

The latest coronavirus surge is raging across the American heartland, most acutely in the Midwest and Mountain West.

This harrowing third surge, which led to a U.S. single-day record of more than 85,000 new cases Friday, is happening less than two weeks from Election Day, which will mark the end of a campaign dominated by the pandemic and President Trump’s much-criticized response to it.

As of Friday evening, 15 states have added more cases in the past week than in any other seven-day stretch of the pandemic: Wisconsin, a battleground in the presidential election, Colorado, Kentucky, Illinois, Wyoming, Idaho, Utah, South Dakota, Montana, Arkansas, Alaska, Tennessee, Ohio, Indiana and North Dakota. And four states have added more deaths this week than in previous weeks: Wisconsin, Kentucky, South Dakota and Oklahoma.

North Dakota leads the nation in coronavirus cases per capita. Illinois is averaging more than 4,100 new cases per day, up 85 percent from the average two weeks ago. And Pennsylvania, another battleground state, on Friday reported a record of 2,258 cases.

The virus will be front of mind for voters in several key states: in Ohio, where more people are hospitalized than at any other time during the pandemic, and especially Wisconsin, home to seven of the country’s 10 metro areas with the highest numbers of recent cases. On Friday, the Wisconsin Supreme Court blocked Gov. Tony Evers’ emergency order restricting the size of indoor gatherings to 25 percent capacity on Friday.

Experts worry that the growing numbers in need of hospital care will only get worse if cases continue to mount, especially in rural areas where medical facilities could be quickly overwhelmed.

Credit…Hannah Mckay/Reuters

Citing a rise in hospitalizations across the state, the Colorado Department of Public Health and Environment announced a strengthening of coronavirus restrictions in certain counties, capping gatherings at 10 people from no more than two separate households. For the third straight day, Colorado announced a new single-day cases record on Friday.

Overnight, nearly 2,500 people were hospitalized in Illinois, the state’s top public health official, Dr. Ngozi Ezike, said in a news conference Friday afternoon. The mayor of Chicago, Lori E. Lightfoot, announced a curfew on nonessential businesses beginning at 10 p.m. on Friday.

In the latest presidential debate on Thursday night, President Trump asserted that the virus was “going away” as he defended his management of the pandemic. Former Vice President Joseph R. Biden Jr., the Democratic nominee, attacked Mr. Trump’s handling, calling for much more aggressive federal action for the “dark winter” ahead.

President Trump and many supporters blame restrictions on business activity, often

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The Americas are at risk of polio outbreak due to disruptions by the pandemic

Countries in the region must maintain polio vaccinations and surveillance during the pandemic to prevent an outbreak, according to experts at the Pan American Health Organization (PAHO).

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“Although as a region we have defeated polio once before, if we allow vaccination coverage rates to fall and become too low, we will be at risk for polio circulation in our communities once again,” said PAHO Director Carissa Etienne. “That is why it is more important than ever to do our part to protect and sustain polio elimination in our region while we wait for countries in other parts of the world to achieve this goal,” Etienne added.

The pandemic has stressed immunization and surveillance systems designed to catch and respond to vaccine-preventable diseases, according to PAHO.

“Now during the pandemic, we must work extra hard to not lose what we have gained,” said Cuauhtemoc Ruiz Matus, head of PAHO’s Immunization Program.

Ruiz said that strong political commitment from governments, strategic partnerships between international agencies, and the work of health care workers contributed to the success to the region’s fight against the virus.

“Without all of these things, we wouldn’t be where we are today,” said Ruiz.

Reported coverage for the polio vaccine for the Americas between 2016 and 2019 ranged between 85-87%, according to PAHO.

Coverage in 2020 might be lower “due to disruptions in primary health care activities caused by the COVID-19 pandemic,” according to PAHO.

Polio once was a common virus. In some young children it can affect the nerves and cause muscle weakness or paralysis. There is no treatment and no cure but getting vaccinated can prevent infection.

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Is Walmart a villain or victim of America’s deadly opioid crisis?

