Countering medical cost myths

[WiseOne]

It's about time someone called the health care industry to account for the pricing games. However, I don't know really how this would enable patients to "comparison shop" when they're limited by their insurance plan to a small network of hospitals & doctors. Not to mention the layer of insurance between patients and the bills they pay.

If the next step is to outlaw "insurance networks" and rely on free market competition instead of contract negotiations to set prices, that would be even better. It would have the very nice side effect of getting rid of the out of network "surprise" billing that is responsible for a big chunk of medical bankruptcies.

[Maddy]

. . .I don't know really how this would enable patients to "comparison shop" when they're limited by their insurance plan to a small network of hospitals & doctors. Not to mention the layer of insurance between patients and the bills they pay.

I'm going to stay optimistic. First, the astronomical deductibles attached to many insurance plans (many in the area of $6,000 per year) make a large segment of the "insured" population essentially uninsured when it comes to all but the most catastrophic stuff. When these people realize that they are, in a very direct way, subsidizing those of their neighbors who have employer-paid insurance (or those who rely upon Medicare or Medicaid), they'll undoubtedly be clamoring for the same discounted price offered to their peers. And what is your doctor going to say to that? "I'm sorry, charging you full price is the only way we can afford to offer discounts to our preferred patients?"

Second, it's my understanding that the fiction of "full price" is a tax avoidance strategy that allows providers to artificially inflate their "customary" prices and then offer (illusory) discounts to those patients who pay out of pocket--discounts that become bogus charity write-offs at tax time. (This, of course, works only so long as you can convince everybody (wink, wink) that somebody is actually paying the undiscounted price.) All that's likely to be coming to an abrupt halt.

Third, the transparency itself is likely to cause a change of behavior on the part of the entire health care cabal, who will, I assume, be averse to having their dirty laundry hung out in the sunshine for all to see. Isolated anecdotes about $20 aspirin tablets are quickly forgotten, but an industry-wide conspiracy to extract as much as possible from people who have no realistic choice but to submit to their extortive terms starts looking to your Average Joe like the flat-out racketeering it is.

Finally, this is likely to be just the beginning. I see the next logical step on the part of the administration being the adoption of regulations that preclude disparate pricing and that require reasonable up-front disclosure.

[WiseOne]

Let's hope you're right Maddy! If the regulation works as the Trump administration hopes it could be a big step forward. If it is effective though, just wait for hospital groups and the AMA to start in on the lawsuit train. They've got a nice little racket going and I'm sure they won't give it up without a fight.

In related healthcare cost news....supposedly this year premiums are reported as being stable. Does that mean health costs aren't going up? Ha, more fool you for believing that. I just discovered that the cost of my prescription meds are going up 121%. I pay full price for prescriptions as part of my deductible, but I do get the insurer's negotiated prices.

I'm experimenting to see if I can't substitute over the counter products (easily available through Amazon). It's not like I can't afford the meds even at the increased prices, but it's so enraging to be fleeced like this. It'll be nice to be able to handle my HRT privately and independently of the health care system.

[Maddy]

https://www.wnd.com/2019/11/doctor-wins ... cal-costs/

Here's a timely case to watch. A North Carolina doctor seeking to provide low-cost MRI services to the community is challenging the state's requirement that he first obtain a certificate of need--an administrative process designed to protect the existing medical monopoly by creating artificial scarcity.

The case alleges North Carolina's CON law is unconstitutional because it bans medical providers from offering services patients need "solely to protect existing providers from competition."

"In order to receive a CON, providers must persuade state officials that new services are 'needed' through a cumbersome process that resembles full-blown litigation and allows existing businesses, like established hospitals, to oppose their applications," IJ said.
* * *
"Can the state ban Dr. Singh from providing low-cost MRI services for patients who can least afford them just to protect established providers from competition?" asked IJ Attorney Josh Windham, who represents Singh. "We’re ready to explain to the court why, under the North Carolina Constitution, the answer is no."