I had really bad nausea and pain, went to my doctor, who said I likely had a kidney stone, and the next step was to get an MRI. I was between jobs with no insurance and few funds, so I asked what it cost. The doctor had someone in his office call the hospital and got a quote for $1,500. I got the MRI knowing only that.
A month later I got a bill for $3,500. I drove out to the hospital (2 hours) to ask wtf. They didn't help at all, wouldn't budge.
So I went home and wrote them a check for $1,500, marked as paid in full, with a cover letter explaining my side of it. It worked. They cashed the check and I never heard another word. I've done further business there with no problem. It's well worth pushing back.
I ended up learning this accidentally and have used it ever since:
I knew that hospitals charge ridiculous prices at first and then insurance jumps in. At the time, the insurance that I was on seemed to have a policy of "first let the hospital bill the patient and see if he/she pays then we'll get in involved." My procedure was $3,000+. That was a joke, but it also wasn't wholly inexpensive. I figured I'd end up for my deductible at about $800 or so. Hospital sent me the bill for $3,500. I expected insurance to chime in, but didn't. A month went by, I got an other bill, only lower. I call the hospital why this wasn't being resolved, and they said "looks like we didn't mark the procedure correctly. Ignore the bill, we'll fix this." Another month goes by, another bill, still lower. The bills still come and they kept changing. Eventually, it gets coded correctly and insurance did their part, and I owed $600. I forget it about, though. I get a call on the phone with the hospital saying, "we're going to send you to collections unless we can get some level of payment on this." I ask what the bill is if I pay in full. She says, "Pay in full and it's $380." I said, "I can make that happen."
The U.S. is quite corrupt like any other "third-world" country. Just in different places. Our places are acceptable, though because "deregulation" or "gun rights" or "free speech".
I went to hospital and they assured me my procedure was covered by insurance and I wouldn't need to worry about that and in worst case scenario insurance would contact me. Couple of days later this hospital sent me $400 bill. It took me several phone calls to get them to acknowledge that they sent it by mistake.
Exactly same situation happened year later but with ~$800 bill.
Although doctors and medical staff themselves are ok, the US healthcare system as a whole is some incompetent clown mafia.
As I understand it, marking your check "paid in full" combined with the cover letter is what potentially worked for you. Simply writing "paid in full" on the check generally isn't sufficient.
Good luck getting a price like this in writing in advance. I have not been able to get doctors or hospitals to tell me what a procedure would cost in advance at all. "So you're telling the only way to find out how much it will cost is to get it done and then see the bill?" "Right".
An actually useful law might be:
Before an elective procedure, they need to give you the price in writing.
The actual price transparency law does not seem to have resulted in any price transparency.
Isn't this fairly typical? I had an emergency visit when I visited the USA once and was flat out told that the insurance bill was about $3000, but they could take $600 if I paid right away. I had out of country insurance, so had to pay upfront anyway, so I chose the $600 option.
Hospitals have incentives to have a high sticker price - it benefits everyone. The insurance companies negotiate to something closer to the "real" price. That makes them happy. Government through Medicaid/Medicare has a way of giving money to hospitals. Customers only care about the out of pocket cost - indeed if they happen to notice the sticker price it'll only be after they know what they're actually paying - so that will actually make them happy.
There's a very small group. 5% or so of people, those who don't have private insurance and aren't on the public insurances - edicare/Medicaid/VA - . Those people are actually in a position where they get to see the sticker price but might have to actually pay it.
Which sucks.
But I don't see how that changes. The people getting abused are - despite what you might hear - are small in number, typically healthy and not particularly poor or old. The ACA actually went after those people - that was what the mandate was about - and tried to get them to buy a lot of insurance. More insurance then they wanted - and the end result was that the mandate's been effectively gotten rid of.
A bit repetitive at times, but also some amazing stories. There’s a hospital in New Mexico that sends out hugely inflated bills to its uninsured patients then sues them and garnishes their wages when they can’t pay.
