Self-insured employers have been fighting the good fight against runaway health costs for their companies and for their workers for decades, without much help from state and national politicians. But a ray of sunshine has emerged: the courts.

A cause-driven law firm, Fairmark Law, has filed a federal class-action law suit in Wisconsin on behalf of self-insured employers and their employees against one of the state’s biggest hospital conglomerates, Advocate Aurora Health. The firm is charging monopolization and price gouging. The David versus Goliath suit was filed in the name of a small company, Uriel Pharmacy based in East Troy, Wisconsin.

The Medical Industrial Complex (MIC) of big hospital corporations and giant health care insurers has increased its rates close to 8% per year over the last two decades. That gouging has had the cumulative effect of raising the cost of care for a family of four to $22,000 to $30,000, depending on which consultant is keeping score.

In contrast, the most astutely managed company health plans have limited inflation to 2% to 3% per year. Total costs for a family can run $12,000 to $14,000 per year. That’s still expensive, but not outrageously so. (Note: The pure medical side of American health can be exemplary.)

That massive cost discrepancy is at the heart of the Fairmark case against Advocate Aurora.

Fairmark looks at the courts as one way to overcome anti-competitive contracting and imbalance of power between smaller payers and the Medical Industrial Complex.

Its Wisconsin case will be buttressed by a recent Rand Corp. analysis that ranks the state 4^th highest in the country in comparison to Medicare payments. Our hospitals charge private companies three times what they pay Medicare.

Advocate Aurora Health has a monster merger in the works with Atrium Health of North Carolina. It’s hard to see any operating synergies between those two distant operations. But the combination would gain leverage for higher prices with the nation’s largest health insurers.

President Biden is signing an executive order on Monday intended to cut back on the bureaucracy around government services for the public such as renewing their passports, applying for loans or changing their name.

The order, which Biden will sign on Monday afternoon, affects 36 “customer experience improvement commitments” across 17 federal agencies. The order targets various government services dealing with travel, retirement, business, health and updating personal information, according to a White House fact sheet.

For example, the order will call for a streamlined enrollment experience for retirees looking to enroll in Social Security, and it will allow retirees to more easily claim benefits online.

Taxpayers will be given new online tools to make filing more easy, and filers will have the option to schedule customer service call-backs instead of waiting on hold.

The order will call for Americans to be able to renew their passports online rather than dealing with print forms, and it will aim to streamline the process for travelers with urgent questions for the Transportation Security Administration (TSA).

The order will also aim to ease the bureaucracy around both student loans and business loans.

The order will create a single portal for the millions of individuals with student loan debt, and small business owners will have a more streamlined process for working with the Small Business Administration on loans, grants and certifications.

After months of stalemate, Congress struck a deal on nearly $900 billion in Covid-19 relief, including a new round of direct payments and help for jobless Americans, families and businesses struggling in the pandemic.

Wisconsin’s Supreme Court heard arguments Thursday in another case that could reframe the power of state government to respond to the COVID-19 pandemic, reviving a debate that began when justices struck down the state’s “Safer at Home” order in May.

The latest dispute stems from an order restricting bar and restaurant capacity that expired more than a month ago, but it raises issues the court left ambiguous in its “Safer at Home” ruling.

Gov. Tony Evers’ administration issued the order on Oct. 6 through powers invoked by state Department of Health Services Secretary Andrea Palm to respond to public health emergencies.

Palm’s order restricted the size of crowds at indoor businesses like restaurants and bars. Under the order, those businesses were limited to 25 percent of their usual capacity. For example, a restaurant that could normally hold up to 200 people would be limited to a crowd of 50.

The Evers administration argues there’s a key difference in this case.

When the court struck down “Safer at Home,” it carved out an exception, stating without explanation in two footnotes in the majority opinion that it was not striking down the state’s powers to close schools.

The law that spells out the power to close schools states that DHS “may close schools and forbid public gatherings in schools, churches, and other places to control outbreaks and epidemics.” The Evers administration argues that Palm’s latest order did just that.

