[wbronitsky]

Matt Stoller, a journalist who blogs about monopolies, just wrote all about the pricing issue this week: https://www.thebignewsletter.com/p/monopoly-round-up-obamaca...

America has doubled down on middlemen controlling the prices of medical care and making sure that there is no set price for anything. With the ACA effectively falling apart in the new budget, we do have a chance to move to a different reality, one where medicare prices are the set prices for everything, but that is nearly a political impossibility given the amount that these middlemen spend in keeping politicians who support that from winning primaries. Instead, we are stuck in a situation where companies get to dictate prices and access to care while we get diminishing returns in health quality and longevity.

[tonymet]

I’ll look into it. From what I can tell it’s not a simple hero vs villain story. It feels more like an industrial disaster or the AWS outage where there are like a dozen compounding system failures leading to where we are today.

Medical billing is like a massive centuries-old tenement building with a patchwork of legacy plumbing, electrical , framing, sewage all patched together with decades of duct tape, wood shards, and rusty couplings. But in this case there’s massive incentives to keep it all bodged because each pipe and crevice hides billions of un-audited income.

[astrange]

Matt Stoller is properly described as an insane person who thinks every single problem in the world is caused by monopolies (yes, including whatever random problem you're thinking of now).

His most notable attributes on Twitter are he constantly lies about everything and that he spends all his time promoting Republicans who are clearly not going to implement his anti-monopoly agenda.

[dragonwriter]

I haven't paid a lot of attention to Stoller particularly, but the rest of that line of thinking frequently correlates with also believing that monopolies are exclusively a result of active government regulation, a belief which is naturally attracted to Republican deregulatory rhetoric.

[astrange]

Oh, I don't think that applies. He's part of a movement called "neo-Brandesian" aka "hipster antitrust", which basically thinks government should promote small businesses by explicitly bullying large businesses, and that the customer welfare standard was a cop out to give up on this.

So not only would they be against deregulation (they think painful regulations are good because pain for the sake of it is good), but the previous admin actually tried this with Lina Khan and it didn't really work.

The issue here is Democrats are "mainstream" coded, so all populist politics works by fighting them even when they're trying to do your own policy.

[mrguyorama]

> one where medicare prices are the set prices for everything, but that is nearly a political impossibility given the amount that these middlemen spend in keeping politicians who support that from winning primaries.

You're missing the part where the Stated and objective goal of popular politicians from one party is not to let that happen.

They don't get elected because someone scheming to control their funding (though that is a proximal cause of Republican candidates getting more extreme: Align with MAGA or get primaried)

They get elected because a huge portion of the USA are divorced from reality and utterly deny said reality. They say "government is less efficient" as we sit on top of this atrocious system, a system where we already have the government version and it's radically cheaper and we could literally just sign up everyone for that, save everyone time, money, and headache, and then improve service quality.

These people deny that nearly all developed countries and lots of undeveloped countries have vastly better healthcare outcomes than the USA, extremely better healthcare access, and pay way way less overall, taxes included.

These people just consume propaganda, and purposely refuse to engage with any clear or obvious evidence that contradicts said propaganda.

[whimsicalism]

i don't really disagree with you, but i do think it is funny given that the single largest policy targeting medical price transparency came from a republican admin.

i'm potentially on board with signing up everyone for medicare, but only if we actually can get voters to vote for the taxes necessary to fund that. i doubt we will be able to given we can't get voters to vote for the taxes necessary to fund existing medicare consumption.