@DutchRojas You cannot provide informed consent without being informed of the price tag. No contract for the purchase of a home would be valid if the price of purchase were not included
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Todd G
264 posts
You can get an itemized receipt for a $4 coffee but not for the $40,000 your hospital “estimates” your knee will cost. In what other industry do you sign the contract, get the service, and then find out the price by mail 6 weeks later?
Friday question.
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Call your senator and ask them to support this. Unless of course you think healthcare and insurance in this country are perfect
The Lion@ReadTheLion
Insurance companies’ ownership of pharmacies and hospitals is raising consumer costs, but economic competition can counter inflating expenses, according to bipartisan legislation from Sens. Josh Hawley, R-Missouri, and Elizabeth Warren, D-Massachusetts. “We need more competition. We need protections for patients. We need better and cheaper health care,” Hawley told The Lion in an exclusive interview Thursday. Hawley and Warren reintroduced The Patients Before Monopolies Act last week to counter the monopolized medical field, in step with their second bipartisan bill, The Break Up Big Medicine Act. The Patients Before Monopolies Act prohibits pharmacy benefit managers (PBMs), the middlemen between pharmacies and insurance companies, from owning pharmacies and hospitals, Hawley explained. “What’s happening is more and more of these insurance companies are buying up everything,” Hawley told The Lion. “They’re buying up the pharmacies. They’re buying up the doctor’s offices. They’re buying up the hospitals.” @HawleyMO Read full story: bit.ly/4vglY42
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@DrDiGiorgio Well put! As it stands, the only real entity with monetary “skin in the game” is the third party payor. They are the gatekeepers of care, yet have no true clinical capacity, and are not impacted by outcomes - of course everyone hates their insurance!
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Unfortunately tackling Medicaid fraud is difficult without imposing some sort of utilization management.
The best kind of utilization management? Patients who have skin in the game.
Give part of the benefit as a cash-equivalent "food stamp for healthcare" and watch your state cook.
Your neighbor, Indiana, is doing it. You should try it out.
Vivek Ramaswamy@VivekGRamaswamy
My message to doctors, nurses, and other healthcare providers: I’ll create a state where you can spend more time caring for patients instead of filling out mountains of paperwork. That actually goes hand-in-hand with combating Medicaid fraud.
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@HeathVeuleman @scottahodge As non-profit status already exempts the institution from income tax, how do the inflated charity costs benefit these hospitals? Are they reimbursed in full or in part by govt intities for the charity care?
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The $163 million in reported charity care for Minnesota’s nonprofit hospitals isn’t valued at what it actually costs the hospitals to provide that care, nor at the “allowable” reimbursement rates that Medicare, Medicaid, or private insurers would pay.
Instead, it’s heavily influenced by the hospitals’ own chargemaster - the grossly inflated list of full prices that almost no one actually pays. So the charity care that they deliver, in reality, is a fraction of what they report.
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Minnesota’s nonprofit hospitals posted $2.4b in net income, which saved them $504m in federal taxes. But they devoted just $163 million to charity care. This means that for every $1 taxpayers subsidized these hospitals, they got .32cents in charity care. That’s a bad deal.
The math gets worse if you add the state’s 9.8% corporate tax rate. Taxpayers get .22cents in charity care for every $1 of subsidy.
‘The system is not working’: Minnesota’s hospitals are among least charitable in nation startribune.com/minnesota-nonp…
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@DrDiGiorgio @cremieuxrecueil Epic is the single largest perpetrator of invasive data grab - monetizing patient data without their consent - hidden behind a cloak public good - shielded from public commentary
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@cremieuxrecueil Epic has done nothing but extract wealth and make doctors hate their jobs.
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@mcuban @SBJ One cannot provide INFORMED consent w/o being informed of a $. Just as u would not sign a purchase agreement without knowing the price of a car/boat/house etc, patients should refuse to consent to any (non-emergent) therapy or procedure w/o being informed of the associated price.
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So true and a great point
I used to refuse to give @SBJ Mavs ticket prices because they ranked team ticket prices based on an average Not even a weighted average
We had $2 and $3000 tickets An average was useless
Christine Price@HEALTHCOSTtruth
The opacity Mark describes is dead on target but it goes one layer deeper than most people realize. The chargemaster itself is statistically camouflaged. High-volume codes (the ones that drive 80%+ of revenue) run 800-4,000% of Medicare (sometimes more). Rarely-billed codes sit near Medicare. When researchers aggregate, the average comes out around "300-400% of Medicare" — and that's the number consultants and brokers cite because they don't know the facts. It's not the real number. The codes that actually generate revenue are running 8-10x what the studies report. I download chargemasters constantly. The pattern is consistent. The opacity isn't accidental. It's engineered to defeat the very studies meant to detect it. The easiest way for anyone to "shop" for hospital healthcare is to request a Good Faith Estimate but you must make sure to tell them you're uninsured or not going to use your insurance (insured patients can't get an estimate - funny how that works). That is as close as the average person will get to seeing "approximate" costs. It's ALL smoke and mirrors. This chart shows (FL hospital). Gross charges AVERAGE 25x Medicare, Cash pay Averages 15x Medicare and UHC "discount" averages 22x Medicare. Before you hire a consultant for hundreds of thousands of dollars (or more) to give you the same tired advice as everyone has heard for decades, you need the facts - not the studies. Studies are almost (if not ALWAYS) skewed in favor of organization doing the study. There are ways to fight back but you have to stay one move ahead of them in their game.
