Sunday, February 24, 2013

Follow the Money

    A few posts back, I referenced my own cynicism regarding the medical industry in the United States.  I acknowledged that I was finally learning that the bottom line for health care in this country is money.  This week's issue of Time Magazine carries the proof of this assertion.  In his piece entitled
Why Medical Bills Are Killing Us, author Steve Brill provides the reader with a powerful examination of America's health care costs.  Instead of asking, "Who should pay for health care related costs?", Brill turns the question into the more thoughtful one of, "Why are we paying so much for health care?".  I didn't have high blood pressure before but reading the full article was enough to give to me.

   I encourage you to click on the link above and open your eyes.  Follow the money in health care.  It's not about physicians' fees but rather about the billing practices in health care, about the influence of phamrmaceutical companies, about the ability of non profits to be profit makers, about the excessive overordering of tests and other procedures and more.  So much more.

   In the interests of getting and keeping your attention,  I am going to give you just five bullet points from this article:

1)  Have you ever heard of "the chargemaster"?  The chargemaster is every hospital's internal price list.  It is the price list and it assigns prices to  thousands of items that could be part of a bill (the tylenol pill, the tubing for the IV, the lab test ordered, every item imaginable).  As the author discovered, there appears to be  no rationale, no process, no accountability behind the structure of the chargemaster.  NO accountability.

2)  69% of bankruptcies are related to illness or medical bills.  69% of those who incurred medical related bankruptcy were insured at the time of their filing.

3)   It is routine in hospital billing to charge for items or services that should not have been charged for at all.  For example, your bill can reflect a charge of  $2,000/day for the use of the ICU because it does have specialized equipment and personnel.  Then they can and do charge you another $1,000 for some kit used in the ICU  for a transfusion or something.  Additionally, you will be charged for every bandage, every tool used.  As the author noted, that is triple billing.  And did I mention routine?

4)  In other countries, there is a cap on prescription drug prices.  Not only is there not a cap in the US, the pharmaceutical lobbyists have managed to get legislation passed that prevents a cap from being put on prescription drug prices.  This leads to such outrageous comparisons as the fact that one nexium pill in the US is the same price as that of eight in France.  One lipitor pill is the same as price as three in Argentina.  Endless examples show that prescription drug prices have been allowed to become unquestionably exorbitant.

5) "Non profit hospitals are making big bucks and hospital leaders are receiving big pay."  For example, University of Pittsburg Medical Center Presbyterian has an operating profit of $769,700,054.  Their CEO compensation is $5,975, 462.  Non profit status?

       I am livid.  This examination of health care costs both scares me and infuriates me.  Money is at the root of so much bad stuff.  Why is it that people think they are entitled to have so much money?  Why can people do this to each other?  So much happens under the guise of big business.  It is a culture gone seriously wrong.  This feels massive and there is no way you or I can fix it.  I am a speck in front of the tank, if you know what I mean.  You can counsel your kids to choose jobs that have health insurance but all that can change  and maybe they can't even get a job.  Our daughter turns 26 on April 8th and, on that day, she runs out of health insurance.  After that she can no longer be covered on our policy.  She has nothing.  She is a nanny and is applying to grad school.  No health insurance in her future. She could pay for a major medical policy but I have learned that major medical is deceptive.  The insurance industry can and does cap it.  Maybe you are covered up to $50,000/year .  That can easily be blown in less than a day, as demonstrated by the article.

    Clearly you must stay healthy or prepare to lose your financial resources.  It won't matter how hard you have worked or what kind of an exemplary citizen you have been.  The health care industry will take away your money without batting an eye and leave you with no recourse.  Disgusting.



  1. I hear you, sistah. I don't begrudge doctors whatever they get paid, because you can't put a price-tag on life. However, I do resent the drug companies and the hospitals for the way they gouge the public. They have a lot of damn gall! Thanks for sharing your thoughts.

  2. Totally agree with what you said, I'm appalled about the healthcare system and I work in it; hubby did too and is trying to get back into it (he was director of materials management for years at hospitals before he quit his job to move closer to his parents in their final year of life; he knows all about charges and costs etc.). I do medical transcription and I can tell you the money is not there in that industry any more. I would encourage NO ONE to get into health care these days. I would hope that I die of a heart attack immediately at home rather than have to submit myself to being in a hospital or have a long illness.


  3. This (in my humble opinion) is the problem with a for-profit health care system...

  4. A few years back my son quit a great job to go back to school, it was two years of intense worry that something would happen to him after his COBRA ran out. Then really health insurance really played a big part in him deciding which job he picked once back in the job market so I sympathize in how you feel about your daughter...

    For me I got my continued wake up call to the horrors of the US healthcare horrors the other day when Walgreens offered me the option of a print out of 2012's prescription statement. Just for me alone, for my RLS and Migraines I spent out of pocket some 700 plus dollars.

    Now imagine how my head almost exploded when I read the bottom line on this one...without my husbands (retirement benefit) insurance coverage those drugs would have cost me in excess of 10 thousand dollars for that same 12 month period.

    Something's gotta change..
    Great post!