FYI, there are usually non-hospital businesses that do xrays and MRIs for substantially less than a hospital charges. They usually know their fees, expect payment at time of service for the uninsured, and have no surprises.
I wonder if you could’ve written a check for $350 (or any amount), marked as “paid in full,” and would have the same outcome. I bet either 1) no one actually looks at the checks or 2) $3,500 is not significant enough for them to fight for at all when a bunch of people are delinquent on $350,000 bills.
>>So I went home and wrote them a check for $1,500, marked as paid in full, with a cover letter explaining my side of it. It worked. They cashed the check and I never heard another word
I hope it ends as you say (think of collection agencies)
It's worth mentioning this is not a fraud deigned by the doctor per say.
They are removed from all of that, and don't care about prices. It's beyond them.
So they just give you a number.
Because there is this big 'goodwill' aspect to healthcare, the professions don't think about it as capitalist, but the hospital is actually pretty aggressive and take advantage of the goodwill aspect.
The US needs a massive overhaul there and it's not about socialism or capitalism, but about simple and hard regulations.
I did some research into this for my current employer and the challenges are pretty well laid out here: the penalties are minimal ($300 / day or $~110,000 per year), the data is kept in the invoice or billing systems, which are complex, and the hospitals do not want to share the truly groundbreaking data, which is the per-provider costs.
In addition, when you Google for competitors you don't find a lot of them, but once you start looking at hospital websites you find that quite a few of them (about 50% of the ones I looked at) have at least a partial solution, often provided by their analytics company as an add-on or footnote.
It does not appear there is a great market opportunity here unless the penalties increase (which the CMS has talked about vaguely, but hospitals are already asking for relief until after the pandemic).
I worked in health care IT (insurance / provider side) during ACA's implementation.
My takeaway is that Congress is technically ignorant of how ossified these backend systems are, but the enforcement agencies (e.g. CMS) are the grease between law and implementation.
F.ex. ACA language and guidance being tweaked right up until the supposed "must be compliant by" date.
Generally speaking, it works about as well as one might hope. All the stakeholders get together, hash out a reasonable schedule for actual implementation, and then everyone generally works towards that.
It helps that the relationships are generally interdependent, and there's enough money sloshing through the system to fund change. So all parties generally do a fair job at converging on the requested changes, quicker than they'd like, but slower than the government would prefer. And then the few trailing insincere implementers start getting beat with fine sticks once the majority of their peers have successfully implemented.
$110k per year seems like a no-brainer for the hospital to just pay rather than comply, assuming they are just purely acting in their own self interest and not for the common good.
My wife is trying to work on price transparency at her practice by offering bundled rates for the surgery she does. She has worked with all the various providers - anasthesia, pathology, the hospital etc to come up with a cash rate that she publishes on her website for the surgery. Most of the parties are very open to it but also extremely worried about outliers. Patients that end up costing 10x what was expected due to complications.
For her this is a minuscule risk, but in her negotiations it has been their main worry.
> Patients that end up costing 10x what was expected due to complications. For her this is a minuscule risk, but in her negotiations it has been their main worry.
And that's probably one of the biggest reason hospitals don't want to talk about actual costs. If you tell someone it's going to cost $X for removing their appendix, but they have a heart attack on the table it's not going to cost $X any more.
Doesn't make lack of transparency right, but in this scenario, I can sort of see why.
You might be interested in the below podcast if you haven't already heard it:
Entrepreneur and Anesthesiologist Keith Smith of the Surgery Center of Oklahoma talks with host Russ Roberts about what it's like to run a surgery center that posts prices on the internet and that does not take insurance. Along the way, he discusses the distortions in the market for health care and how a real market for health care might function if government took a smaller role.
