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Tuesday, March 19, 2019

Sometimes the best journalism explains what’s right under our noses. In Steven Brill’s exhaustive Time magazine cover article “Bitter Pill: Why Medical Bills Are Killing Us,” it’s the staggeringly expensive, grotesquely inefficient and inhumane way Americans pay for medical care.

“In the U.S.,” Brill reminds us, “people spend almost 20 percent of the gross domestic product on health care, compared with about half that in most developed countries. Yet in every measurable way, the results our health care system produces are no better and often worse than the outcomes in those countries.”

Obamacare or no Obamacare, ever-increasing prices show few signs of abating. For all the fear and uncertainty the president’s health insurance reform will eliminate from people’s lives, it’s almost incidental to the overall question of costs.

Moreover, had the law attempted to seriously restrain profiteering hospital chains, pharmaceutical companies and medical equipment manufacturers that Brill depicts as largely responsible for the current morass, there’s no way it could have passed.

Yes, it’s a fiscal issue. If Medicaid and Medicare paid the same amounts for health care as, say, Switzerland or France—the economist Dean Baker has repeatedly pointed out—the Federal budget deficit would virtually disappear. (Although the two federal programs are infinitely more frugal and efficient than the rest of the system.)

But it’s an economic and moral issue as well. Brill was inspired to research the article after noticing the gleaming spires of the Texas Medical Center in Houston, of which M.D. Anderson is the brand name. It’s a great hospital, dispensing world-class care (at world-class prices). But how exactly, Brill wondered, had hospitals become five of Houston’s 10 largest employers? It’s a pattern repeated nationwide, as hospital chains have come to dominate local economies.

Essentially, he found, by gaming what the article describes as “the ultimate seller’s market”—an economic realm where buyers (i.e. hospital patients) are normally ignorant, often frightened and sometimes literally helpless. And who often think they’ve got adequate insurance, until they examine the fine print.

Granted, nobody bargains over a cancer diagnosis or heart attack. Even so, Brill wonderedwhy should a trip to the emergency room for chest pains that turn out to be indigestion bring a bill that can exceed the cost of a semester of college? What makes a single dose of even the most wonderful wonder drug cost thousands of dollars? Why does simple lab work done during a few days in a hospital cost more than a car?

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26 responses to “How Big Medicine Plays Us All For Suckers”

  1. Deregulation of ANY industry is to economic health what Anarchy is to democratic stability.

    Like Democracy, business requires a adapting, tempered balance of regulation and free expression.

    Internet Service Providers.

    Trading Stock.
    Automobile Sales.
    Electric Power.

    ALL these and many more have clamored for deregulation and it’s never worked.
    ALL these and many more have had interested parties wanting to put exclusive control or excessive constraints on them and it has never worked.

    Just face facts; before the facts shove themselves down all our throats.

    • Victoria Lamb says:

      Obamacare does not represent deregulation. In fact, all insurance companies wanting to participate in the insurance exchanges must abide by the same set of rules regarding treatment of beneficiaries: no one can be refused insurance because of a preexisting condition, no one’s insurance can be cancelled if they contract a serious illness, children can be carried on family policies until they are 26, everyone gets an annual physical with no co-pays, insurers must use 80-85% of premium dollars for patient care (instead of administrative costs, marketing, CEO bonuses) or return the unused portion to the patient. Participating companies are thus limited to competing on cost, which should ultimately reduce costs as they compete for patients.

      • Bill says:

        The worst thing that happened to Obamacare was letting the GOP take the public option out of the plan, if it was still there the insurance companies wouldn’t be able to run wild.

    • idamag says:

      If everyone were honest, we would not need regulation.

  2. drzaius says:

    Actually letting the greedy bastards in the health insurance world go off the deep end will do more to ensure a socialist, single payer system than any other factor I can think of.

    • Especially when the Obamacare mandate focuses on forcing the uninsured to get coverage from for-profit insurance companies. The latter is the anti-thesis of socialism. Not surprisingly, opponents don’t hesitate to use claims of socialism, and byh so doing embarrass themselves, to demonize something some of their right wing think tanks proposed before Obamacare was even suggested.
      At first, I thought their opposition was influenced by ideology, I am now convinced it is driven by overt hatred of Barack Obama, and now that he has been re-elected, by the need to discredit his accomplishments. Make no mistake, if a majority of Americans approve of Obamacare after it is fully implemented in 2014, the detractors of that program will claim ownership without hesitation or shame.

