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Healthcare industry follows Big Tobacco’s deadly blueprint

Healthcare industry follows Big Tobacco’s deadly blueprint

Picture of Steven Weissman

i. The Emperor's New Clothes

The healthcare industry’s dominance of our political process and lack of concern for public well-being, follows the same loathsome strategy employed by the tobacco industry. Healthcare is big business that aims to maximize profits. Healthcare economics, like the selling of tobacco in its heyday as a non-addictive, non-carcinogenic product, is based on manipulation of the political process, fraud and deceit.

As a vivid reminder as to how pursuit of profit can be removed from the norms of human decency, consider the day in 1994 when the CEO’s of all the major Tobacco Companies falsely testified under oath before Congress that nicotine is not addictive:

 

The actions of the tobacco industry, which included marketing to children, have been called, among other things, the most deadly crime in human history. The calculates that cigarette smoking is responsible for more than 480,000 deaths per year in the United States and that our healthcare system is dealing with more than 16 million Americans who are living with a disease caused by smoking.

Those who early on tried to expose the health risks of tobacco, or to expose other major scandals, such as Enron, WorldCom, Bernie Madoff or the near collapse of our banking system, were all greeted with skepticism, essentially ignored. For example, Madoff possessed the ultimate credibility and appeared to be above reproach. He was the past chairman of the NASDAQ Stock Market, a quasi-governmental organization charged with enforcing rules to protect the nation’s investors. Madoff’s respectability and credibility blinded the U.S. Securities and Exchange Commission, along with everyone else who was tipped off but refused to see what was right in front of them.

Continuing the pattern of frequent “unforeseen” scandals, the healthcare industry has used crony capitalism to enrich itself through a system that imposes unsustainable health cost misery on the people of the United States.  

Conventional wisdom, as promoted by industry supported politicians, lobbyists, researchers and other representatives, holds that determining the cause of skyrocketing costs poses an extraordinarily sophisticated and complex problem.

In actuality, our costs are sky high because U.S. law has been rigged to permit healthcare to be the only product or service sold without both real pricing and price competition. The industry foists upon our nation the highest cost medical care on earth, by a margin of at least 50% per-capita, while providing significantly lower quality than exists in other wealthy nations.

This is one of those times when the simple answer just happens to be the correct answer. In two weavers sold a high priced suit of the most magnificent fabrics imaginable; with one extremely unique quality. The fabric was invisible only to those who were unfit for their positions or fools. When the emperor parades around, nobody dares to notice until a child cries out "But he isn't wearing anything at all!"

In seeking to justify its charges, the healthcare industry also weaves imaginary fabric. However, it is as plain to see as a naked emperor that the true reason for the nation’s health cost misery is the elimination of real pricing.

ii. The elimination of real pricing

Healthcare pricing has been rigged by the industry that pumps, by far, the most cash into Washington. The healthcare industry spends more on lobbying than the defense, aerospace, and the oil and gas industries combined.

Just as the tobacco industry sponsored false studies regarding the safety of cigarettes, the health industry has successfully used its resources to promote the false idea that healthcare services are too complicated to have actual prices.

Ask the price of anything and the answer is always the same: What insurance do you have?

A medical provider will charge each patient a different amount for the exact same service, depending on the individual’s insurance coverage. This system makes it difficult for a patient to shop for good value; and, assures that providers are exempt from the price competition to which all other businesses are subject.

The part of the Affordable Care Act that was intended to control insurance costs, perversely, incentivizes insurers to pay higher, not lower costs. Under the Act, premiums and profits are legally permitted to rise only as health costs rise. In short, when it comes to pricing, nobody is watching the store and the cash register is wide open.

Because actual billing rates are not set, the health industry is able to prey on patients when they are most vulnerable - - needing care. Those who are out-of-network or uninsured, are charged the highest rates.

The widely discussed concept of price transparency, in and of itself, cannot fix the health cost crisis. 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. Transparency would merely show that each healthcare provider charges extraordinarily wide-ranging different prices for each service it provides and continue to sow confusion over the real price. This kind of disclosure will not effectively enable any patient to shop and compare pricing.

