US Health Care Costs
http://thedianerehmshow.org/shows/2013-02-27/us-health-care-costs
According to journalist Steven Brill, the Affordable Care Act changes some of the rules about who pays for what in health care, but a basic problem remains: the cost. In a lengthy cover story for Time Magazine, he explains why labs, drug companies, hospital administrators and the purveyors of medical equipment make so much money. He also explores why doctors who don’t game the system are getting squeezed and why patients, especially those under 65, are left holding the bag. Join us to talk with Steven Brill about why we pay so much for health care in the U.S. and what we can do about it.
Guests
Steven Brill
journalist and author of "Bitter Pill: How outrageous pricing and egregious profits are destroying our health care," a special report for Time Magazine's March 4, 2013, edition.
Bitter Pill: The Exorbitant Prices Of Health Care
Steven Brill talks to TIME about his cover story on the outrageous pricing and egregious profits that are destroying our health care.
Comments
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Please comment on the growing trend of employers dropping spouses from health insurance coverage because of the increased costs caused by Obamacare.
"By denying coverage to spouses, employers not only save the annual premiums, but also the new fees that went into effect as part of the Affordable Care Act. This year, companies have to pay $1 or $2 “per life” covered on their plans, a sum that jumps to $65 in 2014. And health law guidelines proposed recently mandate coverage of employees’ dependent children (up to age 26), but husbands and wives are optional. “The question about whether it’s obligatory to cover the family of the employee is being thought through more than ever before,” says Helen Darling, president of the National Business Group on Health"
http://www.marketwatch.com/story/why-your-boss-is-dumping-your-wife-2013...
Prepared Remarks of President Barack Obama
Weekly Address
Saturday, August 8th, 2009
"So, let me explain what reform will mean for you. And let me start by dispelling the outlandish rumors that reform will promote euthanasia, cut Medicaid, or bring about a government takeover of health care. That’s simply not true. This isn’t about putting government in charge of your health insurance; it’s about putting you in charge of your health insurance. Under the reforms we seek, if you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan"
Anyone with a functioning brain cell knew this was a lie right out of the box.
As a physician I would argue that health care costs will not truly come under control until the fee for service model is replaced for a more conservative diagnosis based model where reimbursements are dictated by how sick the population is. Otherwise, the incentive for more testing, more consultations and billing for every gauze pad will remain.
An article at MIT's Science Journalism blog said that Brill's proposed solutions, including tightening of antitrust laws aganst hospitals, are "impractical or polittically impossible." I would like to hear Mr. Brill's response.
The drug companies make so much money with little or maybe no respect for the people who need it. Pills and drugs that can be placebos so the scientists can do their studies manufactured alongside drugs used to help people who have terminal illness is a disgrace. The price is outrageous. Then to turn on the TV and see the adds as well as the print add with all the side effects, it is a wonder more people are not addicted.
So far the discussion has been limited to amounts the doctors and hospital charge and who should pay for it. An equally important discussion should be about the very procedures employed. Holistic practitioners offer effective treatments and a fraction of the cost of conventional care, particularly regarding cancer care - which are dilligently ignored or malgned. An example (there are may others) is Insulin Potentiated Therapy, which guides convetional chemo directly to the tumor, and thus requires only 10% to 15% of the convetional dose. This of course cuts costs substantinally but even more importantly decreases the side effects. The comeback is that this tretment is "not proven" - but it also has not been disproven. I would call that neglect, which borders on the criminal. There are other cancer treatments equally effective, but the practitioners are frequently prosecuted and have to cease practicing or move to Mexico. An appropriate change in legislation allowing harmless procedures without full multi-million FDA procedurs, would result in huge savings.
Ritvars Reinbergs, Attleboro, MA
Hate to burst your bubble, but having employees pay for their spouses coverage is a trend that started nearly a decade ago.
