by Ezra Klein
(The Washington Post) - Last week I posted 21 charts showing the absurdly high prices Americans pay for health care. One reader wrote in with a story that is perhaps more compelling than any of them:
Let me briefly share with you a rather amazing personal experience of overcharging by a Harvard-affiliated hospital here in the Boston area. It’s not a huge matter, but it is so outrageous and almost funny in a way that I thought you might have an interest in using it, maybe in something you are otherwise working on.
The hospital did a single toenail clipping. The bill is $1,206.
To avoid misunderstandings, this was not a surgical intervention. It was the same kind of clipping that you do yourself every week, except that only a small piece of only one nail was clipped.
The whole encounter, including the prior doctor consultation, took about 15 minutes.
Admittedly, the tiny piece of toenail was sent in for lab analysis, because the doctor thought there might be some infection. (There wasn’t.) But the lab charges, although extremely high, were only part of the issue.
Here is how the charges broke down in detail. (From Brigham and Women’s, the dermatology department, dating from March 5, 2013.)
Office Visit — $248.00
Biopsy — $182.00
Treatment Room — $328.00
AMB Clinic — $117.00
Pathology Lab — $165.00
Laboratory Services — $166.00
Total — $1206.
I called the billing department of course, and they say that everything seems correctly coded. The billing person agreed personally that the numbers are outrageous but says there is nothing they can do about it. I then called the department of dermatology and spoke to two separate people there, who both also agreed that the charges are ridiculous, but they emphasized that there is nothing they can do, either. I have a call in to the Patient Relations department, and they have promised to return my call within two working days, but frankly I’m not holding my breath for any redress or mitigation from them.
Read more, and get links to further reading
My own personal experience with this - When I had my most serious diverticulitis flairup last summer, I would have died if I had not gone to the ER.
Let that sink in for a second. I WOULD HAVE DIED.
The bill ended up costing more than my car did. In fact over double that.
(Electablog) - [T]he more I think about it, the more I realize that making a last stand against ObamaCare isn’t just a fringe position of Tea Partiers who think it will destroy freedom and make Mt. Rushmore cry. Mainstream Republicans are terrified of ObamaCare for the exact opposite reason — it’s going to work in many ways.
About 10 million Americans will get government insurance in 2014. In the states that accept Medicaid expansion, the growth of rates will immediately slow as emergency room coverage for the uninsured will drop drastically. Income inequality will be improved by the richest Americans paying for the poorest American’s health care. People will stop avoiding the doctor for fear of being branded with pre-existing conditions. And entrepreneurs will have the freedom of starting a new business without fearing the loss of insurance for their family.
As I’ve been saying, ObamaCare is simply the best thing to happen to the middle class since Medicare.
And Republicans will get zero credit for it — even though it contains many of their ideas.
So expect that this year they will do just about anything to make sure we never get what we’ve already worked so hard for.
While ‘Obamacare’ isn’t perfect, (I’d rather see full universal healthcare provided as a public service) it does appear to be a step in the right direction.
There are times I honestly think the hostility towards it from the average conservative voter has a lot more to do with it taking something that separates the “haves” from the “have nots” (access to healthcare) and makes it more accessible/obtainable for everyone.
“I don’t want MY tax money being spent on poor people who can’t afford to pay for their own healthcare” seems to be a common statement that comes from these folks.
I suppose they feel, “That’s what you get for being poor”.
The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, “peer” countries.
In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings.
U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.
The rising level of inequality in the USA is probably one of the things that is effecting people’s health the most. Psycho-social stress has been shown to be a significant factor in determining the quality of life and health.
