Perspective: Congress works to keep medical costs rising

Congress functions as a harmonious well-oiled machine to inflate medical prices. Every politician in the House and Senate is silent as to the actual cause of gigantic insurance premiums, which is rising prices of medical services.

Insurance is just a means to pay medical bills. The problem is there are no legitimate prices.

Ask any hospital, lab or physician the price of anything and all you ever get back is a question: “What insurance do you have?” A simple blood test for cholesterol can range from $10 to $400 or more at the same lab. Hospitalization for chest pain can result in a bill from the same hospital for the same services ranging anywhere from $3,000 to $25,000 or more. Your price depends on how much can be extracted from you on an individual basis, often at your most vulnerable. If you are out-of-network or uninsured you pay the highest prices.

Insurance premiums are determined by the underlying medical costs. A provision of the Affordable Care Act requires health insurers to spend roughly 80 percent of premiums on medical costs. A report by the Department of Health & Human Services (at p. 295) found that the “net cost” of all private and governmental health insurance combined (after payment of medical bills), is a measly 6.4 percent of total U.S. healthcare costs.

Congress turns a blind eye to the pricing of medical services despite the fact that the official U.S. projection confirms national health costs will continue to be driven by the skyrocketing pricing of medical services:

Throughout the 2016-25 projection period, growth in national health expenditures is driven by projected faster growth in medical prices.

The idea that health insurance premiums are the problem is propaganda by the industry which spends more on lobbying than the defense, aerospace and oil and gas industries combined. The healthcare industry has been uniquely authorized to price gouge consumers through the elimination of legitimate pricing for medical services and price competition.

With no pricing mechanism for health services and no consumer protection, the GOP and Dems jointly fostered the most pernicious case of crony capitalism imaginable.

The one untouchable topic, the pricing of medical services, is the entire ball game. The reason Medicare for all appears to be a cost effective option is because Medicare pays less for medical services. For example, Medicare rates on average are at least 33 percent lower for hospital care than private insurance rates. Under any system, payment of outrageous, non-competitive medical bills will yield outrageous premiums and total costs.

Congress should compel medical providers to play by the same rules that apply to all other sellers of consumer goods and services. They should remain free to set their own prices. However, providers must be prohibited from billing each patient a different price for the same service. No politician on either side of the aisle can oppose this proposition.

Legitimate pricing of health services will empower patients to shop. Consumers will be able to Google the cost of any medical service and see real prices. The existence of price competition would force providers to operate efficiently and provide better service at lower cost, just like all other sellers of consumer goods and services.

Partisan bickering over insurance coverage requirements and the size and structure of subsidies is pure political theatre and misdirection. It’s designed to prevent the electorate from focusing on the pricing of actual medical services and it’s working like a charm.

Publicly traded shares of big pharma, the hospital titans and labs make new highs almost every day. These merchants and their lobbyists have wired a well-oiled machine to eliminate price competition and keep their revenues rising. Grotesquely defying logic, not a single national political figure has talked about killing the real monster, which is predatory pricing of medical services.

Both sides of the aisle agree on just one thing: jawbone about skyrocketing insurance premiums, but never, ever, under any circumstances mention the pricing of medical services. The name of the political game is protect medical industry revenue, regardless of the toll on our nation.