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
Please familiarize yourself with our Code of Conduct and Terms of Use before posting your comments.
Does the writer understand that to do away with the patent process would be similar to doing away with copyright removing the ability of a writer to collect “profits” from their work?
Pancake Rankin wrote:
"Most Americans agree and understand we need federally sponsored not for profit medical care and that the corporate model is killing us."
False.
Polls show that most Americans were and are still opposed to government-run health care for everyone. They will be even more opposed when the penalties start kicking in next year.
"The best way to discouraged deranged and pro-corporate posters is never reply to their stupidity. Leave it out there as an embarrassment. They always claim to be Libertarians while licking corporate boots. Anyone can see it."
Not everyone, Pancake. I always appreciate your open-minded approach to every subject and your willingness to give a fair hearing to the views of others.
Here’s a short account of my experiences this year with the U.S. “Sick Care” Money Machine and the Cuban Universal Health Care System.
At the E.R. and hospital in the U.S. system I was treated like a slab of meat to be "fixed" by a crew of doctor/accountants/technicians whose every move and action was often a duplication of effort, resulted in extra pain and suffering with apparently little therapeutic benefit and were ALL studiously logged and resulted in HUGE charges added to a bill that totaled over a QUARTER MILLION DOLLARS for a two day stay and one “procedure” (at "retail").
I am still enraged at the treatment I was subjected to for the first 9 hours at the E.R. and hospital. First was 20 minutes filling out innumerable papers at a desk by a clerk with an insulting attitude before I was allowed to get "treated" (and I have “insurance”). Then said “treatment” included being left, ignored and shivering in a cold, cold “treatment” room on a torture chair (couldn’t sit, couldn’t sleep) from midnight until past 7am before finally being transported to a hospital room where I was awakened a half dozen times over the next 2 hours to be poked and prodded (at great profit to the hospital).
In the Cuban E.R., I was treated from beginning to end like a member of a team dedicated to restoring me to Health (you, know, Health Care – ever heard of it?). Since the Cuban Emergency Room is NOT PRIMARY CARE (they have neighborhood clinics with a doctor and nurse in residence 24/7 for every 120 families for that) I was discussing my symptoms with a kind, caring, knowledgeable DOCTOR within 5 minutes. In another 10 minutes I was on a comfortable bed with an IV in place to restore my fluids and electrolytes. There was NO paperwork since the Cuban System is concerned with Health Care first, last and middle and NOT with making sure everything was “accounted and paid for”.
Part 2:
U.S. For-Profit Sick Care is primarily a CORPORATE enterprise. It’s all about MONEY FIRST! As such, its basic orientation is 180% opposite from Healing. There are many dedicated, caring individuals involved in “health care” in the U.S. but the entire structure of the U.S. Sick Care for Profit System mitigates against them being allowed to be the Healers they wish to be and THEY DON'T KNOW ANY BETTER!
From the paternalistic priesthood of physicians in the medical “schools” and hospitals, to the MBA factories and law schools that churn out the bean counters who run things, from the corporate medical towers with the only doctors in town clustered around them to the extortionists of Big PhRMA, the corporate model of U.S. Sick Care “delivery” is a setup from the beginning to the end (in all too many cases the END being the bankruptcy of the patient) to provide profit for the stockholders of the health insurance and hospital corporations and the drug industry and to detract from Healing for the many, as a recent NPR survey of people who actually USED their “health insurance” showed!
EVERY other industrialized nation on Earth has rejected the For-Profit model of Health Care. In fact, only in the U.S. is health care still considered a commodity instead of a human right. As a result, EVERY other industrialized nation on Earth has a healthier population at far lower cost than in here in the U.S.
Isn't it PAST time to examine the rest of the world's successes, craft a Universal, Effective Health Care System that works from their examples and is sustainable and affordable and dump the failed For-Profit Sick Care System that is making us more ill while bankrupting us individually and as a nation?
The last caller was 100% correct: Medicare for All!
Reply to ecgberht2:
You're entitle to your opinion but NOT your facts.
FACT: over 70% of Americans and over 50% of DOCTORS wanted a "Public Option" included in Obamacare -- it WASN'T thanks to the fact that the bill was written by the execrable USAmerican Sick Care mafia!
