Skip to comments.Bitter Pill: Why Medical Bills Are Killing Us
Posted on 02/22/2013 9:44:29 PM PST by Seizethecarp
When Sean Recchi, a 42-year-old from Lancaster, Ohio, was told last March that he had non-Hodgkins lymphoma, his wife Stephanie knew she had to get him to MD Anderson Cancer Center in Houston. Stephanies father had been treated there 10 years earlier, and she and her family credited the doctors and nurses at MD Anderson with extending his life by at least eight years.
Stephanie was then told by a billing clerk that the estimated cost of Seans visit just to be examined for six days so a treatment plan could be devised would be $48,900, due in advance.
About a week later, Stephanie had to ask her mother for $35,000 more so Sean could begin the treatment the doctors had decided was urgent.
The total cost, in advance, for Sean to get his treatment plan and initial doses of chemotherapy was $83,900.
One night last summer at her home near Stamford, Conn., a 64-year-old former sales clerk whom Ill call Janice S. felt chest pains. She was taken four miles by ambulance to the emergency room at Stamford Hospital, officially a nonprofit institution. After about three hours of tests and some brief encounters with a doctor, she was told she had indigestion and sent home. That was the good news.
The bad news was the bill: $995 for the ambulance ride, $3,000 for the doctors and $17,000 for the hospital in sum, $21,000 for a false alarm.
(Excerpt) Read more at healthland.time.com ...
It is a long read and it hammers Obamacare extensively for doing little to address hospital and MD billing abuses, for failing to include tort reform, and for driving up health insurance premiums in the private individual market.
Meanwhile, ObamaCare is meant to drive the price up.
The article goes to great lengths to highlight high salaries for senior HMO adminstrators and lobbying expenditures to Washington DC, but doesn’t even mention astronomical costs associated with lawsuits, the incredible amount of paperwork involved with such a heavily regulated industry, plain ol insurance fraud, or why those lobbyists are needed in the first place. Medicine took a wrong turn in the mid sixties with the wholesale insinuation of government into the healthcare industry, and the joined-at-the-hip relationship with the legal and insurance industries, and now the government and its lawyers say to remedy those wrongs, the answer is yet more government involvement. Beam me up Scotty.
If I do remember correctly, healthcare providers charge a premium over and above the actual service in order to provide for those that they serve who do not or cannot pay. I had 20 stitches in my finger back in 1979 and remember that they charged $30 for painkiller (aspirin) $140 for the gauze to wrap my finger. When I called and questioned they said they charged the price of a case because they had to cover their service to those who could not pay. I was a student then and had no insurance, but somehow I was considered the “privileged” that had to pay for those who could not.
Just wait until the government makes it free. Then it gets really expensive.
You got it baby! I dread government on any level being involved with medical care, it’s hard enough just dealing with the medical-idiots as it is!!!!
but what I find disingenous is that this couple "had" to go to Houston....for crying out loud, they couldn't find treatment in Cleveland or Columbus, or Pittsburgh?......sounds like they wanted what they wanted and then complain about it....sounds like they knew they could get away with it because granny had a bunch of bucks....
Exactly... I wish I could have done this when I was drop down dead broke poor in 1979! Even then, you did not need to habla... you could just be a broke down in the weeds hippie and get your care for free. I looked like a living breathing person who could pay so they billed me and threatened lawsuits if I did not pay.... oh yeah I paid the stupid bill... $30 aspirin and $140 for gauze to wrap my finger. Sheesh... I couldn’t believe this crap back then and now it’s 100 times worse!
I worked as a PI for Workers’ Comp claims. Why we pay high premiums is the dregs who fraud the system...and the insurance pays out because it’s cheaper (on our dime) to litigate. So I watched lawyers write checks to those dregs who came IN using crutches, left skipping out with a settlement just shy of full payout. Everyone happy?
Furthermore, there was no hammering "for failure to include tort reform."
Do the American people really pay such bill? My understanding is that they put “Return to Sender” on the bills coming in.
For example, liberal rhetoric is that the uninsured drive up the cost of ER care. But the truth is that Medicaid recipients make more inappropriate use of ER than uninsured do. And it raises costs for everyone because Medicaid reimburses less than the actual cost of providing services.
