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'Cries for Help' in Deciphering Regulatory Changes

Christopher Cheney, for HealthLeaders Media, March 19, 2014

People inside and outside the health plan community are still trying to figure out what CMS is likely to do when the agency sets the final Medicare fee-for-service and Medicare Advantage payment rates early next month. I was among the horde of health plan executives, analysts, and journalists under orders to decipher the CMS guidance on Medicare payments.

The agency released its guidance document just before 5 p.m. on Friday, Feb. 21. When I called a government affairs executive at one of the large health plans on Monday, Feb. 24, she said her staff "had been working all weekend" to understand the regulators' intent, but they still had more work to do before they could offer a comment.

Whether you have been working in the private sector for decades or are finishing Economics 101 in college, this level of complexity and uncertainty should send shivers down your spine. My spine variously tingled and contorted over the several days it took to get a handle on CMS' Medicare payment document.

To get a handle on the crushing complexity flowing from reform efforts in the healthcare industry, let the wisdom of the free market be your guide.

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1 comments on "'Cries for Help' in Deciphering Regulatory Changes"


Bruce Landes (3/20/2014 at 10:15 PM)
In the Federalist #62 James Madison wrote, in 1788: The internal effects of a mutable policy are still more calamitous. It poisons the blessing of liberty itself. It will be of little avail to the people, that the laws are made by men of their own choice, if the laws be so voluminous that they cannot be read, or so incoherent that they cannot be understood; if they be repealed or revised before they are promulgated, or undergo such incessant changes that no man, who knows what the law is to-day, can guess what it will be to-morrow. Law is defined to be a rule of action; but how can that be a rule, which is little known, and less fixed? Another effect of public instability is the unreasonable advantage it gives to the sagacious, the enterprising, and the moneyed few over the industrious and uniformed mass of the people. Every new regulation concerning commerce or revenue, or in any way affecting the value of the different species of property, presents a new harvest to those who watch the change, and can trace its consequences; a harvest, reared not by themselves, but by the toils and cares of the great body of their fellow-citizens. This is a state of things in which it may be said with some truth that laws are made for the few, not for the many. In another point of view, great injury results from an unstable government. The want of confidence in the public councils damps every useful undertaking, the success and profit of which may depend on a continuance of existing arrangements. What prudent merchant will hazard his fortunes in any new branch of commerce when he knows not but that his plans may be rendered unlawful before they can be [INVALID]d? What farmer or manufacturer will lay himself out for the encouragement given to any particular cultivation or establishment, when he can have no assurance that his preparatory labors and advances will not render him a victim to an inconstant government? In a word, no great improvement or laudable enterprise can go forward which requires the auspices of a steady system of national policy. But the most deplorable effect of all is that diminution of attachment and reverence which steals into the hearts of the people, towards a political system which betrays so many marks of infirmity, and disappoints so many of their flattering hopes. No government, any more than an individual, will long be respected without being truly respectable; nor be truly respectable, without possessing a certain portion of order and stability.