Posted: August 4, 2021 in: Pain-2-Power, Person of the Week

Katy Talento: Pain-2-Power Person of the Week

Massive changes are afoot in the health care delivery system.  Right now, the people most focused on these changes are health insurers, corporations and those companies that help corporations navigate the complex world of health insurance.  Why?  Because competitive pricing of every conceivable medical procedure and test is heading to the healthcare delivery system and promises the beginnings of true competition between doctors, hospitals, clinics, labs and other diagnostic facilities based on price.

The government actions that are driving these changes have names like the Transparency in Coverage Rule and No Surprises Act.  They mean that, soon, 212 million Americans will be able to check the prices of everything from MRIs to blood tests to surgeries for miles around them, right on their smart phones beforegoing to get those tests or services.  You and I will be able to choose whether to pay, say, $7,000 for a lower back MRI or $900 at facilities and from providers who are the same quality.

By the way, that $900 versus $7,000 figure isn’t overstated.  The costs of lots of tests and procedures vary by a factor of 10X (yup, that’s 1,000 percent) within a 10-mile radius of where a person is located.  A blood test for cholesterol levels might be $75 at one lab and $800 at another.  And this stuff has all been kept secret.

What’s more, the days of getting “surprise bills” from health care providers who just didn’t think it was important to tell us that the surgery we were getting would include an anesthesiologist or another provider who wouldn’t be covered by our insurance will also be gone.   If our insurance leaves $11,000 of services outside our insurance coverage, hospitals and other entities will have to tell us ahead of time and let us negotiate a better deal with them or shop for a better deal someplace else.

What has been happening before now has been so outrageous that both the Trump and Biden Administrations have landed on the same side of this issue.  The effort to bring real competition to the healthcare delivery system, based on true market forces, is a bipartisan one.

Katy Talento, now the CEO of AllBetter Health, a company that engineers health plans that deliver high value and superior care, is one of the reasons these long-overdue changes are finally happening.  In addition to being the CEO of AllBetter.health, Katy is an epidemiologist and has served as a health policy advisor to five U.S. Senators and, most recently, as the lead health advisor to President Donald Trump on the Domestic Policy Council.  It was due, in large part, to her leadership, courage and perseverance that the Trump Administration moved forward with the Transparency in Coverage Rule and No Surprises Act.  She demanded that data like that made available through the efforts of Mark Galvin, CEO of TALON, be used to educate American companies and American consumers about the almost-unbelievably different prices that health care providers, labs, hospitals and outpatient centers were quietly billing for the very same services.

Katy Talento could have gone along to get along.  She could have decided there was just too much red tape in Washington, DC to champion giving Americans the information they require to purchase the health care services they need at prices that are fair.  She could have worried about whether she’d be offered lucrative jobs from the health insurance industry once she no longer served in government.  But, Katy Talento just wanted to do the right thing.  She wanted to empower Americans, no matter how much pain it caused her along the way.  And she’s still doing it by telling corporations how much they could be saving on healthcare expenses, even if it means firing the brokers who sell them expensive plans with services they can get for a lot less.

These are times of great cynicism about government officials and business leaders.  So it is that much more important that Katy Talento represents a leader we can all admire, who has done and continues doing the right things, despite them being the hard and sometimes unpopular (with some vested interests) things.  And that’s why Katy Talento is this week’s Pain-2-Power Person of the Week.

Dr. Keith Ablow

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