Respectfully submitted by Lawrence E. Rafferty(rafflaw)-Guest Blogger
If you have had any medical procedures lately, you may already be aware of the enormous prices being charged by hospitals. What you may not be aware of is just how expensive this medical treatment is and how relying on private health care may just be reducing our lifespans. I apologize in advance on the length of the following examples, but they are necessary to understand the enormity of the issue.
“Brill’s article begins with the story of a 42-year-old Ohio man named Sean Recchi, who traveled to MD Anderson Cancer Center in Houston for treatment of non-Hodgkin’s lymphoma. He and his wife Stephanie had paid $469 a month, or about 20% of their income, for insurance that covered $2,000 per day of hospital costs. His financial troubles started when MD Anderson told him, “We don’t take that kind of discount insurance.” But he had to go to the hospital. His wife recalled that he was “sweating and shaking with chills and pains. He had a large mass in his chest that was..growing. He was panicked.”
Stephanie asked her mother to write a check for $48,900. Sean waited for 90 minutes while the hospital confirmed that the check had cleared. He was also required to advance MD Anderson $7,500 from his credit card. The total cost for the initial treatment and chemotherapy was $83,900, including a $15,000 charge for lab tests for which a Medicare patient would have paid a few hundred dollars, $283 for an x-ray that Medicare categorizes as a $20 charge, and $1.50 for a generic version of a Tylenol pill.” CommonDreams
Those charges were just the start of the enormous costs that Mr. and Mrs. Recchi would be subjected to while dealing with his illness. His total bill for the beginning of his treatment for cancer was $83,900! If Mr. Recchi had been treated under Medicare for the same procedures and blood tests his cost would have been much less. “Had Recchi been old enough for Medicare, MD Anderson would have been paid a few hundred dollars for all those tests. By law, Medicare’s payments approximate a hospital’s cost of providing a service, including overhead, equipment and salaries.” Time
The hospital in this example is a non-profit division of the University of Texas, but its profits are enormous. ‘ “The hospital’s hard-nosed approach pays off. Although it is officially a nonprofit unit of the University of Texas, MD Anderson has revenue that exceeds the cost of the world-class care it provides by so much that its operating profit for the fiscal year 2010, the most recent annual report it filed with the U.S. Department of Health and Human Services, was $531 million. That’s a profit margin of 26% on revenue of $2.05 billion, an astounding result for such a service-intensive enterprise.1
The president of MD Anderson is paid like someone running a prosperous business. Ronald DePinho’s total compensation last year was $1,845,000. That does not count outside earnings derived from a much publicized waiver he received from the university that, according to the Houston Chronicle, allows him to maintain unspecified “financial ties with his three principal pharmaceutical companies.” ‘ Time
Not only is this hospital reaping huge financial windfalls on the backs of its patients and their insurance companies, the compensation of the hospital’s CEO, as noted above, is astronomical. And that compensation does not even include the “unspecified financial ties” with pharmaceutical companies. Does that mean that the CEO is allowed to receive kickbacks from some of the companies that his hospital may be using for their medications?
This is just one example, but the Time magazine article linked above delves into other examples of this type of outrageous medical costs charged to patients. If the patients noted in the examples were able to take advantage of a Medicare for all plan, the costs would be a small fraction of what Mr. Recchi was subjected to. It is interesting to note that the Administrator of Medicare for the entire country made a small fraction of what this one hospital CEO took home. “The Medicare administrator made a base salary of approximately $170,000 in 2010.” TheNation
Just what do we get in terms of service and results for these extraordinary charges? “Our private health care system has indeed failed us. We have by far the most expensive system in the developed world. The cost of common surgeries is anywhere from three to ten times higher in the U.S. than in Great Britain, Canada, France, or Germany.” Common Dreams Our expensive private health care system does not even produce better medical results than the results achieved under Medicare.
“We now have a shorter life expectancy than almost all other developed countries. A National Research Council study placed the United States LAST among 17 high-income countries.
