We have been previously discussing our ridiculous medical insurance system where citizens are hit with obscene charges — often by design to ensnare those unwilling or unable to challenge the charges. It can range from an $18,000 charge for a napping child to $15,000 for tiny screws to $89,329 for a $750 serum. The system exists because Congress allows it to exist in conformity with an army of lobbyists for the pharmaceutical and medical industries. The latest example was laid out by National Public Radio (NPR). Professor Janet Winston, 56, who teaches Humboldt State University, was charged $48, 329 for allergy testing at Stanford Health Care.
Winston was given a series of allergy tests at Stanford for a six-hour drive because she could not even get an appointment with a dermatologist for months — another persistent problem in our broken medical system.
Once at Stanford, they did a good job in determining that she was allergic to a variety of things, which explained her persistent rashes, including the ketoconazole cream prescribed to treat her persistent rash, the antibiotic neomycin, and a clothing dye as well as metals gold, nickel and cobalt. She then got a bill for $48,329, including $848 for the time Winston spent with her doctor.
Her health insurer, Anthem Blue Cross, paid Stanford a negotiated rate of $11,376.47. Stanford then billed Winston $3,103.73 as her 20 percent share of the negotiated rate. The bill showed the same pattern of intentional inflation of costs, which experts told NPR was “nuts.” That included the common 10-1 multiplication of costs that we have seen in other cases. For example, Stanford charged $399 per allergen when the actual test costs around $35.
I remain astonished that the public has not held Congress responsible for allowing this absurd and destructive system to continue without serious reforms. This is about systemic and abusive charges that raise serious questions of fraud, but it is all legal.
Anthem/Blue Cross are not only an insurer. they are also known as a (“MAC”) Medicare/Medicaid Administrative Contractor. So they get paid both ways.
Nonsense Kurtz. You don’t understand this sector of the economy.
Some private physicians are incompetent at collecting bills but not even to the degree you believe. A lot has to do with business decisions that are made that you may not understand. Physicians worry about reputations and malpractice. They have another problem as do hospitals etc. since there is both a duty to treat and a legal duty to treat even if it is known the patient will refuse to pay his bill. Check out ERISA. That helps to cause collections to fall and those fines for violating ERISA rules are huge.
Then one has to ask themselves what settling actually means. A hospital might charge $8,000 for an outpatient procedure and collect only $400 from the insurer. If they were to “settle for 15-50 cents on dollar” they would be making a killing collecting $1,200 to $4,000 rather than $400.
I suggest that, despite the fact that doctors don’t generally make good businessmen, because of their intense concentration on medicine, they are very smart. Do you really want them to put down a medical journal and take a course to enhance their business acumen? A lot of people want a lot of things from doctors, but they have to start recognizing that time spent in one area is taken away from another.
ERISA should have been EMTALA.
there is a lot of bad to say about health care delivery in america. the answers should not be according to hidebound dogma.
however, it is worth noting that in the “People’s Republic of China” there is no universal health care. the system if great for foreigners because they lay them up in a nice room and give a cheap bill. this is systemic deception of foreigners.
the reality for Chinese “citizens” is that they have to pay a big fee at the door or in any case before they bother too much. They are perfectly willing to let patients die for lack of payment up front, and there is no such thing as EMTALA over there.
the communists cured the social evils of private capitalism and now they have….. capitalism run by the communist party
Are people travelling en mass to canada for healthcare at the borders yet? Just wondering about THAT Caravan…..
No, but a lot of people from Canada get care in the US and pay. They even have special companies that help sick Canadians find a medical facility in the US at a cash price generally not easily offered to US citizens.
serious? you have a link for that?
I don’t need a link. Most intelligent people that are familiar with the healthcare sector and foreigners that use our system know about these businesess that expediate the process.
Are the Danes Melancholy? Are the Swedes Sad?
Paul Krugman
2018 Oct 27
The residents of Nordic countries are much better off, all around, than Americans. Except for the 0.1% of course.
No.
1. The per capita product of the United States exceeds those of Denmark, Sweden, Finland, and Iceland by 15% to 35%. Norway has higher levels of production per capita than does the United States, but their advantage is almost entirely attributable to oil exports.
2. The employment-to-population ratios of the four larger Scandinavian countries range from 0.56 to 0.63. That of the United States is 0.60. (Iceland has a ratio of 0.73, quite unusual in the occidental world. Iceland, however, hasn’t any more people than greater Spokane). Unemployment rates in the U.S. are lower than four of the five Scandinavian countries (the exception is Iceland).
