12 July 2011

Why "consumers" can't drive down health care costs

Bloomberg has a great article up about how impossible it is to find out how much medical procedures cost. Mimi Ferraro spent hours trying to find the least-cost provider for an injection of cancer medication she needed. She made her decision based on information that came after numerous calls - to the insurance company, which told her it couldn't give an estimate on the cost until after she'd had the procedure (!) and then a week of waiting on the answer from her oncologist's office. It was wildly inaccurate. She paid $4,099.51 for a shot she was told would be about half that much. She could have gotten it for half that much at a local pharmacy - but it wouldn't have counted toward her deductible. Her high deductible, that is.
This kind of [high deductible] insurance is expected to help reduce health costs. Given a need to make higher upfront payments, patients may be more selective about the services they buy and keep spending low. But there is a significant flaw in this reasoning: Patients aren’t the ones who make the decisions about which tests and procedures to purchase. Doctors are. And doctors, along with hospitals and insurance companies, don’t let on how much the services cost.
Another significant flaw is that a plethora of studies have shown that people do not make good decisions about health care spending. They balk at spending for preventative measures and, when panicked, will spend far too much when it's too late. Not that they know how much they're spending.

Ferraro pulled together some studies that show no one knows what procedures will cost. She thinks that if every patient demands the cost information that she was asking for, costs will actually become transparent. I absolutely disagree. It's not in anyone but the patient's interest to make that transparent, and our for-profit system isn't set up to benefit the patient. Excuse me. I meant the consumer. I would also point out that not only are U.S. health care consumers blindfolded, this kind of treatment is emotional torture and very bad for your health.

But most Americans can tut-tut. It happens to someone else. We look for what they did wrong - like get sick, for instance - and feel reassured that it won't happen to us.

Who needs foreign-born terrorists to wreck our communities when we've got insurance companies!

06 July 2011

Think again if you think being insured = security

Americans love to believe things that are demonstrably untrue - tax cuts equaling increased government revenue and a stronger economy, for starters. Oh, and the whole idea of for-profit insurance companies being an efficient way to finance our health care being another.

So I'm just passing this along - it's not going to make a whit of difference in the debate. The University of Arizona has found that being insured doesn't affect whether you have medical debt.
According to a study published online June 16 by the American Journal of Public Health, after taking age, income and health status into account, simply being insured does not lower the odds of accruing debt related to medical care or medications....

"On average, insurance coverage in Arizona is not protecting families from experiencing medical debt. From other studies we knew that paying medical bills is a problem for a substantial portion of both insured and uninsured Americans. This study helped clarify that the fact of medical debt is an additional and larger barrier to getting needed health care than whether a person is insured or not."

That's according to University of Arizona College of Pharmacy research scientist Patricia M. Herman.

But don't expect the Americans who are swayed by the big-business money that preaches anti-government ideology to take note. (Hell, the mainstream media didn't even take note.)

They're busy admiring Michele Bachmann's poll numbers in Florida, leaving the fact that she's a delusional liar to, at best, the papers' online blogs, to be read by the choir.

Social darwinist Bachmann is quite concerned about a mythical $105 billion "hidden" mandatory spending in the health care reform bill passed last year. That would be the most-debated bill ever passed. Right, Michele.

And the shot heard round the world was fired in New Hampshire. Uh huh. Obviously memory fails us all now and then. But when a third or so of Americans begin to channel the single-minded Walter Sobchak (You're goddamn right I'm living in the fucking past!") from The Big Lebowski, it's hard to know where to begin. As The Dude says, "Walter, I love you, but sooner or later, you're going to have to face the fact you're a goddamn moron."

The scary thing is that these folks aren't just channeling film rage, they and their leaders are unwittingly channeling mass murderers. Bachmann again: “But what I want them to know is just like John Wayne, who is from Waterloo, Iowa – that’s the kind of spirit that I have too.”

As one L.A. Times commenter wrote, "I don't think she was mistaken, she was just speaking in secret code to her minions. She well intends to rape the nation like [John Wayne] Gacy [who was from Waterloo] did to his victims..."

Another commenter offered a SOP right-wing solution: "Let's go to John Wayne's Wikipedia page and change it so that she is right."