Tuesday, February 26, 2013

Bad Medicine

Run, do not walk, to the local newsstand and pick up a copy of this week's Time Magazine for the lengthy investigative reporting done by Steven Brill on the price-gouging and profiteering of the American medical system.
From doctors to hospitals to insurance companies (which actually almost come off as heroes in this tale), Brill follows the money, and does it in-depth and in such a thorough manner that you feel what the various victims of the scamming feel as you read it: anger, terror, overwhelming intimidation.

When Sean Recchi, a 42-year-old from Lancaster, Ohio, was told last March that he had non-Hodgkin’s lymphoma, his wife Stephanie knew she had to get him to MD Anderson Cancer Center in Houston. Stephanie’s father had been treated there 10 years earlier, and she and her family credited the doctors and nurses at MD Anderson with extending his life by at least eight years.

Because Stephanie and her husband had recently started their own small technology business, they were unable to buy comprehensive health insurance. For $469 a month, or about 20% of their income, they had been able to get only a policy that covered just $2,000 per day of any hospital costs. “We don’t take that kind of discount insurance,” said the woman at MD Anderson when Stephanie called to make an appointment for Sean.

Stephanie was then told by a billing clerk that the estimated cost of Sean’s visit — just to be examined for six days so a treatment plan could be devised — would be $48,900, due in advance. Stephanie got her mother to write her a check. “You do anything you can in a situation like that,” she says. The Recchis flew to Houston, leaving Stephanie’s mother to care for their two teenage children.


The total cost, in advance, for Sean to get his treatment plan and initial doses of chemotherapy was $83,900.


Steven Brill is no wild-eyed radical. He created CourtTV and American Lawyer magazine and has advocated for charter schools and the dismantling of teachers' unions as a way to improve education in America.
Hardly a granola crunching hippie, is my point.
In this treatise, he makes a very cogent argument that not only are hospitals -- even non-profits, which opened my eyes -- overbilling, they are basically running RICO scams against consumers, fueled mostly by greed and cynicism.
We all know stories of the aspirin that costs $5 a piece, and we're told its because there's overhead and salaries and equipment to cover. Brill demolishes that shady defense, and points out that most of the money lines the pocket of shareholders and executives of hospitals, doctors' groups and insurers.
As I said higher up, insurers almost look like they're getting scammed, except Medicare. Brill lays out a very strong case for single-payer healthcare, pointing out that Medicare/Medicaid actually get the most cost-effective "bang for the buck" of any insurer out there...and they are still mandated to cover a comfortable profit margin for healthcare providers.
This article may be the arrow that finally pierces the armor of Big Med. Go read it. You'll be mad as hell, and yet come away with a sense of hope for the future.