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Kindle Notes & Highlights
When you go to a restaurant and ask for a menu, you might be alarmed if the waiter or waitress were to respond by asking, “Who’s your employer?” If you then learned that the prices on your menu were much higher than those on menus given to other customers, you’d conclude it’s a dysfunctional market. Yet this is exactly what happens when you need medical care in our status quo system today.
Perfect analogy
It’s ironic that the federal government already has a mandatory disclosure rule for the real out-of-pocket costs people incur at a vulnerable time in their lives. But it’s not a rule for health care—it’s for funeral homes. The Funeral Rule,18 enacted by the Federal Trade Commission in 1984, requires funeral providers to offer itemized pricing information to consumers before they purchase any services. The rationale is that consumers in a distressing situation should have honest pricing information, a rule that should also apply to the living, not just the dead.
Highly reasonable; why does it only apply to this one area? Navigating most healthcare is done at vulnerable times, or at least, patients at large are in vulnerable positions.
I asked him to advocate for his hospital to please stop suing patients and start forgiving them when possible, or at least limiting collections to the Medicare allowable amount when patients couldn’t pay.
“In-hospital care is not health care,” Mike explained. “In-hospital care is about 14% of health care. The rest is determined by social determinants of health, behaviors, and choices.”
We need to restore trust in health care services starting with more honest, transparent, and fair billing practices. It may take an act of Congress to end kickbacks and institute patient protections in the air ambulance business. But state lawmakers could take immediate action to protect consumers. If they can’t control the prices, at the very least they could publicize them. How about a law requiring air ambulances to tell patients how much their flight is going to cost? Or a database that would track and publicly report each company’s charges per flight? The database could also name the
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The employers pay for health benefits out of the pool of money they use for worker compensation. Therefore, that compensation allocated to rising health care costs is not going toward increasing an employee’s wages. In other words, it’s coming right out of the employee’s pocket. It’s one of the main reasons wages have been stagnant in recent years.
A curious CEO would likely hit a wall because pharmacists are gagged under their PBM contract to not disclose what they are paid by the PBM.
Down with PBMs! They are destroying our system!
According to a recent analysis in the journal Health Affairs, reducing generic reimbursement by $1 per prescription would lower health spending by $5.6 billion annually.4
The auditor uncovered the spreads of the PBM being paid with taxpayer money and found that in a single year, the spread had cost the state’s Medicaid program $224 million. That’s about 10% of the total amount of money the Medicaid plan spent on drugs during that time period.5
