Recently I got a notice from Covenant Health saying I owe over $600. My only recent use of their services was a cursory examination and a blood test. They’ve sent me notices that I owe large amounts of money several times before; the bills always go away after a few days. But it’s nerve-wracking and suggests their billing department is inept.

Health care operates under a business model that would be grossly illegal for anyone else. It’s the result of legislation over many years that has relieved health providers of normal responsibilities while making insurance companies, rather than patients, their customers.

Normally you expect to know what you’re going to be charged for something. Even veterinarians gladly provide estimates. It’s impossible to find out from health care providers what a visit or procedure will cost you. At best, you’ll get a range of a couple of orders of magnitude. Tales of people getting unexpected five-figure bills keep turning up in the news. What insurance will and won’t cover is equally opaque. Try making sense of an “Explanation” of Benefits.

We as individuals don’t get a tax break on health insurance, but employers do. This has pushed Americans into dependency on their jobs to get insurance. Obamacare somewhat mitigated this, but it imposed a tax on not buying insurance. You’d think this triumph of corporate lobbying would outrage the progressives, but they’re the ones who wanted it. Laws require lots of things to be packaged into insurance, making it more expensive. Because insurance companies dominate the business, health providers charge excessive rates, knowing the insurers will bargain them down. If you don’t want insurance, you have to pay the higher price as well as being taxed for the privilege.

We might call this situation corporate socialism. Everything is ultimately run by the government, but corporations handle the details, making money while being relieved of accountability.

Here’s an article on what’s wrong and how to fix it from someone who understands the labyrinth of health care laws better than I do.

Will “Medicare for All” fix this? Don’t make me laugh. I’m on Medicare. The concept is incoherent anyway. Medicare works by having people pay money during their working years to support the costs of people who used to do the same. “Medicare for All” implies everyone’s on the receiving side.

Don’t expect this to be fixed soon. The Democrats are angling for even more control of the system, which will make health care more expensive and less answerable. The Republicans will pretend that what we have is “free enterprise.”

And the jerks at Covenant Health will cause a few extra heart attacks with their random billing. Just by the way, they have data security problems as well. I received a notice that I may be eligible for a little money from them in a class action settlement. Covenant Health was hit with a ransomware attack in 2025. If I’m reading the article correctly, they paid off the extortionist and found confidential data was compromised anyway.

Update: Checking some other correspondence, I see that I’ve been billed for a procedure I never had, at a hospital I’ve never been to, referred by a doctor I’ve never heard of. Covenant’s page on surprise billing suggests I contact a Tennessee government agency. I’m in New Hampshire and haven’t been in Tennessee in decades!