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Trump aide: How we're aiming to stop surprise medical bills


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2019 May 14, 7:17am   1,342 views  11 comments

by Patrick   ➕follow (55)   💰tip   ignore  

https://www.cnn.com/2019/05/10/opinions/stop-surprise-medical-billing-opinion-grogan/index.html

At the White House on Thursday, President Donald Trump announced his principles to solve a huge problem facing our healthcare system: surprise medical bills. Present at the event were victims of outrageously large, surprise bills and their family members. ...

Many Americans have had similar frustrating experiences following a trip to the hospital. They thought they understood the care they had received and who provided it only to receive lengthy, unintelligible bills for services they were unaware of by out-of-network providers they never met at prices that far exceed the amounts that insurance pays.
These surprise bills typically result from patients receiving care from an out-of-network provider that they may have reasonably assumed was in-network -- or from receiving out-of-network care in an emergency when they had limited, if any, ability to choose their provider. Think of the time a loved one went to the nearest emergency room in a crisis and was hit with an out-of-network bill. Think of the time you scheduled a surgery after confirming that the surgeon and hospital were in your insurance network, only to be later sent a huge bill for an out-of-network anesthesiologist who you did not choose but who was part of your surgical team. ...

At its core, more transparency and information can solve much of this problem. Every patient should be informed upfront of the network status of all providers in advance of receiving scheduled care, with a single, comprehensible bill with pricing information about the provider, the services that should be reasonably expected, and the out-of-pocket costs for which they will be responsible. And unless patients provide advance consent, out-of-network providers should not be able to send them bills. ...

Congress should come together on a bipartisan basis to pass legislation, based on these commonsense principles, to end surprise medical billing. It is not acceptable to see hospitals -- institutions ostensibly committed to the mission of patient care -- put patients in these unfair and unnecessary financial situations.


I totally agree, but the Democrats certainly don't want to help any Americans while Trump is president. Perhaps more of this could be done by executive order, the way Trump required hospitals and pharmacies to publish price lists.

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1   HeadSet   2019 May 14, 7:22am  

Perhaps more of this could be done by executive order, the way Trump required hospitals and pharmacies to publish price lists.

Yes, why didn't Congress do this, or at least legislators in each State? Like with illegal immigration, Trump has to defy both Dems and Repubs to do what is needed for the citizens at large.

Dentists need to publish lists as well.
2   Shaman   2019 May 14, 7:47am  

Patrick says
totally agree, but the Democrats certainly don't want to help any Americans while Trump is president.


They don’t want to help Americans period. They only want to help illegals get across the border, get on welfare, and get to vote Democrat. The entire party has gone full retard. Any sane leadership that might be left there should take note of what’s happening in the UK right now. Their government stopped representing the people and went all “1984” on its population as well as inviting millions of hostile Muslims and protecting them from any criticism on pain of prison time for speech crime. The two main parties there (Tories and Labor) are now a combined minority, with the Brexit and UKIP parties rising to the majority.

You can’t properly oppress people for long if you don’t also take away their right to vote you out!
3   Booger   2019 Jun 24, 1:40pm  

https://thehill.com/policy/healthcare/449994-trump-issues-executive-order-to-bring-transparency-to-health-care-prices

Trump issues executive order to bring transparency to health care prices


The agencies will also look at regulation to address “surprise billing,” which is when patients end up with a bill their insurance company won’t pay.
4   rdm   2019 Jun 24, 4:19pm  

Here is an interesting article as to why this small step might not work to lower medical bills. It turns on the theory that when the differences in price are known business don't lower their prices to the lowest to compete they in fact raise their prices to be the same or maybe slightly lower than the highest. So if this were to be true ( and nobody knows) you would have transparency but at a generally higher cost.

https://www.nytimes.com/2019/06/24/upshot/transparency-medical-prices-could-backfire.html?action=click&module=Top%20Stories&pgtype=Homepage

"It makes intuitive sense — publish prices negotiated within the health care industry, and consumers will benefit. That’s the argument behind the executive order issued Monday by President Donald Trump that is intended to give patients more information about what health care will cost before they get it.

But the peculiarities of the United States health care system, with its longstanding secrecy around negotiated health care prices, mean there is very little research on the possible effects of the particular thing the Trump administration wants to do.

That means that scholars examining the question have had to reach far beyond the health care industry, and even beyond the United States, for answers about what might happen. Their favorite studies come from markets like Chilean gasoline, Israeli supermarkets and Danish ready-mix concrete.

The scholarship suggests that more transparency in health care could backfire, causing prices to rise instead of fall.The Danish study, in particular, comes up a lot.

