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Profits and Patients: The High Health Costs Killing Americans

Systemic Pain

Health care costs in America are so high that over a third of all Americans do not seek a doctor’s help when sick and do not fill prescriptions as prescribed, according to a report released in October 2015 by the Commonwealth Fund.
High medical care costs are the cause of over half of the personal bankruptcies in America. Worse yet, most persons bankrupted had medical insurance -- insurance that just didn't pay enough of the costs of care. A January 2016 item on the American Journal of Medicine blog noted how medical bankruptcies continue “even under” the federal Affordable Care Act, commonly known as Obamacare.

What’s really ‘sick’ is that actions required to cure the many fundamental problems in America’s health system are treated as side issues in the bitter partisan wrangling around reform of the health care system. Too many elected officials, particularly conservatives, are more interested in preserving health care industry profits than providing affordable care for the voters who elected them. (And why would most elected officials care? They have a gold-plated health plans, paid by tax dollars, for themselves and their families.)

That $1,471 bill this woman received was from a healthcare financial services company in an Ohio city located 425-miles west of the five-year-old hospital in an upscale South Jersey suburb outside Philadelphia where she sought ER treatment. She went to this hospital over thirty-miles from her Jersey home because the two hospitals nearest her home are not noted for quality care.

She sought an emergency room visit late on a Saturday afternoon because of severe pains in her chest that had persisted for days. Since it was a Saturday afternoon, the office of her regular doctor was closed. And since she was having those persistent chest pains, prudence dictated medical attention sooner rather than later to avoid more serious medical complications –- like a heart attack.

That $1,471 bill listed a $1,384 charge for “Emergency Dept Visit” and an $87 charge for an “Electrocardiogram Report.” Those charges raise the obvious question of why weren't they included in that $14,000+ bill issued for the same Emergency Department visit? Is that $1,471 bill a surgical assault on her pocketbook by that hospital? It certainly is an insult.

During that four-hour hospital visit the majority of her ER time was spent in a curtained area, lying in a bed.

An ER doctor confided that he is required to order many tests for “defensive reasons.” The battery of tests she received that increased the cost of her ER visit were given primarily to decrease the possibility of malpractice lawsuits and/or fines from governmental regulators for not performing all that could be done…with "could be done" being different from what "should be done."

For example, she was given two blood tests, the second test administered despite the first test revealing no abnormalities. Since that second blood test merely repeated that first blood test, her insurance company refused to pay for the second test, resulting in her receiving a $175 bill, a bill she had to pay.

And, oh, there was the $100 co-pay payment she had to cough up for the ER visit, as required by her medical insurance plan.

story | by Dr. Radut