Wednesday, May 15, 2013

Next to health is wealth ...

Beware the medical-industrial complex
God help you if have to go to the hospital.

Particularly in Bend.

Thanks to provisions in "Obamacare," we finally get to see what various hospitals charge for the same procedures.

According to data from the Centers for Medicare and Medicaid Services, if you need a permanent cardiac pacemaker implant, and without complications, it would cost $47,619 at St. Charles Medical Center in Bend, the highest in the state and above the national average. If you're on Medicare, the government-run program will pay $17,892. And, if you don't have supplemental insurance, you would owe St. Charles $29,727.

Or, if you drive to Springfield and get the procedure done at Sacred Heart Medical Center Riverbend, it will cost $24,587. After Medicare's reimbursement of $13,080, you would owe Sacred Heart $11,507.

In other words,  St. Charles is gouging you an extra $18,220 compared to Sacred Heart. It would take about a 1,000 trips to Springfield to make up the difference between the two hospitals.

St. Charles also exceeds other Oregon hospitals in the cost of major joint replacement or reattachment of lower extremity, which is a common procedure around these parts.

At the Bend hospital, it costs $50,146. At Salem Hospital, it's a relatively modest $33,649. But, here's the really odd part: Medicare reimburses you more in Salem ($15,532) than in Bend ($14,294).

Again, it appears the drive to Salem could save you about $18,000.

Of course, much of this is old news.

In March, Time Magazine ran a 36-page opus on how the medical-industrial complex is bankrupting the country while providing inferior care when compared with other first-world nations.

It's called "Bitter Pill: Why Medical Bills are Killing Us," written by Steven Brill.

First off, nurses and most doctors are not the target of the piece. They are not getting mega-rich at the expense of the health of most Americans.

No, the story goes after the "non-profit" hospitals and the exorbitant prices they charge for everything from one pill of Tylenol, to a gown for the surgeon to medical devices.

The prices set by various hospitals "chargemasters," bear little relation to the actual costs and seem arbitrary, at best.

Here's the kicker: Those without insurance are charged the highest set prices.

As Brill notes: "If you are confused by the notion that those least able to pay are the ones singled out to pay the highest rates, welcome to the American medical marketplace."

Of course, the only insurance most people can afford does not cover anywhere near what a typical hospital charges.

Brill also shows that we pay 50 percent more for drugs than all other first-world nations.

Meanwhile, hospital CEOs and other administrators make millions.

Brill reports that while hospital administrators whine about the "low" reimbursements from Medicare, they eagerly accept Medicare patients because hospitals get paid so quickly.

Medicare is efficient. Yes, it gets ripped off by doctors ordering more tests than necessary and by patients using services they don't need.

But, Medicare's CEO doesn't make millions.

On a recent Sunday night, I sent an e-mail to Medicare asking who is the boss and how much he or she is paid.

When I checked my e-mail at 8 a.m. the following morning, I had a response.

Medicare falls under the Department of Health and Human Services. Kathleen Sibelius is the Secretary for HHS and she made $199,700 last year. She got a "big" raise this year. She now earns $200,700 for overseeing Medicare and Medicaid, the largest medical entities in America.

Brill's piece doesn't get into the ripoff that is health insurance, but when the leaders of the top health insurance companies in America can make more than $20 million per year, the problem is obvious.

Like the rest of American society, the medical-industrial complex is a major problem because too few at the top take most of the money.

When Obamacare became law, progressives groaned that it was not a single-payer/public option. How could it be? The bill was written by the medical and insurance industries.

Brill reports that between 1998 and 2012, the medical industry spent $5.36 billion on lobbying Congress to write bills that favor the medical industry.

Until we stop corporations from writing our legislation that benefits corporations at the expense of the common taxpayer, then none of our problems will be solved.

1 comment:

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