“I don’t know if you have had the misfortune of having health economists tell you about Danish cement,” said Amanda Starc, an associate professor of strategy at the Kellogg School of Management at Northwestern, one of several scholars who mentioned a paper with a punny name: “Government-Assisted Oligopoly Coordination? A Concrete Case.”

“Everybody loves the Danish concrete example!” said Matthew Grennan, an assistant professor of health care management at Wharton, who has studied the effects of price transparency on hospital purchases.

The Danish government, in an effort to improve competition in the early 1990s, required manufacturers of ready-mix concrete to disclose their negotiated prices with their customers. Prices for the product then rose 15 percent to 20 percent.

The reason, scholars concluded, is that there were few manufacturers competing for business. Once companies knew what their competitors were charging, it was easy for them to all raise their prices in concert. They could collude without the sort of direct communication that would make such behavior illegal. It wasn’t easy for new companies to undercut the existing ones, because the material hardens so fast that you can’t ship it far.

“Collusion is going to be easier when there’s a small number of players,” Ms. Starc said. That’s the case for hospitals in most markets, making them similar to the Danish manufacturers. “There’s a small number of hospitals, and entry is hard.”
5   Booger   2019 Jun 24, 5:11pm  

rdm says
“There’s a small number of hospitals, and entry is hard.”


6200 is considered a small number?
Did you know that there are also lots of non hospitals as well that can do things that one should shop around for, like MRI's.
6   mell   2019 Jun 24, 5:25pm  

First of all gouging is illegal and if the rule of law is applied any effort will land you in prison. Of course under Obummer the rule of law was paused I'm sure Trump will gladly reinstate it. Secondly if this lowers prices why are businesses keeping them secret and harming themselves? Calling bs but there's always a study here and there for the never trumpers. Lastly if you knew the price at all you may choose not to do an unnecessary procedure.
7   rdm   2019 Jun 25, 8:07am  

Booger says
Did you know that there are also lots of non hospitals as well that can do things


My understanding is the Ex. order only affects hospitals and insurers.

The point of the Times piece is that what may seem obviously a good idea may not be. Linear thinking is often wrong.

This is a tiny tweak to a vast system that is seriously screwed up.
8   rdm   2019 Jun 25, 8:24am  

mell says
First of all gouging is illegal


Kind of depends on your definition of "gouging", unless it occurs under certain external conditions such as a hurricane its pretty much buyer beware. As a rule sick people don't make good, discerning customers/ consumers. Their focus is not on cost, and the complexities of health care are beyond the understanding of the average person.

Small markets have little competition in health care. Many rural area hospitals are dead or dying and the care they provide is typically not good. If your goal is to provide decent health care to all citizens at a reasonable cost a free market system does not work. If that is not the goal, then maybe small tweaks to the bloated hybrid employer, private, government system we have feels about right.
9   FortWayneAsNancyPelosiHaircut   2019 Jun 25, 10:28am  

This should be done. One should know all costs they'll have to pay, basically provide a "predetermination" upon entry. You can ask for something like that now, but usually Hospitals go out of their way to not do that since it'll lock them into some price.
10   Heraclitusstudent   2019 Jun 25, 10:35am  

Oh no! they want to forbid extortion... No the healthcare industrial complex will have to finance Democrats at the next election.
Free speech.
11   mell   2019 Jun 25, 11:35am  

rdm says
mell says
First of all gouging is illegal


Kind of depends on your definition of "gouging", unless it occurs under certain external conditions such as a hurricane its pretty much buyer beware. As a rule sick people don't make good, discerning customers/ consumers. Their focus is not on cost, and the complexities of health care are beyond the understanding of the average person.

Small markets have little competition in health care. Many rural area hospitals are dead or dying and the care they provide is typically not good. If your goal is to provide decent health care to all citizens at a reasonable cost a free market system does not work. If that is not the goal, then maybe small tweaks to the bloated hybrid employer, private, government system we have feels about right.


Every market where price is discovered upon billing usually has higher prices. This should be illegal and would be a rare instance of a new law making sense, plus the law would be short and sweet, as short as a couple of sentences, w/ harsh punishment on violation. This is not just healthcare, take Postmates, one of the biggest scams out there. You order food, they quote you $4 delivery fee and then the CC receipt comes and you actually paid $20. Even Uber is now starting with hidden surge fees tacked on after the fact. If you don't charge the entire transaction back to your CC to let them know what you think about fraud, you're the problem. It's just accepted in health-care cause it has been going on for so long and it's a well protected racket. I maintain prices would fall. Let's give it a shot.

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