Santelli: Where the heck was Immelt on regulatory uncertainty two, three, four years ago?

From ZH

Who Spends The Most Dollars Lobbying Washington, DC?

Oil? Financials? Aerospace? When someone asks who the biggest sources of lobby dollars for DC’s politicians-for-purchase are, these are the three usual suspects that come to mind. Some may, therefore, be surprised to learn according to the database kept by OpenSecrets between Pharmaceutical and health product industry, hospital and nursing homes, health professionals and health services, HMOs, or more broadly Pharma/Healthcare/HMO, the total lobby dollars spent between 1998 and 2012 was a staggering $5.3 billion, or nearly three times greater than the second most generous industry: insurance, and well above Oil and Gas at $1.4 billion, and Securities and Investment at $1.0 billion. Is it becoming clearer why the US government has few qualms about unsustainable taxpayer funded healthcare spending, especially when there are so many current benefits accruing to the politicians who see so many billions in benefits from passing lobby-friendly laws now (by which we mean generous taxpayer funding, the bulk of which benefits the healthcare industry’s bottom line)?

From MT

We got this way because:
McCarran-Ferguson, 15 USC 1011-1015, specifically exempted insurance companies from anti-trust law so long as there is a state regulatory apparatus related to insurance is in place. In other words anti-trust laws are severely limited as applied to insurance companies; unless there is no state regulatory code related to that firm the Sherman, Clayton and Federal Trade Commission Acts do not apply to these companies. These acts prohibit acts that restrain trade, including collusive practices that fix prices — but they do not apply to insurance companies generally, as all states have some regulatory apparatus on insurance firms.

EMTALA, a 1980s era law signed by Ronald Reagan, forced the provision of care to people who had no ability to pay for it at the closest facility where it could be reasonably provided. Prior to this law if you had a medical emergency and could not pay you would be taken to a charity hospital for care. This might not be close to you, however, and you might bypass several other facilities that only took patients who could pay in some form or fashion. A few dozen high-profile incidents were someone was having a heart attack, stroke, or had suffered a traumatic injury and died led to the passage of this law. There were over six hundred charity hospitals in the United States, many operated by the Catholic Church, prior to this law being passed. Today there are effectively none. The result is that the mandate of unfunded care was forced, by federal law, upon health care providers.

The pharmaceutical and medical device industries got federal laws and regulations passed to prohibit the transport of legally-owned drugs and devices across international borders and to restrain trade even within the United States. This turned the concept of the ownership of property on its ear and by doing so the drug and device makers were able to charge grossly-disparate amounts of money for the same thing — often by a factor of 10 or more — simply based on where or to whom it was sold. Absent these laws you could drive into Mexico and buy 100 doses of scorpion anti-venom for $100 each from the factory that made it and then return to the US and sell it for $200, a nice 100% profit. You could do this because the current price in the United States at a hospital for that same anti-venom is $39,652 — each. It’s even worse, of course, in that the hospital paid 1/10th of that amount; if you simply sold the dose directly to the stung individual the savings would be even greater. This sort of pricing disparity exists only because of specific federal and state laws that make the operation of a free market and the opportunities that it affords impossible.

There are no basic consumer protection laws that operate to prevent price-gouging and intentional financial******by everyone up and down the line in the medical field. You can’t take your car in for service without being provided a written estimate, and you must provide approval before the charge can typically exceed 110% of that estimate — which you may decline without harm to yourself (e.g. without having your engine ripped into pieces on the floor of the shop with no way to reassemble it.) There is no other field in the United States where you can get away with not quoting a price at all for a procedure, but it happens tens of thousands of times every single day in the medical world. In fact, according to JAMA, more than one half of the top 20 hospitals for a given procedure they surveyed couldn’t provide a price at all for a routine surgical procedure after five separate attempts!

So-called health “insurance” is not actually insurance, and yet this fraud upon the public is neither stopped or prosecuted. Insurance is a pooling of funds by a group against a statistically-unlikely event (or series of events) over a given period of time, with the pooled funds used to pay claims by those who are unfortunate enough to have the bad outcome occur. Health “insurance” violates every premise of an actual insurance contract because health care is not an “unlikely” event (especially routine and diagnostic health care) and in addition alleged “health insurance” requires that you keep paying even after the adverse event happens. You don’t continue to pay a fire insurance policy on your house after the fire; the company pays you. Yet if you contract cancer while having health insurance (the adverse event) you must keep paying premiums, and in fact potentially pay ever-escalating amounts of premium, even though the adverse event already happened!

Should you arrive in a hospital under emergency circumstances you will be forced to pay in whole or part for those who cannot cover their medical expenses in the same hospital, provided you are either able to pay privately or through your alleged “insurance.” If you have assets and refuse to pay you will be relentlessly pursued and sued for that payment, a large part of which — in fact the majority of which — is not paid for your treatment. (Hospitals collect as little as 18% of what they bill. So, in fact, when they come after you for the full amount only about one dollar in six is for your treatment!) There is no other area of commerce in which you can be compelled to pay someone else’s bill that is in arrears with no ability to refuse.

We need to break the health care-government monopoly. We have two years before HC consumes more than $1 trillion annually.

tom daschle concerned on March 11, 2013 at 6:41 PM