3. Robbery rates in Iceland, Denmark, Sweden, and Finland range from 16 per 100,000 to 87 per 100,000, with a mean of 56 per 100,000. Robbery rates in the United States are higher, around 107 per 100,000. The thing is, most robberies in the United States are attributable to the descendants-of-slaves population which has no analogue in Scandanavia. Outside that population, robbery perpetration in this country averages…56 per 100,000. Homicide rates are more severe in the United States (about 5 per 100,000 v. 1 per 100,000). Again, American homicide rates are inflated by the descendants-of-slaves population. Outside that population, homicide rates are about 2.5 per 100,000. (With assiduous law enforcement, you might be able to cut the homicide rate and the robbery rate among black Americans by about 2/3, but that’s not an accomplishment white liberals give a damn about, preferring to fuss over police shootings and ‘mass incarceration’).
4. Life expectancy is higher in the Scandinavia than in the U.S., but life expectancy figures are quite bunched up nowadays and Scandinavia is bested by a dozen other places, among them Japan and Spain.
” Life expectancy is higher”
There are genetic causes. One can compare the life expectancy of those that immigrated to the US and contrast that with the country they came from.
There are statistical data problems with such assessments. If one country lets their newborns less than a certain size die on the table and call it soemthing other than infant mortality then that places a country that counts that as infant mortality at a disadvantage in this type of calculation..
Allan – I watched that Project Veritas video on Sinema. Sorry it did not come out sooner. I am not sure what the internal polls are showing but the external polls are showing a tie. The video has to get enough coverage for the walk-in voters. Mail-in ends tomorrow.
Another Senatorial candidate exposed made a big thing out of the video so portions of the video were played all over the state.
In most states (AFAIK), charges must be usual, customary, and reasonable. Prof. Turley, wouldn’t “reasonable” necessarily be a jury question? Do you have any info on the outcome of UCR challenges to such pricing? And jury verdicts?
Paul, I am sure you already know, Project Veritas has their new video up and today’s is on the Arizona Senatorial race filming the Democratic candidate.
Allan – I did not know. Thanks for the heads up. 😉
This is about systemic and abusive charges that raise serious questions of fraud, but it is all legal.
It may be all legal but is it moral?
A CERTAIN LAW PROFESSOR WE ALL KNOW..
USED HIS LEGAL TALENTS TO WEAKEN OBAMACARE
Jonathan Turley was chosen by then House Speaker John Boehner to argue a case to shut off Federal subsidies that were intended to make Obamacare affordable to the masses. In all fairness to the professor, he may have been more concerned with constitutional principles than healthcare for the masses. Former President Obama had overstepped his authority in granting said funds. Congressional Republicans, however, had no intention of letting Obamacare work. Republicans have yet to devise any functional alternative to Obamacare.
One of Obamacare’s key components was to create uniform pricing structures for the healthcare industry and to create uniform standards for insurance coverage. Currently Trump Republicans have unleashed a scheme to let insurers sell low-cost policies full of coverage gaps; an abuse that Obamacare sought to address. People suffering medical emergencies shouldn’t discover at the hospital that their insurance is totally inadequate. But Trump Republicans want to fool the public into thinking the cost of health insurance has gone down.
Below is a link to Professor Turley’s contribution to the fight against Obamacare.
https://www.washingtonpost.com/politics/judge-strikes-down-obama-health-law-insurance-subsidy-in-victory-for-house-gop/2016/05/12/67a8af78-1863-11e6-9e16-2e5a123aac62_story.html?noredirect=on&utm_term=.bd118ca7c624
The ACA was unconstitutiomal from the get go so save the indignation it should have never existed.
Are the commercials about FL Gov. Scotts exploitation of the healthcare system for personal gain true?
Governor Scott used the existent laws to increase profits. He has been an excellent governor using his talents for the State of Florida. If he is elected Senator then he is exactly the one that understands the healthcare sector and can close the loopholes he utilized to get so rich.
Don’t blame people for utilizing the law to their own advantage. Look for people that have tremendous experience in the field and have demonstrated an ability to serve the people. Scott seems to be one of those people. His rival Nelson hasn’t done much of anything to solve the healthcare dilemma and has made politics into a self serving career, something that should be prevented by the passage of a term limits bill.
SCOTT AN ‘EXCELLENT GOVERNOR’..??
TOXIC GREEN ALGAE SWAMPS SOUTHWEST COAST
Florida Governor Rick Scott, a Tea Party darling, cut $700 million from the state’s water management budget. Since then Florida’s southwest coast has been overwhelmed by toxic green algae that has threatened numerous businesses. Yet Allan claims that Scott is an ‘excellent governor’.
