There are health care nightmares and then there is what happened to Eric Fergusan, 54, in North Carolina. Fergusan was bitten by a snake on the foot while putting out trash last August. He drove himself to the hospital and was given anti-venom medicine that can be purchased online for as low as $750. The bill” $89,227 bill for an 18-hour stay.
He is fortunately insured but it is the latest example of the how medical bills have become little more than openly fraudulent billing by hospitals. Drug and treatment costs have soared in this country because members of Congress and the Obama Administration yielded continually to this powerful lobby that hires former members and staff members and contributes mightily to campaign funds. The result is that citizens are being sheared like sheep as politicians fall over each other to help these lobbyists.
The Lake Norman Regional Medical Center is responsible for this outrageous bill. Blue Cross and Blue Shield reduced the total bill to $20,227 and the couple paid $5,400 out-of-pocket to cover their deductible and co-pay. So how does that work? The hospital charges roughly $90,000 and then suddenly drops to $20,000? In most other fields, that would be called fraudulent billing but, in the United States, it is considered standard billing procedures.
What is really amazing is the frank response of the hospital: “Our costs for providing uncompensated care are partially covered by higher bills for other patients.” In other words, we do not actually charge what your care cost but instead gouge anyone who can pay more to cover losses on other patients. Consider other industries following this practice. “Yes, your car was $40,000 but you have been charged $90,000 because we had some car loans fail with other customers” or “Yes, I agree to represent you for $100,000 but I have a hit-and-run defendant disappear without payment in his case so I am charging you $150,000.” What is equally alarming is the matter-of-fact attitude of the hospitals who first try to overcharge and then shrug and take, in this case, almost one-fifth of the original demand.
These abuses are reported everyday but you hardly see a member of Congress rushing to the floor to demand reforms. Why? Just look at who the former members are working for?
Source: Yahoo
FROM ISSUE NUMBER 3 ~ SPRING 2010
(STILL A VERY USEFUL DISCUSSION)
NATIONAL AFFAIRS:
Health Care and the Profit Motive
AVIK ROY
http://www.nationalaffairs.com/publications/detail/health-care-
and-the-profit-motive
(excerpt)
“Patients pay for health care after, not before, it is received, and frequently pay indirectly for their care via insurers. Because patients don’t see the bill until after the non-refundable “product” has been “consumed” — and because there is virtually no transparency about costs —”
[and]
Princeton economist and New York Times columnist Paul Krugman, with characteristic bluster, wrote recently that “ever since Kenneth Arrow’s seminal paper, [economists have known] that the standard competitive market model just doesn’t work for health care…to act all wide-eyed and innocent about these problems at this late date is either remarkably ignorant or simply disingenuous.”
[and]
“SHOULD THERE BE A HEALTH-CARE MARKET?
The tension between the spirit of medicine and the spirit of the marketplace is hardly a new problem. In Book I of Plato’s Republic, Socrates poses the difficult question: “Is the physician a healer of the sick or a maker of money?” The answer is necessarily both, and balancing the two is not much easier in our time than it was in Plato’s.
Indeed, the ancient ethic of the medical profession — set forth by Plato’s contemporary, the physician Hippocrates of Cos — gives doctors a moral as well as a medical role in their societies. The famous Hippocratic Oath affirms that doctors should protect the sick not only from disease but also from “harm and injustice,” and instructs physicians not to prey on patients’ vulnerability for their own gain. In ancient Greece, the oath represented a minority ethic in a world where charlatans posed as physicians to rob desperate people. Later, Roman physicians found much to admire in the Hippocratic Oath and preserved it for Christian Europe, where the code’s universal moral claims found more hospitable ground. The Christianized Hippocratic Oath became the common standard by which physicians were judged. For new doctors, swearing the Hippocratic Oath became a defining rite of passage — connecting them to generations of their predecessors in an ancient, unbroken tradition that endured into the 20th century.
Today, contrary to popular perception, few medical schools require their students to take the oath;…”
Poor people didn’t lobby Congress for food stamps in the 60’s, but the food industry did, paving the way for inflation in grocery stores. As the number of food-stamp recipients has doubled in recent years, so have food prices. When the technology industry lobbies for subsidies, we will all be faced with $20,000 prices for smartphones and tablets.
Hospital Prices
http://www.huffingtonpost.com/news/hospital-prices
Health Care Costs
http://www.huffingtonpost.com/news/health-care-costs
http://www.huffingtonpost.com/2013/05/08/hospital-prices-cost-differences_n_3232678.html
Hospital Prices No Longer Secret As New Data Reveals Bewildering System, Staggering Cost Differences
by Jeffrey Young and Chris Kirkham
Posted: 05/08/2013 12:00 am EDT | Updated: 05/08/2013 3:24 pm EDT
(Excerpted)
“When a patient arrives at Bayonne Hospital Center in New Jersey requiring treatment for the respiratory ailment known as COPD, or chronic obstructive pulmonary disease, she faces an official price tag of $99,690.
Less than 30 miles away in the Bronx, N.Y., the Lincoln Medical and Mental Health Center charges only $7,044 for the same treatment, according to a massive federal database of national health care costs made public on Wednesday.”
