Why can't US healthcare have a law limiting out-of-network rates?

New / Eng mowgli⌨️
Feb 5 27 Comments

US is the most expensive country for healthcare costs. While there are minor reasons like lifestyle, guns, drugs which make more people need medical treatment, the real reason is predatory pricing. Identical products and services are sold for vastly different prices based on the buyer's (or insurance provider's) capabilities. In-network and out-of-network costs can easily differ by 5000% or higher with sometimes zero transparency.
So why doesn't US Congress pass a simple law that says prices of goods and services should be transparent and out-of-network prices and in-network prices cannot differ by more than 100%?
Won't that bring fair market economics lowering healthcare prices while simultaneously retaining the benefits of capitalism?
Link:
https://tinyurl.com/y9g6mf5o

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TOP 27 Comments
  • Apple hbdeegbbot
    Many people love getting fucked in the ass by healthcare companies, cable companies, energy companies and all the other monopolistic entities. They think if they vote for a socialist system they might help the poor people or even worse the immigrants. So they vote against any candidate who tries.
    Feb 5 0
  • LinkedIn bored🐷
    Transparent pricing is a good idea. Price ceiling is not.
    Feb 5 6
    • New / Eng mowgli⌨️
      OP
      If you ask you get the transparent price of $500, if I ask I am given the price of $5. How does that help you?
      Feb 5
    • LinkedIn bored🐷
      I assume people won’t go to the lab that charges $500 for blood sugar test if there are $5 options available to them.
      Feb 5
    • New / Eng mowgli⌨️
      OP
      That is only IFF $5 options are available. Without insurance, everywhere you ask you only get $500 or more as the transparent price.
      Feb 5
    • LinkedIn bored🐷
      If blood sugar testing is profitable at $5 and every lab is charging $500, then there will be new labs that charge $400 or $50 or $5 to compete and drive prices down.
      Feb 5
    • New / Eng mowgli⌨️
      OP
      Why will any lab offer a lower price when they are already offering the lowest possible price to their in-network customers?
      The issue is not one of price ceiling, it's about price gouging. That free market dynamic you describe only happens when there is one price. It immediately fails when a good can have multiple widely different prices.
      Again every hospital can charge $500 but they must not be allowed to charge $5 to anyone.
      Feb 5
  • Nurx lorfw46
    I don’t get it either. I’m not from the US either and it’s hard to get used to the US healthcare system. It makes zero sense.
    Feb 5 2
    • New / Eng mowgli⌨️
      OP
      If both of us just get our blood sugar tested and I happen to have insurance while you don't, your charge could be 100 times what I pay. If Walmart tried to do that for a bag of cereal they get can get sued, but medical facilities can get away with it legally.
      Feb 5
    • Tesla ffokcuf
      You don’t have insurance you pay way less. That’s why a lot of people use HSA.
      Feb 5
  • Intel Sjkopgg
    Because volume discounts, economies of scale, and negotiating leverage.

    Why not mandate in-network prices have to be raised to out-of-network levels? I’m sure you’d see a lot more suppliers provide services.

    The reason is because the market is 100% better at determining prices than a bureaucrat.
    Feb 5 10
    • Intel Sjkopgg
      No they don’t - Costco doesn’t sell things to non-members.

      Every industry participates in price discrimination (charging people based on the Boyer’s capabilities). The US university system is the most significant example.
      Feb 5
    • New / Eng mowgli⌨️
      OP
      So Costco is a good example too - members of Costco get a discount typically under 10% of prices you get in a regular shop. But healthcare in-network prices aren't discounts by a long shot. They are the normal rates and out of network rates are higher by as much as 5000%. In a normal market like the one Costco operates such a thing is impossible. But not in healthcare!
      Feb 5
    • Intel Sjkopgg
      Lol, I think your bias is showing. There’s no difference between Costco members getting a discount and your in-network provider giving a discount: the vendor is giving a volume discount in both cases.
      Feb 5
    • New / Eng mowgli⌨️
      OP
      What bias? Try giving this link an actual read and see what I mean...
      https://www.change.org/p/end-predatory-healthcare-pricing
      Feb 5
    • Intel Sjkopgg
      The bias that the healthcare market, while opaque, is rational given the circumstances. Predatory pricing is another term for inelastic demand and limited+differentiated+regulated supply.
      Feb 5
  • VMware BobbleHat
    Do you think it actually cost $25 to visit your doctor?
    Feb 5 1
    • New / Eng mowgli⌨️
      OP
      Well, I have HSA so I know it costs me $300 to see a doctor but I really don't know how much it actually costs. Sure the insurance company breaks it down for me, but I have absolutely no idea how much it costs my colleague who has a different plan. The reason is there isn't a single price at all! That's the whole problem.
      Feb 5
  • Microsoft unfanged
    It’s the entire supply chain that’s fucked. Sure they charge $500 for a bag of saline, $40 for a pill of ibuprofen, $10 for a Dixie cup, and $80 to hold your newborn. Similarly they charge the surgeon $450 for a scalpel that’s slightly modified, you can do the modification yourself with a $15 scalpel and 5 minuets.

    Then insurance only pays 10-20% of list prices. The problem is when they don’t extend those same negotiated rates to regular people.

    In terms of price transparency it would be great if along with the charge master they also would be required to publish city, county, state, and national averages pre and post negotiations for procedures. A nominal price list is worthless. This would allow realistic expectations and easy to find cheapest location and easy price comparisons to determine if a location is expensive or not.
    Feb 5 0
  • Tesla ffokcuf
    Government must be out of health insurance business.
    They fucked a lot with Obamacare already.
    Socialist way we’d have to pay + 10-15% for insurance.
    Feb 5 1
    • New / Eng mowgli⌨️
      OP
      Actually this has nothing to do with insurance or politics of who pays for them. It's about the cost of medical services itself. What is needed is a fair market to begin with which does not exist in US.
      Feb 5