With no real pricing for health services and the absence of normal competitive market pressure, of course healthcare costs are skyrocketing. The public is offered a variety of unlikely theories to explain ever higher costs: (a). the expense of technology (however, in all other industries technology has proven to increase efficiency and lower cost); (b). Government regulation (which is a cost in virtually every business); and (c). Malpractice claims and defensive medicine  (however, a comprehensive analysis from the found overall annual medical liability system costs, including defensive medicine, to be just 2.4 percent of total health care spending).

the U.S. health industry is providing worse care (in comparison to other wealthy nations), at an astounding 50% higher cost than the second highest cost nation per-capita.

A concluded, as most citizens already know, prices are too high: “this high spending cannot be attributed to higher income, an older population, or greater supply or utilization of hospitals and doctors. Instead, the findings suggest the higher spending is more likely due to higher prices. . .”

iii. Health insurers rely on predatory healthcare pricing to mislead the public and coerce the purchase of insurance

When any medical bill is incurred, health insurers ordinarily misrepresent that the insurance coverage resulted in a savings to the patient, namely, of the difference between the “list price” (sometimes referred to in the industry as the charge-master price) and the amount paid by the patient. However, list prices are billed only to the roughly 10% of patients who are not covered by any insurance or, are out of network. List prices are approximately 3 to 10 times more than the real prices billed to the 90% of patients who are insured and are widely recognized as phony, having no relationship to either cost or value.

To illustrate this point, consider a hypothetical scenario of a patient insured under a BlueCross policy. The patient has an MRI performed and pays a co-pay of $300 at the point of service. Several weeks later, the patient receives a statement from BlueCross stating that the “amount billed” for the MRI by the radiology center was $2,600 and the amount “allowed” was $375.00. BlueCross pays the $75 balance of the allowed amount, over the $300 co-pay paid by the patient at the point of service.

In this situation, following the usual routine of all insurers, the BlueCross statement sent to the patient will falsely represent that the patient saved $2,300, the difference between the “amount billed” and the $300 co-pay paid by the patient. In actuality, the $2,600 “amount billed” is a phony number and was never in play. The “allowed” amount ($375) is the pre-negotiated rate that the radiology center agreed to charge and gladly accepts from all BlueCross patients under the particular policy. Any patient willing to make a few phone calls to ask for a cash MRI price, including from the same center that BlueCross is telling you “billed” $2,600, would be likely get about the same $375 rate, give or take $100. So, on these facts, BlueCross actually pays a $75 benefit but tells the patient they saved him $2,300, giving the false impression that the insurance coverage proved itself of great value to the patient.

Once predatory healthcare pricing is understood, individuals will realize it is a very rare year in which the outcome of paying for health insurance is a real net positive.

For example, assume the cost of a family policy is $1,500 a month with a $6,000 deductible. If a family member has a serious illness resulting in a $100,000 hospital bill, the real price (i.e. allowed amount) may be just $20,000. So if the family paid $18,000 in annual premiums (i.e. $1500 per month) a $6,000 deductible, they are out-of-pocket $24,000. If not for the fact that predatory pricing is legal, without insurance, their bill would have been for a true market price equal to the $20,000 negotiated “allowed amount” (or less) and the total out-of-pocket cost would be the $20,000 true charge. Incredibly, with the typical phony “list price” $100,000 hospital bill, the patient would have had a net gain without insurance. This is not shown to recommend that individuals forego insurance, but merely to illustrate how the system has been sickeningly rigged by the industry.   

While I take no position as to whether the Affordable Care Act’s mandate was a good idea; it is clear that the decision to enact this legislation and much of the public acquiescence was premised on false information. By design, the healthcare industry is structured in a manner that constantly threatens consumers with the risk of incurring a phony list price bill, thereby driving frightened patients into the waiting arms of insurers.

Our laws have facilitated the cloaking of healthcare pricing under a veil of secrecy. In nearly all states, health insurers and providers routinely include gag provisions in their rate agreements. Neither party is permitted to disclose the rates that the insurance company has contracted to pay and that the provider agreed to accept. Such concealment hides the true market value of healthcare services and allows both insurers and providers to use the threat of “list prices” to stimulate both the purchase and subsidization of insurance.

