Enforcement of 15 USC Chapter 1 to save Healthcare for All

This is the work of Karl Denninger, who ran for the Libertarian candidate for President some years ago. He runs market-ticker.org

Essentially, enforcing 15 USC Chapter 1 to tall parts of the medical health care industry will collapse the cost of care for both the government and private parties by as much as 80% and permanently end and reverse the budget problems it is causing – for the federal government, for state and local pensions, and for private firms and individuals.

via market-ticker.net
You could, via Executive Order, direct {the Attorney General} to enforce 15 USC Chapter 1 against all medical firms as regard disparate pricing based on one’s insurance status, a clearly-extortionate and illegal act under 100+ year old law which forbids any collusive act intended to limit competition and/or fix prices. Said law has been challenged twice by the insurance industry all the way up to the United States Supreme Court with the first such challenge in 1979 (Group Life & Health .v. Royal Drug, 440 US 205) claiming an exemption for health insurance providers under McCarran-Ferguson. THEY LOST. I have repeatedly heard from myriad “lawmakers” that health insurance and medical providers are exempt from anti-trust; this is a bald lie given that there are two cases which went to the United States Supreme Court and were lost after attempting to assert exactly this claim. What’s even more outrageous is that after the second loss the State of California wrote a section into their BPR code (similar to the federal CFRs) that explicitly exempts health providers from the effects of that US Supreme Court decision yet it is a fact that no state regulator or legislature can exempt someone from a federal law.

Karl even wrote a Bill with description at (https://market-ticker.org/akcs-www?singlepost=3419181) The main points:

He wrote a law. He goes more into depth at (https://market-ticker.org/akcs-www?singlepost=3419181) and describes what that system would look like.

o All providers must post, in their offices and on a public web site without any requirement to sign in or otherwise identify oneself to access it, a full and complete price list which shall apply to every person.

o All customers must be billed for actual charges at the same price on a direct basis at the time the service or product is rendered to them.

o For a bill to be valid and collectible it must be affirmatively consented to in writing, with a disclosure of the actual price to be charged from the above schedule for each item to be provided whether good or service, prior to the service being performed or the good furnished, subject only to the emergency exception below. A bill that is increased, has items added to it after consent is obtained, which contains any open-ended promise to pay without an actual price listed for each service or good prior to customer consent or is issued with no consent at all (including having a customer sign a consent form while under the influence of drugs the facility gave them as occurs in virtually every instance today while you’re being wheeled into the OR) is deemed fraudulent and void.

o No event caused by or a consequence of treatment, can be billed to the customer.

o All true emergency patients, defined as those who are unable by medical circumstance to choose where their treatment is to take place and require immediate medical intervention to either stabilize their condition, prevent severe permanent impairment or death (e.g. transported by an ambulance, unconscious with no person with medical power of attorney at-hand, having a heart attack in the ER, etc) must receive the same price for the same service as a person who consents to said service.

o All medical records are the property of, and shall be delivered to, the customer at the time of service in human readable form (a PDF provided on common consumer computer media such as a “flash stick” shall comply with this requirement.) Any coding or other symbols on said chart must include a key to same in English delivered at the same time. No separate charge may be made for the provision of a contemporary record of a medical visit or treatment other than a reasonable charge for physical media if the customer does not have same with him or her.

o All surgical providers of any sort must publish de-identified procedure counts and account for all complications and outcomes, updated no less often than monthly.

o Auxiliary services (e.g. medical or dental Xrays, lab testing, etc) may not be required to be purchased at the point of use.

o All anti-trust and consumer protection laws shall be enforced against all medically-related firms and any claimed exemptions for health-related firms in relationship to same are hereby deemed void; for private actions all such violations proved up in court are entitled to treble damages plus a $50,000 statutory civil penalty per impacted person.

o Any test or diagnostic that carries no exposure to drugs or radiation, nor is invasive beyond a blood draw, may be purchased without doctor order or prescription.

o Wholesale drug pricing in the United States must be on a “most-favored nation” basis.

o No government funded program or government billed invoice will be paid for medical treatment where a lifestyle change will provide a substantially equivalent or superior benefit that the customer refuses to implement.

o Health insurance companies must sell true insurance to sell any health-related policy at all.

o All health insurance providers selling true insurance, in whole or part, must provide within their “true insurance” the ability to “replace like with like.”

o Medicare becomes just another insurance provider.

o For those who have no means to pay and find themselves with a need for medical attention the following provisions shall apply:

