Healthcare reimbursement formulas can look like administrative details buried in spreadsheets and regulations. Until one of them is wrong. In 2006, I discovered an error in the way Medicare calculated payment rates for hospitals across the country. It was understating payments by roughly $1 billion per year. What followed was years of appeals and litigation involving hundreds of hospitals before the matter was ultimately resolved.

Transparency sounds like a good thing. And in many cases, it is. But in healthcare policy, I’ve seen a troubling pattern: Transparency gets weaponized. Not to inform decisions. Not to improve outcomes. But to delay progress, justify inaction, or create political cover.