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Congress is set to ban most surprise medical bills

nytimes.com

281–290 of 440 posts

Re: Congress is set to ban most surprise medical bills

#281
post #100

That it takes such effort to pass a bill like this - 80% public approval, banning a clearly predatory practice, has turned me from a pure free market thinking into a believer in single payer healthcare. The free market just doesn't work when there is very little elasticity in consumption. I've been on the receiving end of a $15K air ambulance bill (thankfully covered by insurance) as well as the out of network specia…

> 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.…

In practice, "free market" as a historically implemented policy has meant "remove all oversight and revoke any protections or governing laws and thus legalize all business practices (such as scams, collusion, price fixing, market manipulations) regardless of ethics and hand the legislative pen to the business leaders to write their own laws.

Ban all forms of community governance, municipal ownership, or a people doing something for their community without using a for profit private company middleman.

Defund and gut any form of a social safety net. Disallow people to challenge a company polluting their drinking water and shut down the agencies tasked to inspect it. Forbid places from passing clean air laws or having the power to say no to any predatory company that wants to come to town

Allow companies to sue entire countries in secret tribunals if a country decides to not eviscerate their health and safety standards. Disallow countries from preferring local industry or keeping out vulture capital doing pump and dump schemes on their water and food supply. Protect these companies by international private militias that have an authority which overrides the country's own military.

Enshrine this right in treaty law so no sovereign people can possibly override it or fight back without severe consequences. Embargo, tariff and boycott them if they don't join in.

Permit companies to hide how their products are produced, lie about abusive and child labor and hide their profits in tax shelters without any consequences whatsoever.

Allow banks to defraud customers with phony accounts, car companies to lie about emissions, energy companies to crash entire state economies, insiders to manipulate the libor rates, and create shell companies using tobashi schemes to hide losses and reverse tobashi schemes to hide profits, and then bail them out with public money when it doesn't work out.

And finally destroy public education and replace it with whatever influence peddler with deep pockets wants to pass off as curriculum so that the public doesn't ever catch on to how much they're getting robbed."

Then there's this slight of hand where the advocates talk about the theoretically heady version of free market and then do mental acrobatics to bridge the policy and theories together. It's a distraction so that all the effort to combat the chicanery is instead exhausted on debates and theory discussions so obtuse intellectualism instead of meaningful directed focussed political action occupies all the time of thought leaders.

It's just coercion exploitation and oppression based on raw capital wrapped with the union busting techniques that keep the con game going without any consequences. It's a giant hustle to snatch and grab profit while turning our back on centuries of progress all under a fraudulent banner labeled "freedom".

Even the right wingers on gab and parler are seeing this now. It's so clear.

Such a scam.

Re: Congress is set to ban most surprise medical bills

#282

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…

> 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. Emergency care is not actually uncommon. Heart attacks, car accidents, these are the leading causes of death. It's completely reasonable to expect this to legitimately consume 10% of healthcare resources. > Anyone that's been to…

They also mark up everything to cover uninsured patients. Who by the way commonly use the ER for primary care and probably explain a lot of that 10 percent.

Re: Congress is set to ban most surprise medical bills

#283
post #246
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…

Has anyone tried to figure out meaningful changes to to laws/regulations to make such private equity raiding unprofitable or attach financial/legal liability for the negative consequences to the people responsible?

It has completely ruined hundreds of industries: driving out all of the experts, wrecking product quality, making companies unresponsive to customers, eliminating good jobs, ....

Re: Congress is set to ban most surprise medical bills

#284

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)

[deleted]

Re: Congress is set to ban most surprise medical bills

#285

Earlier quoted context omitted.

Personally I've never been told to pay up before receiving treatment at a hospital. Especially when I arrive there unconscious. And Herb Cohen would say once you've received the service, you're actually in a great negotiating position. People actually negotiate hospital bills all the time. Especially in those crazy stories you hear about. And you need a citation for your claim about when free markets do and don't wor…

> Personally I've never been told to pay up before receiving treatment at a hospital. Of course you have. The first thing you did when you walked in was hand them your ID and coverage info. You think hospitals operate on the honor system? As a Canadian I've never been asked to pay up before or after receiving treatment [edit: at the point of care]. And before you jump into taxation, Canadians pay less per capita in t…

As a Canadian you pay up every time you pay taxes, and you don't negotiate because you take what the government gives you. If they say your orthopedic surgery happens in six months, then that's what you get, or you start shopping south of the border.

