*This is an AI generated executive summary of an idea I had and wanted to capture. It needs further refinement and wouldn't solve the issues of the us healthcare system, though it might improve the situation for future regulation.* ## The Problem American healthcare costs are opaque and arbitrary. The same procedure at the same hospital can cost vastly different amounts depending on the patient's insurance. Existing price transparency regulations have failed due to poor compliance, weak enforcement, and unusable data formats. Patients cannot shop for care, markets cannot function, and administrative costs spiral. ## The Solution **Mandate uniform, machine-readable pricing at the billing code level.** Every healthcare provider must: 1. **Set a single price per billing code** that applies to all payers (insurance companies, Medicare, Medicaid, uninsured patients) 2. **Publish prices via a standardized REST API** in a regulated format 3. **Update prices at most once per month** with effective dates 4. **Use existing billing code taxonomies** (CPT, ICD, HCPCS, DRG) ## How It Works Providers maintain sovereignty over pricing—they set whatever rates they choose. The only requirements are uniformity across payers and machine-readable publication. The government automatically monitors compliance by querying provider APIs, eliminating enforcement burden and enabling real-time price tracking. **Example API Response:** ```json { "provider_id": "hospital_123", "billing_code": "73721", "code_type": "CPT", "description": "MRI lower extremity", "price": 875.00, "effective_date": "2025-11-01" } ``` ## Why This Works **For Hospitals:** Eliminates costly negotiations with insurers, reduces administrative overhead, and likely increases effective reimbursement rates since bulk discount leverage disappears. **For Patients:** Enables true price shopping, eliminates surprise billing variations, and restores market transparency. **For Government:** Automatic compliance monitoring, historical price tracking, and effortless enforcement through technical standards rather than manual audits. **For Markets:** Price information propagates efficiently, enabling competition on actual costs for the first time in American healthcare. **Against Insurance Companies:** Eliminates "negotiated discount" marketing and bargaining leverage, but preserves their role in network management and claims processing. ## Political Viability Unlike single-payer systems, this preserves private insurance and hospital independence while addressing the core dysfunction of price opacity. Hospitals would likely support it to escape insurer pressure. Small businesses and self-insured employers gain negotiating power. The technical implementation is straightforward using existing billing infrastructure. ## Implementation Path 1. Establish API technical standards and data format specification 2. Set compliance deadline (12-18 months for systems integration) 3. Deploy automated monitoring infrastructure 4. Phase out existing price transparency regulations in favor of unified standard 5. Enable public and commercial development of price comparison tools **The bottom line:** American healthcare's pricing dysfunction is solvable through automated transparency. By leveraging existing billing codes and modern API standards, we can restore market function without disrupting the broader healthcare system structure. #healthcare #policy