Wednesday, March 28, 2012

$5,000 Stomach Ache Exposes the Fallacy of Republican Concept of Market Forces to Control Health Care Costs

But Don’t Worry – All Those Conservatives Have Gold Plated Government Provided Health Insurance

The answer that Republicans and Conservatives have for the rising cost of health care is to allow market forces to work.  Give consumers control over the health care decisions and a competitive market will force down prices.  This is the position of Mitt “I like to be able to fire people” Romney and all the others on the Conservatives side.

Market forces and free markets are great in many circumstances, in fact in most circumstances.  A good example of a competitive market is the auto industry.  Consumers can take their time and become educated on automobiles, consult pricing across the country through the internet, read unbiased reviews of various models and do all the necessary research to make an informed decision.  Organizations like the Better Business Bureau and others provide info on dealer integrity.

Health care is the exception.  To begin with it takes a 4 year college degree, a 4 year post graduate degree and a whole lot of research on top of that to make informed decisions on health care.  Also, a patient frequently does not have the time to gather information as most health care decision require immediate attention.  As far as availability of information and third party unbiased reviews are concerned, forget about it.

So the idea that consumer in a free market situation will use competition to drive down health care costs is absurd, health care being an exception to the market as optimal allocator of resources rule.  This absurdity is illustrated by a Los Angeles Times columnist who gives us the story of a stomach ache that ran up over $5,000 in medical costs.

The story of 11-year-old Ella Moser's $5,000 tummy ache begins in October, when her Studio City parents called their pediatrician one night and were advised to go to an emergency room, just to be safe.

The parents had a high deductible plan, the kind Republicans are pushing as one solution to health care costs because that means the patient, not the insurance company is on the hook for a lot of money.  So here is some of what Ella Moser’s father faced when he had to take his daughter to the emergency room.

The cost for just walking in the door of the emergency room? That came to $1,288. The ultrasound nicked him an additional $1,135. A comprehensive metabolic panel (blood analysis) was billed at $1,212.

Moser was also charged $158, accidentally, for the saline solution he had turned down. The total came to $4,852.55, not counting separate bills that would arrive later and total nearly $1,000, including $540 for pathology and $309 for the doctor.

And that comprehensive metabolic panel that cost over $1,200, yes it is available for less, much less.

That's a test, Dr. Moser said, in which a technician draws blood for chemical analysis, and it takes just minutes. Moser questioned not only the charge, but the usefulness of the test in his granddaughter's case.

Out of curiosity, I went online to see what a lab might charge for a comprehensive metabolic panel.

Any guesses?

Some labs advertise prices as low as $39.

See, Republicans would apparently have expected the father to halt the proceedings, take several days to research the usefulness and cost of the test and then arrange for someone other than the hospital to do it.  Right.  But that is the fantasy world Republicans live in.

No person is at fault here.  The father did what all of us fathers would do, protected his daughter’s health regardless of the cost.  The hospital erred on the side of safety, no one wants an 11 year old girl to suffer a serious health problem because of the cost of care.  No the system is at fault here. 

And this is a system that does not treat everyone equally.  Every Republican (and Democratic) legislator is supplied government health care or provided with health insurance.  And they get the gold plated kind.  And this is not to say they shouldn’t get it, but that they should not deny to others that which they will not deny to themselves.

The Supreme Court is hearing arguments on the ACA and will determine its fate later this year.  Of course, for the Justices this is not a personal issue, their government provided health care is almost certainly the finest in the nation.  Justices like Scalia and Thomas no doubt consider this their right, but only theirs, not anybody elses.

And the good news, Ella Moser is fine.  It was just a tummy ache.

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