Comment by diogenescynic | Hacker News Reader

Comment by diogenescynic | Hacker News Reader

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No, they’re effectively a monopoly for most of the services people actually need. It’s well researched and documented. Google it. They even settled an anti-trust lawsuit with the state a few years back.

https://www.capradio.org/articles/2019/12/20/sutter-health-s...

https://amp.sacbee.com/news/local/health-and-medicine/articl...

https://www.abc10.com/article/news/local/sacramento/californ...

https://www.nytimes.com/2019/10/03/health/sutter-hospitals-m...

https://www.latimes.com/business/la-fi-sutter-health-prices-...

https://www.cbsnews.com/amp/news/california-sutter-health-ho...

https://m.youtube.com/watch?v=n5FFIkdVzq4

It’s a racket. They’re just ripping people off. Sutter is the sole reason healthcare in Sacramento costs more than in LA-and for worse quality care. They’re a grift.

> With most health insurance plans, everything you described would cost you only a co-pay as well (usually $20-40). Uninsured people are the ones stuck with $10k ambulance ride bills... after all, someone has to pay for the services.

You’re either uninformed, lying, or both. Have you ever called an ambulance in California? It’s $2000 minimum even with insurance. This is with an Anthem Blue Cross PPO from a tech company. I’ve had to use an ambulance twice in the last decade and it was considerably more than $20-$40… you were only off by a factor of 50x or 100x.

> No, they’re effectively a monopoly for most of the services people actually need.

No, they aren’t. There's an argument that they may have been in the past, but the practices on which that accusation was based were terminated in a settlement with the state and when the same accusations went to trial in a federal lawsuit, Sutter won outright.

> They even settled an anti-trust lawsuit with the state a few years back.

That was based pricing power for insurance contracting through having must-have hospitals in some areas in Northern California and a system of all-or-nothing insurance contracts that required insurance vendors to make all of their hospitals in-network if it wanted any of them in-network, and other similar bundling. (Interesting, they won outright at trial a federal anti-trust suit on basically the same grounds that was proceeding in parallel, reaching court later, than the state one that they settled.)

And the settlement of the state suit addressed those practices, which is important to the current monopoly accusation, because the accusation in that suit was not that Sutter had a freestanding monopoly (market/pricing power) and illegally leveraged it (in which case, addressing the ways they leveraged it would be expected to leave the freestanding monopoly) but that it had market/pricing power because of the combination of must-have hospitals for insurers and the set of anticompetitive practices that leveraged that into market power.

Living in Sac, we are not remotely in the same league as what is described in OP. Sutter may have outsized market power, but you can definitely get care at a ton of different providers in the area, on e.g. the open market CA insurance plans. I know this because I did it.

Definitely can't speak to the ambulance thing, we've been lucky enough to avoid those at least, if not the ER.

Not one of your links provides any evidence of Sutter being anything close to a monopoly. They do not own the market in California or Sacramento, and the are many other major healthcare providers here including Kaiser.

"Anti-Trust" actions cover a wide variety of anti competitive behaviors.

Additionally, you are misleading people on the cost of an ambulance ride by conflating out-of-network prices and/or medically unnecessary rides.

"Balance Billing" for out of network ambulance rides is now illegal, and uninsured people are capped at billings equal to Medi-Cal.

You’re obtuse. They’re charging more for comparable services in a lower cost of living area of the state, they get away with it because they are effectively a monopoly and there are no real alternatives or competition. They have even been sued and settled anti-competitive behaviors which is evidence to my point… They may not be the literal only healthcare provider but they are clearly able to use their size and scale to rip off locals. Otherwise there’s no other reason Sacramento should be the most expensive place to give birth… it’s a no brainer. You probably work for them or some other PR firm to spread propaganda like this.

> Additionally, you are misleading people on the cost of an ambulance ride by conflating out-of-network prices and/or medically unnecessary rides.

How am I misleading? Those were my real experiences. It’s not like the 911 operator asks about your insurance and makes sure the ambulance is in network. What about when the ambulance is called for you? How is that “unnecessary” if you don’t even have a choice?

I bet you get paid to spread propaganda and lies. This shit is why America sucks—we all get worse healthcare so some rip off company can pay shills like you to spread lies and misinformation. The only people who benefit from the US system are insurance and healthcare executives. We get objectively worse care for objectively higher costs. It’s lose lose for the average person.

> They have even been sued and settled anti-competitive behaviors which is evidence to my point…

No, its not. Its actually evidence against your point that the conditions alleged in the suit – which even in the accusations in the suit were the product of practices discontinued in the settlement – are the current conditions.

(The fact that of the two parallel suits on largely the same allegations covering the same time period under state and federal law, they won the federal suit outright at trial after settling the state suit, is also evidence against the conditions alleged in those suits having been facts even at the time covered by the suits.)

> you are misleading people on the cost of an ambulance ride by conflating out-of-network prices

So I get in an accident and break my leg, someone calls me an ambulance, and while I'm screaming in pain I also need to ask to make sure they get an "in-network ambulance"?

How can anyone defend this system?

> So I get in an accident and break my leg, someone calls me an ambulance, and while I’m screaming in pain I also need to ask to make sure they get an “in-network ambulance”?

No, because as stated in GP, “‘Balance Billing’ for out of network ambulance rides is now illegal.”

That was edited in, it wasn't there when I replied.

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