There are a lot of things the US should do.

Our government is down at the moment, and on-call has no idea how to resolve the issue.

The corporations have been running the country since it was a nation.

I wonder if DOW Chemical and P&G were backing the Federalists in the 1700s or not...

Maybe not corporations, but the wealthy were definitely kicking up a storm over British taxes and import restrictions, and then later driving a lot of the pro-slavery arguments.

I think private banks were...

No, but powerful slaveholding interests were a major factor in the design of our government. It's the reasons our voting system favors low-population states--because slaves only counted as 3/5 of a person and the slaveholders were worried this would mean less representation in government and the danger that owning slaves would be outlawed.

The 3/5ths compromise was about giving less representation to slaveholder states, and was not a moral judgment on the value of slaves.

Slaveholder states would have been perfectly happy for representation to be 1:1 for slaves vs. non-slaves.

Right, they had less representation so they needed to make up for the loss of power with the Electoral College system.

Right, the Electoral College and the Senate benefitted slaveholders by granting them more political power, not the 3/5ths compromise.

That's really not true. US political and economic thought heavily centered around individual proprietors and farmers before the civil war, and was deeply suspicious of large corporations. In some states you could only form a joint stock company for time & scope limited things, such as building a canal.

It's only after the Civil War and into the Gilded Age do we see the rise and acceptance of large scale corporations, but not without conflict. Modern readers will be surprised to know that Marx was relatively popular among Americans in the west during his lifetime (among those that read, naturally), certainly in part due to the increasingly corporate focus that the American economic system was taking at the time.

Another thing worth noting is the push back against the inequality and corruption of the Gilded Age. This time period is when we had our anti-trust laws and improvements to them [1].

The narrative that the government was always broken or in the control of corporate interests takes away agency and responsibility from individual citizens. It may be mostly true, but there's enough glimpses of when citizens were able to corral these interests that it's worth not giving up on.

1 - https://en.wikipedia.org/wiki/Robinson%E2%80%93Patman_Act

Do you have a source for this? I'd love to read more.

David Graeber’s Bullshit Jobs, a Theory, around page 524 or so.

> The mechanics and tradesmen who became the foot soldiers of the American War of Independence represented themselves as producers of the wealth that they saw the British crown as looting, and after the Revolution, many turned the same language against would-be capitalists.

> When US President Abraham Lincoln delivered his first annual message to Congress in 1861, for instance, he included the following lines, which, radical though they seem to a contemporary ear, where really just a reflection of the common sense of the time:[189] “Labor is prior to and independent of capital. Capital is only the fruit of labor, and could never have existed if labor had not first existed. Labor is the superior of capital, and deserves much the higher consideration.”

> In 1880 a Protestant “home missionary” who had spent some years traveling along the Western frontier reported that: “You can hardly find a group of ranchmen or miners from Colorado to the Pacific who will not have on their tongue’s end the labor slang of Denis Kearney, the infidel ribaldry of [atheist pamphleteer] Robert Ingersoll, the Socialistic theories of Karl Marx”

Your comment is funny, but you should be aware this is a state issue, not a federal one.

Unless you are implying every state is down too :)

Interstate commerce, which this most certainly is, is a federal issue?

What makes this a state issue?

Every state has the right to pass laws that apply within it's borders.

The state approach is more fine-grained so a negative outcome is localized, and if the outcome is positive people in other states can enact similar laws if they want.

Couldn't the same logic be applied to every issue? How different is your argument from the one advanced by "states rights" segregationists in the 1960s and earlier?

Not to mention dentists, doctors, hospitals, etc.

I have an eye doctor appt this week and I literally have no idea if it's gonna cost me $50 or $500.

I asked straight up before seeing the doc about the cost and nobody knew. They finally estimated "about $1,500" and my total bill was around $5,000. And if I refuse to pay it, they send me to collections. It's insane what they are allowed to do.

Ask for itemized bill, dispute every single item

https://www.aarp.org/money/credit-loans-debt/info-2019/dispu...

That's both a very useful post, and also enraging that we would have to do something like that to protect ourselves from getting raped by the system.

watch what happens to that bill when you tell them you are going to pay out of pocket instead of using insurance. suddenly, everything has a different price.

