4 ms·

It really is a toothless law, the hospital probably makes more surplus profit from price discrimination in a single week than their entire fine for the year. Th

It really is a toothless law, the hospital probably makes more surplus profit from price discrimination in a single week than their entire fine for the year. The damages should be increased 100x.

causality0 4y ago
In my fantasy world there's a full-on constitutional amendment demanding that any monetary fine must meet or esceed the profits gained by breaking the law.
- zeruch 4y ago
  I've long advocated for a few variations of this: 1. fines must conform to a percentage of the targets earning wealth (e.g. someone who makes 30K a year gets fined $3000, someone who makes 300K gets a 30K fine etc) 2. flat out just as you said, fine must EXCEED by a multiple, the amount they gained (however, determining the gain is in many situations, requiring a lot of forensic accounting to sort out).
  - zeruch 4y ago
    ...now I'm amused by which Ayn Rand sycophant is downvoting me because I propose proportionality so the efficacy of punishment affects evenly across the board. Y'all are the Scientology of pop-econ.
amluto 4y ago
I would advocate a more direct form of damages: a hospital that does not comply may not charge more than the minimum over all hospitals in a 500 mile radius for any procedure. A hospital that does charge more and is caught must refund double the difference. Furthermore, no contractual provision may penalize patients for attempting to seek that double refund, and a class action lawsuit to recover the difference that actually goes to trial recovers triple instead. Hospitals will comply immediately :)
- arwhatever 4y ago
  How about if you can’t post the prices, you simply aren’t allowed to bill for any services?
  - QuarterReptile 4y ago
    This is the one that's simple to enforce. No price, no bill.
    - maxerickson 4y ago
      Y'all are leaving out the no service part that would come with that.
      - amluto 4y ago
        No service = no bonus for whatever exec decided not to publish the list. In general, I’d love to see the same consumer protection required from auto shops applied to a hospital. An auto shop must give an estimate in advance.
      - mindslight 4y ago
        Wut? The service has already been rendered at that point. Without an upfront price, no contract has been formed, so there's no basis for the hospital to bill an unjustifiable amount. At best they could request reimbursement for cost incurred. eg $0.01 for an aspirin and not $60.
        maxerickson 4y ago
        At which point? The hospital would stop providing services shortly after it was informed that it would not be able to bill for them. Also, I'm pretty sure you can write a contract that doesn't have an upfront price.
        mindslight 4y ago
yborg 4y ago
Not only that, but it costs money for the hospital to make the chargemaster available, deal with people asking about it, etc. If the fine is really just $900K, if I was a hospital CFO I'd pay that every year without a second thought, or even work up a service charge to add to all hospital billing a la the "Federal Access Charge" AT&T puts on phone bills so I can get people to blame the government for $15 Motrin tablets in the hospital.
- x-shadowban 4y ago
  An interesting game. The govt could then raise the fine, but would they risk bankrupting the hospitals by pushing too far?
- pishpash 4y ago
  It costs money for the hospital to do payroll for the CEO too but that never gets dropped somehow!

It really is a toothless law, the hospital probably makes more surplus profit from price discrimination in a single week than their entire fine for the year. The damages should be increased 100x.

causality0 4y ago

In my fantasy world there's a full-on constitutional amendment demanding that any monetary fine must meet or esceed the profits gained by breaking the law.

zeruch 4y ago
I've long advocated for a few variations of this: 1. fines must conform to a percentage of the targets earning wealth (e.g. someone who makes 30K a year gets fined $3000, someone who makes 300K gets a 30K fine etc) 2. flat out just as you said, fine must EXCEED by a multiple, the amount they gained (however, determining the gain is in many situations, requiring a lot of forensic accounting to sort out).
- zeruch 4y ago
  ...now I'm amused by which Ayn Rand sycophant is downvoting me because I propose proportionality so the efficacy of punishment affects evenly across the board. Y'all are the Scientology of pop-econ.

amluto 4y ago

I would advocate a more direct form of damages: a hospital that does not comply may not charge more than the minimum over all hospitals in a 500 mile radius for any procedure. A hospital that does charge more and is caught must refund double the difference. Furthermore, no contractual provision may penalize patients for attempting to seek that double refund, and a class action lawsuit to recover the difference that actually goes to trial recovers triple instead. Hospitals will comply immediately :)

arwhatever 4y ago
How about if you can’t post the prices, you simply aren’t allowed to bill for any services?
- QuarterReptile 4y ago
  This is the one that's simple to enforce. No price, no bill.
  - maxerickson 4y ago
    Y'all are leaving out the no service part that would come with that.
    - amluto 4y ago
      No service = no bonus for whatever exec decided not to publish the list. In general, I’d love to see the same consumer protection required from auto shops applied to a hospital. An auto shop must give an estimate in advance.
    - mindslight 4y ago
      Wut? The service has already been rendered at that point. Without an upfront price, no contract has been formed, so there's no basis for the hospital to bill an unjustifiable amount. At best they could request reimbursement for cost incurred. eg $0.01 for an aspirin and not $60.
      - maxerickson 4y ago
        At which point? The hospital would stop providing services shortly after it was informed that it would not be able to bill for them. Also, I'm pretty sure you can write a contract that doesn't have an upfront price.
        mindslight 4y ago

yborg 4y ago

Not only that, but it costs money for the hospital to make the chargemaster available, deal with people asking about it, etc. If the fine is really just $900K, if I was a hospital CFO I'd pay that every year without a second thought, or even work up a service charge to add to all hospital billing a la the "Federal Access Charge" AT&T puts on phone bills so I can get people to blame the government for $15 Motrin tablets in the hospital.

x-shadowban 4y ago
An interesting game. The govt could then raise the fine, but would they risk bankrupting the hospitals by pushing too far?
pishpash 4y ago
It costs money for the hospital to do payroll for the CEO too but that never gets dropped somehow!