  3. Unfortunatelly, that is ACA’s greatest flaw. It does very little to control rising costs by service providers, the pharmaceutical industry and the insurance industry. In theory, Obamacare should produce lower insurance premiums as a result of a larger pool of people. Sadly, there is nothing to prevent insurance companies from continuing to increase premiums to exceed shareholder expectations. The same goes for service providers who are likely to use the tremendous increase in customers to profit from it. The same goes for the pharma industry. These guys are as corrupt as the NRA, the only difference is that one uses a scalpel and the other an AK47. The ones in the middle are the 47% who contrary to popular opinion, do work, pay taxes, and are left at the mercy of those who would sacrifice their own mothers to make a buck.

    • My Husband is not yet on Medicare. His insurance is with Blue Cross/ Blue Shield which, this month, without notice, raised his premium from $1500 a month to $2000 a month! Both prices are absurd but to raise a premium 25% is openly robbing the public!!

    • nobsartist says:

      Sadly, the more you talk about ACA, we see the less it actually does for health care. We should all be glad that those laws protecting gun ownership were put in there.

      Had they started their little party with the objective to actually create a health care bill that would benifiet America, they would have left out the pork.

      Instead we get rayguns failed health care policy on steroids.

  4. David Turrentine says:

    I’m sick of insurance executives telling me what a “necessary” or “unecessary” procedure is. I’m even sicker of Doctors having to raise their fees to cover the pay that these dictators of health care receive. Health insurance needs to be taken over entirely by the government. We forget that every Medicare fraud hits the news, while only a very small percentage of the private insurance frauds are ever exposed in media.

  5. Urbane_Gorilla says:

    We need to remove the ‘middle men’ from the equation. Insurers do nothing for our Health Care except suck blood from it.

    • idamag says:

      Health care should never have been on the stock market. The only cure for the “want-it-all” boys getting their hands on healthcare dollars is a public option or socialized medicine. Healthcare should not be a status symbol for the rich, but a right for all.

  6. elw says:

    Our medical system is expensive and an embarrassment. The US healthcare system is first in cost and at the bottom of the list for quality and outcomes. No other industrial Country, even those that use private health insurers, allows insurers to make the kind of profit that ours do. Furthermore, they have little to no say in what gets covered or how much it can cost. The push for profit in this Country has kill innovation, taken the “care” out of healthcare, and left close to 60 million hard working Americans without access to basic health care needs. The graft and corruption that the “for profit” motive causes in both the insurance and pharma industry is immoral, costly and is paid for by me and you.

  7. No lull in prices…Obamacare ADDED to costs, zero reduction ($2,500 per year promised). But you are right about insurance intermediary costs. If there were no insurance, prices would drop at least 50% over night. Instead we get the polar opposite, government mandated “insurance” (Obamacare) that requires you to fill in a 15-page form to see if you QUALIFY for Obamacare (in today’s news, 3-13-13).

  8. Michael Kollmorgen says:

    It’s way past due that we highly regulate the healthcare industry as a whole.

    We have trusted them too long to self-regulate themselves. They are all greedy, self-serving, profiteering vultures.

    This also should apply to all insurance companies as well.

    Along with this however, we have to do something as well about all these lawyers advertising every single hangnail as an excuse to sue doctors, hospitals and/or caregivers.

    Courts need to be reigned in in regards to allowing many of these lawsuits to go forward.

  9. charleo1 says:

    If one has ever, in the course of their life, suffered a serious illness, or otherwise
    been disabled for any period of time. You change, because of that experience.
    You come to understand, in a basic,and profound way, how all of your goals,
    whatever those goals may be, are probably not going to happen, without good
    health. And, it seems to me, anyway, how cruel, and destructive it is for us
    as a society, so blessed are we, in a land of unparalleled ability. That we could
    possibly sanction the continuance of the pain, we could ease. Or, the illness we
    could cure. There is no moral ground on which we can stand, and consent to that.