I've heard this before and so I tried it, but unfortunately it was not true in my case. They didn't seem to give a crap about that. In one case they actually told me "you should run it through insurance so you get their negotiated price. otherwise it will a lot more expensive"

The real kicker: Before the doc will even see you, you need to sign an agreement that basically says: "You agree to be responsible for paying whatever amount this doctor decides to charge, which could be any amount from $0 to $infinity, and which the doctor will not know prior to treatment."

I've always wondered which part of the medical supply chain is causing healthcare prices to rise so rapidly. There's no way these are natural market rates being driven by supply/demand, it's gotta be something artificial. My guess is something along the lines of medical device companies colluding to prop up prices to hospitals.

It's not collusion, it's a natural consequence of the way healthcare billing is structured in the US. You don't get to comparison shop but also have a captive audience (you're not just going to decide to be blind right?) so there's no pressure to keep prices reasonable.

This makes a lot of money for powerfully connected companies, so don't expect it to change anytime soon. This is why our congress and mass media treat Medicare For All as a joke or something to attack politicians on even though it's popular with a majority of Americans.

You might take a look at some things from e.g. this result[1] around what parts of USA healthcare are negotiatiable and which are fixed. The "$1500 for a gauze bandage" meme makes a little more sense if you view it from the perspective of "we can't charge market price for expensive things like an MRI since Medi___ pays a flat $1.5k/ea, so lets gouge everywhere we can to make up for it". In addition, the business setup of hospitals/providers and lack of a single customer-facing entity/provider that charges you for services makes these even more Kafkaesque.

On top of this, my friends who work at (private, non-general) hospitals work a lot and are not paid what someone on HN might expect for what they put in. This isn't even necessarily ownership vs labor, since afaik the hospitals themselves are not usually in the best of places financially.

To me, the short version is: can't easily negotiate, information asymmetry, and captured regulators. Imo, this isn't helped that in USA we say "healthcare insurance" but what we mean/want seems to actually be "healthcare subsidy/guarantee".

[1] https://www.kff.org/medicare/issue-brief/whats-the-latest-on...

There is no one part, the excessive costs can only be analyzed as a symptom of the system as a whole. One fellow online dubbed this "Coasian hell" and has a good writeup explaining where it comes from: http://www.harrowell.org.uk/blog/2018/01/31/in-the-eternal-i...

No, it’s Medicare cross-subsidization as well as the EMTALA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5769684/

Really this should be medical misconduct - how can the customer give informed consent if they don't know what they're consenting to?

The opposite unknown is also part of the problem -- the facility doesn't necessarily know what procedures are going to happen until you're in the facility being seen by a professional with the authority to order any procedures. Any speculations about what procedures might be necessary by anyone not qualified to order them is akin to practicing medicine without a license, and so is highly avoided.

It's pretty typical in my experience to go to a clinic like that and the staff will have no idea what your insurance will eventually charge you.

It's a complete mess that we need a uh, universal, solution for.

Especially if you don't pay for a really good insurance policy or your employer provides you with a really good insurance policy. You will get screwed with no remorse.

Interestingly I did the math last benefit cycle and if your employer doesn't fully pay for it the better insurance may not be worth it. The additional per month cost cancels out any savings no matter how much usage you get out of it (if you take the out of pocket max into account).

The expectation with all forms of useful insurance (health, auto, umbrella, home/renter's, life, etc.) is that for most people most of the time, they'd be better off not having it.

But in the rare cases when someone does genuinely need it (e.g. your house and all of your possessions burn down, you need treatment for cancer, etc.), it prevents financial ruin.

My point isn't insurance vs. no insurance. My point is that the type of insurance doesn't actually matter that much if you're the one paying for it (versus having premiums covered by your employer). If you get a bad accident on the low end company insurance you pay your $10k out of pocket max. On the top end insurance you pay $4k but also paid $8k more in premiums during the year. The insurance companies did the math to make sure they come out ahead no matter what you choose.

A $10k medical bill is not what I would call catastrophic. Highly unusual, yes. But not catastrophic.

A catastrophic event would be something like you get run over by a car and have to spend weeks in urgent care racking up a six figure bill. Of course, such an event is highly unusual and the vast majority of people will never make a claim of that size or even approaching that size.

By design, people who don't make very much in claims pay for the people who do make those claims but also get the benefit of knowing if such an event ever occurred to them, they wouldn't be financially ruined.

