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2019-11-16 09:23 by Karl Denninger
in Health Reform , 122 references Ignore this thread
Health 'Transparency' -- Real?
[Comments enabled]

You'd be forgiven (maybe) if you didn't pay any attention to the Presser that the President gave on health pricing transparency, given that it wasn't impeachment-related.

Breathless CNN didn't cover it.  Neither did Fox with any sort of density.  CSPAN did, however.  I (mostly) listened to it in my car and had read the published proposal a bit earlier.

You'd be forgiven for thinking that there's a grenade in there that will definitely be stuffed up your ass with the pin pulled.  After all, the health care ETF was up two percent plus yesterday into the maw of this announcement, the exact opposite of what would happen if prices are going to actually come down.

So let's talk about it a bit.

The rules changewhich is sure to run into an immediate lawsuit or 50 by the industry, would allegedly do the following things:

  • Finalize a rule that has been in the pipe for roughly a year now that will require hospitals to show their negotiated prices between insurers and themselves to patients starting in 2021.  What is not clear is whether you'll be able to see all negotiated prices (that is, you'll know that your insurance company pays X, Medicare pays Y, Medicaid pays Z, and the other insurance companies pay A, B, C, D and E) or whether you'll have to know both your insurance carrier and plan code to get anything.  Further, it's not at all clear whether you (or anyone else) will be able to grab the entire bag of data and sift it.  Only a "yes" to both of those will allow you to actually shop.

  • Second, add a rule that will require insurance companies to show you "expected" out of pocket costs before you have a procedure done.  This is a new one and is subject to 60 days of public comment; it has no announced implementation date as of yet.  Most insurance companies will give you this already if you ask (and you damn well should) but the problem with it is that "expected" doesn't mean "binding", even in a "binding estimate" (e.g. subject to 10% variance, etc) format.

The truth of any law is always in the punishment section.  That is, a "law" that has no "or else" is not a law at all; it is a suggestion no matter whether or not it is in the Statute Books.  For a prime example of this look at the Federal Reserve Act which states that the Federal Reserve's mandate is for stable prices.  Well, stable means unchanging and yet Fed Chair after Fed Chair dutifully trots up to the dais and gives testimony to Congress in which he or she states their intent to violate said law, and touts their record in doing so -- that is, they both tout and proclaim their intent to target 2% inflation and have a near-perfect record of actually exceeding 2% over the longer term (the actual record says it's about 3% on a long-term basis, and that's if you believe the so-called CPI!)

How many of said Fed Chairs have gone to prison?  Zero.  Why?  Because there is no or else in the Statute and thus nobody has to enforce it -- and nobody does.  After all, making the stock market go up is more important than following the law, right?

Well, right up until you get a grenade stuffed down your throat it is.

What's the penalty here?  $300/day.  Garbage, in other words, and that assumes anyone actually brings a case to collect it, which for $300/day isn't worth it.  How many hospitals would simply add the $109,000 a year in "fines" to your bill on a ratable basis and shove that up your ass instead of complying?

Probably all of them.

Note also what was missing: No threat to enforce 15 USC Chapter 1, which already exists, has twice been challenged to the Supreme Court for health-care firms and both times the health and insurance industry lost.  In other words we already know that 15 USC Chapter 1, which provides for one hundred million dollar fines for corporations per instance and ten years in prison for all persons involved, applies to this conduct.

Now enforcing that not only requires no comment period it almost-certainly couldn't be successfully challenged legally either since the precedent has already been set all the way to the Supreme Court and, while I certainly expect the medical industry would try to appeal all the way up (after all, the alternative is to quit screwing you up the ass and the related firm's stock prices would collapse) they'd almost-certainly lose since to do otherwise the Supremes would have to overturn not just one but two prior precedents.  That's unlikely enough to be in the realm of fantasy-land nonsense.

So why did Trump do this?  For the same reason he listed three almost-identical items on his 2016 campaign web page, all three of which disappeared on the night of the election: He is a lying piece of **** and is trying to use this for the 2020 election campaign

Proof I'm right?  The Health Care ETF was up over 2% yesterday right into the maw of, and during this announcement.

There is a fix for all of this and it's right here.  Note that exactly zero of that was found in these "proposals" -- not even the you must post a price and everyone pays the same price rule, which incidentally applies to every single item at WalMart and every gallon of gas at the corner station.  Gee, it's so complicated -- NOT!

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Lobo
Posts: 668
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Quote:
Because there is no or else in the Statute and thus nobody has to enforce it -- and nobody does.

