My son recently had a gallbladder attack. Paramedics took him to the emergency room and they kept him for four nights for testing, surgery and recovery.
If you wonder why insurance is unaffordable and the government is going broke, take a look at this bill.
The first question has to be why these guys dare to charge so much more than what the industry looks at as standard fees. And make no mistake, the uninsured working poor would be billed the $48K and the hospital would demand payment. I think we can assume that Medicare pays even less than the insurance companies and Medicaid pay even less again.
The amount the hospital was paid breaks down like this:
The hospital charges make the doctors look good but consider what is really being charged. If we pay a doctor $250,000 a year, that means she needs to earn $125 an hour for a 40 hour week and 50 weeks a year – surprising isn’t it considering all the plumbers, lawyers and mechanics charging so much more per hour? Anyway, at that rate, the anesthesiologist charged for 8 hours – the surgery lasted an hour and a half. I know there was prep but … Now compare what the doctors charged to what the hospital is charging. It is hospitals that are truly out of control.
That the patient had to ante up $3K for what is obviously a rare or catastrophic event is good and bad. The bad is that insurance ought to cover the entirety of an event such as this – that’s the purpose of insurance. The good is that in this area and others, we all need to become far more aware of what is being spent on our behalf. Never forget, we are paying these bills; pay me now or pay me later with interest.
If we ever hope to get medical costs under control, people have to have more skin in the game and we need competition. Most folks have a favorite mechanic because they refuse to pay the dealers to fix their cars. But in this case, you go where the ambulance goes and you are far too sick to go shopping. We count on the government and insurance industry to control the charges – this works for all of our other insurance. Unfortunately, politics and our tort system prevent all common sense when it comes to medical insurance. The market cannot function because of the courts, manipulated public opinion and government intervention.
There are many good ideas in ACA [the Affordable Care Act aka Obamacare] and many missing. Don’t drink the right wing kool-aid, America already insures every citizen; we simply do it in the most expensive and least effective possible fashion. Don’t drink the left wing, progressive kool-aid; government is the problem because it cannot do things.
The solutions will involve at least these key things:
· Government will have to set recommended fees for services, tests and drugs but done on a diagnosis basis – e.g. treating a cold should cost $69.50 including all visits and drugs; bronchitis, $150; broken arm, $250; and so on.
· Government will have to recommend best practices by diagnosis in order to cut down on unnecessary tests.
· Government will have to block all malpractice suits and establish guidelines for arbitration and reparation.
· Health insurance companies will have to be allowed to operate nationally with federal regulation.
· Basic insurance should be individual and replace all existing programs including Medicare, Medicaid, employer, government and pools – we all need to be in the same boat. These services must include dental and optical.
· All funding for insurance, for all citizens, should come from separate, purpose specific taxes paid by individuals; no other tax dollars should be used in the program.
o Insurance companies must pay for the government agency that regulates them and keep reserves necessary to cover failed companies.
o Insurance companies would pay no income taxes and government cannot use company reserves or individual medical taxes for any other purpose.
· Some services will not be provided by basic insurance – there will be rationing and “death panels”.
· No citizen may be prohibited from buying any medical services of any kind nor from purchasing additional insurance that would pay for such services.
These are the basics and everybody knows this has to happen. However, the details and actual legislation must be sold to the general public by the President and joint Party leadership. Nothing this big or this personal can be done by a single Party, even with a super majority and the Presidency – Obamacare proves that.
And finally, the need for cradle to grave insurance is critical to our national competiveness. The program must first and foremost control the current nation ruing cost escalation. We need an ACA and we need an American program – not the socialist stuff of other western nations – and we need it soon.