Some private insurers have actually toyed with plans that do away with fee for service and use capitation and DRG based approaches. That would come closer to cutting overall costs IF the bogus profit motive is omitted. Providers would be paid for maintaining a crop of healthy folks and use only the most cost effective and healthy tests, diagnostics, supplies, devices, and treatments. Some patients will always consume more than the average and some will always under utilize. A person in dire need cannot honestly "shop around" for treatment especially when unconscious or without proper information. Those who insist in having the patient have "more skin in the game" are absolutely out to lunch....their skin is already all in.
Of course, those who use elective services should be able to do price comparisons and decide accordingly.......but most of us really do NOT care to get whittled on just on a whim.
By the way, the private insurers who tried the non traditional payment setup dropped it......they were in business to make huge profits.......duh....they were not serious about cost cutting other than their own costs.
Insurers should be required to follow Hippocrates instead of the almighty buck.
Companies that provide service, devices, drugs in the healthcare environment are no doubt in business to generate and maintain profits. That said Hospitals, MD's and of course anyone involved in the industry is also trying to make ends meet.
The bigger question that I would like addressed is the shear waste and inefficiency found WITHIN Hospitals. There are so many black holes related to costs it is staggering, yet I am unaware of any means of tracking this. Hospitals are also in the business of making a profit, even non-profits.
It would be nice if there was some accountability on everyones part, NOT just "vendors".
Hopefully re-admission penalties will address or start to address this.
Healthcare Blue Book is a great start at empowering patients to compare cost.
Every other industrialized nations (all democracies) has some form of national health insurance. They cover everybody and spend half the amount per person on health care as we do AND their medical outcomes are as good or even better than ours except for breast cancer cure rates.
Our for-profit health insurance system costs us about 31% in administrative costs that don't go to health care; Medicare administrative costs are estimated at between 3% and 6% with over 90% of health care dollars going to actual health care.
3. Germany had a surplus of 400 Billion Euros ( about $5.26 million dollars) in 2011 with their national health care system and France consistently is ranked as having the best health care system in the world.
The only reason we don't provide universal health care in this nation is not because we can't afford it. It is because the for-profit health insurance industry would no longer be able to make billions in profits each year while millions of Americans suffer, die, go bankrupt each year because of lack of affordable health care or overwhelming medical debt.
Why is it so hard for the U. S. to adopt a national health insurance program without insurance companies when the facts (yes, facts) show that is the only way to keep health care affordable - even if not all are insured? Because of the disinformation campaigns by the health insurance companies who will lose billions each year designed to scare people into voting against their interests. I work in health care. The insurance companies are unnecessary middlemen who actually interfere with us getting quality care. It's long past time for them to go.
Speaking as one who has had several bad experiences with medical care, I am far more concerned about the competency of the system. There are those who work in a medical care system who are not competent and should not be allowed to work in the system.
Also, I'm concerned about the fact that insurance companies are determining who gets care and how much they get.
Money rules!
Why are you helping to publicize Mr. Brill’s writing career; he’s not a healthcare professional – why can’t we have a serious discussion about the “healthcare economy” by medical administrators? Brill is not offering any new information today to the DR Show listeners.
Excellent point(s)
There are definitely policy experts out there, however it IS an interesting to have a non-healthcare expert/journalist POV.
This is an incredibly well written and comprehensive piece in Time. One thing that stuck me was that the medical industry puts out five times the amount of money lobbying in Washington than the defense industry. This pretty much explains why single payer died on the table during the debates over the Affordable Care Act.
If more people we covered by Medicare, would the cost to the uninsurd go up, or down? Are these exorbitant charges imposed on uninsured people necessary to compensate for the poor little hospitals being so squeezed by low Medicare reimbursement rates?
I have a 'crazy' cost of health to share. We are fortunate. We have health insurance, so when our 23 yr old son came home with extreme stomach pain we didn't hesitate to take to the ER. He was diagnosed with appendicitis and had it removed. This was technically handled as ‘out-patient’. He was out by 2:00pm the next day. The bill for this emergency appendectomy …. $27,900.00. Just from the hospital. There are a few incidental bills as well.
