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Congress is set to ban most surprise medical bills

nytimes.com

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Re: Congress is set to ban most surprise medical bills

#331

Post by ineedasername »

whiddershins wrote: post #235
npmaile wrote: post #227

Earlier quoted context omitted.

I think the argument you are responding to is not the one the previous user presented. This issue isn't that people are trying to maximize profit leading to issues. The problem is that there is undue government interference in the market leading to all of the negatives that come from people selfishly trying to maximize profit in a cynical way with none of the benefits of people trying to maximize profits by providing…

The thing is, government intervention is probably the biggest way the wolves take over. They distort the market to their benefit using governmental force (aka. regulation)

Who are wolves, the government? If so, I'd be open to suggestions on how the problems can be solved some other way. There's not much regulation related to healthcare pricing at the moment, and between bankruptcies related to medical debt & lack of coverage leading to preventable illness or death, it seems like the wolves are already in control of the system.

Re: Congress is set to ban most surprise medical bills

#332

Post by ineedasername »

btilly wrote: post #246
iaw wrote: post #100

Earlier quoted context omitted.

> has turned me from a pure free market thinking into a believer in single payer healthcare The current trend in 'free-market economics' is to call captured markets free and then argue for the relatively lax regulation. Most markets are not free markets and the healthcare definitely isn't. There's very little true choice, participants are typically under duress when seeking expensive services, and prices are hidden.…

My suspicion is that Private Equity has been funneled in healthcare for two decades intentionally distorting the market behaviors for increased profitability which is why the US has such excessive healthcare costs without any apparent justification. I do not believe that is the primary driver of costs, but it definitely does not help. For those who don't know what we're talking about, private equity looks for compani…

For notable examples, Sears & Toys R Us make for interesting reading.

Re: Congress is set to ban most surprise medical bills

#333

Post by cogman10 »

throwaway201103 wrote: post #230
cogman10 wrote: post #190

Earlier quoted context omitted.

To me, that sort of proves a point. Cancer and other disease are extremely expensive to treat and fairly common in the population. Yet, somehow, emergency care which is a minority of health costs, eats up 10% of the spending. Anyone that's been to an emergency room knows how excessive the price gouging going on there is. Pills that cost $0.10 OTC (or less!) routinely see 100x markup. That same pill can cost anywhere…

There is a lot of overhead in a hospital ER. You need medical equipment to handle all types of injury/trauma. You need advanced and very expensive diagnostic equipment (e.g. MRI, CT scanners). You need treatment/operating rooms and all the supplies. You need physicians and nurses and supporting staff. You need lab services. All of your patients arrive more more or less at random, unscheduled, so you can't really opti…

I agree, yet other countries have and operate ERs at a fraction of the cost of the US simply by virtue of having single payer healthcare.

> You need medical equipment to handle all types of injury/trauma.

This is equipment that most hospitals already have for other reasons. It's not like they have ER MRIs that sit idle and then an MRI for everyone else.

Further, a lot of that diagnostic equipment simply isn't needed in most cases. For ER related problems, xray machines are commonly all that's actually needed. Those are fairly cheap in the grand scheme of things.

> You need physicians and nurses and supporting staff.

A lot of the need for that gets cut dramatically by having a single payer system. The reason we have big ERs is because they are required to treat before seeking payment. As a result, many uninsured and underinsured people are using the ER as a primary healthcare system. Give everyone 0 or low deductible healthcare and you'll see the number of ER visits drop dramatically.

Re: Congress is set to ban most surprise medical bills

#334

Post by arcticbull »

winston_smith wrote: post #290
arcticbull wrote: post #279

Earlier quoted context omitted.

Every medical insurance claim denied in bad faith is an assault if it leads to delay in care, and if it leads to death, is a murder. I suspect if you take that lens, you will see that the government insurance is not the violent one here. 45,000 people die each year in the US without care. Ending that would go a long way to reducing government violence. [1] [1] https://news.harvard.edu/gazette/story/2009/09/new-study-…

And if you define paper cuts as murder, then libraries are the real killers. Do you really want to put your insurance paperwork on the same level as innocents getting bombed?

If they're dead either way, then the same liability should exist. Does it really matter how?

Re: Congress is set to ban most surprise medical bills

#335

Post by guitarbill »

wil421 wrote: post #299
nottorp wrote: post #27

Earlier quoted context omitted.

From what I know about the US even your restaurant example has hidden service fees and mandatory tips and taxes that aren't on the menu?

No hidden service fees. Taxing is not so simple in the US. My county has a lower sales tax rate than other counties around me. When I worked as a waiter the municipality had a special tax on alcohol in addition to the county and states alcohol and regular sales taxes.

> Taxing is not so simple in the US

Isn't this an argument for including taxes final prices, so people don't have to keep track of this? Maybe you're travelling. And it isn't like businesses don't already have to keep track of it for the bill. But instead of requiring businesses to print accurate menus or price labels, the burden is put on the customer to have this detailed knowledge, no matter where they go?

I guess the only two reasons I can think of for this not to happen is so that people have a less intuitive sense/transparency in what taxes the municipality/county/states impose, and so big multi-nationals can show the same "price" in different locations or ad campaigns. None of which ultimately helps the consumer.

To bring it back to the original issue, I guess people don't usually notice because taxes aren't orders of magnitude different, unlike some medical expenses. If you had a beer on holiday, and then found out it was taxed at 200% or even 2000% instead of 20%, you'd be rightfully mad.

