A new report from the Arizona PIRG Education Fund finds that Arizonans are getting hit with what are known as facility fees, leading to higher costs for medical care.

Maribeth Guarino, health-care advocate with PIRG, said facility fees can be thought of as a flat charge, added to a patient's bill only for stepping through the door of a doctor's office to seek care. She said facility fees are arbitrary and cost anywhere between a few dollars and thousands of dollars.

"We're seeing them more because hospitals are buying up independent clinics, physician's offices and other independent provider care settings and then charging these fees as though they're hospital locations, even though nothing has changed except the logo and the letterhead," she explained.

According to Guarino, 15 states around the country, including Florida and Texas, have laws on the books relating to facility fees, but Arizona isn't one of them. She noted states could better prioritize patient protections by ensuring they're informed about the fee before receiving care. And while several federal proposals have been introduced to address the issue, none has made it to the president's desk.

Guarino said the Federal Trade Commission has issued a rule to prohibit what she terms "junk" fees, and hopes the Federal Trade Commission will apply that rule to items such as facility fees. And for patients, she recommends reviewing your bill after you have received care.

"And do your best to shop around, if you can, before you get services," she advised, "because even though there aren't always laws in place to protect patients, sometimes you'll be surprised how much information is out there if you just ask directly."

Guarino added there is no guarantee you'll get that answer, but it doesn't hurt to ask. She said patients should only pay for the services they receive, and providers need to be transparent about the fees they charge.

The fall harvest is around the corner and Minnesota farmers hope their equipment holds up.

Advocates said a new state law, intended to level the playing field in the electronics repair market, has a glaring omission: agriculture.

Minnesota has joined a handful of states in implementing policies known as "Right to Repair" laws, which require manufacturers of certain products to make documentation, parts and tools available to independent repair shops and product owners. The moves follow complaints tech firms hold a monopoly in making repairs.

Gary Wertish, president of the Minnesota Farmers Union, said they support the new changes, but wish they included farm machinery.

"It's really restricting the farmer's rights," Wertish contended. "It still gets back to when you buy a piece of equipment for that kind of money, you should have the right to be able to fix it yourself, or if not, take it to an independent dealership."

Tractors and other equipment are being fitted with new technology. Wertish pointed out if a farmer has to drive several hours to a dealership for an electronic fix, it cuts into their time in the field, potentially harming their bottom line. Companies like John Deere argued they share details through industry agreements called a "memorandum of understanding," but skeptics countered they do not provide enough access.

Wertish noted it would be great for farmers to do repairs themselves when they can. He added having more independent mechanics can bolster rural economies and thinks creating competition would not be a major disruption to large dealerships.

"If they're providing good service, which they are, they're still going to get a large percentage of the customers," Wertish argued. "They're still going to rely on them."

As big repair sites deal with staffing shortages, Wertish emphasized having more options could take some of the pressure off during busy farming seasons. He hopes Minnesota lawmakers take another look at the issue next session for potential changes. Congress also faces pressure to enact a similar law at the federal level.


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More than 70% of Coloradans believe drug companies, hospitals and insurance companies charge too much, according to a new Consumer Healthcare Experience State Survey.

Among respondents, 90% support policy solutions that include making the price of care transparent and ending the practice of surprise billing.

Priya Telang, communications manager for the Colorado Consumer Health Initiative, said nearly three in four Coloradans are experiencing financial hardships due to the high cost of health care.

"Being uninsured due to high insurance costs, or delaying their care because they can't afford it, or they are afraid of how much it's going to cost," Telang outlined. "People are not able to afford their basic health care costs."

More than two in three Coloradans said they have delayed or gone without health care altogether due to cost. Nearly 40% who did get care have struggled to pay those bills, were forced to deplete their savings, maxed out credit cards, faced collection agencies or went without necessities such as food, heat and even housing.

Most respondents blame big industry stakeholders for unfair prices. With November elections on the horizon, Telang pointed out the survey should underscore voters are looking for candidates who can make affordable health care available to all Americans, even in the face of some of the nation's most powerful special interests.

"This is a bipartisan issue," Telang argued. "Republicans and Democrats alike are fed up with having to continue to deal with high prices when it comes to their medical care or prescription drug prices."

Nine in 10 Coloradans support key interventions to lower costs. They say hospitals, doctors and insurers should provide upfront cost estimates and out-of-pocket costs for lifesaving medicines such as insulin should be capped. They said prices for medicines should be standardized and affordable and want the attorney general to take legal action to stop price gouging.


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Criticism of a plan to restructure U.S. mail service is mounting.

Postmaster General Louis DeJoy's 10-year plan, called Delivering for America, was announced in 2021 but has kicked into high gear this year. Intended to make the U.S. Postal Service more efficient and cut spending, the plan has involved moving mail through larger processing centers rather than smaller, local ones.

Sen. Jeff Merkley, D-Ore., said it has led to a slowdown in mail delivery.

"He has had a plan for getting rid of our regional sorting centers or downgrading them," Merkley explained. "Which means that the mail from Bend and Medford and Eugene -- basically all over the state -- has to go just to Portland and be sorted there and then returned."

DeJoy has paused his consolidation of centers through the end of the year, but said he will continue pursuing his Delivering for America plan. He was appointed to the position of postmaster general in 2020 during the Trump presidency by the Board of Governors of the Postal Service.

Merkley pointed out he has heard from constituents as delays in mail delivery increase. For instance, people are getting late fees for sending checks for bills or rent through the mail. He also noted medications are not making it to people in a timely manner.

"In some cases, they can't apply until they've run out of their medicine or nearly out, which means they have to apply at the last minute and by the time the slow mail operates, they have a space," Merkley observed. "They either miss their meds or they have to buy them locally at a much higher price."

Merkley added the Delivering for America plan is not realistic and should be reversed.

"Every other government service we provide we subsidize," Merkley stressed. "We don't expect it all to pay for itself 100%. Mail is so important to people, so important to our communities, so important to our small business, so important to our communication, so important to our sense of community that we should be sustaining it as a high-quality service."


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