Thanks to reddit user christ0ph for providing this information
(Center for Economic and Policy Research) - David Brooks is very upset about the possibility that the cost of Medicare will prevent the United States will be as large a military force in the world in the future as it has been in the past. He tells readers:
“Medicare spending is set to nearly double over the next decade. This is the crucial element driving all federal spending over the next few decades and pushing federal debt to about 250 percent of G.D.P. in 30 years. …
So far, defense budgets have not been squeezed by the Medicare vice. But that is about to change. Oswald Spengler didn’t get much right, but he was certainly correct when he told European leaders that they could either be global military powers or pay for their welfare states, but they couldn’t do both.”
Of course fans of arithmetic everywhere know that the basis for these projections is the assumption that per person health cares costs, which are already more than twice the average for other wealthy countries, will increase to three or four times the cost in other countries. This means that our health care system will become ever more dysfunctional.
While that is of course possible, the problem is not the American people getting what they want, as Brooks asserts, it is the health care industry using its political power to extort incredible sums from the rest of us. If our health care costs were in line with costs in other countries, we would be looking at budget surpluses, not deficits.
In principle we should be able to reform our health care system to get its costs in line with those in other countries. However Brooks never even considers this possibility. (Actually, health care costs in recent years have come in way below projections, suggesting that we may already be on a slower growth path.) Alternatively, if our political system is too corrupt to allow reform we could allow Medicare beneficiaries tobuy into the more efficient health care systems in other countries and split the savings with the government. However Brooks is not interested in this option either.
Brooks would rather see people denied care under the argument that it is necessary to preserve the country’s military standing in the world. In reality, we should make sure that we are not wasting trillions of dollars paying more than necessary for our health care. We should also decide what sort of military involvement we want the United States to have in the world. It may not be desirable to be intervening widely and fighting wars on different continents even if we can in fact afford the cost.
WASHINGTON — The Obama administration will soon take on a new role as the sponsor of at least two nationwide health insuranceplans to be operated under contract with the federal government and offered to consumers in every state.
These multistate plans were included in President Obama’s health care lawas a substitute for a pure government-run health insurance program — the public option sought by many liberal Democrats and reviled by Republicans. Supporters of the national plans say they will increase competition in state health insurance markets, many of which are dominated by a handful of companies.
The national plans will compete directly with other private insurers and may have some significant advantages, including a federal seal of approval. Premiums and benefits for the multistate insurance plans will be negotiated by the United States Office of Personnel Management, the agency that arranges health benefits for federal employees.
Walton J. Francis, the author of a consumer guide to health plans for federal employees, said the personnel agency had been “extraordinarily successful” in managing that program, which has more than 200 health plans, including about 20 offered nationwide. The personnel agency has earned high marks for its ability to secure good terms for federal workers through negotiation rather than heavy-handed regulation of insurers.
John J. O’Brien, the director of health care and insurance at the agency, said the new plans would be offered to individuals and small employers through the insurance exchanges being set up in every state under the 2010 health care law.
No one knows how many people will sign up for the government-sponsored plans. In preparing cost estimates, the Obama administration told insurers to assume that each national plan would have 750,000 people enrolled in the first year.
Under the Affordable Care Act, at least one of the nationwide plans must be offered by a nonprofit entity. Insurance experts see an obvious candidate for that role: the Government Employees Health Association, a nonprofit group that covers more than 900,000 federal employees, retirees and dependents, making it the second-largest plan for federal workers, after the Blue Cross and Blue Shield program.
The United States is a capitalist system. No matter what your feelings on capitalism are, that is the system we are currently working within.
Under capitalism there will always be haves and have-nots. Not everyone can be at the top, and the great majority of people are going to be close to the bottom.
Otherwise, you wouldn’t have people who wash your dishes or serve your food when you go out. You wouldn’t have people who work at the grocery store. Not everyone can be a CEO or even middle management, capitalism CAN NOT work without having different financial “classes”.
Because of this we pool resources (with taxes) so that the people on the lower end of the income spectrum still have access to essential resources even if they do not possess the capital to purchase it. For example, police, (as opposed to private, hired security) to ensure people aren’t breaking into your house and taking your shit or shooting you in traffic because you cut them off. The fire departs, highway systems, the military, all the resources we need to operate as a society, because we NEED them to operate our businesses and go about our lives.
