Why Medical Bills Are Killing Us - how PROFITS increase costs in American "health" "care"

[patrice]

http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/

This is what Risk Managers make possible by controlling the amount of and quality of direct care:

Yet those who work in the health care industry and those who argue over health care policy seem inured to the shock. When we debate health care policy, we seem to jump right to the issue of who should pay the bills, blowing past what should be the first question: Why exactly are the bills so high?

What are the reasons, good or bad, that cancer means a half-million- or million-dollar tab? Why 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? And what is so different about the medical ecosystem that causes technology advances to drive bills up instead of down?

Recchi’s bill and six others examined line by line for this article offer a closeup window into what happens when powerless buyers — whether they are people like Recchi or big health-insurance companies — meet sellers in what is the ultimate seller’s market.

The result is a uniquely American gold rush for those who provide everything from wonder drugs to canes to high-tech implants to CT scans to hospital bill-coding and collection services. In hundreds of small and midsize cities across the country — from Stamford, Conn., to Marlton, N.J., to Oklahoma City — the American health care market has transformed tax-exempt “nonprofit” hospitals into the towns’ most profitable businesses and largest employers, often presided over by the regions’ most richly compensated executives. And in our largest cities, the system offers lavish paychecks even to midlevel hospital managers, like the 14 administrators at New York City’s Memorial Sloan-Kettering Cancer Center who are paid over $500,000 a year, including six who make over $1 million.

[liberalhistorian]

1. Do not even get me started on this, I could easily write

volumes. I will say that one of the major things that should be done is to change the Fair Credit Reporting Act to forbid the reporting of medical debt on credit reports, and changing the Fair Debt Collection Act so as to disallow some of the really egregious, aggressive tactics used by medical collectors, who are among the worst of all collectors. Medical debt should never be on credit reports and should never be considered a measure of someone's "creditworthiness".

It isn't as if you went out on a raging spending spree, blowing the limits on your credit card for stuff you don't need, and then simply didn't pay the bill because you didn't feel like it (which does happen, deadbeats do exist, unfortunately). It isn't as if you're someone who has the capacity to pay your bills, but you spend your money frivolously first, or you just don't pay them, which also happens (the key here is having the capacity to pay them, I'm not talking about people who are responsible and work and work, but who have less money than month through no fault of their own and are constantly living paycheck to paycheck and deciding between food and medicine).

Illness and injury should not be a crime that merits punishment, but it too often is in this society, from being fired or disciplined if you miss work due to illness or injury to having your credit and life ruined financially due to all of the horrendous bills that it takes a lifetime to dig out of, even with insurance. People don't ask to get sick or injured, no one in their right mind asks for cancer or other life-threatening or chronic illnesses or for medical emergencies. The very thought that the system is set up to profit from such misery and that the result is ruined lives is, well, sickening. We are the only industrialized nation that has this view of health care and that causes such suffering as a result.

I'm also afraid to get the mail in the coming weeks. I ended up in the hospital for nearly two days for the flu and a bad cardiac reaction to it that I, and they, thought was a heart attack for the first few hours; this meant all kinds of cardiac and other tests for several hours to try to find out what was straining my heart (I was at 140 beats per minute, my EKG was "frightening" as they said, and they couldn't get it down), before some genius finally said, "hey, let's do a simple flu test". I was so sick with it that I was admitted for nearly two days, I have never in my life felt so weak and exhausted (except maybe right after my hysterectomy a decade ago). I'm generally pretty healthy with no major illnesses, so I was shocked at my reaction to the flu. Then I had to see a cardiologist and have some tests done with him as well. God alone knows how much all of these fucking bills are going to add up to be, I don't even wanna know.

We're already in a pretty desperate financial situation, due to hubby's being out of work for several months last year and his current job being at about half the salary of his previous position and they can get pretty aggressive about payment, even with insurance (we do have insurance, but I don't know how much it's actually gonna pay). I can't tell you how much I resent the fact that the main thing we, as Americans, have to consider is the financial aspect of any kind of illness or emergency, and how it might ruin us financially. That should never, ever be the case in any civilized society, period. CHANGE THE FCRA AND THE FDCA. As in yesterday.

[patrice]

4. Case histories such as this are useful. If you can document dates and such

for your personal records and try to tell the story (probably without names or with aliases in a public place like this) chronologically. Concrete stuff like that is also good to send to your state and federal representatives and senators and then follow-up regularly with them on the issues you raise out of your case study, or give them updates, and ask them about progress, regularly, and keep notes on everything that transpires between you and your elected representation and their responses to the issue. Then, if you can find a few other people who want to collaborate on that kind of work, with their own case histories,you become something more significant to your elected representation. The only thing you'd have to be careful about is to be able to provide documentation about who, what, when, how much $$$ etc., so people don't get in the habit of exaggerating and, thus, losing credibility before you can get the information in front of someone who can help in some way.

I'm going to put my OP in my Journal here and I will return to work on it in various ways; you, of course, could continue to post into whatever threads develop out of that if you wish.

[liberalhistorian]

8. Yes, I do intend to start documenting

and keeping track. It'll be awhile, though, before I know just how much will be owed, how much insurance will pay, and how much we'll be responsible for. And, of course, there will likely be the inevitable fights with the insurance company over what they will and will not pay. They love to take the premium money and then spend their time figuring out how not to have to pay anything.