FACT: EVERY other advanced nation on EARTH has rejected the for-profit model of sick care that the U.S. continues to pander to...and they are HEALTHIER for less than half the money and Happier by every measure...
"kaztec wrote:
Have you ever heard of Angie's List, Yelp, "
Let me know how that market research works out for you the next time you have a heart attack 900 miles from home as I did last year, ok?
EVERY other advanced nation (assuming U.S. is advanced) has REJECTED the concept of Health Care as a commodity and enshrined it as a RIGHT. That's why they're healthier for less than half the cost!
Face it, the U.S. is that last, lone holdout for the failed for-profit corporate sick care system.
Have not seen anything relating to the cost of treatment regarding outcome. I think it would help to have 'quality ofl ife specialist' to help patients and families deal with the realitites of illness and treatment. It is often overwhelming to the consumer and many people think that if things are not pursued aggressively, it means the patient isn't loved by the family. Most medical personnel would never want to subject themselves to treatment that others are put through.
As Mr Brill has rightly concluded that patients do not have bargaining power so the healthcare industry in America does not have to operate by free market principles. This is inevitable considering the social values of a certain privileged minority that operates above the Law and the availability of insurance payments that feed their obscene greed. America must collectively put a leash on the profiteers ( including the malpractice Lawyers ) who have descended on the Healthcare industry, been bleeding the economy for the last 30 years and made America uncompetitive internationally.
Step 1 : detailed & itemized financial model for all treatments including reasonable profit for all concerned as well as R&D costs,
Step 2 : open Medical statistics ( patient / relative feedback on quality & success of treatment received, payments made )
Step 4 : salary and profit margin for Hospitals per IRS
Step 3 : lobbying expenses by Hospitals ( including so-called Non Profit Hospitals ) and Health care industry
Govt. to put up this data on line for all regions and cities
Failing all this just go beyond timid Obamacare and bypass DC corrupted by Healthcare Lobbyists. Employer paid Insurance has been abused by the Healthcare industry and should be replaced by large State Insurance Boards. Create Medical Cost Containment Boards in every State and hold the local politicians responsible.
@chetdude
Whenever I see someone use the word FACT (as though capitalization will help convince us) I know what is about to follow is, well ... you know. You're going to have to show me that poll and it's going to have to have a sample size more than the five people in your immediate family and not have been taken by Daily Kos. Here's a link to a CNN poll from 2010 - not on the public option specifically, but on Obamacare in general, which when you get into the details of the questions is a pretty good proxy:
http://i2.cdn.turner.com/cnn/2010/images/03/22/rel5a.pdf
As for the "other advanced nations on Earth rejecting the for-profit model", blah, blah, blah, I would ask you to name ONE who ever actually tried it.
I agree we have a "sick care" system. It isn't working. But the solution is not to create another Postal Service which is going broke, or another Medicare which is going broke.
chetdude wrote:
"Here’s a short account of my experiences this year with the U.S. “Sick Care” Money Machine and the Cuban Universal Health Care System."
I know, right? When I went to the ER here in my home town, they wanted to stick needles in my eyes and charge me 10 grand. That didn't sound right to me - but then again, it was right before closing time at 6:00 PM so maybe that was it. Then I went to the ER in Cuba at 3:00 in the morning since they're open 24/7, they gave me a pill that cured me immediately, and gave me a refund check for $1300 because the pill was so cheap!
It was awesome!
A loop hole in the system:
Non-profit Intermountain Healthcare, in the Intermountain West, allows another company, a for-profit company, Cardon, to bill Medicare patients when the hospital learns there is a possible third-party claim (auto accidents, work-place injury, etc.).
I am an attorney representing injured people. Cardon does not have to discount the invoice to pay my fee, nor does it have to pay any costs of litigation by the patient to receive a settlement to pay for injuries, including costs of medical care. Attorneys recoup millions for Medicare because those claims have to be paid (subrogation) (or resolved through negotiation) from any proceeds of litigation. Medicare usually discounts the invoices by the usual contingent fee of 1/3, Cardon does not.
We have no way of knowing if the hospital is billing higher, knowing Cardon will handle the invoice, than the Medicare price.
