Tuesday, March 12, 2013

More on why medical bills are killing us, including an account of my own recent experience

TIME magazine has put its brilliant long cover article, "Why Medical Bills Are Killing Us" (March 4, 2013), behind a paywall, so if you're not a subscriber the link won't help. I understand why they did this: my husband has been in the magazine business for over 30 years, and it's awfully hard to pay staff when readers want everything free.

On the other hand, I wish every American and especially every lawmaker (local, state, and federal) would read this article. It explains better than anything else I've read why our health-care system costs way more than that of any other developed country, and why Obamacare, alas, is so unlikely to bring our costs down. It also gives a few good suggestions about ways to improve our health-care system even if we're not in the mood to give it the total overhaul it so desperately needs.

I supported Obamacare. It's awfully hard to steer a parked car, and the Affordable Care Act got us rolling. But we can't stop reforming health-care now, because our system is still broken. I agree with American economist Tsung-Mei Cheng's tongue-in-cheek Universal Laws of Health Care systems (I'm quoting from T.R. Reid's excellent book, The Healing of America, which I reviewed here, here, and here):
1. No matter how good the health care in a particular country, people will complain about it.
2. No matter how much money is spent on health care, the doctors and hospitals will argue that it is not enough.
3. The last reform always failed.
America's health-care system is not getting the results it should. See the latest report from the National Research Council and Institute of Medicine, whose title sums up our situation: "Americans Have Worse Health Than People in Other High-Income Countries; Health Disadvantage Is Pervasive Across Age and Socio-Economic Groups."

The way America's health care is financed would be hilarious if it didn't hurt so many people (go to the library and read the TIME article to be appalled). A personal example: I recently had an electrophysiology study performed at a highly rated Chicago hospital. From my arrival at 6:15 a.m. to my discharge at 9:30 p.m., the care I received was excellent. I am a big fan of most doctors and practically all nurses.

And then I got the paperwork.
  • What the hospital and doctor billed my insurance company: $56,737.28
  • What the insurance company agreed to pay: $18,591.77
  • What I am probably going to have to pay: $858.80
  • What I would be billed if I were unemployed and uninsured:  $56,737.28
Of course the hospital wouldn't be able to collect the full amount if I didn't have it, and I could always negotiate with them - that is, if my English language and negotiating skills were excellent, or if I could afford to hire a negotiator, or if I even knew that negotiation was possible. Or I could declare bankruptcy.

A lot of things still need reforming in our partially reformed health-care system. Could we start by requiring health-care services to have uniform prices for all, and to post their prices so that clients can know the cost of treatment before they sign up? And then could we ask the government not to give health-care services money unless it simultaneously puts limits on how much those health-care services can charge?

1 comment:

Kate Donegan said...

Sigh. Will we ever accept the reality of this situation and stop punishing the poor and the working poor (former middle class?)? I am gobsmacked at Americans' refusal to see the situation for the mess that it is!