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t should tell you everything you need to know that insurers and hospitals have joined together to oppose new rules proposed by the Trump administration last month that would require them to disclose the prices they now negotiate in secret. Their fear is that disclosure will confirm what many have long suspected: that the biggest insurers and hospitals already have the power to raise hospital prices and insurance premiums, increasing their profits and making it easier to drive smaller hospitals and insurers from the marketplace.

In today’s market for medical care, the cost for an MRI or a hip replacement at the most expensive hospital in one region can be three times the cost at the least expensive hospital somewhere else. Even within regional markets, the prices paid to the most expensive provider can be twice as much as the least expensive. And within the same hospital, the price for an uninsured patient can be five or seven times what is charged for a patient covered by the largest private insurer.

There are various reasons for this “price dispersion,” as economists call it, but surely one is that prices are treated as trade secrets. The only time most patients find out the price is after the treatment has been delivered — and even then it often requires an accounting degree to figure it out

The costs, which overwhelmed the Kingsburys and ruined their finances, didn’t have to be so large. A Wall Street Journal analysis of Ms. Kingsbury’s medical bills, insurance statements and newly public data on hospital prices shows how the nation’s seemingly arbitrary hospital pricing left the couple with charges that in some cases would have been far lower for other patients, through no fault of their own.

Ms. Kingsbury had insurance, but that’s no guarantee of a competitive price. Hospitals and insurers negotiate prices to hit financial targets, and their bargaining benefits some patients and disadvantages others, according to the Journal’s analysis and interviews with medical billing professionals and researchers.

A weak negotiator can get stuck with a lousy deal. Trade-offs can give one insurance plan the best deals for some hospital services, but not others. Hospitals often charge patients the highest rates of all when insurance doesn’t cover their medical care

The ICU at Tampa General Hospital in Tampa, Fla., was 99% full this week, according to an internal report produced by the federal government. It's among numerous hospitals the report highlighted with ICUs filled to over 90% capacity.

As coronavirus cases rise swiftly around the country, surpassing both the spring and summer surges, health officials brace for a coming wave of hospitalizations and deaths. Knowing which hospitals in which communities are reaching capacity could be key to an effective response to the growing crisis. That information is gathered by the federal government — but not shared openly with the public.

NPR has obtained documents that give a snapshot of data the U.S. Department of Health and Human Services collects and analyzes daily.

f a health official wanted to know how many intensive-care beds there are in the United States, Jeremy Kahn would be the person to ask. The ICU physician and researcher at the University of Pittsburgh earns a living studying critical-care resources in U.S. hospitals.

Yet even Kahn can’t give a definitive answer. His best estimate is based on Medicare data gathered three years ago

“People are sort of in disbelief that even I don’t know how many ICU beds exist in each hospital in the United States,” he said, noting that reporting varies hospital to hospital, state to state. “And I’m sort of like, ‘Yep, the research community has been dealing with this problem for years.’ ”

Medicare, the government health insurance program for those 65 and over or the disabled, pays one price to independent doctors and another to doctors who work for large health systems — even if they are performing the exact same service in the exact same place.

This week, the Obama administration recommended a change to eliminate much of that gap. Despite expected protests from hospitals and doctors, the idea has a chance of being adopted because it would yield huge savings for Medicare and patients.

The heart doctors are a great example. In 2009, the federal government cut back on what it paid to cardiologists in private practice who offered certain tests to their patients. Medicare determined that the tests, which made up about 30 percent of a typical cardiologist’s revenue, cost more than was justified, and there was evidence that some doctors were overusing them. Suddenly, Medicare paid about a third less than it had before.But the government didn’t cut what it paid cardiologists who worked for a hospital and provided the same test. It actually paid those doctors more, because the payment systems were completely separate. In general, Medicare assumes that hospital care is by definition more expensive to provide than office-based care.

At least 10 people, and possibly as many as 24, died after a hospital ran out of an increasingly precious resource here: medical oxygen. It was the latest in a growing series of such accidents.

