A Bitter Pill

Hi Everyone,

I just finished reading one of the most informative articles that I have ever read regarding our health care system. The article is a first ever for Time Magazine. Time devoted 37 pages to one article, which is basically the entire issue. The issue dated, 3/4/13 and titled, Bitter Pill, is a must read for everyone. Especially if you really want to understand why our health care system is so expensive and will continue to be, until Congress fixes it, which you shouldn't count on. There is no way I can touch on every topic that the article covers, but I will give you some of the highlights:

- One Acetaminophen pill cost 1.5 cents and your hospital marks it up 10,000%.

1) One cancer patient was charged $13,702 for one (Rituximab 660mg) shot of a new cancer drug.

2) One patient with chest pains went to a hospital and after 3 hours of tests and a brief encounter with a Dr. was told that she had indigestion. That was the good news, the bad news her bill came to $21,000.

3) One patient fell on her face and with her nose bleeding heavily, she went to a hospital. She was there about 6 hours of which most of the time was spent waiting. She had 3 CT scans, head, chest and face, and a troponin blood test. Also on the bill were the usual, bandages and tubing for the IV. Her total bill was $9,418.

4) One patient had a stimulator surgically implanted in his back to relieve his pain. He had the procedure done as an out-patient. You would think that out-patient procedures would not be as expensive. His total bill, $87,000.

These were just 4 examples of runaway and excessive bills to patients. I tell you this, if you need a hospital for anything, they should have a cardiologist available for when you receive and look at your bill.

Part of the problem that our health care system faces is something called the chargemaster. In a nut shell, the chargemaster is the master list that has prices for any and all services, procedures and any items used in any given hospital in our country. There is no stone left unturned. Everything has a price and boy are their prices out of this world. What most people are unaware of is this: Medicare and all insurance companies negotiate their prices for everything from the chargemaster list. People who do not have have insurance are billed the full amount as stated in that particular chargemaster list. What they don't know is that the chargemaster list is the beginning of negotiations, not the end all. Believe it or not, Medicare pays far below the chargemaster lists and is so far the best way that the Federal government found to control costs. Medicare's payments must be producing profits since almost, but not all, hospitals accept Medicare payments. Insurance companies pay more than Medicare does.

Unfortunately, our laws prevent the government from restraining prices on drugs. When Congress passed the 2003 Part D, prescription drug coverage, of Medicare, they prohibited Medicare from negotiating drug costs. In essence, Medicare's hands are tied and can't do anything about the excessive prices drug companies charge. Even with Obamacare, Congress locked Medicare out of negotiating drug costs. Medicare is also prohibited from negotiating prices on durable medical equipment, which means manufacturers can and do charge outrageous prices.

But, what really got me mad as hell is when not-for-profit hospitals have year end profits of up to hundreds and hundreds of millions of dollars. But wait you say, non profits aren't supposed to have profits. Especially profits of that magnitude. What do they do with the profits? They buy more equipment and hire a few more personnel. That in itself may not seem bad, but remember they have to buy more equipment each and every year and then they have to have more and more tests done each and every year to pay for the new equipment. This is then repeated year after year with no end in sight. There are non-profit health care companies that have revenues that are actually larger then Apple's.

Again, may I suggest that someone with an ounce of common sense try to stop this insane status quo. Our health care system is and always has been under attack by greedy health care companies along side with drug and medical equipment manufacturers. These skyrocketing costs have the ability to  bankrupt our country sometime in the future.

Til next week.

Peter