Price-fixing in the U.S. healthcare system, by the numbers

A bill arrived for a (routine and negative) medical test today. Due to the artificially restricted supply, the provider attempted to fix the price at $150 (ask a physician who #resists Trump and welcomes migrants if European doctors should be able to come to the U.S. and start offering medical services!). Via the miracle of monopsony, however, Blue Cross dictated to them a price of $47.08 (why the .08?) and thus a paper-in-the-mail process was initiated to collect the cost of a local restaurant meal (annual deductible not yet met so this $47.08 has to be paid on top of the $10,000-ish cost of the policy).

My favorite thing about Bernie Sanders is that he is the only politician with the courage to say “this is dumb; we should try something else.”

Sanders seems to have done well in Iowa (though not as well as the politician that I thought, six months ago, should be #1 among the Democrats). Maybe the enthusiasm for Sanders is partly driven by consumer rage on receiving explicit disclosures like this of how the U.S. health care system is not representative of an ordinary market (you can’t buy food insurance and get 2/3rds off your next McDonald’s bill; McDonald’s doesn’t make that much profit at its headline prices).

I wonder if Sanders’s opponents from all parties (Socialist, Green, Libertarian, Democrat, and Republican) would be wise to start their fight against Sanders by proposing a law that forbids providers to charge a higher price to individuals than to insurers.

8 thoughts on “Price-fixing in the U.S. healthcare system, by the numbers

  1. Actually Mike Bloomberg and Amy Klobuchar both are campaigning for major heath care reforms. They both have long histories of fighting for and getting some reforms passed. See below.

    As far as new ideas all the Democrats want some sort of reform. Some are asking for more radical stuff and some for less. But without a major change in the Senate composition it is very unlikely anyone will be able to get much legislation passed to change things. The Repugnots will keep working for the insurance lobby and the medical suppliers and stop any significant reform that reduces costs.

    https://amyklobuchar.com/amys-story/
    https://www.nytimes.com/2019/12/19/us/politics/michael-bloomberg-health-care-plan.html?auth=link-dismiss-google1tap
    https://www.politifact.com/factchecks/2020/jan/28/michael-bloomberg/bloomberg-highlights-his-efforts-connect-new-yorke/

    • The grand “schemes” (a more accurate word than “reform” for what politicians generally do!) are doomed to fail, though, whereas a one-line law that reads “health care providers cannot charge a higher price to individuals than to insurers” might pass (who would vote against it?) and would take some wind out of Bernie’s sails.

      (You would think that this law, as written, would be unconstitutional since its relationship to interstate commerce is unclear (it is illegal to have a multi-state insurance policy, right? each health insurance policy has to be regulated by an individual state commission?). But these days the Feds seems to be able to write laws about almost anything and supersede state law on any issue.)

  2. How about letting Walmart perform your routine tests at low, low prices? If you were a member of Newt Gingrich’s Inner Circle, you would already know about their plans to continue their health care expansion…

    “Dentists, optometrists, and primary care physicians should take notice — you may have a big, new competitor coming to your neighborhood. And it could mean a huge drop in the prices Americans pay for health services.”

    https://www.gingrich360.com/2020/02/would-you-get-your-teeth-cleaned-at-walmart/

    Would you go to Walmart for a routine medical test that costs $50-$150? It looks like they’re betting that a lot of people will. CNN Money talked about it back in Sept. 2018, and now Newt Gingrich is warming it over. Alas, I am not a member of his Inner Circle so I don’t know what new info. he might have to share, but I wouldn’t bet against Walmart getting this right over the long haul. They have the locations, the customer data, and have done a lot of leg work over the past decade. In a lot of rural areas in particular, Walmart is probably an easier, more convenient and trusted trip for a routine test than the available alternatives.

    https://money.cnn.com/2018/09/19/news/companies/walmart-health-care/index.html

  3. Republicans will be against it because it is more regulation interfering with the free marketplace.

    • They will be right, too. Regulation always has side effects (due to people adjusting their behavior in response to regulation) which normally makes situation even worse, which in turn inevitably has to be addressed with more regulation, creating regulatory ratchet all the way to full collapse. In this case effectively fixing prices will lead to shortages of services provided and give even more power to insurers. Which will then use their power to bilk consumers even more. As it is, the pay yourself option makes sense for healthy people who don’t need to spend large amounts of money on insurance they are unlikely to use. Prohibiting price discrimination by providers will take this option off the table, so more people will be forced to buy insurance to get access to basic medical care.

      The mortal sin of economic analysis is taking only immediate effect into account while ignoring (or remaining ignorant of) secondary and long-term effects. This is known as “what is seen and what is unseen” fallacy. Read Hazlitt’s Economics in One Lesson.

    • averros: But there is nothing free market about the current U.S. health care system. It is illegal for doctors to come in from Europe. It is illegal for doctors to practice across state lines. It is illegal for insurance companies to offer policies across state lines. It is illegal for insurance companies to offer policies with certain characteristics, e.g., that they won’t fund unhelpful screening tests that are fashionable with the government at any given moment.

      But the argument for the new one-line law is not about improving the U.S. health care system, but about helping politicians compete with Bernie!

    • I quite agree that US healthcare is not free market, by any means. It is already regulated nearly to death (literally – of patients).

      Somehow the fools think that regulating it even more would improve things – even after being rudely shown, again and again, that it never works. Not a single one of them ever asks a question: how come it became so expensive in the first place? All their ideas on how to “fix” healthcare revolve around forcing other people to pay up.

      And, yes, the healthcare in US is a bunch of overlapping cartels enforced by the unholy alliance of medical guilds (AMA and such), pharma megacorps, various armed bureaucrats (did you know that FDA has its own military-style armed force?) and socialist redistribution arms of the government masquerading as insurance companies. Somehow cartel-busting is never on the table, due to the fact that most federal US politicos are wholly owned by these cartels – it’s not as much competition with Bernie (the old psychopathic coot has no chance anyway), but competition for lobbying $$$.

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