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A hospital waiting room. Photo: Patricia De Melo Moreira/AFP/Getty Images

Investigative projects from Kaiser Health News/NPR and Vox have exposed pernicious billing practices from hospitals and doctors that have left patients shocked, angered and exasperated.

The bottom line: Hospitals have taken PR hits with the airing of surprise bills, but nothing suggests their practices will change in the short term.

Driving the news: The $109,000 heart attack bill, reported by KHN's Chad Terhune, went viral this week, and the hospital eventually caved by offering to wipe away 99% of the amount billed.

  • This was an extreme example of a family getting blindsided, but "in smaller amounts, $10,000, $20,000, it happens all the time," KHN editor-in-chief Elisabeth Rosenthal told "CBS This Morning."
  • More than half of U.S. adults "have been surprised by a medical bill that they thought would have been covered by insurance," according to a new survey from research group NORC at the University of Chicago.
  • However, every American facing medical debt does not have their own personal investigative journalist.

The big picture: Drug prices have been in the crosshairs of lawmakers, and health insurers have always been a punching bag. But hospitals and doctors aren't attracting any large-scale movement to rein in pricing and billing tactics.

  • "There's a huge amount of trust in the providers people choose to go to," said Caroline Pearson, senior fellow at NORC. "I think we've got a long way to go until we have backlash against those providers. But as insurance gets more complicated and out-of-pocket costs rise, we're going to see more and more surprise bills."

The other side: Ashley Thompson, SVP of policy at the American Hospital Association, said in a statement that "patients and their families should be protected from...unexpected medical bills," but "insurers have the primary responsibility for making sure their networks include adequate providers."

Looking ahead: Medicare for All and all-payer rate setting are the most direct ways to eliminate surprise bills, but the industry is not about to support those policies.

  • America's Essential Hospitals, the lobbying group for safety net hospitals that presumably would have the most to gain from rate setting, has "no formal policy position" on Medicare for All.

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Illustration: Annelise Capossela/Axios

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  3. Vaccine: Fauci: 100 million doses in 100 days is "absolutely" doable.
  4. Economy: Unemployment filings explode again.
  5. Tech: Kids' screen time sees a big increase.
  6. World: WHO team arrives in China to investigate pandemic origins.
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Russian opposition leader Alexey Navalny was detained upon his return to Moscow on Sunday, which came five months after he was poisoned with the nerve agent Novichok. He returned despite being warned that he would be arrested.

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President-elect Biden arrives to introduce his science team in Wilmington yesterday. Photo: Kevin Lamarque/Reuters

President-elect Biden has ordered up a shock-and-awe campaign for his first days in office to signal, as dramatically as possible, the radical shift coming to America and global affairs, his advisers tell us. 

The plan, Part 1 ... Biden, as detailed in a "First Ten Days" memo from incoming chief of staff Ron Klain, plans to unleash executive orders, federal powers and speeches to shift to a stark, national plan for "100 million shots" in three months.

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