Our elected representatives have sold out the nation by allowing healthcare providers a special exemption from the customary requirement of actually pricing products and services. This is the most vicious implementation of crony capitalism in our history. While there are no reliable statistics available on the number of people who forego doctor visits or avoid a necessary medical procedure due to cost, this national scandal is undoubtedly causing far more death, human suffering and personal bankruptcies, than any that came before.

iv. The Healthcare Industry Crushed Consumer Protection

Imagine you are at a department store and three people in line before you are each charged $19 for a particular shirt; but the same cashier charges you $175 for the exact same item. Everyone would recognize such conduct as outrageous. Only the health industry is legally permitted to impose random, predatory pricing for essential, life or death services.

Last summer, the New York Department of Consumer Affairs made national headlines when it forced Whole Foods to admit the company short-weighted customers. Our government employs thousands to protect us from being bamboozled on an ounce of ham or fruit or gasoline and in other areas as well, yet we are abandoned when it comes to healthcare pricing. 

Medical price gouging and fraud are so widespread that, to protect the U.S. treasury, there is a special Medicare Fraud Strike Force. However, individual non-Medicare patients are on their own and, because actual pricing is not disclosed, are unable to even learn what their price is supposed to be. If you eat at a restaurant with no prices on the menu, you really cannot protect yourself from being charged 10X higher than what you expected.

Citizens have no effective remedy to defend themselves against the industry that used political influence to write its own business rules. This is unfair and unsustainable, as well as un-American.

v. The Solution Is To End Predatory Pricing

The solution is for Congress to take action and require healthcare providers to bill all patients, insured and uninsured, the same amount for the same service. Hospitals, physicians and labs should have continued freedom to set their own prices, but predatory pricing - - a different rate for each patient - - must be prohibited. Patients should not be financially brutalized for being out-of-network or uninsured. Health insurers should not be permitted to mislead the public by falsely claiming credit for saving us from phony list prices.

When rates are set, patients will be able to shop for good healthcare value. Providers will be forced to compete based on price, quality and service. Healthcare costs and insurance premiums will plummet.

Politicians uniformly misdirect public attention to the cost of health insurance as the real problem. However, the cost of health insurance is simply a direct function of underlying medical costs. Debating ways to make the sale of insurance more efficient or subsidized merely sidesteps the truth and protects predatory pricing. To achieve a material reduction in the cost of health insurance, there necessarily must be a material reduction in the amounts paid out for physicians, hospitals, labs, and pharmaceutical companies. Health insurance costs will plummet when real pricing is required, which allows consumers to shop for fair value and requires providers to compete.

The healthcare industry’s abusive conduct and the tremendous misery it is causing, give a single payer system immediate appeal. However, do we really want to place our confidence in politicians to negotiate rates with the industry - - before at least giving competitive market pricing a chance? Free market pricing has proven to be the most efficient method of distributing goods and services ever known to humanity. We should give the proven system of market competition a chance before turning to a single payer system, where prices may be set in in smoke filled rooms, with healthcare lobbyists seated at the head of the table. Such a scenario, for many Americans, may evoke memories like the Pentagons purchase of $1,000 hammers and toilet seats.

Conclusion

In 2013, when my friend and client of 35 years died, I agreed to become interim president of the Miami hospital he founded a half century ago. I gained an insider’s view of the healthcare system and what I learned was sickening. I went public, vowing to seek reform.

I created a () which has garnered more than 100,000 signatures in a few short weeks. It is helping to galvanize support for the idea that to end skyrocketing health costs, it is essential to place real prices in the hands of patients. Thousands of public comments on the (including many from people who identify themselves as physicians, nurses and others working in healthcare) are forming a growing and shameful diary of human suffering caused by industry overreach.

I also to Hillary Clinton, Donald Trump, Gov. John Kasich and Senators Ted Cruz and Bernie Sanders to publically pledge support for outlawing predatory healthcare pricing. Voters need to know where the Presidential candidates stand on this vital issue.

Unless health services are required to have real prices, just like all other goods and services sold in the United States, free market competition will continue to be blocked and patients will remain unable to shop for good value. If this change is made, healthcare costs will plummet, causing health insurance rates to plummet as well. It really isn’t complicated.

 

Comments

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I signed your petition on Change.org when it first began. I hope you succeed in your noble cause!