My wife has been diagnosed with Crohns disease. This piece rings home to us!
I have one example of how much "fluff money" is in the health care industry in the US- The maker of my wife's drug is capable of giving away rebates each year to those who seem resourceful or lucky enough to find out about their program. To me it seems like it would be more fair to just lower the cost of the drug to everyone rather than run/administer an entire Rebate program, ie renting a space printing, saleries etc!
Thanks,
Peter
"Kyra Wolfe wrote:
Every other industrialized nations (all democracies) has some form of national health insurance. They cover everybody and spend half the amount per person on health care as we do AND their medical outcomes are as good or even better than ours except for breast cancer cure rates.
Our for-profit health insurance system costs us about 31% in administrative costs that don't go to health care; Medicare administrative costs are estimated at between 3% and 6% with over 90% of health care dollars going to actual health care.
3. Germany had a surplus of 400 Billion Euros ( about $5.26 million dollars) in 2011 with their national health care system and France consistently is ranked as having the best health care system in the world.
The only reason we don't provide universal health care in this nation is not because we can't afford it. It is because the for-profit health insurance industry would no longer be able to make billions in profits each year while millions of Americans suffer, die, go bankrupt each year because of lack of affordable health care or overwhelming medical debt.
Why is it so hard for the U. S. to adopt a national health insurance program without insurance companies when the facts (yes, facts) show that is the only way to keep health care affordable - even if not all are insured? Because of the disinformation campaigns by the health insurance companies who will lose billions each year designed to scare people into voting against their interests. I work in health care. The insurance companies are unnecessary middlemen who actually interfere with us getting quality care. It's long past time for them to go."
Why indeed? If we tried to institute universal health care, big insurance would drown Congress in money with orders to kill universal health care or lose re-election. So it's not likely we will see universal health care.
I caught a snippet of Diane Rehm explaining to a caller and the panel the other day as to why talk show hosts should not disseminate unproven and inflammatory opinions as the caller said Alex Jones and Glenn Beck do. I admired her so much when she talked about how some of the audience may lack the capacity and/or means to research and verify. That may also be true of some commenting here. Maybe I have been punitive and accusatory toward these unfortunates and if so I apologize.
That has also revealed that I was ill informed about the underclass component of DRShow demographic. I thought NPR listeners were affluent, educated and brand loyal; but apparently they are usually not. But I observe ignorance and brainwash are already making a strong showing today.
Two years ago, I was admitted to a hospital; I was "Baker acted". I was confused and took 4x the dose of lamotrigine that was prescribed. The hospital looked up my insurance and filed without my knowledge. I was held for two days. Later on I received a bill from the hospital for over $3000. I never asked for this and yet I now owed it. I began paying $10 a month, which all I was able to afford at the time. Now, they've turned this over to a collection agency and ruined my credit. I just don't understand how they can get away with this.
Approximately 10 years ago, my husband was diagnosed with a large brain tumor. We lived in a smaller city, with one neurosurgeon. The neurosurgeon, at the first appointment after discovery of the tumor, explained to us that in order for him to move forward with surgery, we would need to "put at least $50,000 down," since we had no health insurance at the time.
I found a job with a company which offered insurance and had no restrictions on pre-existing conditions. 9 months later, my husband had his lifesaving operation. The only bills I paid were the bills incurred over the course of those first 3 days of discovery: $4,000.
If we had not moved in order for me to take the job, my husband would have either died, or we would have been in debt to the tune of over $1 million.
accountant wrote: "Hate to burst your bubble, but having employees pay for their spouses coverage is a trend that started nearly a decade ago."