When the pipes carrying oxygen to critically ill Covid-19 patients stopped working at a hospital in the southern Indian state of Karnataka on Sunday evening, relatives of sick patients used towels to fan their loved ones in an attempt to save them.

Local officials provided different accounts of the death toll at the hospital. Some said that at least 10 died from oxygen deprivation. Others said that 14 more died after the accident but that they died of comorbidities related to Covid, not directly from the oxygen shortage.

An estimated 100 million Americans have medical debts. Their bills make up about half of all outstanding debt in the country.

About 20 percent of hospitals nationwide have debt-collection policies that allow them to cancel care, according to an investigation last year by KFF Health News. Many of those are nonprofits. The government does not track how often hospitals withhold care

Under federal law, hospitals are required to treat everyone who comes to the emergency room, regardless of their ability to pay. But the law — called the Emergency Medical Treatment and Labor Act — is silent on how health systems should treat patients who need other kinds of lifesaving care, like those with aggressive cancers or diabetes.

That's not the case in the US, however, where the number of patients with the coronavirus currently in hospital has reached record numbers.

According to data from the Department of Health and Human Services, 145,982 people were in hospital with the virus on 11 January, surpassing a previous record set in January 2021

Let's begin with this chart comparing how many people in several countries have been in hospital with Covid-19 during the pandemic. It's adjusted to account for population size and represents a ratio of the number of infected hospital patients per million inhabitants.

Dying Infants and No Medicine: Inside Venezuela’s Failing Hospitals

“The death of a baby is our daily bread,” said Dr. Osleidy Camejo, a surgeon in the nation’s capital, Caracas, referring to the toll from Venezuela’s collapsing hospitals.

It is just part of a larger unraveling here that has become so severe it has prompted President Nicolás Maduro to impose a state of emergency and has raised fears of a government collapse.

New York is the center of the Covid-19 pandemic in the United States, and Elmhurst hospital in the New York City borough of Queens is the center of the center.In just one 24-hour period this week, at least 13 patients were reported to have died at the hospital, where the medical examiner’s office has stationed a refrigerated trailer to act as a makeshift morgue. Officials have described the hospital as “overwhelmed”, “overrun” and calling out for one thing: “Help.”

The US surpassed virus hotspots China and Italy with 82,404 cases of infection on Thursday night, according to a tracker run by Johns Hopkins University. Hours earlier, New York’s mayor, Bill de Blasio, had announced there were 23,112 Covid-19 cases in New York City alone, and 365 deaths.

The hospital is located in one of the poorest and most diverse areas of the city, home to 20,000 recent immigrants from 112 different countries. It was already operating at 80% capacity before the coronavirus pandemic, with plans to expand its emergency department.

In effect, the health service was caught between the desire of one constituency to take control of its own health care and the need of another to keep a well-established hospital operating. In the end, it slashed services at the hospital in November, closing its inpatient critical care unit, women’s services and emergency room.

The closing of the hospital facilities comes as coronavirus cases rise across the state and hospital beds dwindle, forcing the leader of one of the tribes served by the hospital, Gov. Brian D. Vallo of the Pueblo of Acoma, to declare a state of emergency.

t was not hospital policy for patients to be told to wait in the parking lot for emergency care. He said the agency had requested more information on the situation but had yet to receive it.

While Florida was an early leader in the share of over-65 residents who were vaccinated, it had fallen to the middle of the pack by the end of July 2021. When it came to younger residents, Florida lagged behind the national average in every age group.

That left the state particularly vulnerable when the Delta variant hit that month. Floridians died at a higher rate, adjusted for age, than residents of almost any other state during the Delta wave, according to the Times analysis. With less than 7 percent of the nation’s population, Florida accounted for 14 percent of deaths between the start of July and the end of October.

Of the 23,000 Floridians who died, 9,000 were younger than 65. Despite the governor’s insistence at the time that “our entire vulnerable population has basically been vaccinated,” a vast majority of the 23,000 were either unvaccinated or had not yet completed the two-dose regimen.