There’s no incentive for hospitals to provide transparency, and less formal doctors to worry about it. For now everyone is getting paid, and the only way to fix the system will be to stop paying many of the middle people that exist just to raise costs. It’s like trying to change the car buying industry, there’s simply too much money for it to improve without significant regulatory change. I think The transparency idea is just not going to hold water and will eventually be ignored or diluted.
"Hospitals were more likely to make their charge data available and to offer a shoppable services tool than to post negotiated rates or cash prices.
The bottom line: "Compliance could be limited because the penalties for noncompliance are minimal (maximum $300 per day) and the costs of disclosure potentially great," the study's authors write."
The penalty for not complying needs to be waaaay higher than $300/day for hospitals to start complying.
It should be illegal to render medical services without first declaring the precise amount of money it will cost the end user.
If I go to a doctor and they recommend a procedure, it should be on them (the service provider) to tell me the cost and I should pay it right then and there. Billing later should be strictly outlawed.
I wrote Hacking Healthcare, created clearhealth open source EMR, a decade plus managing hospitals and multi-practice groups. There are a couple of bad actors out there but for many of these organizations, though it may seem impossible to believe, they really haven't yet been able to coordinate all the entities involved to put together the list. People think of hospitals as monolithic entities but many are much more like medical malls than anything.
Further for many institutions there is a plain cost/benefit. The maximum penalty for non-compliance is $109,500 a year though as far as I know 0 fines have been assessed yet. If you are a large institution it can easily cost many times that to put together and maintain this list in a compliant manner.
Byzantine barely begins to describe the way medical procedures are billed, inpatient especially. It is not at all like a retail interaction. For a given patient on a given insurance program on a given period within a contractual cycle, the rate of charge and reimbursement may differ. Many contracts include a most-favored-nation type clause that mean when one program's reimbursements change then many other ones may need to be updated as well.
I'm not trying to defend any of this but just point out that there is a lot of behind the scenes complexity to the current system that is easy to gloss over when it is thought of in retail terms.
While I admit I haven't listened to the podcast (yet) I'm not sure how you get around that issue that the free market value of medical services will defacto price in the value of your life and health, which is infinite.
I think a whole universe of content could be expanded from that episode and I wish that more of the people commenting here would listen to that episode.
US healthcare system is a joke. I have many examples but my recent one is pretty annoying.
My cost of PT with insurance $150 per visit, cash cost without insurance $69 per visit. Like wtf......I get why cash price is lower but this needs to stop. It is getting to a point where you are better off with a high deductible plan and paying cash for minor visits.
I don't know a single individual who used the US healthcare extensively and said "Wow, US healthcare is amazing".
The price transparency rule was kind of useless already in the setting of most people being insured, it doesn’t really tell people how much they are going to end up paying.
I want to start a site that lets people submit their explanation of benefits from their insurance company and eventually lets people shop for insurance and/or hospital/clinic based on what they end up having to pay.
And where I'm from the state health organisation where everyone is insured sets the prices for all the procedures. If hostpitals want to get paid by them, then these are the prices they will be paid. It works, it's simple. Prices are adjusted based as time goes by, the hospitals make a small profit, but they are mostly non-profits run by the cities or universities.
> the penalties for noncompliance are minimal (maximum $300 per day)
That's the problem right there.
Instead of having a slap-on-the-wrist fine, they should have put in a ceiling on what you can charge if you don't disclose.
Compliance will happen very quickly if non-compliant hospitals are only allowed to charge say $50 / visit for clinic, $200 / visit for outpatient procedure, $500 / visit if admitted, or $1000 / day for a hospital stay.
And if different providers are involved (e.g. your hospital stay involves a GP, specialist, anesthesiologist, and surgeon who all bill as different entities), they have to split your $1000 among themselves -- they don't each get to charge you $1000.
"Compliance could be limited because the penalties for noncompliance are minimal (maximum $300 per day) and the costs of disclosure potentially great"
Lol what a joke. $300/day is like a drop in the ocean for most hospitals/clinics. No wonder no one is complying. Let's add Prison time to executives and see how fast they comply. I absolutely hate dealing with incompetent/fraud billing systems of our healthcare system.