> The insurance companies did the math to make sure they come out ahead no matter what you choose.

That's plainly false. See any true medical catastrophe.

Adding to the industries that get into shady territory: universities. Campus fees, "activity" fees, etc. Now apparently COVID-related fees too [1].

[1]: https://www.cnbc.com/2020/08/20/college-students-get-hit-wit...

This doesn't sound like a consumer protection issue to me. The fees are transparently listed in advance of attendance aren't they? You can choose to pay them or decline to attend. Different from a hotel where you get hit with unexpected fees when checking out and it's too late to negotiate or decline to stay.

You’re still cornered by the need. If every other place also adds random inexplicable fees then you end up paying them anyway. I guess you could argue that it’s just the same as a price increase, but like tax in the US, those weird fees are only disclosed at the checkout, not upfront.

> COVID-related fees

That's a dark phrase.

The Honda dealership in my town charged me $19 for a Covid Cleaning Fee.

I occasionally use the Rinse laundry service and they have a bizarre $5 COVID safety fee which is refunded 3 months later.

https://www.rinse.com/blog/rinse/health-and-safety-fee/

Truly it's bizarre.

Because the thing is, we can. Remember how in the early days of Expedia, flights were listed as crazy cheap, and then when you clicked through to buy, you discovered they'd tack on another 30-50% in fees and taxes? But that changed in 2012 when advertised airfares were forced to include all mandatory charges.

Why they don't do that with all industries -- the ones you've listed, plus making it so cell phone and internet providers can't start randomly tacking on new "network maintenance fees" and other BS -- is beyond me. It shouldn't just be airfare, it should be everything.

I mean, you'd think one of the political parties -- presumably Democrats -- would say, hey that'd be a popular move with voters, and make it part of their platform? But no.

the stranglehold of the two party system buoyed by corporate cash means that they only have to seem a tiny bit less bad than the other party.

for better representation and a better society, we need election and campaign finance reform asap. unfortunately that doesn't serve the desires of the politicians or the entrenched parties, so we need to get creative about how to realign those incentives.

> We need election and campaign finance reform asap

It’s never going to happen, see Citizens United v FEC and the upcoming 6-3 conservative majority on the Supreme Court. This is most unfortunate, and will only get worse.

"We" don't like regulation these days. Airlines, for example, were treated like public utilities with tariff schedules approved by some board.

Flights were more expensive, but the business was sustainable. Now you have airlines like Norwegian Airlines where you could fly from an out of the way airport in NY to London for less than long-term parking.

You jest, but my 2 week parking at Stewart was double the price of the round-trip flight to Edinburgh. We only lived 1 exit down on the interstate, I should have just had a taxi drop me off.

But they closed that down a couple of years ago (Thanks Boeing). Now the only route from NY to UK is JFK to LGW, but the flights were still so cheap (and hopefully they don't go under) that my wife and I always upgraded to their "premium economy" which was still only $1200 round trip NYC to London, and you get leg room, 2 checked bags, and guaranteed overhead space.

Over the past couple of decades, our elected representatives have prioritized the welfare of corporations over the welfare of human beings. Price transparency laws harm corporations and benefit consumers; therefore, they are unlikely to be approved for law by the elected representatives.

It’s an incomplete statement if you leave out the “why”. Lobbying. If that were regulated and corporation money didn’t indirectly buy votes through ad-spent but votes were won through actual policies and independent voter thinking, representatives would represent what voters (or a slice of them) wanted.

As it stands, they win elections by catering to a very, very small slice that can bring them into power: Corporations. Their donations are a more sure-fire bet to winning elections than trying to win over regular people.

At the same time price transparency & monopoly restrictions is fundamental for a working capitalism.

Without that there will be no proper self regulating marked and all the points why capitalism is supposed to work will not uphold anymore.

Yep, it’s a definite ying and yang. Sapiens (the book) spends a few very interesting chapters on the inner workings of this dynamic and how it shaped the world as we know it.

> Why doesn't the US have universal laws that cover price transparency in general?

And that's just the beginning. In any modern country citizens would have access to things called "courts". Not in the US, not if you want to sue a business. In the US, courts have been replaced with "arbitration" where businesses have a heavy advantage. See: https://www.nytimes.com/2015/11/02/business/dealbook/in-arbi... In what other modern country is citizens denied access to courts, when they have been wronged by a business?