As the opioid crisis ravaged communities across the United States two years ago, the U.S. Attorney for the Eastern District of Texas at the time, Joe Brown, set about fixing blame on Walmart, alleging its pharmacies were filling prescriptions from “pill mill” doctors facilitating drug misuse and abuse by overprescribing narcotics.

The Department of Justice has also had a long-running civil investigation into Walmart’s pharmacies. The Bentonville, Arkansas, retail behemoth is now preemptively suing the Department of Justice, asking a federal district court to untangle the contradictory laws that have left Walmart open to investigation. The “DOJ is threatening to sue Walmart for not going even further in second-guessing doctors,” Walmart said in a press release, while “state health regulators are threatening Walmart and our pharmacists for going too far and interfering in the doctor-patient relationship.”

Walmart has been tightening its policies on filling opioid prescriptions, according to its “opioid stewardship initiative” – not just questioning particular scripts, but refusing to fill any prescription for controlled substances from doctors about whom the company had doubts. In part to appease federal regulators, Walmart applied various restrictions on controlled substances. But soon state authorities accused the company of violating state regulations – even of committing crimes – by blocking prescriptions or even just filling smaller quantities of drugs than doctors had specified. The company also received pushback from medical groups that accused Walmart of trampling on doctors’ prescribing prerogatives.

Walmart’s damned-if-you-fill-the-script, damned-if-you-don’t bind reflects the problems faced by large chain pharmacies, which also include CVS and Walgreens. They are among the chief targets in opioid-related lawsuits that may be some of the most complicated and expensive litigation in American history – the so-called National Prescription Opiate Litigation. The companies didn’t get there on their own: Contradictory regulations, demands, and threats from Washington and the states have combined to create a tangle trapping the pharmacies, leaving them exposed to plaintiffs’ lawyers in a massive “multi-district litigation” playing out in an Ohio court.

The nationwide tobacco litigation of the 1990s was complex enough, involving the states and a handful of cigarette manufacturers. By contrast, plaintiffs in the National Prescription Opiate Litigation – counties, boroughs, parishes, cities, townships, municipalities, and villages – number in the thousands. They are looking for just about everyone in the opioid business – manufacturers, distributors, and retailers – to pay for the opioid misuse that has been so costly to society. Plaintiffs’ lawyers are seeking damages well into the billions.

The court case consolidated in 2017 was supposed to get rolling in November, but has recently been postponed to the spring out of concerns COVID-19 would spread through a crowded courthouse.

The “multi-district litigation” follows efforts by federal prosecutors who have tried to build both criminal and civil cases against pharmacies, including Walmart, for not acting soon enough in blocking all prescriptions written by doctors pharmacists had questions about.

Pharmacies, though, are a curious place to assign blame for the opioid epidemic. They don’t make the drugs: Controlled substances are

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America’s history of racism was a preexisting condition for COVID-19

A Louisiana pastor prays as his parishioners die, first from cancer and now from COVID-19. An Indigenous community in New Mexico lacks adequate health care as the death toll mounts. A sick hospital worker in New Jersey frets about infecting others in her heavily populated neighborhood.



a group of people standing in front of a mirror posing for the camera: Parishioners stand in Our Lady of Grace Catholic Church in Reserve, LA, during a sermon by Rev. Fr. Christopher Chike Amadi.


© Jasper Colt, USA TODAY
Parishioners stand in Our Lady of Grace Catholic Church in Reserve, LA, during a sermon by Rev. Fr. Christopher Chike Amadi.

As the country cries out for a vaccine and a return to normal, lost in the policy debates is the reality that COVID-19 kills far more people of color than white Americans. This isn’t a matter of coincidence, poor choices or bad luck — it’s by design. 

A team of USA TODAY reporters explored how the policies of the past and present have made Black, Asian, Hispanic and Indigenous Americans prime targets for COVID-19. They found:

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  • America’s education and economic systems are still unequal, disproportionately leaving people of color out of higher-wage jobs. When COVID-19 struck, more people of color were serving as essential workers directly in the path of the virus.