My steps to solve this:
1. Get rid of health insurance companies in EVERY process. If I want to visit my doctor for a basic checkup, let me pay cash. The cash price should be displayed/known in advance and I can shop around multiple doctors in my area.
2. With #1, get rid of crazy premiums , copays etc for most of these visits. Boom, u save shit ton. And no, don't argue with me that my employers provides great insurance. You don't want health insurance tied specifically to employers. You should be free of that.
3. Govt should subsidize the out of pocket costs for going to doctors . Increase a little bit of taxes for this. still a saving because you are saving SHIT TON of money when not paying crazy premiums etc. FOr those who argue otherwise, let me give you an example. For a family of 4, my total cost for an ok insurance is $2200/Month. This amount has to be paid regardless of whether I see a doctor or not. Then comes the copays, deductibles etc. Amounts can vary based on how "great" your plan is but the fact here is that shit tons of money is being paid to insurance companies for doing nothing and being a middleman. Get rid of this and you can add a small progressive tax instead. Will gladly pay that because I for sure wont pay $25,000 premiums per year and another $5000 in deductibles BEFORE i get a single penny from insurance companies. Oh and this keeps the price gouging racket going.
4. Let insurance companies stay in the market for "nice to have" procedures.
Imagine if Car insurance became like health insurance. Who wants to argue that prices won't go up for EVERYTHING including a basic oil change.
130 years of medical regulations by Physicians and it's broken.
Any solution is politically impossible because the medical cartels can lobby(read-bribe) politicians.
My only idea is for a tech company to use AI/Science to diagnose and treat. I imagine the physician cartel will attempt to ban competition, but as long as they are correct more often than physicians, writing is on the wall.
I would love to see a coordinated push by people simply refusing to pay hospitals' post facto billing nastygrams. AFAIK, medical "debt" doesn't even end up on your social credit report in the US.
Without any up front prices, there is no contract that obligates payment. Instead, hospitals collect under the idea of "unjust enrichment" - you needed help, they provided it, and so you should compensate them. But that still doesn't allow them to set arbitrary prices the way they do ($6 for a $0.02 aspirin!), but only to recoup their actual costs. A few form letters that billing department victims could use to assert their legal rights would go a long way.
You wouldn't pay a second post-facto bill from your grocery store based on some justification that "the cashier you went to didn't actually work for the grocery store", and we shouldn't accept similar nonsense from medical providers.
[+] [-] hirundo|4 years ago|reply
A month later I got a bill for $3,500. I drove out to the hospital (2 hours) to ask wtf. They didn't help at all, wouldn't budge.
So I went home and wrote them a check for $1,500, marked as paid in full, with a cover letter explaining my side of it. It worked. They cashed the check and I never heard another word. I've done further business there with no problem. It's well worth pushing back.
[+] [-] cdumler|4 years ago|reply
I knew that hospitals charge ridiculous prices at first and then insurance jumps in. At the time, the insurance that I was on seemed to have a policy of "first let the hospital bill the patient and see if he/she pays then we'll get in involved." My procedure was $3,000+. That was a joke, but it also wasn't wholly inexpensive. I figured I'd end up for my deductible at about $800 or so. Hospital sent me the bill for $3,500. I expected insurance to chime in, but didn't. A month went by, I got an other bill, only lower. I call the hospital why this wasn't being resolved, and they said "looks like we didn't mark the procedure correctly. Ignore the bill, we'll fix this." Another month goes by, another bill, still lower. The bills still come and they kept changing. Eventually, it gets coded correctly and insurance did their part, and I owed $600. I forget it about, though. I get a call on the phone with the hospital saying, "we're going to send you to collections unless we can get some level of payment on this." I ask what the bill is if I pay in full. She says, "Pay in full and it's $380." I said, "I can make that happen."