Don’t forget healthcare “totally random cost between a lot and infinity. Find out months or years after treatment. ”.

"Starting at $x" ads like this are by far the least egregious any of those examples. I don't really see much of a problem with advertising configurable products like this, especially when it is called out specifically as a starting price. The F150 can be priced from $28,745 all the way to $81,000+ and anything in-between. People know trucks have options, and they know that when Ford says it's "starts at $28,745" they're not talking about the top of the line trim. Nobody is being hurt by these practices.

Fun fact; the F150 is so customizable that there are times and places where it's impossible for some car websites to parse their VINs back into a make, model, and style (trim). This is an issue that we didn't have with any other OEM, but it required that all systems assume that Style was optional.

> Nobody is being hurt by these practices.

Price obfuscation makes it nearly impossible to do a like-for-like price comparison between two manufacturers. If the consumer isn't being hurt by these practices, then why do car dealership groups need to continue lobbying the government to uphold laws preventing direct-to-consumer sales? They know that open-pricing would drive competition and erode their middleman profits.

> nearly impossible to do a like-for-like price comparison between two manufacturers

Not really.

https://shop.ford.com/build/f150

https://www.chevrolet.com/trucks/silverado/1500/build-and-pr...

The price isn't obfuscated. Manufacturers even publish nice tools that transparently explain their pricing model. The pricing is necessarily varied because the product configuration is varied.

Dealers are a whole different story; I agree dealer protection laws shouldn't exist, and manufacturers aren't really a fan of those laws either.

The key test to me is - can the thing actually be purchased at the listed price or not. In the case of hotels, for example, the resort fee often isn't optional.

Because the free market only works well with easy price discovery, and having to operate in a free market limits your margins.

Because some people would make less money.

Studies have shown that people spend less money when prices are higher/all inclusive. Check out the story of Stubhub and their attempt to be all inclusive. (tldr: people stopped buying tickets until they unbundled the mandatory fees)

What's good for GDP is good for America!

You don’t need a law for something a consumer can vote with their money. If annoying price structures are that bad, a competitor will create a superior pricing system that takes away marketshare. If that doesn’t happen, then it’s probably not a big deal. Adding laws increases the complexity to comply.

The whole point is that the competitor can't compete because the consumer is being lied to about the price in the first place—which they don't know until it's too late.

People think they have a lot more say with their insignificant purchases then they really do. Insignificant purchases by individuals can't sway how businesses run.

This is about as bad an argument as saying that voting is pointless because one individual vote is not going to change anything. Individual purchases summed up amount to a lot.

If it was comparable we wouldn't need regulation to protect consumers.

Voting is answering a direct question. Yes or no with direct results. Your purchase isn't like that, they're not votes. Business behavior is decided by what is more profitable. That also assumes there is a choice to be made. There's nothing you can do if all options behave the same way.

Your vote doesn't matter if the two options you vote for are the same. Often not true for politics, frequently can be true when making purchases

The article says they put asterisks on the prices along with clarifications in the small text. That’s not being lied to, just annoying.

I literally thought I knew what the prices were until I read this article. I saw the "from $699" and "knew" it meant the cheapest model (the mini) was $699. Turns out I was wrong. I was wrong because they mislead me. Knowing the truth matters for me both in purchasing decisions and in recommendations to others, which I do a lot of.

The problem is a lazy media. The headline becomes “$699.”

I don’t think so. I wasn’t looking at media. I was looking at Apple content. Is the lowest priced iPhone $699? No it isn’t. What exactly does “from $699” mean when the cheapest one is actually $729?

It’s death by a thousand cuts. There is no way a consumer can win and be able to make effective choices in this environment.

> If annoying price structures are that bad, a competitor will create a superior pricing system that takes away marketshare. If that doesn’t happen, then it’s probably not a big deal.

Post hoc ergo propter hoc

Just because it happens, doesn't mean it is not a big deal.

> If that doesn’t happen, then it’s probably not a big deal.

This assumes that agents in the market are rational actors, which they are not. Even when deception becomes the norm enough fall for the lower advertised prices to make the tactic optimal, despite the tactic's negative impact on marks and savvier consumers' alike.