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Comment by rqtwteye | Hacker News Reader

I don’t understand how hospitals and insurance are constantly getting away with this nonsense. Even if people are against socialized medicine and free markets, they should at least make sure that there actually is real market where all participants have the necessary information. And hospitals should be forced to follow rules like sending itemized and accurate bills on time. When I worked in the office I often overheard people being on the phone daily for hours to deal with hospital or insurance. They can basically ignore callers without any repercussions.

I don’t understand how this abuse can be accepted.

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It is impossible to even have anything resembling a "free market" for healthcare. Free markets in that sense require that what's being bought be a commodity: it can't be something that's life or death, the buyer has to be able to shop around, has to have perfect information, and has to have ample differentiated options within easy reach.

None of those are likely with (especially non-elective) healthcare.

Healthcare must be treated as a human right, not a profit center.

I am not even talking about "free markets" but just a functioning market where all participants have the necessary information and have to follow certain rules. It seems hospitals and insurances can get away with murder unless you can afford to pay for a lawyer full time.

What's really nonsense is that prices for known covered procedures through insurance aren't available until you've already enrolled into that insurance.

For example, insurance companies will never tell you the "allowed coverage" of anything until you've already enrolled into their insurance in which case you're locked in for 1 year due to open enrollment.

Imagine if you go to the dentist and your insurance says it will cover 100% of preventative care such as a cleaning. There's always a * there which states they will only cover 100% up to their defined "allowed" or "covered" amount which is a value they get to define in secret.

It means if your cleaning costs $150 they might decide to only cover 100% up to $110 because they determined they won't pay more than that and there's no way to find this number out until you've already enrolled and either had the procedure done or have your medical provider submit a claim as a price check but at that point it doesn't matter because you've lost the ability to pick providers by price. The numbers change every year and every provider has different numbers.

...But it's even more complicated than that, because for many providers that submit directly to insurance (this obviously doesn't apply to those you pay out of pocket and then submit to insurance yourself), they will completely either accept the "allowed amount" from the insurance if it's lower than what they would normally charge, or possibly partially accept it, dropping their fee from what it would normally be, but not as far as the allowed amount, leaving you still paying some amount more than the copay.

Single-payer healthcare cannot come soon enough.

I'll be macabre because it is what happens when you mix markets and human morbidity and mortality. What is the market value of your parent's life? Your children? Your spouse? Care to put an exact dollar amount beyond which you would not pay for care for them?

Because Congress won’t fix it.

And lobbying makes sure they won't.

Don’t blame lobbying, blame a lack of decent humans in a position of power. How much lack of function do you need to take orders from a lobbyist as a representative?

Are we electing people? Or puppets? Mostly rhetorical.

"don't blame them, they were tempted with bribes!" is to use the younger generations terms, cope. It wasn't that these were upstanding people lead down the wrong path, they were corrupt from the start.

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