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Bitter Pill: Why Medical Bills Are Killing Us
Time (Special Report) ^ | February 20, 2013 | Steven Brill

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-Hodgkin’s lymphoma, his wife Stephanie knew she had to get him to MD Anderson Cancer Center in Houston. Stephanie’s 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 Sean’s 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 I’ll 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 ...

TOPICS: Crime/Corruption; Culture/Society; Government; Politics/Elections
KEYWORDS: healthcare; medicaid; medical; medicalcare; medicalinsurance; medicare; medicine; obamacare
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To: cherry

Re: “This couple “had” to go to Houston”

Exactly right.

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.

21 posted on 02/23/2013 1:46:49 AM PST by zeestephen
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To: Theodore R.

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.

22 posted on 02/23/2013 1:57:16 AM PST by zeestephen
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To: cherry; Jeff Head
but what I find disingenous is that this couple "had" to go to Houston.

Tell that to Jeff Head.

23 posted on 02/23/2013 2:19:18 AM PST by DuncanWaring (The Lord uses the good ones; the bad ones use the Lord.)
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To: Seizethecarp

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. :-)

24 posted on 02/23/2013 4:24:33 AM PST by BwanaNdege ("To learn who rules over you simply find out who you are not allowed to criticize"- Voltaire)
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To: mnehring

How do you say in Spanish, “I am an illegal alien. I demand free health care”?

25 posted on 02/23/2013 4:40:32 AM PST by Mister Da (The mark of a wise man is not what he knows, but what he knows he doesn't know!)
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To: Seizethecarp

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.

26 posted on 02/23/2013 4:44:40 AM PST by bigredkitty1 (March 5,2010. Rest in peace, sweet boy. I will miss you, Big Red.)
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To: Seizethecarp
I paid $800.00 to get one ankle x-rayed at the Bon Succor Hospital in Richmond Va. This was at the out patient clinic NOT the emergency room.
27 posted on 02/23/2013 4:56:53 AM PST by central_va (I won't be reconstructed and I do not give a damn.)
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To: SpaceBar


28 posted on 02/23/2013 5:01:42 AM PST by Dysart
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To: endthematrix

Why we pay high premiums is the dregs who fraud the system.

Exactly, but don’t leave out the Doctors that add fraudulent charges.

29 posted on 02/23/2013 5:03:46 AM PST by freedomfiter2 (Brutal acts of commission and yawning acts of omission both strengthen the hand of the devil.)
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To: BwanaNdege

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.

30 posted on 02/23/2013 5:06:09 AM PST by freedomfiter2 (Brutal acts of commission and yawning acts of omission both strengthen the hand of the devil.)
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To: antceecee
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.

And you also read that pigs can fly - you better keep an umbrella with you all the time!

31 posted on 02/23/2013 5:15:51 AM PST by corkoman (Release the Palin!)
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To: mnehring
Just wait until the government makes it free. Then it gets really expensive.

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!

32 posted on 02/23/2013 5:16:06 AM PST by Dysart
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To: Seizethecarp

Another commentary on this article, from Karl Denninger:

33 posted on 02/23/2013 6:42:15 AM PST by DuncanWaring (The Lord uses the good ones; the bad ones use the Lord.)
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To: Mister Da

Soy demasiado perezoso para aprender a español, por lo que la gente me puede decir algo que decir

34 posted on 02/23/2013 6:51:11 AM PST by mnehring
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To: cherry
no question health care is astronomical.....but for every nurse you see, you have tons of secretaries, and business people and kitchen cooks and electricians and housekeepers etc just to keep the hospital running....

The people who operate the physical plant aren't the cost drivers. Not by a long shot.

35 posted on 02/23/2013 6:51:32 AM PST by Poison Pill (Take your silver lining and SHOVE IT!)
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To: SierraWasp

“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 patient’s 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 everyone’s 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. Shouldn’t 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 doesn’t 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 don’t 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.”

36 posted on 02/23/2013 7:54:48 AM PST by Seizethecarp (Defend aircraft from "runway kill zone" mini-drone helicopter swarm attacks:
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To: Seizethecarp
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.

Under Medicare about $2,000 will be paid the $21,000 figure is for the uninsured.

37 posted on 02/23/2013 8:49:07 AM PST by Mike Darancette (Soylent Green is Boomers)
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To: Seizethecarp
OMG!!! I didn't know how to navigate their strange website!!!

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)

38 posted on 02/23/2013 3:18:20 PM PST by SierraWasp (Mark Twain said: "It's easier to fool someone than to convince them they've been fooled!!!)
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To: corkoman

Obviously it works for you.

39 posted on 02/23/2013 6:25:23 PM PST by antceecee (Bless us Father.. have mercy on us and protect us from evil.)
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To: Seizethecarp

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.

40 posted on 02/27/2013 12:01:15 PM PST by RWB Patriot ("My ability is a value that must be purchased and I don't recognize anyone's need as a claim on me.")
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