The U.S. is quite corrupt like any other "third-world" country. Just in different places. Our places are acceptable, though because "deregulation" or "gun rights" or "free speech".
[+] [-] shiftpgdn|4 years ago|reply
[+] [-] ridethebike|4 years ago|reply
Exactly same situation happened year later but with ~$800 bill.
Although doctors and medical staff themselves are ok, the US healthcare system as a whole is some incompetent clown mafia.
[+] [-] benjohnson|4 years ago|reply
As I understand it, marking your check "paid in full" combined with the cover letter is what potentially worked for you. Simply writing "paid in full" on the check generally isn't sufficient.
More info form real attorneys (unlike me)
https://www.lawyers.com/legal-info/consumer-protection/banki...
[+] [-] HarryHirsch|4 years ago|reply
That's what normalization of deviance looks like.
[+] [-] jrochkind1|4 years ago|reply
An actually useful law might be:
Before an elective procedure, they need to give you the price in writing.
The actual price transparency law does not seem to have resulted in any price transparency.
[+] [-] MattGaiser|4 years ago|reply
I was flat out offered the cheap cash settlement.
[+] [-] hackeraccount|4 years ago|reply
There's a very small group. 5% or so of people, those who don't have private insurance and aren't on the public insurances - edicare/Medicaid/VA - . Those people are actually in a position where they get to see the sticker price but might have to actually pay it.
Which sucks.
But I don't see how that changes. The people getting abused are - despite what you might hear - are small in number, typically healthy and not particularly poor or old. The ACA actually went after those people - that was what the mandate was about - and tried to get them to buy a lot of insurance. More insurance then they wanted - and the end result was that the mandate's been effectively gotten rid of.
[+] [-] ryneandal|4 years ago|reply
[+] [-] codegeek|4 years ago|reply
[+] [-] benlivengood|4 years ago|reply
You can get much better discounts by talking to the hospital's business/billing office and demonstrating difficulty to pay.
[+] [-] sgerenser|4 years ago|reply
A bit repetitive at times, but also some amazing stories. There’s a hospital in New Mexico that sends out hugely inflated bills to its uninsured patients then sues them and garnishes their wages when they can’t pay.
[+] [-] maxmcd|4 years ago|reply
[+] [-] rsyring|4 years ago|reply
Example: https://priorityradiology.com/
Xrays were under $250 and MRI was $600 last time my family needed it.
[+] [-] baron816|4 years ago|reply
[+] [-] onetimemanytime|4 years ago|reply
I hope it ends as you say (think of collection agencies)
[+] [-] JohnWhigham|4 years ago|reply
[+] [-] muttantt|4 years ago|reply
[+] [-] JJMcJ|4 years ago|reply
[+] [-] jollybean|4 years ago|reply
They are removed from all of that, and don't care about prices. It's beyond them.
So they just give you a number.
Because there is this big 'goodwill' aspect to healthcare, the professions don't think about it as capitalist, but the hospital is actually pretty aggressive and take advantage of the goodwill aspect.
The US needs a massive overhaul there and it's not about socialism or capitalism, but about simple and hard regulations.
[+] [-] redis_mlc|4 years ago|reply
[deleted]
[+] [-] terryjsmith|4 years ago|reply
In addition, when you Google for competitors you don't find a lot of them, but once you start looking at hospital websites you find that quite a few of them (about 50% of the ones I looked at) have at least a partial solution, often provided by their analytics company as an add-on or footnote.
It does not appear there is a great market opportunity here unless the penalties increase (which the CMS has talked about vaguely, but hospitals are already asking for relief until after the pandemic).
[+] [-] ethbr0|4 years ago|reply
My takeaway is that Congress is technically ignorant of how ossified these backend systems are, but the enforcement agencies (e.g. CMS) are the grease between law and implementation.
F.ex. ACA language and guidance being tweaked right up until the supposed "must be compliant by" date.