I know only too well of what Dr. Brill speaks as it relates to salient hospital bills. After loosing a lung to valley fever and yes paid for my own healthcare, I rec'd a bill. The prices were ever so escalated with many errors meaning the wrong patient. The price of a box of kleenex, suppositories which were never used, etc. I challenged each and every line but I still paid. I was not able to get health insurance since I was self employed, the price with my health care provided tripled after this event. I went searching but no one would cover me, and I paid professionally and physically. With a pre existing condition and self employed no health insurance provider had to cover me...that was now 10 years ago I still pay though my health is now very good, I remain without health care. My upper respiratory infections super sensitive after the surgery landed me in the ER. I offered to go on the speaking circuit re: Valley Fever but no one was interested. Thank you for this though in AZ thank you
chetdude wrote: "FACT: over 70% of Americans and over 50% of DOCTORS wanted a "Public Option" included in Obamacare"
As far as I can tell these are pole figures from 2009 if that? Do you have a source for these "FACTS", links please! also there exists mass ignorance on what single payer, public option and what government controlled health care mean. I think your numbers prove nothing.
chetdude wrote:FACT: EVERY other advanced nation on EARTH has rejected the for-profit model of sick care that the U.S. continues to pander to...and they are HEALTHIER for less than half the money and Happier by every measure...
Not every measure at least. Cancer outcomes are better here.
"You're entitleD to your opinion but NOT your facts."
Every time I read this quote, I brace myself for a barrage of BS.
Something interesting.
Public Preference:
Current System or Universal Coverage?
Current system: 32%
Universal coverage: 62%
Universal, with waiting lists for non-emergency treatment: 39%
Universal, with limited choice of doctors: 35%
http://abcnews.go.com/sections/living/US/healthcare031020_poll.html
We need much more attention to the 'business practices' of healthcare because their billing practices and 'bulletproof alternate economy' is worse than the Wall Street Derivatives we were so outraged about a few years ago. Steven Brill's article should only be the beginning to disassemble this national outrage.
Market forces are totally prevented from working to contain costs and improve outcomes because the current business practices of the healthcare industry are protected by the same old people who protect all the other disfunctions in our economy CONGRESS.
None of these bubbas have the guts to stand outside their bloody partisan politics and honestly represent their voters and citizens. Congress, in my view, is soley to blame for creating the conditions that are destroying this country in every way.
As someone who has spent the last 7 years as a caregiver to someone with a very dangerous illness, I believe the worst people to check on the intricacies of the cost of care are ill people and their family. Besides an emotional difficulty and time in dealing with thousands of pages in bills and EOBs, this is exactly the time to work only on the care of the person. Any time spent on getting competitive rates interferes with care. I spent that time checking survival rates of institutions instead. Getting a second opinion on care or researching care options should be the main concern of the family. (btw for other caregivers, PubMed and clinicaltrials.gov by NIH are lifesavers and great resources)
And there fantastic advances coming in health care coming thanks to the ARA/Recovery Act and the health care reform law. There have been billions of dollars spent on:
Tell me about it. I read a Time article, about how uninsured or under-insured patients are fleeced because hospitals can charge just about what they please, for which insurance companies negotiate huge discounts and for which Medicare doesn't even bother to pay, because it would cost more to process the payment that they would get for it.
For example: you need a minor surgical procedure. You're required to get a lung X-ray, because there might be something going on with your lungs. Gods forbid such plague, but whatever. You have to go along, because if you don't either the doctor won't treat your or if they do they make you sign reams of paperwork so that if something did happen on the operating table, your insurance company would say they wouldn't pay.
Never mind that your lungs sound absolutely fine, your heart rate and blood pressure are exemplary, your blood work doesn't show anything worrisome and while you're slightly overweight, you're not obese and don't suffer from diabetes.
There is no *need* for this test, but we all have to cover our behinds, don't we?
Nicole Smits wrote:
"You have to go along, because if you don't either the doctor won't treat your or if they do they make you sign reams of paperwork so that if something did happen on the operating table, your insurance company would say they wouldn't pay."
"There is no *need* for this test, but we all have to cover our behinds, don't we?"
Are we noticing a trend here? TORT REFORM!!! Republicans tried to get it in ACA. Democrats blocked because of the ABA lobby. (ACA might be better ... Ambulance Chasers of America)!