Because the ER cannot turn away most people who go there inappropriately (i.e., those who could be treated outpatient) these costs get passed on to everyone else. With millions slated to be dumped into Medicaid next year, I expect ER costs to mushroom.
What a load of gibberish. Healthcare bills are high because 80% of the bill is paid out in court cases. Tort reform in Texas had their healthcare costs drop dramatically.
Then there are the subsidies. You get to pay for illegal aliens (who show up in the emergency room and never seem to pay anything), single moms and their kids, homosexuals and their extravagant healthcare needs.
Only about 14% of the bill is yours.
The article pointed out that a large “non-profit” hospital can have a 25% profit margin. Most large businesses have a 2% to 7% profit margin. I read several years that the profit margin in the medical/pharmaceutical world was around 20%
I do acknowledge that most businesses do not have the research and development costs that are incurred in the medical/pharmaceutical industry... But I also have read that citizens of USA have had to bear the bulk of these front end R & D costs when these pharmaceuticals come to market. The rest of the world does not pay anywhere close to the costs for pain killers and other drugs that we have to pay in USA.
Try checking out “Forbes CEO Compensation” at Google, for what CEOs of some of the big pharmaceutical, medical services, etc. companies are getting paid.
Re: “This couple “had” to go to Houston”
Time Magazine forgot to tell us something....
The MD Anderson Center in Houston has been ranked the #1 cancer treatment clinic in the USA for at least ten years.
That probably means it’s #1 in the world.
The Saudi royal family goes there.
You can imagine what that does to treatment costs for the uninsured.
If Hugo Chavez had gone there, he might have had some chance at beating his pelvic sarcoma - although that’s a horrible cancer, and most people do die.
Re: “Return To Sender”
Many people do.
But medical providers then send your unpaid bills to Collection Agencies.
Enjoy the phone calls.
And there goes your credit rating!
Off the top of my head - more than 50% of USA bankruptcies are because of unpaid medical bills.
Tell that to Jeff Head.
Supply & Demand.
If we had the bottlenecks to the supply of toys like smartphones and flat screen TVs that we have to the delivery of medical services then very few people would have these and other toys.
The America Medical Association, coupled with the muscle of various governments and the threats of the Tort industry have greatly restricted the supply of medical services.
Why are routine first aid procedures done in the emergency room at a cost of hundreds or even thousands of dollars? Convert one of the nail salons located in the from of your local Super Walmart into a First Aid Station. Staff it with nurses, EMTs and former military medics/corpsmen. Run it as a business generating the same profit margin that the Sporting Goods, Tire departments or the McDonald’s does.
Install a medical triage database system plugged into “Tech Support” to help the senior medical tech decide which cases need to be seen by an MD. We have an excellent medical diagnosis course designed for workers in very remote areas, places where they may be the only one around with reading, communication and transportation resources. One of the other people on campus came to the MD teaching the course with a medical complaint. The doctor turned the patient over to two students, telling them, “This is what we a re here for. Diagnose this man’s problem.”
A while later the two students & the patient returned, shaking their heads. “We’ve never heard of it, but we believe that he has TB of the pelvis.”
Long story - short, the doctor asked a few questions, then took everyone to the local hospital’s radiology department. The patient had TB of the pelvis! The two students who did the diagnosis? Their day job was has sheet rock installers.
Run medical service as a business. Remove the artificial limits on the supply of doctors created my medical schools.
Doctors are treated like ‘gods’, omniscient, above mere mortals. Yet my doctor spends more time typing into a database than he does examining me or talking with me. Anyone ever hear of “Speech to Text”?
/rant.... for now. :-)
How do you say in Spanish, “I am an illegal alien. I demand free health care”?
These astronomical costs are the very reason I avoid the doctor at all costs. If I have to see one, I usually head to a doc-in-a-box, aka an urgent care center. At least what they bill you will not bankrupt you. Granted, they are limited in what they can do(no setting broke bones, no stitching gaping wounds), but for the basic cold/flu/allergies/sore throat/stuffy nose stuff that won’t respond to OTC meds, they get the job done. You’re in and out. No hours long ER wait with a waiting room full of even sicker people and no final billing that is more costly than the down payment on my last new car.