It wasn’t always this way. Since 1960 there has been a close parallel between worsening life expectancy and increased health care costs as a percentage of GDP. Most disturbing is our growing infant mortality rate relative to other countries. A UNICEF study places the U.S. 22nd out of 24 OECD countries in “children’s health and well-being.” In startling contrast, Americans covered by Medicare INCREASED their life expectancy by 3.5 years from the 1960s to the turn of the century.” Common Dreams
That last factoid on life expectancy is amazing. We are paying far more than any other country in the world for our private health care system, but we are not getting the world-class results for those high prices. Why do we as a nation continue to allow the medical industry to charge these exorbitant rates? The answer is the lobbying money spent on our politicians in Washington and in state capitals all over this country. We have to take over the for profit health care system and replace it with a Medicare for all type system or we will continue to overpay for less. Will Obamacare help this situation? It may, but we won’t know for a few more years if costs are controlled and results are improved.
Will Obamacare start us down the road to a single payer system? One can hope, but I am not holding my breath. Does it make sense to cut Medicare services and push back the eligibility age in light of the huge national costs incurred in the private health care system? What do you think?
Doesn’t intent enter into malpractice? if the doctor’s qualified to perform the procedure then where’s the malpractice, no operation is a sure thing.
Private insurance is a nightmare, but medicare is not exactly without problems.
I experienced a gap in insurance coverage while I was waiting for my medicare coverage through SSD to kick in. During that time I paid $4,367.00 retail for a one month supply of one medication(Xyrem) I was taking. When my medicare coverage finally began, I paid $6.30 and my RX plan paid $547.00…..paid in full. I am still making payments 3 yrs later for that retail script.
Now on medicare with a supplement plan, I have collection accounts totaling $39,833.27 that have tanked my credit score. This is because medicare has denied payment for a 3 day hospital stay due to TBI from a fall that they insist should be covered by my auto insurance(thinking it was from a car accident) when I fell in the bathroom of my home. I have been fighting this collection account for over two years now with no success. To an outsider, my position makes total sense. To the bureaucracy of medicare, they are secondary because I had a car accident resulting in some injuries 16 months before this fall in my home. The fall in my home had nothing to due with the neck and shoulder injuries I sustained in the mva, but they can’t “get” that.
Both of these situations are problematic and indicative of system failures.
Great post.
the lawyer in my case got 33%. Track records are all well and good but sometimes medical malpractice occurs regardless of someone’s track record. A nurse sneezes, the doctor’s arm yanks, they do not operate on the right area, etc. Studies have shown when docs apologize and try to make it right, patients are less willing to sue. The problem is with the system where apologizing is seen as an admission.
(In my case, I was forced to settle for bupkis and within 4 weeks the doctor was nominated as Pa sec’ty of Health (Peter J. Jannetta 1995 – 1996) the state was a player in my drama and the forcing of settlement as were those docs and nurses who refused to testify.
You get the state and medical societies to start sanctioning and taking action against the bad docs and the non existent med. mal. “crisis” will go away.
(btw Public citizen has estimated 15% of docs commit 85% of the malpractice. Also 85% of all cases are lost by the patient regardless of the proof. I agree there has to be a better way but free rein is not it.)
Lee sorry for your situation. under my system it would buyer beware his track record would be public knowledge. How much did the lawyers get?jalf. They have created the perfect situation a minimal amount of time no injury and half the settlement
Bruce, you probably are lucky enough to have never been injured by medical malpractice.
The doctor who paralyzed my face and closed the door for any other doctor to get in the area needed to try and fix my permanent chronic facial pain.
There was proof negligence, med. malpractice “ghost surgery” and he perjured himself as to informed consent. Under your system he would get away with it completely (He essentially did in my case because of my attorney but that is a different discussion) which allows the bad doc to continue committing malpractice.
The state has refused to let the public know the track record of doctors. That would not cost much to have a public data base.
Bruce, non doctors decide now, it is usually a bureaucrat who gives the ok or not ok to medical procedures, surgeries/treatment.
As for legal services, I was lied to by the home inspector about the condition of the house I bought. I could not afford a lawyer and legal aid only takes those cases where no money is involved. Where I live there is no option, if legal aid won’t help you only have attorneys who charge 250/hr and up. In the city there were a number of options, university clinics, disabled rights advocates, etc. A lot of people are put in situations where for the lack of money to pay a lawyer they are stuck in bad/dangerous situations. I believe there should be some option other then being financially well enough off to pay these fees or nothing. It is why so many industries get away with what they do, they know that many of their victims will not be able to get an attorney to take their cases.
