According to one of a series of exhaustive studies done by the McKinsey & Co. consulting firm, we spend more on health care than the next 10 biggest spenders combined: Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain and Australia. We may be shocked at the $60 billion price tag for cleaning up after Hurricane Sandy. We spent almost that much last week on health care. We spend more every year on artificial knees and hips than what Hollywood collects at the box office. We spend two or three times that much on durable medical devices like canes and wheelchairs, in part because a heavily lobbied Congress forces Medicare to pay 25% to 75% more for this equipment than it would cost at Walmart.
Last week I tried to use grant money to order a textbook off Amazon. I got an email from purchasing telling me we are no longer allowed to use Amazon to purchase items. So I had to spend $60 instead of $40 to get this goddam book from an 'approved' vendor (who hasn't shipped it yet even though its been 10 days, and they'll probably charge $20 for shipping, too). Now $20 is small potatoes, but when it comes to, say, buying a new freezer, they will rip you a new asshole. The same freezer you can buy at Best Buy for $500 will cost you $1200 from Fisher Scientific. Why? Because the government is paying, ultimately. They write the rules so we have to overspend. Health care lobbyists are the devil incarnate, and the lawmakers are their henchmen. I love the example in this piece about the $200 surgical gown that you could buy on your own and bring to the OR for about $6. So typical. People complain about government waste, but they don't complain about the laws that ensure the government is wasteful, brought to you by big business.
If anything, Medicare gets the best deals because of its huge base that it can use as leverage. TFA mentions that, among the current choices of no insurance, private insurance, and public insurance, the last option gets the best prices. The average-sales-price-plus-6%-premium rule is downright stupid, but it's only a piece of the larger puzzle. Short of a law regulating the salaries and costs of hospitals, bartering is the next best strategy for pushing down prices. Also, FTFA: That's a pretty good sign to see for an organization so closely tied to life and death.Medicare’s total management, administrative and processing expenses are about $3.8 billion for processing more than a billion claims a year worth $550 billion. That’s an overall administrative and management cost of about two-thirds of 1% of the amount of the claims, or less than $3.80 per claim.
As an economist, I know the US health care system delivers mediocre results at a higher price than other countries. I try to keep my cool as I run the numbers. "Just the facts, Mam," as Joe Friday used to say. Then I read something like this and I lose my professional cool:[Sean] was “sweating and shaking with chills and pains,” Stephanie recalls. “He had a large mass in his chest that was … growing. He was panicked.” . . .
Nonetheless, Sean was held for about 90 minutes in a reception area, she says, because the hospital could not confirm that the check had cleared. Sean was allowed to see the doctor only after he advanced MD Anderson $7,500 from his credit card.
Speaking as someone whose wife is a doctor, whose finances are regularly impacted by payments on $200k worth of student loans, who has designed for two medical device manufacturers and who has a close friend in charge of benefits at one of the most famous hospitals in the world: I'd fucking love to see the entire nightmare come crashing down around their shoulders.
This article is one of those great Articulations. Simple language yet damning arguments, calm, and I absolutely love the translation the journalist provides when discussing the itemized hospital bills -- also, you say
>crashing down Are we talking end of Fight Club, the credit card buildings crash, cue Where is my Mind?Dozens of midpriced items were embedded with similarly aggressive markups, like $283.00 for a “CHEST, PA AND LAT 71020.” That’s a simple chest X-ray, for which MD Anderson is routinely paid $20.44 when it treats a patient on Medicare, the government health care program for the elderly.