Generally speaking, it works about as well as one might hope. All the stakeholders get together, hash out a reasonable schedule for actual implementation, and then everyone generally works towards that.
It helps that the relationships are generally interdependent, and there's enough money sloshing through the system to fund change. So all parties generally do a fair job at converging on the requested changes, quicker than they'd like, but slower than the government would prefer. And then the few trailing insincere implementers start getting beat with fine sticks once the majority of their peers have successfully implemented.
But agile, it ain't.
[+] [-] bootlooped|4 years ago|reply
[+] [-] conorh|4 years ago|reply
[+] [-] comeonseriously|4 years ago|reply
And that's probably one of the biggest reason hospitals don't want to talk about actual costs. If you tell someone it's going to cost $X for removing their appendix, but they have a heart attack on the table it's not going to cost $X any more.
Doesn't make lack of transparency right, but in this scenario, I can sort of see why.
[+] [-] adolph|4 years ago|reply
Entrepreneur and Anesthesiologist Keith Smith of the Surgery Center of Oklahoma talks with host Russ Roberts about what it's like to run a surgery center that posts prices on the internet and that does not take insurance. Along the way, he discusses the distortions in the market for health care and how a real market for health care might function if government took a smaller role.
https://www.econtalk.org/keith-smith-on-free-market-health-c...
https://surgerycenterok.com/blog/
[+] [-] bobduke|4 years ago|reply
The patient gets an "out the door" price and those most qualified (doctors and insurance companies) can argue about the actual cost.
Even if the costs ended up exactly the same, the patient would not be stressed by the "surprise" bills and out-of-network nonsense.
[+] [-] BurningFrog|4 years ago|reply
Their price list: https://surgerycenterok.com/pricing/
[+] [-] nemo44x|4 years ago|reply
[+] [-] underseacables|4 years ago|reply
[+] [-] annexrichmond|4 years ago|reply
[+] [-] KoftaBob|4 years ago|reply
The bottom line: "Compliance could be limited because the penalties for noncompliance are minimal (maximum $300 per day) and the costs of disclosure potentially great," the study's authors write."
The penalty for not complying needs to be waaaay higher than $300/day for hospitals to start complying.
[+] [-] standardUser|4 years ago|reply
If I go to a doctor and they recommend a procedure, it should be on them (the service provider) to tell me the cost and I should pay it right then and there. Billing later should be strictly outlawed.
[+] [-] costcopizza|4 years ago|reply
Or is the regulatory framework waaaaay too favored towards incumbents to even fight?
This shit is beyond frustrating. Healthcare could actually be semi reasonable if prices were as transparent as other industries.
[+] [-] pchristensen|4 years ago|reply
[+] [-] duffpkg|4 years ago|reply
Further for many institutions there is a plain cost/benefit. The maximum penalty for non-compliance is $109,500 a year though as far as I know 0 fines have been assessed yet. If you are a large institution it can easily cost many times that to put together and maintain this list in a compliant manner.
Byzantine barely begins to describe the way medical procedures are billed, inpatient especially. It is not at all like a retail interaction. For a given patient on a given insurance program on a given period within a contractual cycle, the rate of charge and reimbursement may differ. Many contracts include a most-favored-nation type clause that mean when one program's reimbursements change then many other ones may need to be updated as well.
I'm not trying to defend any of this but just point out that there is a lot of behind the scenes complexity to the current system that is easy to gloss over when it is thought of in retail terms.
[+] [-] hackeraccount|4 years ago|reply
It is clearly coming from a ... more sympathetic to free markets side of the argument but I honestly believe it's interesting on it's own terms.
It includes an explanation of the delightful term "compensated uncompensated care"
[+] [-] Workaccount2|4 years ago|reply
[+] [-] adolph|4 years ago|reply
[+] [-] avgDev|4 years ago|reply
My cost of PT with insurance $150 per visit, cash cost without insurance $69 per visit. Like wtf......I get why cash price is lower but this needs to stop. It is getting to a point where you are better off with a high deductible plan and paying cash for minor visits.