Re: Congress is set to ban most surprise medical bills

#336

Post by gotostatement »

AdrianB1 wrote: post #307
gotostatement wrote: post #297

Earlier quoted context omitted.

> socialized healthcare and that dream of free healthcare for all is an impossible utopia, you just need to think about it to realize I can't understand this argument when Canada, England, France, Israel, and many other countries already have healthcare that is totally free to people at the point of service, and people rave about it. Can you explain why you still think it's utopian when it already exists?

Because of limited resources in Canada they had waiting times of several years (Google can point to multiple sources), UK or Nederlands a few months (I have friends working as doctors in these countries) or, in Eastern Europe, you need to get your own drugs from home because the hospital does not have it. With the perceived "free healthcare" the use increases a lot and the limited resources cannot scale up to infinit…

well it's your word against that of many other people I've seen raving about their system. how about a reliable source that says that people are unhappy with it?

Re: Congress is set to ban most surprise medical bills

#337

Post by astura »

JacobSuperslav wrote: post #42
bearjaws wrote: post #25

Having gone through cancer treatment here in the USA, I have received over a dozen 'after the fact bills' over the past 5 years, sometimes over 9months after the procedure, mainly involving blood work and CT scans. I missed one bill that came months after chemotherapy for $87 in 2015, it only had a 60 day notice before sending to collections. Mind you I was on disability from my employer that paid well. -80pts on my…

how come in Europe credit score isn't really a thing and everything works fine? that's another thing that needs to go

Credit scores are very much a "thing" in many parts of europe.

A big difference is a lot of the credit scoring systems outside of the US doesn't take into consideration positive actions - only negative ones. So paying off a loan won't help you show you are a responsible borrower, but failure to pay it will hurt you.

There's also varying definitions of "fine" in "everything works fine." The USA has way more of a variety of financial products and the most qualified borrowers pay much less. One can argue that's a good thing, or a bad thing. (It's a good thing for me, personally.)

Re: Congress is set to ban most surprise medical bills

#338

Post by ineedasername »

gregario wrote: post #192
kstrauser wrote: post #168

Earlier quoted context omitted.

I've that this before, but I like my markets free as in GPL, not free as in BSD. That is, I want the markets themselves to be free, even if that means that participants in the market have limitations put on them to keep them from capturing the market, forming monopolies, etc.

It's the regulations / limitations you are proposing that make it possible/likely that a monopoly will form. See Milton Friedman on this. There's basically no example of a monopoly forming outside of government regulation.

I don't think so. It is notable that many monopolies sprung up in the US in the late 1800's/early 1900's before there was significant regulation, which is what in fact lead to the first significant laws related to monopolies and "trust busting".

There is certainly the danger of regulatory capture that increases the costs for competitor to enter a market, but that is different than regulations on how large corporations are allowed to wield their power as market leaders. You need to distinguish between regulations that increase the costs for new competitors vs. those that prevent bullying/price fixing etc. For example, it was anti-trust regulation that gave rise to popularity (not initial creation) of Unix, and interoperability regulations that further expanded competition in the telecom industry.

Re: Congress is set to ban most surprise medical bills

#339

Post by zajio1am »

herbstein wrote: post #121
jsperson wrote: post #48

Earlier quoted context omitted.

> The existing health insurance industry is far from free market. Try getting a price for a procedure or visit beforehand. Oh, I know. I've tried getting prices in the past. Traditional providers can't do it. One thing that has opened my eyes is using a Direct Primary Care (DPC) provider. I pay $75 a month for direct access to my doctor (email, text message, cell phone etc.). The access is great, but an unexpected si…

> Other countries seem to have solid solutions for "socializing" medicine What baffles me the most is that most "socialized" systems functions much like a tax-paid insurance policy that covers everything and has no profit motive. Even in a normal insurance situation you're "paying for someone else's treatment". That's the whole point of insurance.

It is not just tax-paid insurance. Main point is that single-payer is essentially monopolist buyer and can use its market power to push prices down. Which is good to get cheap and good medical care, but may lead to systemic underfinancing of healthcare and associated problems.

Re: Congress is set to ban most surprise medical bills

#340

Post by unishark »

arcticbull wrote: post #328
unishark wrote: post #317

Earlier quoted context omitted.

> Do go on. Why is dying due to an explicit action any more of a free choice than dying of an explicit inaction? Because one is coercion and the other is simply an economic system. Which by the way is also used for all the other necessities of life too. How about food? The whole point of a free market is competition, so if you were at least arguing for emergency situations there's be something to talk about since it'…

I provided two examples of a coercive economic system. Just because it's an economic system doesn't make it any less coercive. The dictate is clear. A free market requires a voluntary participation of both the buyer and the seller . Threat of death is not voluntary participation, so it is not a free market. In a car crash you are not in a position to negotiate or make providers compete for your business. In functioni…

> - Healthcare for 40% of Americans? Socialized. (Medicare, Medicaid, VA). Medicare is socialized medicine.

> Americans pay less for food than anyone else and more for medicine than anyone else.

Is your point then that food is cheap because it is socialized at a 100% rate as you want healthcare to be? Or that your references to socialism are all red herrings?

Poor people can get free healthcare the same ways they get free food, Govt programs and charities. Food banks are private charities, by the way.

You are not defining coercion properly. It means force or threats of force.

Freeways are not a necessity of life, though we are certainly coerced into paying for them. At least they aren't as expensive as that Army you mentioned. Apparently you define all government spending as socialism, making the only other possible form of "govt" anarchy itself?

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