Kyra Wolfe's comment below is so true. In our country, Physicians for a National Health Program has advocated for Medicare for All for over 20 years. Health care is a social justice issue that has been stolen by a profiteering medical industry. Mr. Brill's article tells the story of the demise of the personal well-being and economic sustainability of more than 2/3 of our population (60% of bankruptcies in the US are due to medical expenses). As president of Health Care for All Colorado, an affiliate of PNHP, we are mounting a grassroots campaign to educate Coloradans of their power to adopt a unique Colorado Universal Health Plan, one big risk pool and one payer.
I encourage groups in every state to contact www.PNHP.org and join this movement. Money may be power, but people vote.
"dvw wrote:
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.
February 27, 2013 - 9:38 am"
The Railroads were brought under control by the Govt, to the benefit of all, including the Railroads.
Monte Haun mchaun@hotmail.com
All I know is that I feel like a sitting duck. If I or a family member gets sick with something serious we stand to lose everything we worked our lives for just because we got sick. Insurance premiums are so expensive that we struggle every month to pay for them. We are a very small business and those premiums are eating us alive. The policy we have is bare bones. So it doesn't cover much. Great that I can now get a mammogram at no cost. But, if something shows up I'm screwed.
I don't know anyone that isn't worried every single day about getting sick, about destroying their family finances if they got sick. I know people that said if they get diagnosed with, say cancer, they will deny treatment to avoid their family having to suffer financially and be left destitute. How sad in one of the wealthiest countries in the world that its citizens are treated this way.
So, I ask all of you. What is it going to take for real change to happen? How did the healthcare industry become so powerful? Who failed to watch the henhouse?
It seems like Health Care Industry as a whole have become professional extortionists.
Because often "insurance pays" (after deductible) the patient cares not in least about ultimate cost of "treatment".
There are no checks and balances.
I don’t mean to say there aren’t good people in industry that care deeply about their patients, but… what a racket!
As article states, Americans spend about twice what people in other developed country's pay for a health care system that provides worse outcomes than many.
Ouch!
At our local hospital, it seems that a prerequisite to becoming a nurse is that one needs to be AT LEAST 100 lbs overweight.
It's not encouraging that health professionals seem to fairly clueless about basic health and nutrition.
ecgberht2, you are mistaken, my friend. Most Americans DO prefer a single payer plan for all the reasons discussed in this program.
See this link for numerous poll questions on the topic: http://www.medicareforall.org/pages/Chart_of_Americans_Support
Keepinitreal wrote:
"ecgberht2, you are mistaken, my friend. Most Americans DO prefer a single payer plan for all the reasons discussed in this program.
See this link for numerous poll questions on the topic: ..."
Thank you for that unbiased look at opinions from 2007 - 2 years before Obamacare. And from a site called "Medicare for All". They wouldn't have an axe to grind, would they?!
"Over half of Americans want national single-payer health care, Improved Medicare for All.
That fact was documented in 2007, as per the bar chart below, and was confirmed multiple times since then."
'confirmed multiple times since then'? By what. The CNN poll I posted from 2010 that showed Americans DO NOT WANT Government-run healthcare?
Get serious.
You have to be kidding. Right?
I think electricity is a better example.
Although nearly 90 percent of urban dwellers had electricity by the 1930s, only ten percent of rural dwellers did. Private utility companies, who supplied electric power to most of the nation's consumers, argued that it was too expensive to string electric lines to isolated rural farmsteads. Anyway, they said, most farmers, were too poor to be able to afford electricity.
The Roosevelt Administration believed that if private enterprise could not supply electric power to the people, then it was the duty of the government to do so. Most of the court cases involving TVA during the 1930s concerned the government's involvement in the public utilities industry.
Health care should be regulated by strick government regulations and cost controls. They do this in Japan where hospitals and doctors all charge the same no matter where they are based. A visit to a doctor in Tokyo is the same as one in Kyoto.
So your solution is to keep this corrupt dysfunctional system in place.
You anti-government types have no ideas, none. All you do is make some nasty comment about “ liberals” and then use the Post office as an example, which was in the black until the GOP members of Congress got their dirty little hands on it.
The problem with your argument is it does nothing to solve the problem.
The problem is not Medicare, it's the cost of health care which is rising all the time.