When you have a system that HAS to have lower “classes” of income, denying a basic human quality of life item like healthcare to those who fall to the lower end of the income spectrum that HAS to exist in a capitalist society when we are full well and able to pool resources to provide that healthcare is quite frankly inhumane and disgusting.
It is detestable to set up a system where you HAVE to ”winners” and “losers” (and a lot more “losers” than “winners” because capitalism can not operate without the lower income “classes”) and then turn around and say, “You have to be sick/in pain/dying because you don’t have access to enough capital to ensure your well being and quality of life.”
That’s not the world I want to live in, and this past election, a majority of Americans agreed.
When I’m at my most cynical I almost believe that the Republican Party is conspiracy to force women into abortions.
In countries where the GOP dream of making abortion illegal has been realized, abortion rates are higher than countries where access is available.
In Arizona where anti-abortion crusaders have passed some of the most restrictive women’s health laws in the country, abortion rates seemed to have increased.
And nothing is more incomprehensible than the GOP’s campaign against what should be seen as the greatest victory for pro-lifers in decades: the contraception mandate.
Women will receive in any insurance plan contraception with no co-pays. And nothing the government has ever done will prevent more abortions.
Several states have mandated that insurance include contraception for years. The reasons for this are obvious. Reproductive health care is basic health care for women. Not only does contraception save insurers and the public the costs of unwanted children, it’s necessary for many women to treat common health problems. Arguing against including contraception in insurance because it may violate an employer’s beliefs is like arguing insurance shouldn’t cover kids born out of wedlock.
In America, you have the freedom of your beliefs. And I have the freedom to not have your beliefs thrust upon me.
by Vyckie Garrison | Reality Check
When I moved to Canada in 2008, I was a die-hard conservative Republican. So when I found out that we were going to be covered by Canada’s Universal Health Care, I was somewhat disgusted. This meant we couldn’t choose our own health coverage, or even opt out if we wanted too. It also meant that abortion was covered by our taxes, something I had always believed was horrible. I believed based on my politics that government mandated health care was a violation of my freedom.
Fast forward a little past the Canadian births of my third and fourth babies. I had better prenatal care than I had ever had in the States. I came in regularly for appointments to check on my health and my babies’ health throughout my pregnancy, and I never had to worry about how much a test cost or how much the blood draw fee was. With my pregnancies in the States, I had limited my checkups to only a handful to keep costs down. When I went in to get the shot I needed because of my negative blood type, it was covered. In fact I got the recommended 2 doses instead of the more risky 1 dose because I didn’t have to worry about the expense. I had a wide array of options and flexibility when it came to my birth, and care providers that were more concerned with my health and the health of my baby than how much money they might make based on my birth, or what might impact their reputation best. When health care is universal, Drs are free to recommend and provide the best care for every patient instead of basing their care on what each patient can afford.
I found out that religious rights were still respected. The Catholic hospital in the area did not provide abortions, and they were not required too. I had an amazing medically safe birth, and excellent post-natal care with midwives who had to be trained, certified and approved by the medical system.
I started to feel differently about Universal government mandated and regulated Health care. I realized how many times my family had avoided hospital care because of our lack of coverage. When I mentioned to Canadians that I had been in a car accident as a teen and hadn’t gone into the hospital, they were shocked! Here, you always went to the hospital, just in case. And the back issue I had since the accident would have been helped by prescribed chiropractic care which would have been at no cost to me. When I asked for prayers for my little brother who had been burned in a camping accident, they were all puzzled why the story did not include immediately rushing him to the hospital. When they asked me to clarify and I explained that many people in the States are not insured and they try to put off medical care unless absolutely needed, they literally could not comprehend such a thing.
This is a long read but worth it. A lot of Americans have huge misconceptions about socialized healthcare, and this article goes a long way in dispelling some of the myths.