Tag: health care costs

In a recent series of article by New York Times‘ reporter Elisabeth Rosenthal on the cost of health care in the US, they examined the cost of an ER visit and getting there by ambulance. The cost of three stitches for one young lady was $$2,229.11 and a 15 minute ambulance ride for another with head and facial injuries was  $1,772.42. Why does it cost so much? Part of the reason is privatization and lack of regulation.

Paying Till It Hurts: E.R. Visit

As Hospital Prices Soar, a Stitch Tops $500

In a medical system notorious for opaque finances and inflated bills, nothing is more convoluted than hospital pricing, economists say. Hospital charges represent about a third of the $2.7 trillion annual United States health care bill, the biggest single segment, according to government statistics, and are the largest driver of medical inflation, a new study in The Journal of the American Medical Association found. [..]

The main reason for high hospital costs in the United States, economists say, is fiscal, not medical: Hospitals are the most powerful players in a health care system that has little or no price regulation in the private market.

Rising costs of drugs, medical equipment and other services, and fees from layers of middlemen, play a significant role in escalating hospital bills, of course. But just as important is that mergers and consolidation have resulted in a couple of hospital chains – like Partners in Boston, or Banner in Phoenix – dominating many parts of the country, allowing them to command high prices from insurers and employers.

Think the E.R. Is Expensive? Look at How Much It Costs to Get There

Thirty years ago ambulance rides were generally provided free of charge, underwritten by taxpayers as a municipal service or provided by volunteers. Today, like the rest of the health care system in the United States, most ambulance services operate as businesses and contribute to America’s escalating medical bills. Often, they are a high-cost prequel to expensive emergency room visits.

Although ambulances are often requested by a bystander or summoned by 911 dispatchers, they are almost always billed to the patient involved. And the charges, as well as insurance coverage, range widely, from zero to tens of thousands of dollars. [..]

Part of the inconsistency in pricing stems from the fact that ambulance services are variously run by fire departments, hospitals, private companies and volunteer groups. Some services are included in insurance networks, others not. [..]

In a recent study, the federal Health and Human Services Department’s Office of the Inspector General noted that the Medicare ambulance services were “vulnerable to abuse and fraud,” in part because there were lax standards on when an ambulance was needed and how the trip should be billed. The number of transports paid for by Medicare increased 69 percent between 2002 and 2011, while the number of Medicare patients increased only 7 percent during that period. In the last year, two ambulance companies have pleaded guilty or settled claims for overbilling Medicare. [..]

If an emergency call comes to 911, dispatchers decide which ambulance to send, depending on proximity. Most ambulance companies bill according to the level of skill of the team on board, rather than the medical needs of the patients they collect. A team capable of administering Advanced Cardiac Life Support costs more than one with only basic first aid training.

Distance rarely counts for much, although a small mileage charge is added to the fee. Some companies even charge hundreds of dollars extra if a friend or relative rides along with an injured patients.

The cost of health care in the US is four times what it is in other countries that have universal health care polices. In the US hospitals the cost are often buried in red tape and layers of bureaucracy. As an example of items that jack up the hospital bill for a stay in an American hospital take something as simple and life saving as a liter bag of normal saline, salt water.

How to Charge $546 for Six Liters of Saltwater

by Nina Bernstein, New York Times

It is one of the most common components of emergency medicine: an intravenous bag of sterile saltwater.

Luckily for anyone who has ever needed an IV bag to replenish lost fluids or to receive medication, it is also one of the least expensive. The average manufacturer’s price, according to government data, has fluctuated in recent years from 44 cents to $1.

Yet there is nothing either cheap or simple about its ultimate cost, as I learned when I tried to trace the commercial path of IV bags from the factory to the veins of more than 100 patients struck by a May 2012 outbreak of food poisoning in upstate New York.

Some of the patients’ bills would later include markups of 100 to 200 times the manufacturer’s price, not counting separate charges for “IV administration.” And on other bills, a bundled charge for “IV therapy” was almost 1,000 times the official cost of the solution.

Salt in the wound, the cost of healthcare

Chris Hayes, host of MSNBC’s All In

Just keep all of this in mind when people talk about Obamacare implementation and scream about Socialism and a government takeover. We are trying to move-slowly, incrementally-toward a system that’s sane. But as long as the price in the American health care system is $546.00 for six of these, the system is still broken.

And you know the reason they can’t just charge those kinds of exorbitant rates in places like Belgium? The government simply prohibits it.

As Obamacare implementation rolls out, it won’t take long for it become clear that the problem isn’t that it’s a government takeover of healthcare.

It’s that it’s not enough of one.

We are being told that the mess this President caused when he helped pass the Bush tax cuts in exchange for 1 year of unemployment insurance – which was unnecessary because Republicans caved on UE extension before – WITHOUT even securing a rise in the debt ceiling by putting his full trust in John Boehner with the full faith and credit of the US. This of course gave Boehner immense political power and the right hostage needed to cause the debt ceiling debacle just like I predicted. Well here are are again dealing with the fallout.

Already? Obama Tells Supporters to Expect ‘Bitter Pills’

As the Huffington Post, who listened in on the call, reports:

The president, speaking from a White House phone, cautioned listeners to expect disappointments during his second term. As he has in the past, Obama warned that he was prepared to swallow some bitter pills during the negotiations, including some that would agitate the base.

“As we move forward there are going to be new wrinkles and new frustrations, we can’t predict them yet,” he said. “We are going to have some triumphs and some successes, but there are going to be some tough days, starting with some of these negotiations around the fiscal cliff that you probably read about.”

Though his encouragement to his activist base may be encouraging to some, the President’s preemptive admission that he’s willing to give away bargaining chips so early in the game will surely irk those who criticized Obama for his negotiating style throughout his first term. That will be doubly true for progressives who have publicly called for a more hardline stance when it comes to defending key social programs like Social Security, Medicare, and Medicaid.

We know from the president’s interview with the Des Moines register that much of what was in the memo revealed by Bob Woodward as part and parcel of all of this nonsense we shouldn’t even have to be dealing with in the first place is a starting point. Oh yes, many will screech about how Simpson Bowles is dead because the commission was a failure, but the horrible ideas live on through our elected leaders that keeps bringing them back to life.

Obama vows debt-cutting ‘grand bargain,’ immigration reform in Des Moines Register interview

“I am absolutely confident that we can get what is the equivalent of the grand bargain that essentially I’ve been offering to the Republicans for a very long time, which is $2.50 worth of cuts for every dollar in spending, and work to reduce the costs of our health care programs,” Obama said. (The White House quickly clarified that he meant $2.50 of spending cuts for every dollar in new tax revenue.)

“We can easily meet-‘easily’ is the wrong word-we can credibly meet the target that the Bowles-Simpson Commission established of $4 trillion in deficit reduction, and even more in the out-years …

This is not going to help the unemployed and it’s economic illiteracy. When you hear things like, “We all agree we must pay down the deficit,” it might as well be, “We all agree on economic illiteracy. Come on. Everybody’s doing it.”  Anyone who is still making excuses for this doesn’t even understand why this fake fiscal cliff, really an austerity bomb as Brian Beutler of TPM puts it, is coming back up in the first place.

“The past isn’t dead. It isn’t even past.” – William Faulkner

This is quite literally true so for all those “that was then this is now” excuse makers, you have a lot of studying and reading to do.