Why we pay high premiums is the dregs who fraud the system.
Exactly, but don’t leave out the Doctors that add fraudulent charges.
Why are routine first aid procedures done in the emergency room at a cost of hundreds or even thousands of dollars?
Because the health industry can “justify” exorbitant fees if they force you to go to the ER.
And you also read that pigs can fly - you better keep an umbrella with you all the time!
Our greater concern should, and soon enough will be, our QOC, rather than than the cost. To say nothing of our benevolent-- just take a pain pill but not too many while you wither away post 67.5-- govt rationing...far worse than traditional third party rationing to which we have grown accustomed.
Not that the cost of said Obamanative (that's mine) healthcare won't be astronomical, unsustainable. Which will in turn drive even more dire clincial outcomes!
Another commentary on this article, from Karl Denninger:
Soy demasiado perezoso para aprender a español, por lo que la gente me puede decir algo que decir
The people who operate the physical plant aren't the cost drivers. Not by a long shot.
“I read the whole article and never detected even one hammer blow upon the Obamacare carcus!
“Furthermore, there was no hammering ‘for failure to include tort reform.’”
You missed the following on page 3 of the article:
“When Obamacare was being debated, Republicans pushed this kind of commonsense malpractice-tort reform. But the stranglehold that plaintiffs lawyers have traditionally had on Democrats prevailed, and neither a safe-harbor provision nor any other malpractice reform was included.”
You missed the following on page 4 of the article:
“Steve H. was about to run up against a seemingly irrelevant footnote in millions of Americans insurance policies: the limit, sometimes annual or sometimes over a lifetime, on what the insurer has to pay out for a patients claims. Under Obamacare, those limits will not be allowed in most health-insurance policies after 2013. That might help people like Steve H. but is also one of the reasons premiums are going to skyrocket under Obamacare.”
You missed the following on page 7 of the article:
“Millions of plans have annual payout limits, though the more typical plans purchased by employers usually set those limits at $500,000 or $750,000 which can also quickly be consumed by a catastrophic illness. For that reason, Obamacare prohibited lifetime limits on any policies sold after the law passed and phases out all annual dollar limits by 2014. That will protect people like Scott and Rebecca, but it will also make everyones premiums dramatically higher, because insurance companies risk much more when there is no cap on their exposure.”
“But Obamacare does little to attack the costs that overwhelmed Scott and Rebecca. There is nothing, for example, that addresses what may be the most surprising sinkhole the seemingly routine blood, urine and other laboratory tests for which Scott was charged $132,000, or more than $4,000 a day.”
You missed the following on page 8 of the article:
“Similarly, when Congress passed Part D of Medicare in 2003, giving seniors coverage for prescription drugs, Congress prohibited Medicare from negotiating.
“Nor can Medicare get involved in deciding that a drug may be a waste of money. In medical circles, this is known as the comparative-effectiveness debate, which nearly derailed the entire Obamacare effort in 2009.
“Doctors and other health care reformers behind the comparative-effectiveness movement make a simple argument: Suppose that after exhaustive research, cancer drug A, which costs $300 a dose, is found to be just as effective as or more effective than drug B, which costs $3,000. Shouldnt the person or entity paying the bill, e.g. Medicare, be able to decide that it will pay for drug A but not drug B? Not according to a law passed by Congress in 2003 that requires Medicare to reimburse patients (again, at average sales price plus 6%) for any cancer drug approved for use by the Food and Drug Administration. Most states require insurance companies to do the same thing.
“With that escalating bill in mind, Bach was among the policy experts pushing for provisions in Obamacare to establish a Patient-Centered Outcomes Research Institute to expand comparative-effectiveness research efforts. Through painstaking research, doctors would try to determine the comparative effectiveness not only of drugs but also of procedures like CT scans.
“However, after all the provisions spelling out elaborate research and review processes were embedded in the draft law, Congress jumped in and added eight provisions that restrict how the research can be used. The prime restriction: Findings shall not be construed as mandates for practice guidelines, coverage recommendations, payment, or policy recommendations.
“With those 14 words, the work of Bach and his colleagues was undone. And costs remain unchecked.”