"Such exclusions barely existed three years ago, but experts expect an increasing number of employers to adopt them,”
With healthcare costs continually on the rise — a situation compounded by ObamaCare’s new taxes and regulations — employers are looking for every means possible to keep those costs down. The healthcare law requires them to offer coverage to all full-time employees and their dependent children aged 25 and younger. The one person whose coverage it does not mandate, however, is the employee’s spouse; spousal coverage, therefore, is increasingly on employers’ chopping blocks.
According to MarketWatch, since the passage of ObamaCare, companies have instituted various measures designed to discourage, if not outright exclude, individuals from obtaining health coverage via their spouses’ employers. “Such exclusions barely existed three years ago, but experts expect an increasing number of employers to adopt them,”
http://www.thenewamerican.com/usnews/health-care/item/14623-employers-dr...
I disagree with the assertion that insurances have no power. I am in health care and I can tell you that almost all of the major insurances pay Medicare rates or below.
S. Edward Burns wrote:
"Why are you helping to publicize Mr. Brill’s writing career; he’s not a healthcare professional – why can’t we have a serious discussion about the “healthcare economy” by medical administrators? Brill is not offering any new information today to the DR Show listeners."
Why would you want to hear a discussion of the system by those who run it. That would be like wanting to hear a discussion of organized crime by the Gotti family. It might be interesting, but would do nothing to expose the system. We've gotten to used to sports, where broadcasters have been, to a great extent, replaced by ex-jocks.
My blog Failed Implant Device Alliance is exposing the fact that more than 90% of implanted medical devices are cleared by the FDA with no clinical testing. Currently there are two ‘bellweather’ trials: one on failed Metal on Metal hips and the other on failed vaginal surgical mesh. Tens of thousands of harmed patients are in line for delayed justice. The profit is private/corporate, but the accountability is public/taxpayers. Harmed patients and their families are legally abandoned by the perpetrators of the harm. The medical device industry lobbies our elected officials to limit the protections of patients and load the regulatory agency (FDA) with conflicted decision-makers. fida-advocate.blogspot.com
While everything your guest is saying is correct, I don't here him addressing the fact that a big part of why hospitals charge so much is because of all the people they cannot turn down that come into the ER who do not have insurance. They cannot simply let someone who has a hear attack die and those services don't generate any money yet is most costly. That is another reason why you see 1 pill on tylenol costing so much. Also, we are not as healthy as we think we are, there is not enough incentive to take care of ourselves when we know that we have all these drugs that allow us to eat the junk food that the government btw doesn't regulate at all. There is a much bigger picture here that evil hospitals administrators and medical professons.
Although I agree with almost all of the points, I believe a part of the inflated prices at hospitals are to cover all of the care that is given to uninsured patients who will never be able to pay their bills. Because ERs are required to treat everyone, a great deal of care of the uninsured is never paid for except by the inflated prices for those who do pay. The Obamacare attempt to get everyone on some kind of insurance will help, although a universal Medicare model would put more pressure to drive down prices.
@Pancake Rankin
I don't listen to Alex Jones - I didn't know who he was until a few weeks ago. But Beck I have heard many times. He always challenges his critics to disprove the factual specifics of the things he says. They rarely come forward to even try to do that. Instead, they launch "inflammatory opinon" as you are doing.
Also, oddly, you forgot to mention the likes of Chris Matthews or Larry O'Donnel. Hmmm. What an interesting coinkydink.
I was in the emergency room for a couple of hours about 6 years ago for ecoli poisoning. This resulted in a bill for $5000 which I have been paying down little by little each month since. I recently received a letter in the mail that an anonymous charitable donor would pay my remaining balance. After hearing this story I have one question and one comment:
1. Do you believe this was really a "charitable donor" or was this a way for a hospital to write this off some how?
2. It makes me sick to think that if this was actually a charitable donor, that they would have to pay so much when this money and kindness could be used for other things than giving more profit to this hospital.
a long time listener from Canyon Lake, TX
What about the VA system?