  1. EMTALA is hereby repealed.
  2. The provisions of this section, bearing on those who cannot pay for medical services, shall apply only to US Citizens and lawful permanent residents. This instantly puts a stop to the “uncompensated care” problem for illegals and the “come here pregnant and poop out a kid” expense issue as well. No medical provider shall have any liability, whether civil or criminal, for their refusal to provide care for which they are unable to secure payment when furnished to other than lawful permanent residents or Citizens. Other nations that wish to negotiate a billback provision for their citizens in order to insure that payment is secured may, of course, do so but under no circumstance shall a person who is not a citizen or permanent resident obligate any provider to provide services without payment, nor may they avail themselves of the backup payment provisions of this section, nor does any cause of action in favor of any person arise in equity or law for a provider’s refusal to provide care to a person who is not a citizen or permanent resident without sufficient guarantee of payment for medical goods and services.
  3. For those with true emergencies (as defined above) and who are lawful permanent residents or citizens and thus can identify themselves as such but are unable to pay the treating hospital/ER shall bill the US Treasury for the lawful charges incurred under the above framework and shall be paid within 30 days. All provisions of the above shall apply for what constitutes a lawful and payable bill and shall be provided to the customer at the time of service along with the fact that same has been forwarded to the US Treasury for payment.
  4. For those with non-emergency conditions who are (1) US Citizens or (2) lawful permanent residents and who assert they are unable to pay the medical provider shall bill the US Treasury for the lawful charges incurred under the above framework and shall be paid within 30 days with the provision that government billing shall not be available for any condition, drug, device or treatment for which a lifestyle modification that the consumer refuses to make will alleviate any or all of said expense and need for medical goods or services. Again, all provisions of the above shall apply for what constitutes a lawful and payable bill and shall be provided to the customer at the time of the service being provided. Treasury shall provide a means of rapid verification of citizenship or permanent resident status for the use of medical providers, with access to same restricted for this exclusive purpose so as to allow validation of such claims at the time of service (if we can have a background check call-in number for gun sales we can certainly verify citizenship status for those who claim to be indigent and in need of medical care!)
  5. Said charges under (3) and (4) will, when submitted to Treasury, result in an invoice being sent to the taxpayer in question and may be settled within 90 days of submission at no penalty. This allows a person who temporarily cannot pay or who is misidentified as not having a means of payment (whether insurance-based or otherwise) to make payment directly to the US Treasury without risk of an adverse tax action. If said bill(s) are not paid in full within 90 days then they become a tax lien subject to collection exclusively from any or all of (a) refundable tax credits, which may be garnished at up to 100%, (b) tax refunds, which may be garnished at up to 100%, (c) other entitlement checks excluding Social Security retirement which may be garnished at a rate of no more than 25% (e.g. social security disability, general assistance, etc) and (d) windfall amounts in cash or property that cumulatively exceed $10,000 in a rolling 12 month period from any source (e.g. inheritances, lottery winnings, gifts, etc.) that may be garnished for payment up to their full amount. Statutory interest at 110% of the current 1-year Treasury bill rate, with the rate adjusted on the last business day of each calendar quarter, shall be applied on any remaining balance until paid in full. This will be vastly cheaper than Medicaid – about 10% of what is spent today, in fact, and a good part of it will be recoverable over time.
  6. At death if a tax lien exists for unpaid medical bills it shall be treated as any other tax lien for the purpose of claim against the decedent’s estate except that in the case of a married couple with a surviving spouse who’s marriage pre-dates the medical expenses in question any such claim shall not be recoverable during the surviving spouse’s remaining life but rather shall become a claim against said surviving spouse’s estate at the time of their death. Remarriage, creation of a trust or other estate-planning vehicle after the event(s) giving rise to the medical tax lien shall not modify or defray this liability and may not be used to shield the assets of the surviving spouse from an existing claim.
  7. Any provider of service that falsifies billing under this section, bills at inflated prices or otherwise violates the provisions of this law in regard to any bill submitted to the US Treasury for payment shall be deemed guilty of a criminal felony for which the punishment shall be the forfeiture of three times the billed amount and each individual who has caused such an invoice to be issued, transmitted or otherwise participated in same shall be subject to a fine of not less than $1,000 nor more than $10,000 and imprisonment of not less than 2 and not more than 5 years. Each fraudulent invoice shall constitute a separate and distinct offense, all penalties shall be consecutive and additive, and liability for same shall be joint and several.
  8. Misrepresentation of citizenship or permanent resident status for the purpose of obtaining health care to be billed to the Treasury shall be deemed a criminal felony punishable by not less than one and no more than ten years imprisonment and a civil penalty of three times the amount of the charges incurred. Upon conviction said individual shall also be immediately deported and suffer permanent exclusion from the United States; said penalties may not be decreased or waived irrespective of other circumstances.

o ALL provisions of the PPACA and other public health related laws contrary to the above, whether in law, CFR, Internal Revenue Code or otherwise are declared contrary to public policy, void and unenforceable, and all State Laws and Regulations contrary to same are preempted, void and unenforceable since medical care inherently involves commodities that travel in interstate commerce and thus the sale of such goods and services fall under the Commerce Clause to the US Constitution.

If Trump uses tariffs to replace the income tax, he needs to also fix entitlements.
If you can cut heath care by… what are they, 30%+ of GDP, it’s no longer an issue.