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Betrayal: Corrupt Congress could fix healthcare with 3 sentences

Betrayal: Corrupt Congress could fix healthcare with 3 sentences

Picture of Steven Weissman
Corrupt Congress Image
Corrupt Congress

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.

Proposed Legislation


Picture of <span class="username">Guest (not verified)</span>

It seems to make sense.

Picture of <span class="username">Guest (not verified)</span>

Dear Dr. Weissman, thank for keeping up the good fight. I wonder if it would be worthwhile to partner with AARP to create some more awareness around this issue. You are absolutely correct about this. There will be no change until pricing is posted.
Best Wishes,
Fran Meenan

Picture of <span class="username">Guest (not verified)</span>

I agree this wouldm reduce costs for every one and fix our healthcare system.

Picture of <span class="username">Guest (not verified)</span>

I think this should be widely shared. I'll start!

Picture of <span class="username">Guest (not verified)</span>

The society need is to get rid of capitalist corruption in human services. The answer would be to create an efficient government for management which could do work less costly than private business There are other related problems which contribute to the high cost. When someone is trying to address these problems they are labeled as communists by media, which is a threatening word for our generation of undereducated citizens.

Picture of <span class="username">Guest (not verified)</span>

How do we get anyone to listen and act on this?

Picture of <span class="username">Guest (not verified)</span>

This is certainly the most accurate examination of the situation I've seen in some time. The solution is so obvious but lobbyist influence our corrupt congress to maintain the status quo. Forget about the good of the country. Shamefully they only care about what's good for them!

Picture of <span class="username">Guest (not verified)</span>

Great article and 100% correct. I am appalled at how much medical care and medicine in this country costs. You never know how much you have to pay until after the fact, and only recently are prices posted for Anthem on some of their websites (depending on which version you have through your employer), that enable you to shop for procedures. I like your solution better because it is totally independent of "insurance" and covers the entire country.

Picture of <span class="username">Guest (not verified)</span>

Keep up the good fight

Picture of <span class="username">Guest (not verified)</span>

One is tempted to dismiss this article as one from a former hospital official seeking to blame the physicians for health care costs, when doctors come to work and see whoever shows up often as salaried employees of the hospital who determines the billing. For those who are self-employed, charges are one thing and reimbursements are entirely another. Far more doctors give services away than do hospitals. And doctors costs are greatly influenced by exorbitant malpractice premiums they are required to carry or some hospitals will not let them practice there at all. So everyone is greedy because of the need to sustain themselves and not strictly because of the desire to become wealthy. Institute tort reform, reduce medmal premiums, insure the indigent, charge reasonable fees, and make hospitals non-profit, and you will see great things happen. And maybe our smartest and most altruistic graduates will start to choose medicine again as a career.

Picture of <span class="username">Guest (not verified)</span>

As this article says, there should be standardized pricing across the board and prices readily available online and posted where patients can see them in clinics, hospitals and medical offices. The flip side is that there is the expense of equipment and facilities for practitioners. In France, patients are told to go to the pharmacy and directly purchase dressings etc for after procedures and it is expected of them.
The other thing that affects doctors is the exorbitant cost of training and them after their education is complete, their pay as residents in the private sector versus doctors who go into the military or other service to pay for their education and training don't have that overhead to pay back at high interest rates, thus building in this to their charges potentially.
And then there is the cost of medication. Pharmaceutical companies bitch about the cost of research and development, and then wine and dine doctors and heavily tv advertise to unsuspecting American consumers who are told "ask your doctor if xyz is right for you", when most people don't know and should only ask about it after prescribed. Those costs are built in and passed along as another exorbitant package. And we must not forget side effects of those meds that can be far worse and more costly than the original condition for which they were prescribed.
Lastly, there is insurance for coverage for the patients. And there are the expensive premiums doctors must have to protect themselves should they be sued for negligence.
All of these can't be answered with those 3 seemingly simple answers. If they could, it would be a miracle!

Picture of <span class="username">Guest (not verified)</span>

I have been arguing that networks need to be eliminated and that the government should require that providers price services as a multiple of Medicare. How can I help

Picture of <span class="username">Guest (not verified)</span>

This nails it. So logical and concise. Now, how do you break the current system to ever get something like this through the gauntlet.

Picture of <span class="username">Guest (not verified)</span>

OK - please send this information to our president and Congress

Picture of <span class="username">Guest (not verified)</span>

The reason a destitute woman can't be tossed out on the street is Medicaid, not Medicare, which applies to seniors and some disabled. Are we talking about Medicaid? Perhaps nitpicking, but we need to be accurate with these critical issues to be taken seriously.

Picture of <span class="username">Guest (not verified)</span>

Excellent article! What can citizens do to let Congress know that fixing healthcare pricing is what we want? I signed the petition. Is there more we can do?

Picture of <span class="username">Guest (not verified)</span>

I have witnessed the "Art" of pricing when it comes to insured or non-insured.

I received a bill from a Hospital Clinician for $ 500 for an annual "routine" Eye exam. I had the same procedue done this year from a private Eye Dr. and all I had to pay was a $10 co-pay. SAME PROCEDURE & SAME INSURER.

A DERMATOLOGIST visit at the Same Hospital (Clinic ) walked in the room....loked at my skin....walked out...wrote a prescription for the HIGHEST PRICED MEDICINE possible..... The Bill for a 45 SECOND visit - $400.... My insurer Paid. !!!!!

Picture of <span class="username">Guest (not verified)</span>

Wow!!! could it be that simple, yes it could, we have to pull the curtain back and let everyone see the true pricing.
Without disclosure of our system, we will continue to repeat the same results over and over like the last 50 years.
Let's be partners with everyone making money, but not 300-1,200 mark up. It's time to come together for all of us to have good health care.

Picture of <span class="username">Guest (not verified)</span>

Good idea, but that wouldn't do anything about predatory insurance companies, all of which are corporate and therefore want only fat dividends for their stockholders and fat salaries for their executives. "Affordable" health insurance should be based solely on a person's NET (not gross) income, and should cost no more than 2.5% of same. If the insurance companies can't "live" on that, they should fire about 90% of their expensive top brass.

Picture of <span class="username">Guest (not verified)</span>

I think this is simple and straightforward proposal that makes sense. There are too many special interests and doctors that are in specialties that make a huge profit and would never agree to this model. This includes the current HHS coordinator, Tom Price.

Picture of <span class="username">Guest (not verified)</span>

This is so true. This is so easy. This is so necessary. It will never happen.



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