But as the current administration works to reverse the actions of its predecessor, it should recognize that former President Donald Trump introduced some policies on medical care and drug price transparency that are worth preserving.

o be clear, the Trump administration, generally, put the health care of many Americans in jeopardy: It spent four years trying to overturn the Affordable Care Act, despite that law’s undeniable successes, and when repeal proved impossible, kneecapped the program in countless ways. As a result of those policies, more than two million people lost health insurance during Mr. Trump’s first three years. And that’s before millions more people lost their jobs and accompanying insurance during the early days of the Covid-19 pandemic.

These master price lists span hundreds of pages and are hard to decipher. Nonetheless, they give consumers a basis to fight back against outrageous charges in a system where a knee replacement can cost $15,000 or $75,000 even at the same hospital.

Across the US, preparations are underway to quickly distribute Covid-19 vaccines once authorized, but experts say before that relief occurs, the coming months will be difficult.

What comes next is likely the country's "worst-case scenario in terms of overwhelmed hospitals, in terms of the death count,"

Dr. Robert Redfield, who warned Wednesday the next three months are going to be "the most difficult in the public health history of this nation."

Nationally, covid hospitalizations under insurance contracts on average cost $29,000, or $156,000 for a patient with oxygen levels so low that they require a ventilator and ICU treatment,

The calculus in place in 2020 changed with the advent of vaccines, which now makes most hospitalizations preventable,

Hospitals along the Connecticut River, the border between Vermont and New Hampshire, draw patients from both states. Vermont health plans are waiving deductibles and co-pays into 2022. In New Hampshire, where Anthem Blue Cross Blue Shield has a dominant presence, insurance companies have reinstated cost-sharing.

A lot has changed for Omicron in just two weeks. At December’s onset, the variant was barely present in Europe, showing up in 1 to 2 percent of COVID cases. Now it’s accounting for 72 percent of new cases in London, where everybody seems to know somebody with COVID.

The same exponential growth is happening—or will happen—in the United States too, just in time for the holidays.

Here is some simple math to explain the danger: Suppose we have two viruses, one that is twice as transmissible as the other. (For the record, Omicron is currently three to five times as transmissible as Delta in the U.K.

In response to some private hospitals’ decision to bar partners, New York will order all hospitals to allow partners in delivery rooms, despite the coronavirus risk.

Women preparing to give birth at some hospitals in New York City will no longer have to labor alone, state officials said Saturday.

The order, which the governor released Saturday night, is a response to a decision earlier this week by two major New York City hospital systems, NewYork-Presbyterian and Mount Sinai, to ban support people from labor and delivery rooms because of the coronavirus pandemic.

In mid March, we heard that doctors from a nearby hospital didn’t have enough valves for their lifesaving ventilator machines. And the company that produced the valves couldn’t meet the growing demand.

Our company is five years old. We make earthquake sensors, silicone bandages, bicycles — practical stuff. We had never made valves before, but we wanted to help.

We visited the hospital to see the valve, which connects the patient to the breathing machine, mixing pure oxygen with air that enters through a rectangular window. It looks like a chess piece waving one arm and it needs to be replaced for each patient.

In September, after six months of exhausting work battling the pandemic, nurses at Mission Hospital in Asheville, N.C., voted to unionize. The vote passed with 70%, a high margin of victory in a historically anti-union state,

The nurses had originally filed paperwork to hold this vote in March but were forced to delay it when the pandemic began heating up. And the issues that had driven them toward unionizing were only heightened by the crisis. It raised new, urgent problems too, including struggles to get enough PPE, and inconsistent testing and notification of exposures to COVID-positive patients.

For months now, front-line health workers across the country have faced a perpetual lack of personal protective equipment, or PPE, and inconsistent safety measures. Studies show they're more likely to be infected by the coronavirus than the general population, and hundreds have died,

What is missing from the stampede of policy innovation is something to tackle one of the best-known causes of high costs in the book: excessive market concentration.

The share of metropolitan areas with highly concentrated hospital markets, by the standards of antitrust enforcers at the Justice Department and the Federal Trade Commission, rose to 77 percent from 63 percent over the period.

If there is one thing that economists know, it is that market concentration drives prices up — and quality and innovation down.