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A long read but worth while. I experienced the exact scenario described here when processing bills for my elderly mother, who injured herself last summer and subsequently passed away.

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It is time for real healthcare reform. Preditary healthcare pricing must end. It is time to introduce healthy competition into healthcare and a system judged by quality of service instead of quantity of services provided.

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I used to work in a hospital based Lab. Recently was sent to ER for a teeny bit of chest pain. Bills come, review bills. Among tests run a CBC. In the past when billed for a CBC I was charged once. This time I was charged $60.00 for each component of the CBC $60. for the red count, $60.00 for the white, $60. for the platelet count, $60.00 for the differential $60. for each component to be read by a pathologist.. That's $480 for a simple blood test done by computer that prints out the results in about 1 minute. By the way, my Dx was URI and UTI. Will never again mention chest pain to a doctor unless it's crushing. When asked how bad the pain was I said 0.5.

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Rosemary Maziarz-don't let your anger with the broken system of healthcare endanger your life! I went to the ER with 0.5 chest pain and ultimately found that I had an 80-90% blocked artery. If I had ignored it until I had crushing chest pain (which as a woman I may never have experienced) I could have had my first and last fatal heart attack.
Patients have to navigate the healthcare system and be their own best advocates until we can fix the broken system. I hope you will spread the word about the petition and in the mean time call the hospital and fight to correct that ridiculous billing error.

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Any person who plans not needing a doctor in life should be concerned

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To start to inform oneself on this matter, read the wiki on the Flexner Report of 1910. OK, now you've read it, dig: Systems of training and credentialling always serve two purposes, 1. quality control and 2. economic barrier to entry to control supply. These days, front line care personnel are not the largest cost drivers. Flexner, who was not a physicain or even holder of a scientific degree, but apparently a reasonably well-intentioned and well-connected businessman, would be horrfied by what US healthcare has become, seems to me. Important history here. Helps to understand how deeply entrenched the for-profit medical oligarchy is, IMO.

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I have been suffering from debilitating back pain for a year now. I finally had enough and went to the doctor a month ago. I was told I needed 1 month of physical therapy in order to get better. I said OK and went to my first appointment, happy to get relief. Then I found out my insurance, the exact same policy from last year, was changed to a deductible plan. $800 per person or $1600 per family. My physical therapy was going to cost me $150 per appointment until the deductible was met; with 3 appointments a week for a month. After deductible it would be $35 per appointment. At its most that's $450 a week, and at the least $90! I had the 1 $150 appointment and never went back, my family can't afford that, and so I'm still in pain every day. Also, my 14 year old autistic son was suffering from anxiety and sadness. He tried to hurt himself at school in Feb, so they called an ambulance. The 20 minute ride that required no intervention on his behalf, he just sat there scared quiet the whole way, is going to cost us nearly $800. The emergency room is billing us twice, once for the actual ER bill, and another for the doctor. This has got to stop! Our insurance premiums through my husband's work cost us about $8000-$10000 a year, yet we still have a $1600 family deductible and a 20% responsibility afterwards! We have 4 children to care for, and yes we actually have to decide if we can afford to go to the doctor, before we go! My special needs children require special services that we are lucky if they get covered at all, or if they are aren't covered for much or have a cap! It's extremely hard to help an autistic child on our own because we can't afford those services even though we pay so much for insurance! I truly pray for change in this industry. The suffering of others should never be for profit, there's a reason slavery was abolished!

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In the meantime, I think a grassroots organization should start a movement where people can upload their insurance statements regarding bills (obviously not including personal information), where it states the list price versus the allowable amount paid by the insurance. It won't help the patient to shop for better prices yet but will publicly call out the providers, hospitals, etc. .

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Yes I have experienced predatory pricing of both drugs and surgical procedures when health insurance denies coverage. The markup above what the hospital normally charges is staggering and in my view criminal. This is especially true of not for profit hospitals as they have special exceptions from law by Congress. The source of the problem is their ability to set inflated prices they know will never be collected from the insurance companies. This disgraceful practice is controlled in each hospital by the Charge Master. Only in Maryland is this practiced blunted by law. The hospitals in Maryland are profitable without prices gouging patients and are know for their outstanding level of patient care (see John Hopkins in Baltimore).