The link below is a “Palm Beach Post” editorial condemning Scott’s environmental stewardship. It also notes that Scott has made a lame attempt to blame Bill Nelson for the Algae. One can Google numerous articles on said topic.
https://www.palmbeachpost.com/news/opinion/editorial-scott-must-answer-for-environmental-malpractice/iMPX17Y5afQmzxpF8V7pOP/
well the democrat should run on that instead of baiting trump voters.
and when the republican wins as he probably will, he better mend his ways. the waterways need sufficient funding. the situation is an outrage
It is true that the algae bloom will hurt Scotts chances of victory, but one has to consider that the algae blooms have been a problem in Florida for at least hundreds of years.
Scott came in at a time where Florida was at a crossroads. It was one of the hardest hit states in that recession as you always point to whenever the discussions turn to Obama’s failures. Scott didn’t control the federal government but the mistakes made by Obama drastically threatened the state. The choice Florida had was to go into deeper and deeper debt like New Jersey a state not that badly affected by the recession. NJ is a debtor state and is among the worst. Scott realized that the debt could destroy Florida for a long time and Florida’s growth. Instead of Florida becomming a debtor state it came out of the recession intact without increased debt and grew. Florida maintained its most essential services and Scott despite the lack of funds spent money on research to discover how to control the algae bloom which to date has not been found. In the end economics controls the lifeblood of a state and the lifeblood of its people. Scott did a tremendous job. He, like every governor before him could not do anything about the algea bloom without science determining how to manage it. The algae bloom like hurricanes are natural phenomena that the state lives with until discoveries are made to control those problems.
As far as the Palm Beach Post goes, it is a terrible newspaper for one of the richest areas in Florida. It is totally one sided even banning paid for advertisements when those advertisements conflict with their leftist ideological position. My understanding is that their readership is dropping at a much faster rate than the readership of other newspapers. We will aways have to face bloggers and newspapers that have little understanding of the problems facing us as a people and even less understanding of the unintended consequences caused by their foolishness.
Obama caused the recession, Allan..???
The Great Recession started ‘before’ Obama took office. It wasn’t Obama’s fault that Florida had been too dependent on new construction.
This is just another example of revisionist history fabricated by Allan, our In-Hous Revisionist Historian.
Obama’s failures with regard to the recession. I didn’t claim he caused it.
Read the written word and if you don’t understand the context ASK.
nonetheless. its a problem like litter. tragedy of the commons. negative externalities, etc. and complicated by their particular geography which is a blessing to the public if it can be maintained.
Florida has atypical ecosystems like the Everglades and other water ways that are threatened by irresponsible development that imposes negative externalities on the public. the government has a place in controlling the negative environmental consequences of excess paving and runoff from private uses. Florida as a state loses if private interests abuse whatever politicians are in place who do not see to this critical government function just as much as if they let the place be over-run by a million illegal immigrants drawing on public welfare programs and tossing their garbage on the sides of the highways.
Republicans can rebut the presumption that they are pawns of wealthy private interests by addressing all these kinds of problems alike. if they fail to do that then they fail just as much as Democrats do.
“nonetheless. its a problem like litter.”
You are right Kurtz, it’s a form of litter without a present solution. Unfortunately people like Peter that can do nothing and know even less conflate saving Florida’s economy with causing the algae bloom that has existed through Republican and Democratic Governors and for the most part Florida has had good governors Democratic and Republican.
I believe Florida has done a lot of good things to help its environment but it is a very sensitive area of the country that requires a lot of care. The problem that people like Peter can’t see is that caring for people and the environment costs a lot of money so when they don’t take the economy into consieration there is no money for any of these things. Peter didn’t care about the economy of Florida in his first comment because all he seems to care about is proving how the other side is negligent.
The big private interest in Florida that I think is doing the most damage to the environment are the sugar farmers supported by the feds policies of taxing the importation of sugar. It’s easy to blame wealthy private interests but one has to be careful in doing so because those wealthy private interests have created a lot of the wealth we have in this country today.
youre unkind for busting his balls on his own website
Medical care is an important example of an activity for which the invisible hand of Adam Smith puts a thumb on the scales.
Hire a lawyer and file bankruptcy.
do you have no respect for where money comes from and how the majority of people earn it?