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Americans are using Buy Now Pay Later options to pay for needs like groceries or medical care.
54% of users said they couldn’t make ends meet without these loans.
Nearly half of users in the last year were late at least once—compared to 34% in 2024.
This is Trump's economy.
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@DrDiGiorgio A patient cannot provide informed consent, without being informed of the cost prior to signing. It never happens, but should every time without exception. And in fact, should not be liable for a bill they receive if informed consent was not given
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I’ve seen hospital list prices as high as $18,000 for an MRI.
Rep. Eric Burlison@RepEricBurlison
An MRI in a hospital: $2,400 An MRI through direct primary care: $600 This should be a wake up call for everyone.
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@BreitbartNews It’s not a revenue problem, it’s a spending problem. Spend less than you make - just like every honest hard working American citizen
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WARMTH OF COLLECTIVISM UPDATE: Mayor Zohran Mamdani declares a "budget crisis," asks for a bailout from the state government, and pushes back his deadline for completing the city budget at least 10 days:
"We cannot close this deficit with savings alone. We need new revenue, and we need a structural reset in our relationship with the state. That is the only way to meet our legal obligation to pass a balanced budget."
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@DrDiGiorgio Nobody “likes their insurance.” Thats simply a fallacy. If they do, it just means they’re aren’t consuming healthcare and don’t realize they’re getting ripped off. Two tiered system will work, govt for the have nots, private HDHP/HSA for the havs
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It’s worth noting what single payer actually means:
If you like your insurance, you can’t keep it.
Your only option is government run insurance.
No Kaiser, no HSA, no blue cross.
There’s plenty to dislike about private insurance. Government insurance will be much worse.
Tom Steyer@TomSteyer
At some point we have to accept health care "reform" is not the answer. Single payer is the answer.
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@J2H12345 @realdocspeaks @DrDiGiorgio Because the American voter will never accept a system that refuses people at the door. If they don’t pay, they know they’ll still get the care. And that cost has to be recovered somewhere
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You are looking at this the wrong way. MRIs are too cheap to insure, and patients should pay out of pocket for them.
In my ZIP code, an MRI of the lumbar spine costs $244.85.
Why would we insure something that costs less than $300?
A maintenance package on a Honda that includes an oil change, tire rotation, brake inspection, and filter replacement costs the same as the MRI.
Insurance should be reserved for catastrophic events.
Benjamin Lee@Benjamin_D_Lee
@realdocspeaks Ultimately there is a finite amount of time on an MRI available and having some friction and utilization management process isn’t necessarily a bad thing to weed out bad actors. If I can find a chiropractor to order weekly MRIs for my sore back, should insurance have to pay?
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@realdocspeaks @DrDiGiorgio Someone still has to fund the HSAs, and HDHP. For the indigent, that will be government. Thus, socialized healthcare. Call a pig a pig
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@Todd_WG @DrDiGiorgio The answer to this is an expanded HSA paired with a catastrophic account.
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@SacksDisa @realdocspeaks @DrDiGiorgio Many of your “rich friends” are probably living paycheck to paycheck. High salaries don’t negate poor financial hygiene. But yes, when people expect to pay $80 dollars for an oil change but can’t fathom that price for a physical-there’s a mindset problem
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@Todd_WG @realdocspeaks @DrDiGiorgio I have had more many rich people balk at paying their 40 dollar copay that those if much more meager means
It’s an attitude problem
by design the public doesn’t think they should be responsible for how medical services they use are paid for
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@DbauerBR549 @realdocspeaks @DrDiGiorgio Or how about a system where the patient is the provider (empowered by AI decision tools). At least at the PCP level. Preventative medicine is personal. Patient empowerment. Emancipate healthcare
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@Todd_WG @realdocspeaks @DrDiGiorgio What about a $50 wellness appointment with an NP or a PA?
If I want an MD or DO I spring for the $200.
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@DrDiGiorgio The alt to socialized healthcare is to turn people away at the door. I’m in the “healthcare is a privilege not a right”court, the voter cannot stomach that reality. Socialized care is the only path to population care. For those who consume individual rights have to be restricted
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This is how socialized medicine leads to a slippery slope where they slowly take away your freedom.
First they ban tobacco, next it’s red meat, candy, video games…
RavenNole 🇺🇸@RavenNole
@robkhenderson This actually makes sense in any country with socialized healthcare. Smokers need to pay a premium to purposely harm their bodies. In the US, they pay more for healthcare. When th government pays healthcare, people who live a healthy lifestyle will vote to restrict bad choices.
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@SteveForbesCEO You can’t truly provide informed consent, without knowing the price tag for the care you receive. Thus hospitals have been in violation of informed consent, really, since forever !
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Price transparency in health care is not optional. It is the baseline for any real market. Patients deserve to know costs upfront. washingtontimes.com/news/2026/apr/…
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@realdocspeaks @DrDiGiorgio The only entity capable of placing a price on the value of care they receive is the patient - but only if they are actually on the hook for the bill. Market forces have been broken by a socialized healthcare system disguised as a private one. The two can’t co-exist
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