You missed to following on page 11 of the article:
“The hospitals continuing consolidation of both lab work and doctors practices is one reason that trying to cut the deficit by simply lowering the fees Medicare and Medicaid pay to hospitals will not work. It will only cause the hospitals to shift the costs to non-Medicare patients in order to maintain profits which they will be able to do because of their increasing leverage in their markets over insurers. Insurance premiums will therefore go up which in turn will drive the deficit back up, because the subsidies on insurance premiums that Obamacare will soon offer to those who cannot afford them will have to go up.”
“None of these suggestions will come as a revelation to the policy experts who put together Obamacare or to those before them who pushed health care reform for decades. They know what the core problem is lopsided pricing and outsize profits in a market that doesnt work. Yet there is little in Obamacare that addresses that core issue or jeopardizes the paydays of those thriving in that marketplace. In fact, by bringing so many new customers into that market by mandating that they get health insurance and then providing taxpayer support to pay their insurance premiums, Obamacare enriches them. That, of course, is why the bill was able to get through Congress.”
“Finally, we should embarrass Democrats into stopping their fight against medical-malpractice reform and instead provide safe-harbor defenses for doctors so they dont have to order a CT scan whenever, as one hospital administrator put it, someone in the emergency room says the word head.
“Trial lawyers who make their bread and butter from civil suits have been the Democrats biggest financial backer for decades. Republicans are right when they argue that tort reform is overdue. Eliminating the rationale or excuse for all the extra doctor exams, lab tests and use of CT scans and MRIs could cut tens of billions of dollars a year while drastically cutting what hospitals and doctors spend on malpractice insurance and pass along to patients.”
Under Medicare about $2,000 will be paid the $21,000 figure is for the uninsured.
Now I see that each page was so long with 7 scroll-downs for each page and then punching the arrow at the bottom of each abnormally long page to advance to the next... WHAT'S UP WITH ALL THAT???
I stand corrected, but now it looks like this verbose article was almost as long as Nancy Pillosey's stupid law!!!
Thank you for correcting my misunderstanding and for filling in all the info hidden just around the corner with a marker burried at the end of each page.
Furthermore, it now looks even more like a huge pitch for SINGLE GovernMental PAYER and sour grapes against those with the resources, time and patience to navigate the halls of CONgress by the snivelling people that believe that no one should ever profit from treating the sick under any circumstances... ie The British Isles, Canada and Austrailia, et al...
Bottom line is there are too many cooks in this stew and worst of them are crooks with law degrees, as opposed to liberal cooks!!! (aka kooks)
Obviously it works for you.
I can’t wait to see what the excuse is when medical care becomes unobtainable for all but the elites. Obamacare was supposed to the cure-all (even though it didn’t actually do anything), so government’ll eventually have to come up with an excuse for it not working.
The shortage of psychiatrists in SW FL is so severe that they are able to refuse to accept Medicare participation and still fill their appointments with wealthy patients.
So poorer seniors won’t be able to “keep your doctor” if he dumps Medicare, which happened in my family on Jan 1, 2013.
When profits are 26% of revenue, they are doing a lot more than charging for those who cannot pay.
Although it is officially a nonprofit unit of the University of Texas, MD Anderson has revenue that exceeds the cost of the world-class care it provides by so much that its operating profit for the fiscal year 2010, the most recent annual report it filed with the U.S. Department of Health and Human Services, was $531 million. Thats a profit margin of 26% on revenue of $2.05 billion, an astounding result for such a service-intensive enterprise.
In fifty years, it will make little difference if old Martha dies in 2013 or 2018. Either way, Martha will be gone and probably forgotten. However, if in fifty years, taxpayers are still paying for Martha's extra five years, that will make a difference. Right now, our country is becoming flooded with old Marthas.
If old people want to spend a lot of money to unnecessarily extend their miserable lives, it should be their own money. The taxpayer is tapped out.
Expensive, wasteful spending to unnecessarily extend lives should be left up to the individual on a "pay as you go" basis. Pay as you go - and, when you stop paying, it's time for you to go.
If you think health care is expensive now, wait until you see what it costs when it's free. -- P. J. O'Rourke