  10. MrsMas says:

    What kills me is this: Here I am, 23 years old, married, with insurance through my husbands employer. Not only do we pay a per-paycheck premium of nearly $200/month for the two of us, but we also have a $1750 deductible- the supposed “low deductible” plan. I am pregnant. Here is the math on that: $200/mox9mos= $1800 through the pregnancy. Have to pay the $1750 before that insurance kicks in… we’re already up to $3550 BEFORE any copays. Doctors charge for delivery: $397 (that’s my 20% after deductible); anesthesiologist: $300 (again, my 20%); room/board at hospital for 2 days: $800 (my 20%). This does not include the $160/per ultrasound (4 done as of now), the $800 genetic testing that my insurance denied after-the-fact, even though I called and was told it was covered at 80%, and my 20% copays for every doctors visit.
    So we’re up to $6487 and I haven’t even all my appointments yet (i’m half-way through). I make $13/hour, hubby makes $12.50. This pregnancy is putting a huge strain on us. However, if I was to quit my job tomorrow, I could get on medicaid and not pay a darn thing. I feel like I am punished for working, for paying my taxes and being a good citizen who wants to reproduce. What’s wrong with this picture?

    • Michael Kollmorgen says:

      I’m 63 years old. I just qualified for Medicare ONLY because I am termed Disabled by SS.

      Yes, I have the best medical coverage I ever had, even when I was working.

      But, here is the kicker. Yes, Medicare covers 80% of my medical cost. I am covered by AARPs United Healthcare Package which deducts $100 a month for its payment, which is automatically deducted from my SS. I pay $10 a visit to a doctor, and co-pays for medicine. Very Low.

      My medical bills including the United Plan, co-pays are roughly around $150 a month, AT THIS TIME. I can assure you it can go way up as a result of having some very serious illnesses. Some of these illnesses can break you and cause you to loose your home. In some cases, they won’t cover certain illnesses. Every Medical Plan has small print that spell out in great detail what IS NOT covered. And, they all vary from plan to plan.

      Because of the seriousness of the illness, the cost skyrockets, not because they can’t treat it, but because without medication and treatment, you die.

      In another words, they are profiteering on you trying to avoid death. In other areas, they are profiteering on you trying to stay healthy.

      What pisses me off more than anything is that, yes, I am covered at the moment. But, the COST is passed on to everyone else. There is no COST CONTROLS instituted in any way.

      Why was it I could get a bed pad at the drug store for my mother, now passed away, for 10 times more than what the same exact model and size I could get at a Pet Store to soak up a dogs doo?

      Or, why is it, if I had to pay OUT OF POCKET, for 1 Asthma Inhaler at Wallgreen for roughly $80, but with the same script, I can fax it to a Canadian Drug Store, get the very same Inhaler for only $20, including shipping? AND, I can buy them in bulk.

      • MrsMas says:

        I work with the disabled, I help uninsured folks get state/county services when they come into the hospital uninsured. I work with SS and know hundreds of people in the same position as you, Michael. It’s so unfortunate that we are putting the people we need to take care of most into this position.

  11. Bill says:

    The GOP wants to get rid of all programs that don’t benefit the rich, how people can support them is beyond me.

  12. “Thank You, Blue Shield of CA”… I’ve just learned that, in addition to seeing my health insurance premium jump by 24.3% for the `crime’ of turning 55, my wife – who is listed as a dependent on my policy, was ALSO surcharged ~8% more, based upon MY age (she would NOThave been surcharged if she had a separate policy).

    In what warped alternate universe is this considered `fair’?

    Q: What is the difference between an intestinal parasite, and a health insurance company?

    A: One is a brainless and blind blood-sucker which extracts blood – heedless as it cripples- or kills its `host’…and the other is just a worm that can be eliminated with a short prescription.

    Health insurance long-ago became the single largest monthly cost for our small business; I just hope we can survive until HCR truly kicks in…

    • Michael Kollmorgen says:

      Blue Shield is probably the highest costing Medical Insurances you can get.

      There ARE much cheaper Insurances around.

  13. holyreality says:

    Freemarkets cannot be worshiped in the Healthcare Sector.

    Freemarkets led us to Gene’s summary. When profit is the motive in an area of human necessity we must regulate it like a public utility.

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