The usual babble against some system like Canadian health care is that Joe Bob wanted a face lift operation and had to drive to Ohio to get it because the Canadians were too backed up. Americans are bought and sold on this rich man’s poor man’s game. What we dont realize is that the rich get poor if they dont have insurance and have to obtain health care.
One really bad aspect of our millionaire doctor system is that it attracts the greedy not the talented who have a gift and a heart for the needy and ill amongst us.
The break out might come if one state would establish a socialized medical care system. It could go side by side with a private system but dont allow public funds to go to private ripoff hospitals or private cliniics. The
VA model has improved since the Vietnam War years and I know many vets who receive good care at VA facilities. It would take a state with the least percentage of chumps who thnk that because they have insurance and like their lilly white suburban hospital with few minorities attending as patients that the system as they have it is fine. There are a few states where the general population is less chumpified than the normal American citizen. How bout you Oregon?
Bruce,
Limiting the right to sue for malpractice goes hand in hand with socialized single payer systems. In those systems, it is usually not allowed except in the most egregious circumstances and after certification by medical professionals that standards of care were breached in an inexcusable (and usually inexplicable) manner.
To reduce medical costs. First do away with malpractice insurance and the right to sue doctors for malpractice. This will reduce the number of tests doctors use to cover themselves plus the cost of the insurance the doctors need to make public their track records for certain procedures verified by the AMA.
I don’t think we need a panel of non doctors giving us the thumbs up or down on weather we get a necessary procedure to prolong our life based on WHAT surely nothing medical or else they’ed use doctors to make the determation.
Bron.
Control of what or whom? Obamacare will provide up to 40 million new customers to insurance companies. How is that control?
rafflaw:
120,000 people die in medical mishaps per year, 50,000 on our highways.
Obamacare isnt about saving lives, its about control.
Gene H:
So Cigna was the manager and not the insurer. Ok, companies which self insure would do that. I got fired from a company which self insured after my daughter was born, the bill was huge and there was going to be much more. They could not possibly have afforded it without some harm to other employees. Arent you a greater good type? Or does it only apply when the government is doing it?
I have had a very close association with the medical profession for the last 21 years and my wife and I have dealt extensively with insurance companies. We had the most trouble with the company who self insured and had an insurance company manage the fund.
Well said Gene. The facts in the above linked articles referenced a 2007 study that estimated 45,000 died because they could not get insurance alone.
“I dont believe that insurance companies kill people on a regular basis by denying coverage.”
http://en.wikipedia.org/wiki/Death_of_Nataline_Sarkisyan
Nataline is but one of many who have suffered and died because of private insurance denying treatment. Ask any surgeon, doctor or nurse. Most of them have a similar story.
“I am sure there are instances but who would use their service if they did that regularly?”
People who have no choice by operation of the market and a lack of public option.
Elaine,
good point. If we can just convine the Military industrial complex that they have to take a significant cut and tell Washington politicians that war shouldn not be the first choice, we would be ok. However, I think we will get a single payer system before we control the MIC.
Bron,
I am glad your daughter is alive but the facts noted above state that we all would live longer if we had a single payer system.
rafflaw,
It makes no sense to cut Medicare services–or to raise the eligibility age.
Maybe we should stop spending so much of our tax dollars on wars, weapons, our military empire and start spending more money on infrastructure and the health, welfare, and education our our citizens.
Bron,
You only think you want government paid for legal services. That situation would create so many conflicts of interest it would be untenable. That is why the stop gap of PD’s ends at criminal law. It’s a stop gap to ensure that no one faces criminal charges without representation. If someone sues you in civil court? Go ask for a PD as see how long it takes them to laugh. Same goes for prosecuting a civil case. You don’t want the government paying the salary of your lawyer when they may be the defendant.
Argument by incomplete comparison and facile logic.
Healthcare services are not the equivalent of legal services.
I completely agree with what Gene H said. I have government insurance, and it’s been the best I’ve ever had. When I had private insurance, it did everything possible to parse and deny every level of care so that on top of whatever health issue you were having, you were also dealing with the burden of extreme stress in fighting for your medical benefits. It is obscene in the extreme.
It’s a shame that the Obama Administration and the Democrats caved on the public option. I believe many more people would have chosen a Medicare-type public option over private insurance. My 95-year-old mother has been covered by Medicare and a supplemental insurance–which is affordable–for many years. She has never had to pay huge hospital or doctor bills.