I think this story from JS Online should pretty much put an end to any pretense that our health care system bears any resemblance to a free market economy.
An elderly woman underwent hernia surgery and had to stay overnight for observation. She was already required to take certain medications and, therefore, had the necessary supplies. However, the hospital refused to allow her to take her own medications during her stay; charging her the inflated in-house rates for the medications. Her medication bill included $16 for four acetaminophen tablets (that’d be Tylenol), $4 for a single multiple vitamin, $49 for two breast cancer tablets that Walgreens sells for $9.93 each when purchased in a 30-day supply, and $13.98 for an antacid tablet that sells for $1.27. She also was charged $258 for an asthma inhaler that costs $42 at Walgreens.
Meanwhile, Medicare only pays for prescription medicines for patients who are “admitted,” but not for patients who are merely “checked in for observation.” Regardless of the status, however, patients are not allowed to bring in medications they have already purchased themselves.
One hospital administrator justified the practice of jacking up the prices for in-house drugs by noting that the hospital loses money on Medicare and Medicaid patients and, therefore, has to make up the costs elsewhere, such as from the uninsured or from those covered by commercial insurers.
It should, but it won’t. Not for the faith-based community of supply-side Jesus.
For those in the reality-based community, it won’t tell ’em a whole lot they didn’t already know, but every little bit helps.
This kind of cost-shifting happens all the time. I asked for an itemized bill, and disputed everything we hadn’t specifically asked for. My wife was issue a hand-operated breast pump (about a $20 item) and was billed almost $300 for it. That came off the bill once disputed. But item after item was inflated that way. Another standard is to charge $16 for the marks-a-lot pen the patient uses to write “wrong leg” on the side not being operated on. They then reuse the pen over and over on subsequent surgical patients. I have to imagine you can make a cool grand off that $1.19 pen if done right…
The argument they would make about giving their own meds is that their pharmacist can insure the proper chain of custody has occurred, etc. Plus, it’s their shop, they can do what they want. Similar to McDonald’s frowning on people bringing their own coke in to drink, etc.
A few thoughts…
1. Seems to me one could create a profitable business contesting medical over-charges for a percentage of the savings.
2. “Socialized medicine” became a reality in 1965 Medicaid was enacted as an individual entitlement.
3. Students enrolling in medical school are declining at a rate of 17 percent over the past ten years. There are fewer qualified physicians to meet the demand of an aging and growing population. Socialized medicine is partially to blame.
4. Physicians and medical care facilities pick up much of the tab for medicaid.
5. When Indiana removed some 11,000 medicaid recipients from the rolls, a suit was filed in federal court in behalf of one of those eliminated. The federal court forced the state to reverse its decision. The state of Indiana has no recourse but to participate in socialized medicine.
— end of sermon
Someone without insurance gets a much higher bill than someone with insurance.The added cost to our bills is to cover those who have no insurance who also get medical care.Who is supposed to pay,if not all of us? I’ve always maintained that true 100% socialized medicine would cost everyone less.At least prices would be controled for the consumer,and that should be number one priority.
My concept of ‘socialized medicine’ is not putting private companies in charge of drugs, and how many health insurance companies are not private?
And the point made above is that we have PRIVATE control without true supply and demand..It’s pure manipulation for profit.No modern CEO would ever rely on unfettered market dynamics.
Some points and counterpoints to Kenn Gividen:
1) I agree that it sounds like a market opportunity; but market opportunities come from waste as well as production. I suppose this is a way of recapturing some economic benefit from waste; the problem is that industries built on waste can end up lobbying to maintain the arrangement that produces the waste in the first place, preventing the more efficient allocation of capital and labor resources.
2) Depends on what you mean by “socialized medicine”. We’ve definitely socialized the costs to a great degree…and yet millions go without the benefit — health insurance. When costs and risks are socialized but benefits are not, you have a kind of domestic mercantilism. State capitalism, really. Not the free market kind.
3) Correlation does not equal causation. Do you have a cite for your statistics? I did some web searching and found lots of stuff about minority enrollments in medical schools decreasing, but nothing demographically neutral. Furthermore, can you point to studies that actually suggest that A) reduced earning power is the reason for decreased enrollments; B) that Medicaid is a cause of reduced earning power; and C) that physicians’ earning power has decreased to a relatively greater degree than other professionals’ over the past decades? (See, for example, a report by the Economic Policy Institute, Wages and salaries at unprecedented low growth rate.)
4) How much? Do you have any data?
5) I don’t know if this is the same situation, but there is a little something about Indiana Medicaid I’ve dealt with. As I understand it, Indiana and New Jersey are the only states that don’t link Social Security Supplementary Income payments (for the disabled) to Medicaid disability benefits. As Medicaid is a federal program, I don’t see why a person’s eligibility should vary by their state of residence.
I realize you did characterize your comment as a sermon, but I hope that’s not because you feel no obligation to back up policy arguments with data.
One quibble with Branden Robinson’s comment above:
The benefit of interest is health care – and the disassociation of health care from both health insurance and patient payment is a large part of what makes our current system so confusing and frustrating.
There are probably any number of well-intentioned ways to make the provision of health care worse than our current system – anyone who can lead us to significantly better outcomes than we now have will get my vote, for anything up to and including Pope.
Parker,
Excellent point — I misspoke, and thank you for your correction.
This is an interesting discussion but it thus far has discussed generalities. I would never utter the word free market in the same sentence of healthcare.
The only free market side that healthcare has every seen is a person who pays cash. Wether it be work comp, a ppo, hmo, or state funded health insurance these types of insurances place restrictions on types of service, location of service, etc.
As far as the cost of healthcare…it has become a volume sensitive service industry broken down by pressures from federally funded/state funded programs, non-profits hospitals, poorly worded laws (EMTLA), restrictive practice acts(physician assitants) etc…the list for healthcare costs in Indiana can be see here: http://www.in.gov/fssa/programs/chip/insurance/pdf/FINALexecsum.pdf
Moreover, how does one compare costs and quality. Medical groups are not allowed to compare prices for the same service…so how does the patient? Next, when discussing quality what is the best litmus test for medical services provided?
Mr Gividen states the enrollment for medical school is going down…by reporting a number of 17%. Mostly, because it is whole lot of work and most of fun is being taken out it by not taking care of the patient. To confound this problem not only is enrollment going down but nobody wants to go into Primary Care, which is a incredibly volume sensitive buisness.
Within ten years or less we will be at critical mass and the healthcare system will implode. We are headed towards universal healthcare. But, as one speaker told me..”It is not socialized medicine. That is when the government owns/employs the doctors and PAs.”
Well that’s a relief!