Friday, February 22, 2013

Finally the problem is not insurance it is the cost of Healthcare

It is Time, hardly a mainstream or respected publication anymore, but that makes it all the more shocking they finally came around to the cost problem, not evil greedy insurance companies.

"Stephanie was then told by a billing clerk that the estimated cost of Sean’s visit — just to be examined for six days so a treatment plan could be devised — would be $48,900, due in advance. Stephanie got her mother to write her a check"

"About a week later, Stephanie had to ask her mother for $35,000 more so Sean could begin the treatment the doctors had decided was urgent."
"Sean was held for about 90 minutes in a reception area, she says, because the hospital could not confirm that the check had cleared. Sean was allowed to see the doctor only after he advanced MD Anderson $7,500 from his credit card."
"The total cost, in advance, for Sean to get his treatment plan and initial doses of chemotherapy was $83,900."
The whole article is great for how infuriating it is.  So much was wrong with this entire situtation.

  1. We already have small group reform which guarantees them coverage and subsidized rates. How can they borrow $83,900 to pay for treatment but couldn't borrow $500 to $1,000 a month for a real insurance policy?
  2. Max rates $5K HSA with Anthem wouldn't have cost that much more than their worthless $469 a month policy. 
  3. $5,628 a year in premium for a $2,000 daily hospital benefit is absurd. 
  4. Finally the most important part, they could have gone to UH Ajiuha new cancer center and had an entire course of treatment for $83,900. Hospitals charge these ridiculous amounts because people pay them. CTCA is just as bad. 
 I would argue the system worked perfectly this time.  Someone made a bad decision by not buying the proper insurance. They then followed it up and made another bad decision by insisting on going to an overpriced hospital. They paid for it themselves, that is exactly how it should work.

It's when they bring to light the hospitals charges we see the problem;

 "Dozens of midpriced items were embedded with similarly aggressive markups, like $283.00 for a “CHEST, PA AND LAT 71020.” That’s a simple chest X-ray, for which MD Anderson is routinely paid $20.44 when it treats a patient on Medicare, the government health care program for the elderly.

Every time a nurse drew blood, a “ROUTINE VENIPUNCTURE” charge of $36.00 appeared, accompanied by charges of $23 to $78 for each of a dozen or more lab analyses performed on the blood sample. In all, the charges for blood and other lab tests done on Recchi amounted to more than $15,000. 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."

The more stories like this printed maybe the politicians will stop beating up on the payors and do something about the providers and abusive charges.

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