The solution to transparency in health-care pricing would be solved in totality if the insurance companies were required to publish their negotiated rates to all providers ["State should follow Everett Clinics lead and create transparency in health-care prices," Opinion, Nov. 3]. Without that information, institutional and office pricingrates are of limited value.

Of course, Premera Blue Cross opposedHB 2572, possibly the firststepin leading to that requirement. The insurance industry hassuccessfully lobbied in Washington state in preventing theOffice of Insurance Commissioner frombeing able to evaluatecash reserves (which are in the billions)of their companies when accepting or rejectingannual premium rate changes.

The focusshould be on reducinghealth-care costs, yet Premera has taken an active role in increasing costs toconsumers. Their action of reducing by 15 percent the previous negotiated rate for office visits toemployed independent primary care nurse practitioner providers in our state has forced practices out of business or to sell out to large hospital organizations.

Beside reducing access to care, Premera has now ensured the consumer will pay a facility fee (often double to triple the office visit costs). Yes, the consumer can benefit from seeing the billed costs for health-care, but their real costs are tied to the rate of reimbursement.

Linda van Hoff, Redmond

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Health-care prices: Real costs are tied to the rate of reimbursement