Now you see it, now you....just kidding. You're NEVER gonna see it.

A few years ago we did a fairly sizeable home remodel for a client.  In conversation I learned that the Mrs was a now-retired hospital CFO.  (Her hospital was absorbed into another even larger system, and she took her bonus/payout and retired.)  I shared with her my frustration trying to figure out hospital and doctor statements, and she just chuckled and said, "Of course you're frustrated.  That's by design."

She told me how hospitals had a MSRP Blue Book (my term, as I can't remember what she actually called it) which listed their charges for everything you could possibly imagine.  "Appendectomy $19,300; double heart bypass $94,000; set broken arm $12,600, aspirin $10", etc (I can't remember her actual numbers).  

But then she told me their dirty little secret:  ALL their numbers were totally made up!  They bore no resemblance at all to their actual costs.  There is no industry standard.  And every other hospital had their own Blue Book, too, with their own totally made up prices, and they often differed widely.  That's why you'll hear TV investigative reporters tell of how one hospital charges $300 for a mammogram, while another across town charges $2,700.

Of course insurance companies have contract pricing where they pay MUCH less, but if you have to pay yourself, this is what they bill you.  Some pay, some walk it entirely, but some come back to negotiate (and the hospitals allow themselves LOTS of room to negotiate).  It's a giant shell game!

Some doctors do something similar.  You call a doctor and ask if they take your brand of insurance and are told yes, so you make an appointment.  A few weeks later you find out from your insurance company that the doctor charged more than the "usual and customary" fee, and that the balance is up to you.  Gee, thanks for telling me up front, doc.

Ditto for prescription drugs from your insurance plan or Medicare drug supplement.  They cover what is on their "formulary" list only.  Their what?  If it isn't on their list, you're SOL.  (Shit Out of Luck)  And they list page after page of things like hydrothialomicizinetine trididodickyluckypucky.  WTH?  What happened to "Lyrica" or "Crestor"?  Sadly this is the way our world works today....you're led to believe one thing, only to find out later the fine print screwed you over.

We little guys don't stand a chance!

So now they're going to REPEAL AND REPLACE Obamacare.  OK, great, by all accounts it needed to be overhauled.  But please tell me how they're going to get all those various interests, each with their own proprietary fine print, to agree to a viable replacement?  Each will be maneuvering to throw the other under the bus first. (No honor among thieves, you know.)  And it will eventually have to be voted on by Congress....yes, bought-and-paid-for Congress.  *bend over folks*

There's fine print everywhere....buried in that 8 page credit card agreement, that 75 page mortgage document, your homeowners/renters/auto/life insurance policies, your auto loan agreement, that investment prospectus....everywhere!

Here's the deal:  most businesses today don't WANT you to know how they operate.  They LOVE doing business in the shadows.  Transparency is the LAST thing they want.

Ever hear of the Consumer Financial Protection Bureau?  It was an outgrowth of the financial meltdown back in '08.  Its supporters will tell you it exists to slap down businesses that take advantage of unsuspecting consumers (ie: non-lawyers who can't understand all that legalese/fine print).  Detractors, such as the Big Banks, the US Chamber of Commerce, and I'm sad to say the Republican establishment, will tell you it "interferes with their ability to conduct business as they feel they need to", and besides, regulations are JUST DOWNRIGHT UN-AMERICAN!!  *saluting flag*

Seems to me if the Big Banks, the US Chamber of Commerce, and the Republican establishment (and probably more than a few Democrats, too) would behave the way their mamas taught them, there wouldn't be a need for a Consumer Financial Protection Bureau.

What you DON'T know WILL hurt you, or at least COST you.  Caveat Emptor now more than ever, my friends.

S

Get ready to RUUUUMMMMMBLE!

Democrats and Republicans are meeting (separately) in Washington today with their managers and trainers to strategize for their upcoming "To Repeal Or Not Repeal Obamacare" heavyweight fight.

In this corner we have the "Oh Dear God, Save My Legacy" Democrats.  They want to keep Obamacare, pointing out 20M people now have insurance thanks to it.  (But they will quietly mumble that, yes, it needs some major "tweaking".)

And in the opposite corner we have the "Repeal and Replace" Republicans.  They want to kill Obamacare, effective on    fill in a date__.  In the meantime they will work on whatever it is they will replace it with, TBD.

Obamacare has helped many people for sure, but stories abound of people whose insurance premiums have gone from $400 a month +/- pre-Obamacare to $1,400 a month +/- after.  And even after that, deductibles and copays are still up substantially.

But "replace later" is a joke, too.  There are far too many vested interest "cooks" in the kitchen for that process to ever produce a tasty dish.  Doctors fear socialized medicine, insurance companies fear serious regulation and/or competition, seniors fear having their Medicare thrown under the bus, young people don't even think they need insurance at all, hospitals are for whatever will pay them the most (and don't kid yourself, "non-profit hospitals" are NOT "non-profit"), pharmaceutical companies LOVE the "charge anything you want" sweetheart deal they have now, etc.

And to make matters worse, BOTH sides agree that we need to preserve the "no pre-existing conditions", "no lifetime $$$ limits", and the "keep the kids on mom and dad's policy" provisions we have now, which are THE MOST EXPENSIVE parts of Obamacare.  We want to have our cake and eat it, too!

The other, not-talked-about option is to re-institute the laissez faire system we had before Obamacare, the one that was slowly-but-surely failing.  Every year a few million more people had their stable (?) corporate jobs and insurance benefits disappear as their jobs went overseas or they became "independent contractors/consultants" with no insurance at all.  These people had to either pay through the nose for private insurance, do without proper health care and be sickly, or depend on hospital emergency rooms for care they couldn't pay for, which often led to bankruptcy, none of them good options.

My opinion (whether you want it or not) is that both replacing Obamacare with something that keeps the strong points of it intact, or heavily amending the existing Obamacare scheme, amount to the same thing.  Both sides might as well sit down together and use that as their starting point.

Right now our society has developed to the point that for national security reasons as well as for business reasons, ALL Americans must have health care.  Leaving some without health care weakens us both domestically and internationally, and we can't afford that.  We're too compassionate to leave some behind to suffer, and our adversaries/competitors have become much too strong for us to go toe-to-toe with unless we work harder than ever and ARE HEALTHY.  We're not China....our workers are not expendable.

So let's suck it up buttercups.  We can either pay for it now, or suffer the consequences later.  (And we WON'T like the consequences!)

S