Becka, bankruptcy is a wonderful way for poorer people to level the playing field. If one has little money one loses little money in bankruptcy court yet very large sums of money owed disappear. The threat of bankruptcy, if used properly by an uninsured person when facing a hospital, pushes the hospital to settle for a reasonable sum. You can’t get blood our of a stone.
medical providers are incompetent at collecting bills in court. they will usually settle for 15-50 cents on dollar if they dont have to go to trial
and if they have to go to trial they are liable to screw it up somehow
So what you are saying is President Trump is not only right in goinig after the obscene pricing of medicines about 2.5 times that of Mexico or more but the even more obscene pricing of various charges and the even much more obscene pricing of the cost of tort lawyers part in running up the bill.
Thanks for the support and we will pass that on to The Terminator. Since no Congress in the last sixty or so years I’ve been voting has done squat and since most of them were either Democrats or their right wing Republicans in Name Only.
Question if these Proffesor are so smart how come they weren’t smart enough to ask their law school department to get in on the act? Something perhaps to do with inflated salaries and benefits for those four hour a week teaching schedules.
Many practioners left Caifornia and moved to the USA as did a lot of other skilled business and trade workers.
The American healthcare industry has been skewed and severely damaged by unconstitutional, redistributionist, taxpayer funded “insurance” coverage. American free enterprise and the free markets of the private sector have been nullified by illegal and unconstitutional governmental mandates. Healthcare provision is free enterprise conducted by organizations which constitute private property. Open and free market competition generates the highest product at the lowest price.
The Constitution grants power to Congress to tax merely for “…general Welfare..,” omitting and, thereby, excluding individual welfare.
The Supreme Court and judicial branch have failed utterly and criminally in their function and duty to support and uphold the “manifest tenor” of the Constitution.
_________________________________________________________________________________________________________
Article 1, Section 8
The Congress shall have power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfare of the United States; but all duties, imposts and excises shall be uniform throughout the United States;
_______________________________________________________________________________________________________
James Madison defined private property as
“that dominion which one man claims and exercises over the external things of the world, in exclusion of every other individual.”
____________________________________________________________________________________________________
Employing the approach of “Crazy Abe” Lincoln and Barry Soetoro, the President must repeal and abrogate, by “proclamation” or executive order, all laws and programs that nationalize the healthcare industry and mandate free or “low-cost” healthcare to individuals of any particular group or description as a form of unconstitutional redistribution of wealth.
The disease of unconstitutional taxation for purposes of redistribution and confiscation of private property in the realm of healthcare must be subjected to “…extreme methods of cure,…” per Hippocrates.
_______________________________________________________
“For extreme diseases, extreme methods of cure, as to restriction, are most suitable.”
– Hippocrates
Congress is in the pocket of the medical industrial complex and Big Pharma. In this election cycle, the fearmongering is more rampant than ever before: “government take over of health care” is one of their tactics, as if anything could be worse than what we already have. Literally every Republican lies about protecting pre-existing conditions, even those who have voted repeatedly to repeal the ACA. Republicans have no better health care plan; in fact, they have no plan at all. Not only does the medical industrial complex come up with absurd charges, but they keep jacking them up, year after year, knowing that the day will finally come when the American public has had enough. They want the baseline prices to be so high that it wouldn’t hurt them if they were locked in for many, many years.
When people talk about no plan being available people are really talking about a politically viable plan. There are many plans that have been produced and could make things better. John Goodman has provided a good deal of policy and logic that could help produce a better healthcare system.
You just aren’t educated on the subject.
Please cite me the Republican plan to protect pre-existing conditions. Can you? Of course not. You are the one who is uneducated on the subject of the nonexistent Republican plan to protect pre-existing conditions and yet repeal the ACA.
Coverage for an illness and receiving adequate medical care for that illness are two different things. Take note that the uninsurable have frequently been covered by state funds, special pools, Medicaid and other things.
Did Obamacare protect those with pre-existing illnesses when they couldn’t afford the premium, deductibles, co-pays and balance bills? You don’t have the slightest idea of what you are talking about.
Our bill from a local hospital afiliated with Partners Health Care in MA for the first of a series of three rabies shots was $10, 000.
That charge did not include physician fees.
Monopoly Medical Capitalism. Fraud. Here is one solution. Get a big fat bill? Refuse to pay. Sue them. Sue them for fraud. Seek punitive damages. Get a jury trial. Select a jury. Punitives should be ten times the amount they ask for above skunk level. Class action suit. Punitive damages there too. Share the money recovered with the class of those affected. All those patients who went to Stanford Medical Care etc.
This Dong Speaks For Itself blog needs to be more specific about remedies.