I don't know a single individual who used the US healthcare extensively and said "Wow, US healthcare is amazing".
[+] [-] epmaybe|4 years ago|reply
I want to start a site that lets people submit their explanation of benefits from their insurance company and eventually lets people shop for insurance and/or hospital/clinic based on what they end up having to pay.
[+] [-] skeletal88|4 years ago|reply
[+] [-] csense|4 years ago|reply
That's the problem right there.
Instead of having a slap-on-the-wrist fine, they should have put in a ceiling on what you can charge if you don't disclose.
Compliance will happen very quickly if non-compliant hospitals are only allowed to charge say $50 / visit for clinic, $200 / visit for outpatient procedure, $500 / visit if admitted, or $1000 / day for a hospital stay.
And if different providers are involved (e.g. your hospital stay involves a GP, specialist, anesthesiologist, and surgeon who all bill as different entities), they have to split your $1000 among themselves -- they don't each get to charge you $1000.
[+] [-] sithlord|4 years ago|reply
My question is, is that even CLOSE to enough of a sample size to make any meaningful statement?
[+] [-] codegeek|4 years ago|reply
Lol what a joke. $300/day is like a drop in the ocean for most hospitals/clinics. No wonder no one is complying. Let's add Prison time to executives and see how fast they comply. I absolutely hate dealing with incompetent/fraud billing systems of our healthcare system.
My steps to solve this:
1. Get rid of health insurance companies in EVERY process. If I want to visit my doctor for a basic checkup, let me pay cash. The cash price should be displayed/known in advance and I can shop around multiple doctors in my area.
2. With #1, get rid of crazy premiums , copays etc for most of these visits. Boom, u save shit ton. And no, don't argue with me that my employers provides great insurance. You don't want health insurance tied specifically to employers. You should be free of that.
3. Govt should subsidize the out of pocket costs for going to doctors . Increase a little bit of taxes for this. still a saving because you are saving SHIT TON of money when not paying crazy premiums etc. FOr those who argue otherwise, let me give you an example. For a family of 4, my total cost for an ok insurance is $2200/Month. This amount has to be paid regardless of whether I see a doctor or not. Then comes the copays, deductibles etc. Amounts can vary based on how "great" your plan is but the fact here is that shit tons of money is being paid to insurance companies for doing nothing and being a middleman. Get rid of this and you can add a small progressive tax instead. Will gladly pay that because I for sure wont pay $25,000 premiums per year and another $5000 in deductibles BEFORE i get a single penny from insurance companies. Oh and this keeps the price gouging racket going.
4. Let insurance companies stay in the market for "nice to have" procedures.
Imagine if Car insurance became like health insurance. Who wants to argue that prices won't go up for EVERYTHING including a basic oil change.
[+] [-] deregulateMed|4 years ago|reply
Any solution is politically impossible because the medical cartels can lobby(read-bribe) politicians.
My only idea is for a tech company to use AI/Science to diagnose and treat. I imagine the physician cartel will attempt to ban competition, but as long as they are correct more often than physicians, writing is on the wall.
Reminder physicians created the opioid epidemic.
[+] [-] mindslight|4 years ago|reply
Without any up front prices, there is no contract that obligates payment. Instead, hospitals collect under the idea of "unjust enrichment" - you needed help, they provided it, and so you should compensate them. But that still doesn't allow them to set arbitrary prices the way they do ($6 for a $0.02 aspirin!), but only to recoup their actual costs. A few form letters that billing department victims could use to assert their legal rights would go a long way.
You wouldn't pay a second post-facto bill from your grocery store based on some justification that "the cashier you went to didn't actually work for the grocery store", and we shouldn't accept similar nonsense from medical providers.
[+] [-] tolstoshev|4 years ago|reply