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Even in a polarized political landscape, legislators from both parties are able to agree to take action against medical debt. KFF Health News reports that "New laws to curb aggressive hospital billing, to expand charity care for lower-income patients, and to rein in debt collectors have been enacted in more than 20 states since 2021." The article also notes that while one party might have initiated most of the legislation, the laws passed with the support of the other party.

Even in a polarized political landscape, legislators from both parties are able to agree to take action against medical debt. KFF Health News reports that "New laws to curb aggressive hospital billing, to expand charity care for lower-income patients, and to rein in debt collectors have been enacted in more than 20 states since 2021." The article also notes that while one party might have initiated most of the legislation, the laws passed with the support of the other party.

Part of the momentum seems to stem from the fact that medical care is, in many cases, necessary for survival, so patients do not have many options, especially in the case of emergencies. Another part of the motivation seems to be that hospitals may be engaging in what are considered unfair business practices. For example, Oklahoma passed a new law that "bars medical providers from pursuing patients for debts if the provider has not publicly posted its prices." Perhaps these legislative actions will be a cautionary tale to other parts of the industry to avoid practices that seem unjust.

Medicare pays private insurers to insure Medicare patients, through what are known as Medicare Advantage plans. The idea is that Medicare pays a fixed amount per patient per month, and if private insurers are able to be more efficient with their care, the insurers can keep the difference. If insurers are less efficient and lose money on patients, they are responsible for the loss. However, one factor is that Medicare will pay more for patients who have more complex or severe health conditions. On the surface, reimbursing insurers more for sicker patients is very reasonable. In practice, however, the insurers are the ones who determine whether a patient is sick enough to qualify for the greater reimbursement. Although certain guidelines are supposed to be followed, it might not be difficult to imagine how some rules are bent. The government has tried to recover some overpayments to Medicare Advantage plans, but KFF Family News reported on the challenges of doing so.

Medicare pays private insurers to insure Medicare patients, through what are known as Medicare Advantage plans. The idea is that Medicare pays a fixed amount per patient per month, and if private insurers are able to be more efficient with their care, the insurers can keep the difference. If insurers are less efficient and lose money on patients, they are responsible for the loss. However, one factor is that Medicare will pay more for patients who have more complex or severe health conditions. On the surface, reimbursing insurers more for sicker patients is very reasonable. In practice, however, the insurers are the ones who determine whether a patient is sick enough to qualify for the greater reimbursement. Although certain guidelines are supposed to be followed, it might not be difficult to imagine how some rules are bent. The government has tried to recover some overpayments to Medicare Advantage plans, but KFF Family News reported on the challenges of doing so.

One of the structural challenges of the payment recovery seems to be related to the length of time the lawsuits can take (over a decade), and how Medicare staff leave their jobs -- sometimes to take up jobs related in the Medicare Advantage industry. Another challenge is that Medicare is concerned about continuity of care and the challenges that might arise if a Medicare Advantage insurer leaves the market.

As another example of the popular sentiment turning against some medical billing practices, California has passed legislation banning providers from sharing medical debt with credit reporting agencies. The article notes that "credit reporting is the most common collection tactic used by hospitals to get patients to pay their bills. A credit score ban might make it more difficult for hospitals to collect."

As another example of the popular sentiment turning against some medical billing practices, California has passed legislation banning providers from sharing medical debt with credit reporting agencies. The article notes that "credit reporting is the most common collection tactic used by hospitals to get patients to pay their bills. A credit score ban might make it more difficult for hospitals to collect."

It seems unclear how providers in California will react to this new legislation. For example, perhaps more hospitals will require an initial payment before major surgeries that are not emergencies. Nevertheless, the rationale offered seems logical: "medical debt — unlike other kinds of debt — isn't an accurate reflection of credit risk". If that is the case, it seems appropriate that medical debt should not factor into one's credit score.

KFF Health News published a happy story about a manufacturing company reducing its healthcare costs. A major step was establishing its own clinic -- staffed by a local health system -- where basic primary care is provided for free for employees and their families. Another step that the company took was to reduce costs for patients who needed to visit specialists and hospitals if they agreed to visit providers who are highly rated in terms of quality.

KFF Health News published a happy story about a manufacturing company reducing its healthcare costs. A major step was establishing its own clinic -- staffed by a local health system -- where basic primary care is provided for free for employees and their families. Another step that the company took was to reduce costs for patients who needed to visit specialists and hospitals if they agreed to visit providers who are highly rated in terms of quality.

The article notes that not all companies who have experimented with running their own clinics have seen positive financial results. One potential factor is whether a company's workforce is sufficiently centralized. Although not stated in the article, it also seems that the size of the workforce is important to attaining economies of scale. It is also possible that manufacturers of physical products would benefit more from an onsite clinic than a company of knowledge workers. The article notes that "savings can take a while to materialize," suggesting that the move is likely more palatable to companies who have enough to invest for years. It would have been interesting to know how much of the company's savings were attributable to the clinic, and how much of it might be attributable to other parts, such as steering patients towards higher quality specialists or having insurance plans without deductibles.

In the current highly polarized political landscape, the two main US presidential candidates have found something to agree upon: moving to lower drug prices. KFF Health News reported on various actions each candidate has previously taken to reduce prescription drug costs. While the specific policies may differ, expensive medication seems to be a theme that resonates with voters.

In the current highly polarized political landscape, the two main US presidential candidates have found something to agree upon: moving to lower drug prices. KFF Health News reported on various actions each candidate has previously taken to reduce prescription drug costs. While the specific policies may differ, expensive medication seems to be a theme that resonates with voters.

The current vice-president cast the tie-breaking vote to allow Medicare to negotiate drug prices. Somewhat in contrast, the former president wanted to allow importing drugs from Canada.