Put simply, America’s history of racism was itself a preexisting condition.

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Of the 10 U.S. counties with the highest death rates from COVID-19, seven have populations where people of color make up the majority, according to data compiled by USA TODAY. Of the top 50 counties with the highest death rates, 31 are populated mostly by people of color. 

“COVID-19 has brought out into the open, with painful clarity, these divisions in our society that have been there for a long time but, for one reason or another, people were able to overlook them,” said Philip Landrigan, director of the Global Public Health Program at Boston College.

With nearly 1,000 people a day dying from the virus and scientists scrambling to grasp exactly how the virus spreads and kills, federal and state data has not provided enough demographic detail to show the full impact on communities of color. The race and ethnicity of people who contract the virus is known in 52% of cases, according to the Centers for Disease Control and Prevention. 

But study after study has shown clear patterns in whom the virus kills.

How systemic racism led to COVID-19’s rapid spread among people of color

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Black people are more than twice as likely to die from the virus than white people, and Hispanics and Native Americans are 1.5 times more likely to die, according to The COVID Tracking Project. 

“You can’t change the fact that America is so segregated and that people of color tend to live in communities where the environmental conditions are worse, and that can increase your risk of heart disease or lung disease and diabetes,” said Richard Besser, former acting director of the CDC and president and CEO of the Robert Wood Johnson Foundation, the nation’s largest

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America’s Last Line of Defense for a Safe Vaccine

When the Food and Drug Administration ran into White House resistance to its proposed vaccine safety standards in early October, the agency took a bold step: It published the guidance on its Web site. The public could now see what vaccine manufacturers and the FDA’s own independent advisory panel would require to ensure a longer, scientifically rigorous process.

The two public health agencies responsible for overseeing the approval, distribution and use of a coronavirus vaccine—the FDA and the Centers for Disease Control and Prevention—have been undermined and politicized. The FDA’s proposed guidelines for emergency use of a coronavirus vaccine did finally clear the White House, but the well-publicized resistance has further undermined public trust in Operation Warp Speed just as the United States inches toward a viable vaccine. At a time when trust should be growing, the opposite is happening.

What should give Americans hope, however, is that both the FDA and the CDC have a last line of defense when it comes to approval and distribution of a vaccine: panels of outside experts who now merit the nation’s attention and unequivocal support. If, in the days ahead, either of these independent bodies are sidelined, ignored or in any way circumvented, a red line will have been crossed, and the safety and/or efficacy of a coronavirus vaccine can reasonably be questioned.

For the CDC, it’s the Advisory Committee on Immunization Practices, or ACIP, which next meets October 28–30. We each served terms on this committee at different times, and neither of us ever felt any political pressure during our tenures. The FDA equivalent is the Vaccines and Related Biological Products Advisory Committee, or VRBPAC, which next meets October 22. Most Americans have never heard of either.

These panels of health experts, with expertise in vaccinology, immunology, pediatrics, internal medicine, infectious diseases and preventive medicine, among other disciplines, have been studying and assessing the myriad coronavirus vaccines under consideration. Each has been scouring data from phase I and phase II trials, and now are awaiting phase III data about some of the most promising vaccines in development.

The advisory panels operate with intentional transparency. The public has access, often in real time via livestream, to their discussions and discoveries, and public records document their work. The 15 voting members on each advisory committee all undergo conflict-of-interest reviews, with annual filings to safeguard compliance. Vaccine interests and financial attachments are disclosed, and members must recuse themselves from related votes. Whether for a coronavirus vaccine or other vaccines, these panels make recommendations as to whether a vaccine is safe, efficacious and ready to be licensed (FDA), as well as how and to which populations a vaccine should be distributed (CDC). Though the members on each committee surely understand the politics of the moment, they will never bend to it.

Today, despite regular political pressure being applied on FDA and CDC to meet arbitrary deadlines for a vaccine release, the time-tested vaccine vetting and approval system has held up since it was established nearly

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