HEALTH AFFAIRS
http://content.healthaffairs.org/content/27/5/1389.full
Private Equity Investment In Health Care Services
Hospital Stocks SOAR After Supreme Court’s Landmark Decision to Uphold Obamacare- 2012-06-28
“Gouge: an act of extortion; swindle.” (dictionary)
Medical care delivery: Silence to Voice:
Code Green: Money-Driven Hospitals and the Dismantling of Nursing (The Culture and Politics of Health Care Work… by Dana Beth Weinberg and Suzanne Gordon (Feb 26, 2004)
From Silence to Voice: What Nurses Know and Must Communicate to the Public (The Culture and Politics of Health… by Bernice Buresh and Suzanne Gordon (May 28, 2013) (original: 2006)
Sunday, December 25, 2011
Hospital Corruption in New York State ?
Bribes Versus Political Campaign Donations : Who Decides When Money Corrupts The Healthcare System Of New York State ?
http://nyc-mayor-2013.blogspot.com/2011/12/hospital-corruption-new-york-state.html
They should make all fees transparent, published, and irrespective of insurance company.
http://www.labornotes.org/2013/06/private-equity-stalks-hospitals
Private Equity Stalks Hospitals
Health care workers rushed to a Brooklyn hospital yesterday for an emergency rally to keep it “Open for Care,” after administrators began diverting patients away. In New York, New Jersey, and Massachusetts, hospital unions are battling shadowy operators with dollar signs in their eyes.
(quote)
““These hospital conversions from not-for-profit to for-profit I believe are at a tipping point,” HPAE President Ann Twomey told a state senate committee in May, “threatening to undermine access to care and affordability of care for our communities.” – See more at: http://www.labornotes.org/2013/06/private-equity-stalks-hospitals#sthash.CtfHh0Bx.dpuf“
Maybe there should be a disclaimer that reads Something like this.
Notice:
You maybe required to pay the bills of patients in the adjoining rooms.
“Yes, your car was $40,000 but you have been charged $90,000 because we had some car loans fail with other customers.”
The difference is that the government did not pass a law requiring that cars be given for free to customers who could not pay for them. Hospitals must, by law, treat patients who cannot pay.That does not make the hospital’s extortion right, but it gives them a veil of legality for it and leverage to make it work.
The government has further complicated that by passing a law requiring insurance companies to coverpeople who have known conditions such that they are issuing policies which they know in advance will cause them to lose money.
The other issue is reducing the $80,000 bill to $20,000, caused by contracting with insurance companies who negotiate discounts. Hospitals don’t really discount the bill, they simply raise the price until the discounted price affords them their desired 50% level of profit.
The government, having passed laws forcing “for profit” companies to lose money, then grants those companies exemptions from regulations and common sense which result in this outrageous game playing and what would otherwise be massive illegality. The end result is even larger profits than these companies would have made without all of the governmental interference.
Disgusting example of corporate greed.
A two-year Senate investigation of dental chains owned by private-equity firms found that Small Smiles’ business model deceptively gave managers rather than dentists control over the clinics.
Senate Report Faults Children’s Dental Chain for “Fundamentally Deceptive” Care
July 25, 2013, 4:40 pm ET · by David Heath , The Center for Public Integrity
The bipartisan report recommends removing Small Smiles, one of the nation’s largest dental chains for children, from the Medicaid program for encouraging dentists to perform unnecessary treatments to boost profits.
———————————————————————–
June 26, 2012, 5:22 pm ET by David Heath Center for Public Integrity, and Jill Rosenbaum, FRONTLINE
“…But Kool Smiles is not a charity. It’s run by a company owned by the private-equity firm Friedman Fleischer & Lowe of San Francisco, a firm whose investments exceed $2.5 billion in companies including the fast-food chain Church’s Chicken and the payday lender Speedy Cash.”
http://www.pbs.org/wgbh/pages/frontline/health-science-technology/dollars-and-dentists/complaints-about-kids-care-follow-kool-smiles/
check out the comments (esp. the ones that defend this practice)
http://www.pbs.org/wgbh/pages/frontline/dollars-and-dentists/
Watch Dollars and Dentists, a joint investigation by FRONTLINE and the Center for Public Integrity.
(also)
http://www.pbs.org/wgbh/pages/frontline/health-science-technology/dollars-and-dentists/senate-report-faults-childrens-dental-chain-for-fundamentally-deceptive-care/
A two-year Senate investigation of dental chains owned by private-equity firms found that Small Smiles’ business model deceptively gave managers rather than dentists control over the clinics.
Great example of how the duopoly is bought and paid for by special interests, drug companies being in the upper echelon of those groups.
Two guys are out hunting. One of them gets bit by a snake on his scrotum.. His buddy gets on his cell phone and calls the local ER. A doc gets on and gives the friend instructions. “First, find the bite mark. Make certain there’s only one.” The friend gives a, “Yes, Sir.” The doc continues, “Now, make an incision between the bite and the heart, deep enough to draw blood.” The victim is waiting impatiently. Then the doc says, “Then suck out as much blood as possible. Do this @ least 4-5 times, spitting out the poison on the ground. Do this or he will die.” The victim, now panicky asks his buddy, “What did the doc say!!” The buddy gives a forlorn look and says quietly, “Doc says you’re goin’ to die.”
It’s the insured vs uninsured….. What I found interesting is the story of a person that went to a hospital…. Out of net work…. The insurance company paid its portion but they went after the guy for the difference….. About 80k….. You have the bankruptcy reform act which prohibits discharge of debts to most hospitals…. Etc….
Hospitals are masters at over charging the helpless. While they are ripping off their patients they are spending millions on ADVERTISING! They are paying administrators millions! And most are enjoying nonprofit status. ACA failed to put the brakes not is greed.