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Currently having immunotherapy infusions every othe week. It was billed at approx $14k/ea time in 2015, but in 2016, $29k. How is this possible or allowed?

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The costs of health care is totally outrageous. Time to fully impose government regulations and take 90% of Big Tobacco and Insurance profits if it refuses to comply.

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Health Care pricing like that of many other goods, is based on 'what the market ' will bear. So if the Blues will contract to pay more for a product than they did a year ago, given the rise in labor costs, which is the bulk of the cost for hospitals, clinics, and their product suppliers, the price to the Blues will increase. Medicaid is the lowest payer, followed by Medicare, the rest fall somewhere in between. And the hospitals and clinics have to cover their expenses or they like any other business go under. Health care has been an expanding market, offering more for the rise in prices, whether it's fancy meals, or the best/newest equipment. The process spirals prices upward.

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This is such an important issue that it HAS to be fixed. I am so angry at our Representatives that they allowed this scam to continue and even get worse. How do these people sleep at night?

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Ins. Companies also want to know what your yearly income is before a price is quoted. I recently started receiving Medicare but my husband is a few years younger and still employed. They managed to get it all and we are told that it wont cover anything until we have spent 8000.00 on medical care. We are very healthy and active and only I take BP medication and my husband doesn't take anything. It would take us forever to spend that kind of money for office visits or my generic BP medication, especially not in a years time. So we have to pay them that large monthly amt. of almost a thousand dollars if we see a doctor we will have to pay for that and all ancillary services out of pocket too.
I do not feel like this is any kind of an insurance policy for us, more like ins. for them to not have to pay anything for us! Extremely unfair and basically just gouging consumers because we have no rights here and are completely at their mercy! I think we are going to have to cancel and go without so we can afford to see the doctor. Oh and pay the fine for dropping it because we cant afford it. BTW, the insurance company is Anthem!

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This is such an important issue that it HAS to be fixed. I am so angry at our Representatives that they allowed this scam to continue and even get worse. How do these people sleep at night?

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Ins. Companies also want to know what your yearly income is before a price is quoted. I recently started receiving Medicare but my husband is a few years younger and still employed. They managed to get it all and we are told that it wont cover anything until we have spent 8000.00 on medical care. We are very healthy and active and only I take BP medication and my husband doesn't take anything. It would take us forever to spend that kind of money for office visits or my generic BP medication, especially not in a years time. So we have to pay them that large monthly amt. of almost a thousand dollars if we see a doctor we will have to pay for that and all ancillary services out of pocket too.
I do not feel like this is any kind of an insurance policy for us, more like ins. for them to not have to pay anything for us! Extremely unfair and basically just gouging consumers because we have no rights here and are completely at their mercy! I think we are going to have to cancel and go without so we can afford to see the doctor. Oh and pay the fine for dropping it because we cant afford it. BTW, the insurance company is Anthem!

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This is such an important issue that it HAS to be fixed. I am so angry at our Representatives that they allowed this scam to continue and even get worse. How do these people sleep at night?

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This is such an important issue that it HAS to be fixed. I am so angry at our Representatives that they allowed this scam to continue and even get worse. How do these people sleep at night?

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Medicare Advantage plans need reform, as well. The insurance companies are collecting all the insured Medicare payments without, in reality, covering much of anything. The co-pays for nearly every procedure, prices that procedure outside the realm of possibility for most retired persons, who manage to survive on Social Security income. So they are, in essence, denied most healthcare.

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Medicare Advantage plans need reform, as well. The insurance companies are collecting all the insured Medicare payments without, in reality, covering much of anything. The co-pays for nearly every procedure, prices that procedure outside the realm of possibility for most retired persons, who manage to survive on Social Security income. So they are, in essence, denied most healthcare.

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As a consumer and a member of the health care field I am appalled at how expensive costs are.

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Thank you for doing this! We must make a change for the better. Shame on lobbyists for manipulating the people. We do need to end predatory pricing! Healthcare cost is out of control.

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All people need to be treated equally in health care costs, regardless of their means or insurance policy.

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I am on Medicare ( with a supplimental policy) and am preparing to see a heart specialist today . Arrangements have been made by my family doctor.I have no idea of the costs of today's services and will probably never see a statement. Simply put, it's "do or die" these days.