Or ever will until enough of us get off our dead asses and demand stable and posted prices and make the or else very, very graphic.

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Village Idiot
Raftermanfmj
Posts: 4849
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USA
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Saw this on Zerohedge yesterday and the yahoos were all cheering like it was the "best thing evah, and proof that Trump loves us, and our little children too!"

I do not have the background to dissect it like our host does, but I knew it was complete bull**** when I saw it was to be implemented in 2020; not 1 January, not after breakfast, but 2020 ffs.

Trump is just as controlled as Obama was, another reality show to watch as the country burns to the ground.


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I have never wished to cater to the crowd; for what I know they do not approve, and what they approve I do not know. - Epicurus
Oderint dum metuant - Caligula & Police State USA
Mannfm11
Posts: 5710
Incept: 2009-02-28

DFW, Tx
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At least the idea is out there on an official basis. We know how long this bull**** has gone on and it has hardly come up in DC. Congress will have to act for there to be teeth. Any private plan is going to have to include something to break the medical racket. It appears the Democrats are hell bent to protect the racket or their Medicare for all bills would be much lower. They will cut benefits first, rather than face the nationwide racketeers in medicine.

As far as the market goes? It won't go much higher. Growth is slow and Price to GDP is toppy. Long bear coming. Rats are moving to the high points, where the rackets are.

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The only function of economic forecasting is to make astrology look respectable.---John Kenneth Galbraith
Augeries
Posts: 23
Incept: 2019-09-26

"North of Boston" whatever that means
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Haha remember when Trump tried to get Congress to fix healthcare? Repeal and Replace! He spent 6 months championing the warmed over dog**** replacement plan the Republicans spat out, then gave up completely after McCain torpedoed it.

I'll still vote for Trump in 2020 vs the nutjobs against him, if only because I don't fear him trying to take more of our rights away, but he isn't the mad dog I was hoping for.
Bakednotfried
Posts: 17
Incept: 2011-11-03

CenCal coast
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Why doesn't any of this "news you can use" get hacked and leaked?
I think the hospital's price structure is based primarily on the quality of a person's health insurance. So they can make up for the losses from getting stiffed by those that can't or won't pay.
Why doesn't the home addresses of the the local PD get posted by hackers.
Certainly the boys in blue would take this as a threat to their families and
act accordingly.
Most of those responsible for serious data breaches have gotten off with maybe a loss of their job (which they weren't qualified for anyway) or a slap on the wrist.
Raftermanfmj
Posts: 4849
Incept: 2010-09-06

USA
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Grrr. Meant 2021.

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I have never wished to cater to the crowd; for what I know they do not approve, and what they approve I do not know. - Epicurus
Oderint dum metuant - Caligula & Police State USA
Lemonaid
Posts: 10741
Incept: 2008-01-20

Metro Detroit
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Democrats are scum that will NEVER talk about posting medical provider prices publicly.

Their constituency is the free **** crowd and expect YOU to pay extra to cover THEIR medical bills.


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"There is no means of avoiding the final collapse of a boom brought about by credit expansion. The alternative is only whether the crisis should come sooner as the result of a voluntary abandonment of further credit expansion, or later as a final and total catastrophe of the currency system involved." Ludwig von Mises
Tickerguy
Posts: 160514
Incept: 2007-06-26
A True American Patriot!
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Can I pay in lead at 3200fps?

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Winding it down.
Thomdd1959
Posts: 56
Incept: 2013-02-17

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On the lack of enforcement of All anti-trust and consumer protection laws concerning all medically-related firms:

"He has refused his Assent to Laws, the most wholesome and necessary for the public good." -- Declaration of Independence, 1st Grievance

https://www.archives.gov/founding-docs/d....

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Government only works for the benefit of the people when it is conducted in the full light of day. -- Karl Denninger
Tickerguy
Posts: 160514
Incept: 2007-06-26
A True American Patriot!
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Exactly. So **** him and **** everyone in the Executive.

All of them.

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Winding it down.
Fumei
Posts: 268
Incept: 2019-01-08

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Karl, including civilian and military personnel, the number needing a big red, white, and blue dick rammed into their arseholes exceeds 4 million.
Tonythetiger
Posts: 15
Incept: 2019-01-27

Fort Walton
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I recently came across this article, which shows what happens when one follows Karl's remedies in a fairly close manner.

Odd thing is, where these principles have been used, it worked. Imagine that!

https://www.marketwatch.com/story/the-us....
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