Critics of Palm’s order argue it should be struck down because it relies on part of the same law that the Supreme Court addressed when it struck down “Safer at Home.”

“We have the same agency here. We have the same pandemic. They are repackaging these same exact arguments they made the last time,” said attorney Misha Tseytlin arguing on behalf of the Mix Up, Inc., an Amery bar and grill challenging Palm’s order. “I understand the composition of this court has changed since, but the law hasn’t changed.”

The Federal Reserve kept its benchmark interest rate at a record low near zero Thursday and signaled its readiness to do more if needed to support an economy under threat from a worsening coronavirus pandemic.

The central bank’s policy statement Thursday was approved on a 10-0 vote. Robert Kaplan, president of the Federal Reserve Bank of Dallas, who had dissented at the previous meeting, voted with the majority this time. Another dissenter in September, Neel Kashkari, head of the Minneapolis Fed, was absent, with his alternate, Mary Daly of the San Francisco Fed, approving the statement.

The statement was nearly identical to the one the Fed issued in September. At that meeting, it adopted a policy goal change it had made in August to keep rates low for some period of time even after inflation hits its 2% annual target. The reason was to allow the Fed to supply a longer boost to the economy and for unemployment to fall further before the policymakers begin to worry about inflation.

Congressional leaders said Tuesday night they are making progress on a sweeping deal to fund the government and provide coronavirus relief but hadn’t yet clinched an agreement.

The top four congressional leaders met twice Tuesday as they race the clock to try to fund the government by Friday and break a months-long stalemate to provide more coronavirus aid.

The bipartisan package was split into two different bills. One $748 billion piece includes another round of Paycheck Protection Program (PPP) assistance for small businesses, an unemployment benefit and more money for schools, vaccine distribution and other widely agreed upon items.

The second, $160 billion piece ties together the two most controversial elements of the coronavirus negotiations: more money for state and local governments and protections from coronavirus-related lawsuits.

Presidential electors are meeting across the United States on Monday to formally choose Joe Biden as the nation’s next president.

Monday is the day set by law for the meeting of the Electoral College. In reality, electors meet in all 50 states and the District of Columbia to cast their ballots. In 32 states and the District of Columbia, laws require electors to vote for the popular-vote winner. The Supreme Court unanimously upheld this arrangement in July.

The voting is decidedly low tech, by paper ballot. Electors cast one vote each for president and vice president.

The Electoral College was the product of compromise during the drafting of the Constitution between those who favored electing the president by popular vote and those who opposed giving the people the power to choose their leader.

Each state gets a number of electors equal to their total number of seats in Congress: two senators plus however many members the state has in the House of Representatives. Washington, D.C., has three votes, under a constitutional amendment that was ratified in 1961. With the exception of Maine and Nebraska, states award all their Electoral College votes to the winner of the popular vote in their state.

A U.S. government advisory panel endorsed widespread use of Pfizer’s coronavirus vaccine Thursday, putting the country just one step away from launching an epic vaccination campaign against the outbreak that has killed close to 300,000 Americans.

Shots could begin within days, depending on how quickly the Food and Drug Administration signs off, as expected, on the expert committee’s recommendation.

“This is a light at the end of the long tunnel of this pandemic,” declared Dr. Sally Goza, president of the American Academy of Pediatrics.

In a 17-4 vote with one abstention, the government advisers concluded that the vaccine from Pfizer and its German partner BioNTech appears safe and effective for emergency use in adults and teenagers 16 and over.

Pfizer has said it will have about 25 million doses of the two-shot vaccine for the U.S. by the end of December. But the initial supplies will be reserved primarily for health care workers and nursing home residents, with other vulnerable groups next in line until ramped-up production enables shots to become widely available on demand — something that will probably not happen until the spring.

Next week, the FDA will review a second vaccine, from Moderna and the National Institutes of Health, that appears about as protective as Pfizer-BioNTech’s shot. A third candidate, from Johnson & Johnson, which would require just one dose, is working its way through the pipeline. Behind that is a candidate from AstraZeneca and Oxford University.