Hyperinflation Thrives in the Shadows of American Healthcare

The first installment in this series mentioned: “the shadows” of healthcare, where the general public rarely looks because it takes too much time to penetrate the darkness and understand how this complex sector of the economy works.

A friend told the story of a recent brush with “the shadows” at his local pharmacy. His out-of-pocket cost had risen for a longstanding prescription covered by Medicare. Curious, he asked to see how much of the cost Medicare-covered. He was startled to see how much “pain” he and his fellow taxpayers were being “spared.”

That experience could be replicated endlessly across America.

The money we pour into the complex, third-party payer machinery built by the government and the insurance industry is the price we pay for our beloved painkiller — the “opiate of the masses,” to borrow a phrase from Karl Marx. The pain of paying outrageous prices is dulled, usually just enough so that we don’t get too worked up.

We operate under a system of price opacity. The prices being charged are not transparent, not visible to us. We don’t know how those prices are set or where the money goes. We don’t really care.

That’s what opacity does. As a narcotic, price opacity is a high-performance wonder.

But there’s an appalling cost to not knowing the cost. My friend’s surprise at the pharmacy is what Americans would experience routinely by looking into hospital bills, bills for visits to clinics, and bills for diagnostic testing of all kinds.

Did you hear the one about the $25,000 test for strep throat? How about the $59,490 ultrasound? At least those two monstrosities were caught. Did you know that outrageous charges are paid routinely by computerized systems and without the benefit of human review? We’ve created a devil’s playground.

  • What if we could re-establish a transparent, competitive marketplace, consistent with American principles of choice (not European principles of government control), a marketplace that would not only set prices organically and rationally but drive them down — way down?
  • Would freedom from an “opaque” system save money — money now disappearing into the great maw of third-party profiteers and supporting the huge administrative, regulation-spawned overhead discussed in our last article?
  • Would we free up money for research to find the cure for cancer, to resolve the opioid crisis, and to meet the needs of the underserved, the uninsured, and those with pre-existing conditions?

Now, do you understand the big driver of healthcare’s hyperinflation over the last several decades? Why healthcare insurance premiums have become outrageous? Why the cost of healthcare is the top issue for American households? Why the snake oil salesmen of Medicare-for-All can find a gullible audience?

It is we who have remained anesthetized and “in the dark,” while the players who count on our darkened stupor have profited wildly, although adding nothing of value. By preferring that darkened stupor, we’ve allowed private interests and the hyper-lobbied political class to turn American healthcare into an overpriced nightmare.

Is anyone trying to let more light into this opaque system?

Yes. Certain executive orders are the first steps in that process. Are there powerful interests who lobby against the light?

You bet.

Whatever our philosophy of life, we can all appreciate the truth of the central figure of Christianity as recorded in the New Testament’s Gospel of John: ”… this is the condemnation, that light is come into the world, and men loved darkness rather than light, because their deeds were evil. For every one that doeth evil hateth the light, neither cometh to the light, lest his deeds should be reproved. But he that doeth truth cometh to the light…” (John 3: 19-21)

Call your legislator with this message: “In healthcare, we want transparency in pricing to replace opacity. Get off your duff and make it happen.”

This article first appeared in The Intelligencer and is featured here with author permission.


Marion Mass, M.D.
Marion Mass, M.D.
In 2016, I was privileged to be a co-founder of Practicing Physicians of America (PPA), a true grassroots organization. We have a diverse board, including Brian J. Dixon, M.D., pediatric psychiatrist; Niran S. Al-Agba, M.D., pediatrician; Westby G. Fisher, M.D., cardiologist; and Judith L. Thompson, M.D., general and breast surgeon. With the publication of the position paper, Reducing Cost and Waste in American Medicine: A Physician-Led Roadmap to Patient-Centered Medical Care, for the first Free2Care Physician Symposium in April 2019, groups similar to PPA networked to form the FREE2CARE Coalition, which has since become an umbrella for 30 groups, 8 million citizens, and 70,000 physicians. Many in the coalition now speak, write, and advocate at the state and national levels to advance the agenda articulated in the original position paper. I have no conflicts of interest, have never taken a speaking fee, and serve as a volunteer on my county newspaper’s editorial board and with my county’s health society. Friends and family know my foibles and faux pas best. Sometimes, I’ve been so focused on the task at hand that I’ve run errands in public in my bathrobe—my attire of choice when writing at home.

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