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my husband has prostate cancer for the 2nd time. It's been kept in check and he feels quite well with no symptoms. The doctor changed his medication 2 weeks ago without seeing him for several months and without any type of testing. I went to get the new Rx and was told it would be a $40.00 co pay (not unusual) so I paid. When handing me the Rx the tech asked if I knew that for 120 pills it was $27,000 (a 3 month supply). Unbelievable and shocking. In addition, this medication stated it was to be used for metastasized prostate cancer and those who had their testicles removed. My husband has no history of this. Something needs to be done about this sort of predatory pricing. Think of those who need this type of medication and have no insurance. It becomes a death warrant.

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This article is very informative. It is pretty amazing that not having fixed pricing for health services isn't discussed more as a huge factor in raising costs and keeping them high. Right now we have people getting gouged having to pay for treatments that they need and consumers can't even shop around. As this article also highlights, they trick you into thinking they are saving you money when often they aren't. I'd also look into practices in the pharmaceutical industry. There are too many shady and manipulative practices in that industry to list here.

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Thank you so much for having the courage and intelligence to write such a clear and horrifying narrative. There is so much wrong with our health care system and this is one of the major problems. I saw so many obvious flaws while taking care of my parents. I did not know how to bring them to light but you have in a large way. Light to a very dark and corrupt practice. I will help you in any way possible. Best of luck and may God bless you for doing what is right instead of thinking of yourself.

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I have worked in the healthcare sector for years, Mr Weissman has captured the problem exactly. The people who really suffer are those in need of these overpriced services. Stop these people preying on the vulnerable, it is an unconscionable abuse. The problem is basically rooted in the all pervading lobbying system which enables the "legal" corruption of those in Washington charged with doing the right thing for the American people - all of the people. This truly is a scandal sustained by those elected who have been bought by those who profit
from it.

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I believe the problem is more of the insurance than the providers. The fact that insurance will collect so much premium for such lengths of time and the singular time there is need to come true for you, they bring up copayment and you still end up paying most of your bill is the real ripoff. However I really agree with you that it's with the connivance of the health system. The unfortunate part is that so much funds going into health sector neither gets into the healthcare system nor the patient. It all ends up in the pockets of insurance. It's a real shame and yes, your petition is a really good start point on the way to go. People should not get fleeced when they are vulnerable.

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The real solution is single payer system owned by the government, where drug prices and service prices have to be negotiated between the gov and the greedy drug companies and hospital systems, transparent pricing would help some, but is not the final answer.

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I really appreciate everything you are doing to expose the unethical & immoral actions of the healthcare industry & politicians/government agencies. Because of the outrageous prices of healthcare/medication, I have suffered. I have very little income. --- It IS TRUE IN AMERICA, the rich get richer while the poor get poorer!!! The "American Dream" is dead or dying in America!

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Maybe it's time to deny the ability to use collections agencies for healthcare costs, and protect consumer's credit scores from non pay of medical bills where there are no price controls. Seems fair to me. If there's no ability to control prices, there should be no punishment for not paying them. Somehow the economics need to work, this might be one way to help that.

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I despair that neither the end of predatory pricing in the health industry nor the institution of single payer can end the stranglehold the health industry has on the American people, but we must make continuous effort to correct this evil. For the current system is indeed evil and the American people are at the point of the spear.

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As long as health costs are shrouded in secrecy true universal health care coverage will be unobtainable. We are truly at the mercy of a rigged healthcare system. This is so un-American.

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In addition to having marked prices of all health care services, if Health Insurance Companies could sell in Multiple States, there would be more competition for policy holders, and that would drive down the price of health care as well.

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Thank you for this useful information! Unfortunately again and again it shows that our elected politicians can and are being bought and instead of representing the people they are filling their pockets. Oh, almost forgot that WE ARE PAYING FOR THEIR HEALTHCARE TOO! Shame...

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Thank you for explaining a complicated issue, and trying to promote justice and the common good by your advocacy.

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please take control of the health care industry because it's obvious the health care industry is not going to take control of itself but only manipulate the system and keep putting profits ahead of people.

