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Wednesday, March 6, 2013

We Keep Focusing On The Wrong Questions and Answers

We are  concentrating all our efforts on who should pay for the rising health care costs instead of asking, “Why are we paying so much?” Right now, Congressman Paul Ryan is rewriting a bill to tinker with raising the eligibility age for Medicare but there is no legislator on either side working on lowering the rising cost of health care. Unemployment is at 8% yet;no committee is working on that problem because all the emphasis is long-term debt instead of where it should be;short term growth job and growth projects..

I’ve read the 24,105 word article written by Steve Brill(Bitter Pill ..Time Magazine) about four times because it’s unbelievable how we just accept that we have to pay more on health care than the next ten highest spending countries combined. Health care in the United States is a seller's market, and we are buyers with very little knowledge of how the system works and we don’t usually have the ability to negotiate. Little Johnny wakes up in the middle of the night crying out with pain, so we take him to the nearest ER and plop down our insurance card, and we won’t realize the cost until we get the bill in the mail. We have no idea if we could have saved some money by comparing the costs of another ER just down the road because that’s not practical. The Hospital takes full advantage of those who do not ask for detail billing and continues their practice of over billing; in fact,  overpayments  are 25% of our bloated health care spending.

Steve Brill has made numerous television appearances saying that Medicare because by law can pay hospitals only the approximate cost of care is the sole program that bends the cost curve. On that basis, he believes people should go on Medicare at a younger age if we are interested in reducing costs but that message is falling on deaf ears, for obvious reasons. He advocates allowing Medicare to competitively price and assess drugs because it would save us billions. Instead of of means testing Medicare recipients, the author thinks wealth individuals should pay a higher co-pays. I guess the idea is not to let Medicare taking the identity of a welfare program.

Health care is the only area where advanced technology has made it more expensive. It encourages more procedures and treatment by making them easier and more convenient. There is also that legal incentive because a doctor can’t be sued for doing too much. Since the same tests are given for a heart attack victim as one for symptoms of a one; new technology in the future may rectify that.

The author hits the non profits pretty hard because they don’t have to pay income taxes or shareholders,  so they funnel all the profits to expansion and CEO pay. A CEO of Sloan-Kettering justified the higher rates because they applied them to [wealthy] uninsured persons from overseas, which allows them to serve the poor. The chargemaster prices are so high (even with discounts and Medicare) that it has allowed them, to become high profile businesses using the charity distinction (1% of its funding) to have the best of both worlds.

Health care costs are over $2 trillion a year, and it will continue to rise unless more hospitals and doctors are aware of their costs. The Cleveland Clinic deconstructed the price of their top three procedures, so they could accurately measure their costs. They tagged all the instruments,equipment,medicines,and even timed the patients stay in post-anesthesia care. They then tagged and labeled their supply cabinets with their costs. They also stressed message of “ Without compromising quality ,consider cost-effective alternatives.”Unfortunately, many hospitals and doctors don’t know or have to know the true costs of their service because they can easily pass them off to their customers.

I hope I never get the displeasure, but if I ever get hospitalized, I will ask for detail billing now that I know what to look for. I will check on the level of room I am being charged for since hospitals charge their ER services by level, depending on the amount of equipment and supplies needed. Level one requiring the fewest.The hospital and doctor's level should be the same. I will question charges for additional reading of tests or scans unless it’s part of a second opinion or consultation. I will also make sure I was not charged for a canceled test due to high blood pressure or elevated blood sugar levels.

The article was packed with endless useful information, and I know that I did not do it any justice in the confines of this blog. I left –out so much because it was repetitive injustices that we continue to hear but don’t do anything to stop.  It reminds of Wall Street surpassing historic highs this week after shaking down America to the tune of $8 trillion, but the emphasis for some is on reducing welfare. The article also took me back to the old days of investigative journalism.

I left out the unlawful and hideous practices of the health insurance companies  and many new proposals that might work if given a chance but there's always manana.


Mike said...

Who elected these Washington right wingers wannabees like Emmett Alavrez and Hagan?

Alavrez is sending a message to Washington…pleeeze and he wants the money spent on class rooms….The issue is solar panels and not ideology or his personal wants.

Hagan doesn’t like the state or feds spending money like this but some other city will get the project, learn a little about solar and perhaps save the their city a little money in the future.

Perhaps the city doesn’t have the money to spare for a project like this; I’ll buy that but that other stuff is plain malarkey and small town grandstanding…I have to agree with the words of Tom Halepaska “"I'm not elected to the federal level, and I don't make policies the federal government makes “at least he knows where his place is.

You are the city councilmen dudes act accordingly and quit auditioning to be the next Ted Cruz.

Mike said...

I see where Gov. Perry will take the Federal money for Medicare to let him set up his own Like that is going to happen...The state with the most people who don't have health care refuses 100% fed funding for three years...How does that make sense?

Edith Ann said...

In his warped, screwy, how-can-I-help-a-friend thinking, it does.

It is 7:25 and Rand Paul is still yammering...zzzzzzzzzzzz.....

Mike said...

And it's all for naught because as soon as Rand Paul gets through rambling John Brennan will be confirmed as CIA director...A Mr. Smith goes to Washington ...he's not.

Edith Ann said...

I never understood why medical stuff has to cost so much, but you are right--no one questions it!

Except my sister--Citizens told her $1050. for her share for an MRI, and she called around and found the place on Navarro that only charged her $125. for her share.

No wonder Citizen's continues to show a profit.

Mike said...

The article says we put up with it because:

1. We only pay 20%
2. Unlike your sister most don't shop around
3. We think that's just the way it is

Yes Citizens is profitable but DeTar is also very profitable.

Just a hunch but when the whole ACA finally kicks in next year ;the patient protection portion will change the rules of the game.