Health or Poverty? Hospital Brass, Congress, and Lobbyists Are Killing Health Care!

Time Magazine featured a gripping and informative article by Steven Brill called "Bitter Pill, Why Medical Bills are Killing Us", that every health care consumer and nurse should read, .  The article was the longest in the history of Time, and in my opinion a nauseating look into how health care policy and pricing guts Americans.

Mr. Brill explains how nonprofit hospitals and for profit hospitals are price gouging patients on everything from a $7 alcohol wipe to $400 per hour nursing care (not 1:1 ratios either).  His article is supported by patients' stories and their medical bills.

He delves into the way that Medicare is able to contain some of the costs of care, such as pricing for CTs which have no price regulation nor consistency hospital to hospital, charging upwards of $6,000, where Medicare has been able to negotiate a charge of $500.  As for other insurance companies they have their own negotiating numbers, which are discounted from the hospitals' chargemaster.  Brill explains that each hospital has a charge master which is a listing of what each item costs, and that the patients are billed and sometimes over billed for these items. The chargemaster also prices lab tests and other diagnostic tests.  When Brill asks hospital higher ups about the charge master they responded as though it wasn't a concrete or important component of pricing, but again and again he provides evidence that everyday patients are charged enormous amounts of money for inexpensive items.

Medicare is the largest insurer in the U.S. and holds a good amount of leverage, but it is not absolute leverage.  While cost savings have been negotiated with hospitals for tests and services, congress has banned Medicare's ability to negotiate with big pharma over drug costs and the cost for durable medical equipment.

Congress has very little reason to do the right thing for their constituents when lobbyists out number the members of congress and spend millions of dollars to get them reelected.  According to Brill in 2012 the American Hospital Association spent $1,859,041 on lobbyists while other healthcare lobbyist have spent $5.36 billion since 1998.  Brill points out the during the same time lobbyists for defense spent $1.53 million and the petrol industry courted Washington with $1.3 billion.

While health care reform has come to the aid of some, the fundamental broken parts of health care are still very much intact, an internal anaconda, squeezing the wellness out of health care from inside the hospitals themselves.  If we are to take health care reform seriously we need to have a fair market value system. People generally don't choose to go to emergency rooms, they often have no choice, its like a hostage situation.  Do you want to live, then you take what you are given and hope the ransom isn't too high, or you leave without care and possibly die.

http://www.time.com/time/covers/0,16641,20130304,00.html