[patrice]

9. Good! No huge hurry. This issue is NOT going away. period.

[sheshe2]

2. Our health care providers of today...such stellar individuals.

It's show me the money or we show you the door. Why should the Sean Recchi's of the world have sit in pain and suffering while the hospital sits in front of their computers waiting an watching to see if a check has cleared. Most business's have a policy of seven to ten working days for a check to clear. Are hospitals going to ask their patients to be patient!

I so love the word "Non Profit" for these hospitals..what an oxymoron.

And in our largest cities, the system offers lavish paychecks even to midlevel hospital managers, like the 14 administrators at New York City’s Memorial Sloan-Kettering Cancer Center who are paid over $500,000 a year, including six who make over $1 million.

Read more: http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/#ixzz2LbmVicu7

Thanks, patrice, keep it coming until someone hears.

[patrice]

3. I will try to post one good article a day and put it in my journal, so when it's

something as good as this one, I can return to it and analyze it for more search topics.

[moondust]

5. CNN/AC360 has done two segments in conjunction with this report.

Wednesday: http://ac360.blogs.cnn.com/2013/02/20/family-fights-474k-hospital-bill/?hpt=ac_bn8

Thursday: http://ac360.blogs.cnn.com/2013/02/21/who-profits-off-your-hospital-bills/?hpt=ac_mid

Oh yeah, the author of the report was Jon Stewart's guest on The Daily Show Thursday.

[Egalitarian Thug]

6. K&R This is only the start of it and why I oppose the ACA so strongly.Thanks Patrice. n/t

[Festivito]

10. ACA brought profiteering DOWN to 20%. Less would be better, but...

as a step, it's a step in the right direction rather than the worse steps we were making before ACA and would still be making had ACA not passed.

[Egalitarian Thug]

12. No, it really isn't. It puts upward pressure on costs by, oh never mind...

We'll just wait for it to take its course so you can see for yourselves what a bad idea this was. We will be back here in a decade and another million or more untimely deaths discussing what we can do to fix the mess. Or not. This is like NAFTA all over again.

[Festivito]

13. No! to your no, because, yes, it is better than what we had.

This has LESS upward pressure on costs than before.
This has LESS people dying unnecessarily than before.

And, if you are such a genius that you could have gotten us single-payer in one fell swoop, ... Where were ya?

[Egalitarian Thug]

14. Out there with all the other geniuses* being locked out of the discussion by the corporate

servants who resurrected this abomination from the grave because they knew people are just dumb enough to believe almost any lie they're told as long as the right person tells it.

You all love to bring up the evolution of SS in this argument, but here's the essential difference. SS began as and is a government benefit. This is a private mandate.

*Genius defined by everybody with any understanding of our medical system.

[Festivito]

15. Not smart enough to get by that roadblock. Me neither.

Not smart enough to get those dumb people behind you. Me neither.

We got what we got. It's better than what we had.

I'd like it to be better, but I did not know how to get there.

Just have to keep fighting.

[Selatius]

7. Medical parts suppliers are some of the worst. They're essentially a cartel in everything but name.

A catheter could cost a hundred bucks, simply because there is really only one or two manufacturers of said product, and they are thus free to mark up prices sky high.

There has been almost no enforcement of anti-trust laws here. Many hospitals in a particular state are typically owned and operated by the same conglomerate. There is no competition on pricing. Of course, if you got shot in the stomach, your first question isn't going to be which hospital is the cheapest to attend; it's where is the nearest hospital.

Nobody in living memory has come out full-bore in favor of serious trust busting. We need another Square Deal and another New Deal in all markets.

Forcing people into this system isn't going to solve the problem of prohibitively expensive health care, even if everybody was insured by private health insurance companies.

[HiPointDem]

11. Public-private 'partnership' without *strong* controls on profiteering is the worst of all possible

systems.

It's just like military contracting.

That's why I *know* ACA is going to increase costs unless there are some strong regulations put in place, & I'm not seeing them. What I am seeing seems to hit individuals -- like the 'fat' tax.

Sorry, fat people aren't the reason US health care is so expensive. Nor are smokers.

[jsr]

16. Recommend

[eridani]

17. Comment by Don McCanne of PNHP

Steven Brill's TIME article, "Bitter Pill: Why Medical Bills Are Killing Us," seems to be awakening those who have, until now, accepted the very high prices of health care as an inevitability for having a technologically advanced health care system here in the United States.

In his 36 page article - which will surely be required reading in many health policy courses - Brill makes it clear that we no longer need to take the "bitter pill" of medical bills that are killing us. Clearly, Medicare already has several tools to control costs and has the potential for further improving value in the nation's health care purchasing.

At the end of his article, Brill seems to be advancing a non sequitur when he writes, "The real issue isn't whether we have a single payer or multiple payers. It's whether whoever pays has a fair chance in a fair market... We don't have to scrap our system and aren't likely to." This certainly does not follow from what he had to say as the central theme of his article.

He then recommends some tired or inadequate remedies that would have very little impact on the problems that we face in health care. What is ironic is that he has built a tremendous case for the logical solution - an improved Medicare for all - and then he seems to dismiss it. You cannot read his article and escape the conclusion that a single payer national health program is an absolute imperative, that is, if we really do want affordable care for everyone.

Download this article (the full 36 pages is available for free at the following link), and share it with others. But put a Post-it note on it that states: WARNING! For the health of our nation, ignore the section at the end titled "Changing Our Choices" (that's the tired remedies section), but concentrate on what an improved Medicare system could do for all of us. http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/