Monday, March 4, 2013

A Few Thoughts On Steven Brill's Bitter Pill Article In Time Magazine

You shouldn't have to be a genius or a healthcare expert to understand that you shouldn't have to go bankrupt in a country like the United States because you slipped and fell or had chest pains and needed a hospital visit. I'm reading about this in Steven Brill's exposé Bitter Pill: Why Medical Bills Are Killing Us of our current medical system on why hospitals charge exorbitant prices for routine medical equipment and tests. It's enough to make you sick (ha!).

Hospitals across the country use a machine called the chargemaster that calculates the prices that hospitals charge patients for medical screening tests and procedures, treatments, medication and even the doctor's surgery gown. It can even charge several hundred dollars to a patient just for the doctor to look at the test results. The line item analysis done in Brill's article is shocking: $7 for a cotton ball to sterilize the skin before an injection; $200 blood tests that should cost no more than $15; $32 for the use of a reusable blanket to keep a patient warm during surgery; $39 for the gown worn by the doctor during the surgery when 30 can be bought online for $180; and $49,237 for the use of a Medtronic stimulator, a device which costs just $19,000 to buy wholesale.

The list goes on and on showing hospitals price gouging as much as 21 times the wholesale costs of their equipment. Why should a trip to the hospital that involves some routine tests cost someone $87,000? Brill says hospitals want to over test patients to prevent themselves from getting sued. OK, but why such high prices? Not-for-profit hospitals are really being run like for-profit enterprises argues Brill, with their presidents making upwards of several million dollars a year. The mysterious chargemaster machine determines the prices based on location and other factors that are not well known.

Medicare significantly lowers these costs to seniors but often healthcare can only negotiate 35 to 50% lower rates that are still high because of the initially high costs. What needs to be done is get these prices down. Some countries enforce price limits to prevent this kind of gouging but critics of that here say it's socialism - and we can't have that in America. So I guess then we'll have to keep this hospital industrial complex running, which will only lead to these costs going up, and more and more Americans getting stuck with the bill.

It is my contention that healthcare and hospitals should not be a for-profit industry. The necessity of the health business should give us the impetus to enact reasonable moral guidelines that prevent so called "not-for-profit" hospitals from turning into the kind of greedy corporations that run Wall Street.

This has also gotten my worried about potentially having medically related financial woes in the future. I've been eating much more healthy in recent years and have increased my fruit and vegetable intake significantly. I still occasionally binge on garbage but I'm much more conscious of it now mostly because I'm older and I know my body will begin breaking down. The fear of a potential $87,000 medical bill motivates me too.

My advice to anyone reading this, especially if you're young, is that healthcare starts with you. You can't treat your body like crap forever, you need to consciously take the initiative to become a healthier person and this will help you for the rest of your life. The sooner you do this the better. Two reasonable steps for the lazy:

  • You don't have to become a health fanatic, per se, but if you eat fast food and other forms of edible garbage, eat at least as much healthy food with it so there's a balance. 
  • And if you're a partier and like to drink and smoke and do drugs, at least exercise a few days a week to balance it all out. 
Maintaining a reasonable exercise routine and balanced diet goes a long way.

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