If you don't think it's criminal for a hospital to charge $5,890 for saline solution and $65,600 for the management of a patients oxygen then you sir have some serious issues. If you think you're imune to these outrageous scams that are being played out everyday then you are very much mistaken.
Ahh yes. Tort reform, purchasing insurance across state lines, competition, and the "the US has the best health care" mantra - all these old tired (aka failed) arguments for drilling down to cost cutting and the very stuff Mr. Brill revealed in his article.
- What patient or family member would relinquish the right to be compensated for negligence and malfeasance? Certainly not members of Congress. Medical errors are absolutely rampant in the US - well documented in the media.
- each state defines the basic rules for health care in that "political entity" and insurers tune their products for each state - a policy in one state may/may not cover specifics in another - and the 10th Amendment provides an obstacle that Constitutional attorneys would have to overcome; ironic that "conservatives" use that Amendment to defend some things and ignore it for healthcare
- Please someone tell us how an uninformed person, typically not physically or mentally competent at the time of an emergency, not medically trained, can "shop around" among competitors for specialized, knowledgeable, IMMEDIATE care - especially for life saving -Often there is a single geographic location for many people to get care - NO competition available
- The US now is ranked 27th in actual results in health care for most folks - just because the Shah of Iran and Dick cheney got great care does NOT mean a homeless soul could get that same care (Cheney somehow got a heart by jumping over the line and bypassing all the existing rules for who gets one at such-and-such-an-age etc.)
It is always about the money - and maybe always will be.
Note: one of the many dentists who came and went in our area decided he could enjoy life and make more money as a martial arts instructor - go figure.
"ecgberht2 wrote:
chetdude wrote:
"Here’s a short account of my experiences this year with the U.S. “Sick
Care” Money Machine and the Cuban Universal Health Care System."
I know, right? When I went to the ER here in my home town, they wanted
to stick needles in my eyes and charge me 10 grand. That didn't sound
right to me - but then again, it was right before closing time at 6:00
PM so maybe that was it. Then I went to the ER in Cuba at 3:00 in the
morning since they're open 24/7, they gave me a pill that cured me
immediately, and gave me a refund check for $1300 because the pill was
so cheap!
It was awesome!
February 27, 2013 - 12:45 pm"
Their Stats beat ours hollow, ours being some of the worst in the First
World.
But I'll give you a 7 for your biting Irony!!
Monte Haun mchaun@hotmail.com
February 27, 2013 - 5:51 pm
"deserttreeplus1 wrote:
...
I don't know anyone that isn't worried every single day about getting
sick, about destroying their family finances if they got sick... How sad
in one of the wealthiest countries in the world that its citizens are
treated this way.
Who failed
to watch the henhouse?
February 27, 2013 - 7:56 pm"
Who failed to watch the Henhouse?? The media that's who.
The Media are Part and Parcel of the
Reagan/Bush/CIA/Mossad/FBI/NeoCon/GOP/Media/Military/Wall Street/
Bankers/ Hoover Institution/NPR/Bloomberg News/MI5-MI6/ NRA Militia/
Kabal and is the sole institution that controls the deceit and
manipulation that has led many Americans to accept and believe a body of
nonsense that has led us, like Lambs, to our own slaughter.
Look at the GOP Budget Plans and if that doesn't make you sick, then
look at the Romney/GOP Platform. Are you blind, he wanted MORE TAX CUTS
FOR THE RICH and increased Military spending paid for with Draconian
cuts on least well off of us, already reeling since Reagan worked his Magic?
What is the WaPo up to this week?
Two (2) Smarmy articles suggesting that The First Lady Forced the
Academy Awards to let her award an Oscar. Followed by Hundreds of the
filthiest, disgusting slime Comments against the First Lady that I have
ever heard.
While the President, denied a media platform, tries to cadge a little
time on the Evening News or Facebook.
Fifty Republican Criticisms of Obama's handling of the Sequester to one
Democrat criticism of the Obstructionist Party.
For all their Guns and Treasons and Assassinations and Threats and
Spying and Black Flag Ops, a couple of good speeches by a Ted Kennedy or
a Harry Truman or either Roosevelt would have the People thoroughly
angry and send the little Rats running for their little Rat Holes.
Monte Haun mchaun@hotmail.com
February 27, 2013 - 10:06 pm