Our colleague Kira Davis at RedState has an important report out this week on a crooked situation in the healthcare industry that hasn’t attracted nearly enough attention. It’s long been known that healthcare providers work behind the scenes with insurance companies to establish price schedules for products and services they provide to patients. In this hidden price-fixing scheme, hospitals and other medical providers come up with lists of wildly varying prices for everything from x-rays to pregnancy tests. They have one (lower) price for people without insurance, but if you have a good insurance plan through your employer, your price will be unbelievably higher. (Frequently more than double.)

A new policy put in place by the Trump administration finally sought to address this situation. Under this policy, hospitals are required to provide the federal government with records of all the prices they negotiate with private insurers. This information was to be made transparently available to the public so they could shop intelligently for the best deals. As Davis notes, the New York Times (to their credit) did some intensive digging into how the policy was working out and what the pricing information revealed. They found that the disparities were frequently even worse than you might have imagined.

It shows hospitals are charging patients wildly different amounts for the same basic services: procedures as simple as an X-ray or a pregnancy test.

And it provides numerous examples of major health insurers — some of the world’s largest companies, with billions in annual profits — negotiating surprisingly unfavorable rates for their customers. In many cases, insured patients are getting prices that are higher than they would if they pretended to have no coverage at all.

For only one of many examples, they cite the cost of a standard colonoscopy at the Mississippi Medical Center. Depending on what insurance you have, here is what you could expect to pay:

• Uninsured – $782
• Cigna – $1,463
• Aetna – $2,144

Those prices are for people receiving the exact same procedure performed by the exact same person (in many cases) using precisely the same medical supplies and equipment. If you have a top-notch health insurance plan from Aetna, you will literally be charged nearly three times as much as an uninsured person would pay. And that drives up everyone’s health insurance costs.

The hospitals hate this policy because they don’t want the public to know what they’ve been up to. A group of hospitals gathered together (no doubt with the help of the insurance companies in the background) and sued the government to do away with the rule. They have lost in court twice thus far.

But as the Times went on to point out, some of the largest insurers are simply ignoring the rules and refusing to provide the required pricing information.

NYT also found that there were several bad actors still holding out on fulfilling their legal responsibility for transparency. These “bad actors” are among the most profitable medical facilities in the nation.

Five of the major insurance companies — Aetna, Cigna, Humana, United, and the Blue Cross Blue Shield Association — all declined reporters’ requests for interviews.

Cedars-Sinai in Los Angeles told NYT, “We do not post standard cash rates, which typically will not reflect the price of care for uninsured patients” They have yet to provide their pricing.

These schemes to fleece the insurance companies are obviously far more common than many of us may have imagined. And healthcare providers work a variety of angles. I’ve recently been dealing with one such issue at my own healthcare provider. Over the past couple of years, I’ve been receiving phone alerts telling me I need to set up an appointment for a checkup far more often than the annual schedule I was used to. This year I’m in line to have my third visit, though the doctor hasn’t found any changes or any need to adjust medications or anything else. And yet my neighbor who is ten years older than me with some significant health challenges (and who goes to the same clinic) tells me he’s still going once per year. Why? He’s on a fixed retirement income without great coverage, while I have a nice plan through my employer with Blue Cross Blue Shield.

I can assure you that I’m going to be having a chat with them about this the next time I go in. And the press needs to ride shotgun on the companies listed above who are not in compliance with the regulations. This situation should be intolerable to all of you.