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One of the reasons our health care costs are so high…

… is because we refuse to standardize prices for treatment.  I think I have told this story before but here it is again.  My French lab partner’s husband had a hernia operation.  It was outpatient and he spent about 4 hours in the hospital, not even enough time to get his gourmet meal.  When she got the bill, it was for something like $70,000.  She’d never seen anything like it in her country so she called the insurance company, who told her there had indeed been a mistake.  The actual cost was something like $40,000.

For four hours, no overnight stay and an uncomplicated hernia operation on a healthy 30 something year old male.

Now, Centers for Medicare and Medicaid Services has compiled a database that you can peruse to find out what treatment costs at various hospitals in your area.  In my state, you can pay up to $99,000 for treatment of COPD in Bayonne or cross the river into New York and pay a mere $7,044 for the same treatment.  The higher prices are sometimes due to the hospital making capital investments in new technology but it could very well be going to higher salaries for hospital executives and not staff.  Wouldn’t you like to know in advance where all that money is going?  I think it’s about time hospitals are forced to disclose this information up front.

And it’s more than time for hospitals, pharmacies and other third parties to stop taking advantage of asymmetric information about what they are paying and what they are charging.  Consumers don’t have time to continually check to make sure they’re not being swindled and governments have a responsibility to make sure we’re not being cheated.

That’s what we elect our representatives to do- to protect us from systemic exploitation.

 

The One Paragraph that Sums it all up

This is the blurb on the frontpage of the NYTimes about the Romney-Ryan plan vs the Obama administration on the issue of Medicare:

President Obama and his campaign are arguing that the Romney-Ryan approach to Medicare would leave older Americans vulnerable to rising health care costs.

I’ll bet that when the writer wrote that paragraph he or she had no real insight about what they were talking about.  It’s just the zeitgeist. There doesn’t seem to be an epiphany here.  Why are health care costs continuing to rise?  How is it that our elected representatives have allowed these costs to rise without restraint? And it fails to put the blame where it belongs, especially when it comes to the Affordable Care Act. The biggest failure here is Obama’s because he and the Democrats have been unwilling or unable to prevent health care costs from rising to unsustainable levels.

And let us be clear about this, we have known that the rise in health care costs would be unsustainable, a deficit hog and a drag on the economy since the Clinton administration.  But the Republicans flooded the airwaves with Harry and Louise and the Democrats were too craven to stand their ground.

It doesn’t matter whether the Republicans restructure or eliminate Medicare or not.  The costs will keep on rising because we have done absolutely nothing to stop them from rising. The costs related to Medicare must be addressed.  There are painful ways of doing it, like the Romney-Ryan plan that would boot old people back into the private insurance market when they can least afford it, or there are less painful ways but expanding the insurance pool and putting a firm cap on the cost and types of procedures that will be covered, just like every other developed country in the world with good health care systems do.

What we have here is a failure of leadership.  We do not have a president or Congress who is willing or able to make a case for sensible reforms or is willing to say that Americans have to get over their ego and misinformed sense of superiority problem.  A good doctor can be found in many places including hospitals that serve the poor and the military, higher costs do not necessarily equal better care, you don’t need to go to a swanky hospital for good treatment, some alternative medicine is crap and we shouldn’t be paying for it, and the hospitals and other providers are not entitled to every last penny in the Treasury just because they send us an invoice.

But whatever.  Neither party has any intention of taking on the real problems associated with healthcare.  Neither wants to tell the public like it is or get the providers’ hands out of what they perceive to be bottomless pockets.

Your politicians at work.  Wake me in 2014.