The Bitter Pill

[Alma]

This is one of the longer magazine pieces I've read in some time. Rivals the Scientology piece Lawrence Wright wrote in terms of length. It's billed as an expose of why health care costs so much.

More anecdotes than anything else, but some of the anecdotes could trigger risible anger. The gap between what the federal government will reimburse through Medicaid and what patients without insurance have to pay is startling. Startling.

Probably my favorite anecdote: A "billing advocate" helps a family wipe out $300,000 bill simply by responding to the hospital and challenging the chargemaster's rates. The hospital (technically non-profit) currently recovers only 18% of the revenue it originally charges and operates at a rather small percentage loss. That's how marked up the costs are.

http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/

 

[Dick Whitman]

It's a good piece - I'm not all the way through it all. Kudos to Stephen Brill for removing his lips from the charter schools teat long enough to write it.

I'll pick one bone, though. Early on, he mentions that the percentage of GDP spent on health care is almost 20 percent. According to David Leohardt, it's 18. Then he says that the percentage across Europe is "about half that." Leohardt has written that it is actually 12 percent.

So Brill leads the reader to believe that U.S. spends twice as much as Europe on health care. But it doesn't. The thing is, it's bad enough without him feeling compelled to cook the books. I'm not sure why he felt like he had to spruce it up there.

 

[Football_Bat]

Not the bitterest pill (I ever had to swallow).

 

[Bob Cook]

Not the bitterest pill (I ever had to swallow).

Damnit, if you're going to cite a great song, give us a link!

 

[Mizzougrad96]

Brill was promoting this on The Daily Show last week...

It sounds like an amazing piece.

 

[Bob Cook]

Brill was promoting this on The Daily Show last week...

It sounds like an amazing piece.

Slate's Matthew Ygelsias, while agreeing with your point, said the question framing the piece was wrong. It's not "who should pay for health care." It's "why does health care cost so much."

http://www.slate.com/blogs/moneybox/2013/02/22/brill_on_health_care_steven_brill_s_opus_on_hospital_prices.html

A lot of it has to do with leverage. Part of the benefit of being in a group insurance plan (not an individual plan) is that you have someone with leverage to negotiate prices down.

You know what would result in health care (including the cost of training medical students, which doctors spend a lifetime making up) being cheaper? Single-payer, with a Medicare-for-all system negotiating on behalf of the American people. It also would mean companies no longer are on the hook for setting up and maintaining health coverage. That's my business case for single-payer.

And yet, there is a lot of mistrust on using Medicare's bargaining power. Part D -- the prescription drug coverage expansion -- is a great idea, but it's so freaking expensive because Medicare cannot, by law, use its bargaining power to get better prices on drugs.

 

[Alma]

You'll see single-payer eventually.

 

[Dick Whitman]

You'll see single-payer eventually.

It's got to be inevitable.

 

[Versatile]

Did anyone else think this thread was about Norrin Radd?

 

[Orange Hat Bobcat]

If nothing else, I hope the story leads to an eventual overhaul of ridiculous markups (for things like aspirin) and double- and triple-charges. It would take years, but that is ridiculous. If you're a non-profit, act like one.

 

[Bob Cook]

If nothing else, I hope the story leads to an eventual overhaul of ridiculous markups (for things like aspirin) and double- and triple-charges. It would take years, but that is ridiculous. If you're a non-profit, act like one.

Non-profit is a tax status, not a designation you're pure as the driven snow. Nonprofits still need to make money, and a lot of them make scads of it.

Some states are using the strategy of taxing away nonprofit hospital's property tax exemption if they're deemed not to do enough charity care. Given the amount of property, and the value of the buildings on it, that hospitals have, that can be a pretty huge hit.

 

[Inky_Wretch]

Wasn't MD Anderson the hospital where ABC filmed a reality show a few years ago?

 

[waterytart]

You'll see single-payer eventually.

From your lips ...

 

[BTExpress]

Saddest story I've read in a while. Appalling and embarrassing.

 

[JR]

My brother went in to Hamilton General Hospital up here for open heart surgery before Xmas to replace a mitral valve. He spent about five days in the hospital after surgery. Total cost: about $10.00 to rent his TV. And his doctors have been astonished at how fast he's recovered. He turns 60 this year.

Am not gloating but there ARE alternatives to US healthcare. Canada has a single payer system and no, we do not have socialized medicine. And our system is cheaper because we do not have layers of bureaucracy.