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I recently went to a podiatrist associated with a huge hospital system. My ankle, which has been very painful for years, was acting up. She looked it it, felt it, asked a couple of question and gave me an injection of Cortizone. When my statement came from Medicare, I found she had charged them $880. for that visit! And the hospital added on their administrative charge as well! What the heck? Yes, predatory medical practice pricing!
Please keep going on this major issue. Please keep sending us information on what is happening (Nothing, as long as the Republicans hold sway in Congress!), and help us find a way to force change, just like the tobacco industry was forced to stop their predatory practices.

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I agree completely with the author. I am an insurance broker that sells medical insurance for over 30 years. I have seen the cost of medical insurance go up so much that it is difficult for most people and businesses to afford. If providers were forced to show their fees, and insurance companies were forced to lower their premiums, then maybe everyone would be able to afford medical insurance. The only way for this to truly happen is if all lobbyist groups were outlawed.

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Thank you for this post. This is the clearest and most succinct presentation of this subject I've seen. It explains things that I have for years suspected but couldn't pull together. Your article has the sound and feeling of "rightness" to it. Thank you for sharing your observations made from inside the system.

J R

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It is time to make the cost of health care and medical procedures transparent and fair.

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End predatory pricing. Make pricing more transparent. Stop the greed and help the innocents.

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Please outlaw predatory healthcare pricing.

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It is soooooooooooooooooooo out of control. My husband had cancer, and we have lousy health insurance through his employer so we have just finished paying the out of pocket costs for the surgery and hospitalization and this is almost 2 years later! Now, we just got slammed with all the bills for the scans, etc. that he has to have for the cancer screening follow-up! I would not have a certain test just because I don't have the money to pay for it!! And this is with both of us working (me - no raise in 4 years and none in the foreseeable future and his barely getting a raise once a year and the insurance gets worse and worse with them paying very little and us paying a whole lot!!!! It is awful ... it really is a crime!!! You live in fear of having to have something done if something is found - because it will bankrupt you!!!! What an awful country that has become - with so much greed from those that have so much already!!!!! The average worker is screwed ... it's all about corporate profit and there is no care or concern for people!

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Insurance companies including salesman managers secretaries janitors mail carriers get 80% of the insurance premiums leaving only 20% for the payment of actual Health Care. This was discovered during an interview with an insurance company. Eliminate insurance in favor of national insurance which pays only for services. This is no different then logging and fishing. Find a new job

Add this to your petition.

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Unfortunately this article is not entirely accurate. I also wanted to know if the amount "charged: to my insurance company was a bogus inflated cost, so a couple of years ago,I asked Quest Diagnostics for a quote for lab work and compared the quoted price with the allowed cost on my insurance carrier's Explanation of Benefits. The quote from Quest was far higher -- nearly 10 times higher- than the insurance allowed costs, although the employee at Quest had told me they were willing to reduce it by 30% if I paid up front. In other words the insurance negotiated price was considerably lower than the direct cost to the patient at the lab. I don't know how often or at which facilities this is true, but it requires further investigation.

Also, most people have health insurance because they are afraid of the catastrophic costs that can occur with cancer and other diseases. So instead of saving money for health care costs, they buy medical insurance.

Dental insurance, by contrast is unnecessary and a waste of money. Since for people who take reasonable care of their teeth, catastrophic events are extremely unlikely, and it is more profitable to pay cash and not purchase the insurance. Of course insurance companies are in the business of making money!!

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Thank you for your courage in speaking out and acting in the face of the shameful nature of healthcare in the USA. I live abroad and can see how ever increasing numbers of retired people are chased away from the USA, faced by the impossibility of predicting and providing for medical emergencies that we all must sooner or later face as we age. The Healthcare Industry more than any other factor is making it impossible for American citizens to plan for a decent retirement in their own country. All presently proposed solutions will ultimately fail, until the American people free themselves from the illusion that they are the freest people on Earth, and demand that the responsibility for their health and life be placed in the one government that has the scope and the resources - and not in a patchwork of states that have neither the ability nor the resources to offer universal health solutions for all of the people.

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I had surgery while uninsured, and my husband felt that he had done a very good job to negotiate a 30% reduction in the total billing. This article makes me realize that we were STILL subsidizing the insurance industry, and donating money to the hospital/provider system to cover the uninsured that they treat.

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