The Market Ticker
Commentary on The Capital Markets- Category [Health Reform]

It never ends, does it...

WASHINGTON (AP) — Ending insurance discrimination against the sick was a central goal of the nation's health care overhaul, but leading patient groups say that promise is being undermined by new barriers from insurers.

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More than 300 patient advocacy groups recently wrote Health and Human Services Secretary Sylvia Mathews Burwell to complain about some insurer tactics that "are highly discriminatory against patients with chronic health conditions and may ... violate the (law's) nondiscrimination provisions."

...

Coverage of expensive drugs tops their concerns.

So let's see.

First we set up a system that allows for all sorts of chicanery in how drugs are priced.  For example, we explicitly allow restraint of trade by various entities -- most particularly the drug-makers.  This allows them to do things like charge 10x (or even 100x or more) as much for a drug here in the United States as they do somewhere else -- say, Canada.

Or, for that matter, to charge $30,000 for a drug in the US that costs $100 in Mexico where it is made a couple of hours away by car -- and where you can buy it over the counter.

This would never be sustainable except for laws that criminalize you buying that drug in Mexico (lawfully, I might add) and driving back across the border with it to make a commercially-reasonable (say, 50%?) profit.

This sort of restraint of trade is supposed to be against the law where market power exists.  Well, does it exist for these drugs?  Are there reasonably equivalent alternatives to these therapies?  Nope, which is why that sort of pricing exists in the first place.  That would be market power.

Every contract, combination in the form of trust or otherwise, or conspiracy, in restraint of trade or commerce among the several States, or with foreign nations, is declared to be illegal. Every person who shall make any contract or engage in any combination or conspiracy hereby declared to be illegal shall be deemed guilty of a felony, and, on conviction thereof, shall be punished by fine not exceeding $100,000,000 if a corporation, or, if any other person, $1,000,000, or by imprisonment not exceeding 10 years, or by both said punishments, in the discretion of the court.

So where are the indictments, prosecutions and imprisonments?  Oh, the only person who goes to jail is the guy who tries to break that restraint of trade!  How?  Because these firms got laws passed to make that explicitly illegal, and their conduct lawful.

But try it in any other line of business, and well, you go to jail for 10 years and, if you're a person you get fined $1 million smackers too.  If a corporation is involved the fine is $100 million.

Speaking of bilking people.....

A lipid panel is one of the most basic blood tests in modern medicine. Doctors use it to measure cholesterol levels in their patients, probably millions of times each year.

This is not a procedure where some hospitals are really great at lipid panels and some are terrible. There's just not space for quality variation: you are running blood through a machine and pressing buttons. That's it.

And that all makes it a bit baffling why, in California, a lipid panel can cost anywhere between $10 and $10,000. In either case, it is the exact same test.

It's not baffling at all.

It's theft.

The $10 is reasonable.  The $10,000?  It's robbery and the only way anyone gets away with it is by performing the test without disclosing the price and/or in a setting where you can't negotiate at all (say, because you're unconscious!)

Now consider this -- it is illegal to jack up the price of gasoline when there's a hurricane coming in this state.  You can go to prison for it, and the fines are substantial.  Why?  Because the state has determined that as a matter of policy you are not free to negotiate whether you will buy or not under that circumstance.  If you do not have fuel and are trying to depart the area, you either buy or you're ****ed.

Ok, now I can see the argument the other way too -- there's likely to be a scarcity of gasoline under those circumstances, so allowing the market to set prices could be better.  After all, would $10/gallon be "better" if the alternative is no gas at all?

Maybe, maybe not.  But what if the price was $5,000/gallon if you pulled in during said storm with a big car full of household goods and the storm was an hour away, but the guy filling his generator auxiliary tank was charged $4/gallon?

Ah, that's exactly what's going on here, isn't it?  And in that case I suspect virtually everyone would want to see the gas station owner hung up by his balls, and might choose to do it themselves.

So..... why is it again that the CEOs of these hospitals are free to roam among us instead of being asset-stripped to their underwear and sentenced to a nice long stay in a prison cell?

Answer that, and then answer why you allow that situation to continue.

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Tell me why?

A New Jersey teacher said he was charged nearly $9,000 after he showed a cut middle finger to a hospital emergency room aide.

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The hospital’s CEO Mark Spektor told the station Hanusz-Rajkowski’s visit cost so much because his insurance carrier United Healthcare refuses to offer fair reimbursement rates.

Why is that legal?  Why isn't it considered Racketeering?

Why can Mr. Spektor buy gas without paying $50/gallon?  Why can his wife and kids (if he has them) buy clothes without paying $500 for a pair of jeans?  After all, his hospital is robbing everyone who comes in there.  Charging him like this is exactly what he did to this teacher, is it not?

Tell me, America, is even $400 appropriate for washing and bandaging a cut?  How is that worth more than $50 -- maybe?

Tell me, America, why do you think anyone should lift a damned finger to do anything for you, to create a single job, to start a business, to do anything other than spit in your face until you all get off your collective asses and put a stop to this ****, locking up everyone involved in it, forfeiting all of their personal wealth and demanding the return of every single penny that was billed at these outrageous rates?

And no, having "insurance" doesn't help you.  You know that deductible you have on your Obamacare policy?  You get to pay until that's exhausted.  In this case, for many people they'd pay damn near that entire bill.

If you don't pay they send it to collections and sue.

TRYING TO CHARGE SOMEONE $9,000 FOR A ****ING OIL CHANGE THAT SHOULD COST $50 WILL LAND YOUR ASS IN PRISON, ESPECIALLY IF YOU DON'T TELL THE CAR OWNER UNTIL AFTER THE WORK IS DONE.

TELL ME WHY SPEKTOR ISN'T ROTTING IN A JAIL CELL AND THIS RACKET HAS NOT BEEN SHUT DOWN -- AND WHY ARE YOU ALLOWING THIS TO HAPPEN NOT ONLY IN THAT ONE HOSPITAL, BUT IN ALL OF THEM?

THAT CHARGE IS ARGUABLY 100 TIMES A REASONABLE FEE FOR THE PERFORMED SERVICE -- AND AS I AND OTHERS HAVE DOCUMENTED THAT SORT OF FINANCIAL******IS NOT AN INFREQUENT OR UNCOMMON OCCURRENCE EITHER.

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