Re: Congress is set to ban most surprise medical bills

#286
post #67

Earlier quoted context omitted.

Some people wear a tag with their blood group on it. Perhaps we should be wearing tags with the amount of money we're willing to spend on a hospital visit.

I'm curious, would this even be essentially "accepted" by any hospital in the US? Not just a tag, but if you were going in for a procedure, could you even say "I want to be sure I will not be treated by anyone not covered by my insurance plan"? Because basically all the forms you need to sign upon admittance essentially say "We can charge you whatever we want and you are responsible for paying it."

I would probably refer to the ethics dilemmas around "do not resuscitate" tattoos as the closest analog that I've heard about.

Re: Congress is set to ban most surprise medical bills

#287

Earlier quoted context omitted.

Personally I've never been told to pay up before receiving treatment at a hospital. Especially when I arrive there unconscious. And Herb Cohen would say once you've received the service, you're actually in a great negotiating position. People actually negotiate hospital bills all the time. Especially in those crazy stories you hear about. And you need a citation for your claim about when free markets do and don't wor…

> Personally I've never been told to pay up before receiving treatment at a hospital. Of course you have. The first thing you did when you walked in was hand them your ID and coverage info. You think hospitals operate on the honor system? As a Canadian I've never been asked to pay up before or after receiving treatment [edit: at the point of care]. And before you jump into taxation, Canadians pay less per capita in t…

> You either have insurance or you're driven into Chapter 11. Further I suspect this is not due to good will but rather government intervention.

You really are making a lot of bold assertions. If you declare bankruptcy, the hospital gets zero. Negotiation is a process by which both sides give something to meet in the middle. Yes they do it.

https://www.cnbc.com/2020/10/28/you-can-negotiate-your-medic...

Re: Congress is set to ban most surprise medical bills

#288

Earlier quoted context omitted.

The problem is that we've taken on this hidden assumption that "free market" somehow means that a hospital can create an arbitrary bill for urgent care, and you have no choice but to pay it. That's not really intrinsic to the free market paradigm, but rather an orthogonal corruption pushed via the legal system. In a different thread I pushed the lack of a contract argument, and got back a more fitting legal theory th…

> It was also just a more straightforward example than the overall food market still functioning even though we're all just three weeks away from starvation. Eh, the overall food market doesn't quite fit as an analogy here. I know I'm not alone when I say I have close to a year of food storage; it's not really the same for surprise healthcare bills.

There are still people who don't have such stores of food though. But sure, another example is a pedestrian with a gas can arriving at a gas station. The point is there are many things that are necessary for modern existence, yet there's a competitive market of not-completely-powerless actors keeping prices in check for the nearly-powerless ones. Healthcare is an outlier by being an extreme market failure, through both not enough regulation and too much regulation (that is to say, corruption).

(Although maybe with the rise of big surveillance and fine grained price discrimination we'll start to see these situations in other markets get exploited more)

Re: Congress is set to ban most surprise medical bills

#289
As the recipient of a $25,000 bill for an emergency visit to an out-of-network hospital that I have been fighting for two years (still ongoing), this is such an overdue blessing.

FYI -- many individual states ban "balance billing" i.e. hospitals sending you the leftover bill that insurance didn't cover (btw -- hospitals can charge a special "out-of-network" rate, in my case 10x the average cost around the area for the services I received). Problem is, if you are on a "self-insured" plan (your card should say this, these are plans you'll get at university or when working for a large company), the state law can't do anything, and there has been no federal law banning this practice. It's absolutely inhumane.

Re: Congress is set to ban most surprise medical bills

#290

Earlier quoted context omitted.

Ironically the proposed solution is usually to put the government in charge, which is far larger and more violent than any private company.

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?
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