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  1. Until hospital chargemasters reflect actual costs and not some arbitrary cost why should I trust that healthcare is being efficiently delivered? My insurance premium for an early retiree (not medicare eligible) has tripled in 4 years and my wife and I now pay nearly $10,000 per year through Aetna and the employer Avaya picks up the difference. My parents, both retired, pay $12,000 per year for Medi-gap insurance plus Medicare premiums (means tested). All this talk about increasing coverage to the uninsured and underinsured to guarantee more income for physicians and hospitals is disgusting. It has to stop. Get the root of the problem of healthcare cost inflation before adding to the problem. I firmly believe the problem is the relationship between hospitals and physicians. Hospitals provide services not for patients but for physicians. To retain physician services hospitals have to engage in captial spending constantly. The proliferation of new technology is a cost increasing phenomenon for healthcare making it a perverse market. Lip service is paid to outcome management or trying to identify minor cost savings but to little effect. Over 25% of healthcare costs are incurred to translate chargemasters to DRGs and private insurance coding among other billing related matters. Even if HIPPA is successful and chargemasters are standardized and billing is simplified this is just a one time cost savings and will be swamped by the underlying drivers of healthcare cost inflation.

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