Everything we hear about healthcare from the GOP and Dems is a scam. In Shakespeare’s words: “It is a tale told by an idiot, full of sound and fury, signifying nothing.”
The debate over the structure of health insurance and how premiums are funded is largely irrelevant and meaningless. Politicians who constantly repeat the phrase “free market” in relation to health insurance are spewing double talk, based on either ignorance or deliberate propaganda.
The actual problem is the pricing of medical services. Insurance premiums are just a symptom, the disease is the rigged pricing of medical services.
Competition is the only power that holds prices in check and it has been eliminated for hospitals, labs and physicians. The health industry spends more on lobbying than the defense, aerospace, and the oil and gas industries combined. Activist investor Dave Chase bottom lined the result (Forbes): “the Middle Class is in a 20-year long economic depression that is at least 95% due to healthcare.”
Was Healthcare Pricing Structured by The Mob?
The elimination of free market price competition by medical service providers (not health insurers) is the reason U.S. healthcare costs are $10,000 for every man woman and child, 50% more than the next most expensive nation on earth.
Medical providers give each of us “an offer we can’t refuse” like the Godfather: Sign here and agree to pay whatever we say – if you want to stay alive. There is no realistic way for consumers to seek fair value for their medical services.
Our own government has officially determined that rising medical prices will continue to drive the explosive growth in national health costs and premiums: “Throughout the 2016-25 projection period, growth in national health expenditures is driven by projected faster growth in medical prices.”
Make no mistake, the pricing problem in healthcare services is not a mere lack of price transparency. The problem is that there are no actual prices at all. It is a purely predatory, vicious system.
Ask any hospital, lab or physician the price of anything and all you ever get back is a question: “What insurance do you have?” A simple blood test for cholesterol can range from $10 to $400 or more at the same lab. Hospitalization for chest pain can result in a bill from the same hospital for the same services ranging anywhere from $3,000 to $25,000 or more. Your price depends on how much can be extracted from you on an individual basis, often at your most vulnerable. If you are out-of-network or uninsured you pay the highest prices.
Industry apologists claim that everyone is actually “charged” the same amount, it’s just that we each receive a different “discount.” With healthcare, which you cannot skip and you cannot shop, it’s the same as being robbed at gunpoint.
Legitimate Pricing of Medical Services Would Instantly Fix Healthcare
Congress must compel medical providers to play by the same rules that apply to all other sellers of consumer goods and services. They should remain free to set their own prices. However, providers must be prohibited from billing each patient a different price for the same service.
Legitimate pricing of health services will empower patients to be able to shop for fair value.
Legitimate pricing would also mean networks are obsolete. We could use any healthcare provider in the nation without being price gouged for being out-of-network or uninsured.
Without networks, Americans would no longer be limited to treatment by a handful of local health providers pre-selected by their insurer. Networks are an offensive and costly restriction on choice which nobody should tolerate – especially when making life or death decisions.
Real free market competition by healthcare providers will reduce health expenditures by a minimum of 33% - overnight (and the USA would still have approximately the highest cost per person healthcare on earth).
With 3 Sentences - Congress Could End the Healthcare Pricing Nightmare
Congress must simply require that all Medicare providers post legitimate prices for all non-Medicare patients. The 1986 Emergency Medical Treatment & Labor Act requires all Medicare participating hospitals to provide emergency treatment to non-Medicare patients regardless of their ability to pay. It is the reason a hospital can’t toss a destitute woman, about to deliver child, onto a sidewalk at midnight.
Virtually all hospitals and labs, along with the vast majority of physicians participate in Medicare. Adding legitimate pricing to the requirements for Medicare participation will end our rigged healthcare system utilizing a mechanism Congress has previously employed.
In conclusion, the legislation proposed below illustrates how a Corrupt Congress could fix our sick system - in 3 sentences.