Friday, December 6, 2013

Get a Few Stitches, Get Charged Thousands of Dollars – When Will the U. S. Realize the Economics of Its Health Care System Are Broken

Well Somebody Has to Make an Obscene Profit

The problems with the U. S. health care system go far beyond the problems with Health Care Reform, which presumably will be fixed as soon as those in charge realize how big systems work.  The problems with the U. S. health care system is costs, not ACA.  And ACA will do little to reduce costs, because a fee for service system is built to increase costs, not reduce them.

So no one should be surprised when the New York Times found out that a simple visit to a hospital to get some stitches costs thousands of dollars.

Chelsea Manning in St. Clair, Mich., in November. She tripped and fell in the driveway of her home, and needed six stitches for which she was billed close to $3,000.Joshua Lott for The New York Times

On a quiet Saturday in May, nurses in blue scrubs quickly ushered the two patients into treatment rooms. The wounds were cleaned, numbed and mended in under an hour. “It was great — they had good DVDs, the staff couldn’t have been nicer,” said Emer Duffy, Orla’s mother.

Then the bills arrived. Ms. Singh’s three stitches cost $2,229.11. Orla’s forehead was sealed with a dab of skin glue for $1,696. “When I first saw the charge, I said, ‘What could possibly have cost that much?’ ” recalled Ms. Singh. “They billed for everything, every pill.”

Here is the gross, in every way, summary.

A day spent as an inpatient at an American hospital costs on average more than $4,000, five times the charge in many other developed countries, according to theInternational Federation of Health Plans, a global network of health insuranceindustries. The most expensive hospitals charge more than $12,500 a day. And at many of them, including California Pacific Medical Center, emergency rooms are profit centers. That is why one of the simplest and oldest medical procedures — closing a wound with a needle and thread — typically leads to bills of at least $1,500 and often much more.

The Republican solution, a market based pricing system where consumers buy based on price is, of course, ridiculous.  No parent is going to shop around for the best price while their child needs stitches, and even if they do they cannot get pricing information anyway.

At Lenox Hill Hospital in New York City, Daniel Diaz, 29, a public relations executive, was billed $3,355.96 for five stitches on his finger after cutting himself while peeling an avocado. At a hospital in Jacksonville, Fla., Arch Roberts Jr., 56, a former government employee, was charged more than $2,000 for three stitches after being bitten by a dog. At Mercy Hospital in Port Huron, Mich., Chelsea Manning, 22, a student, received bills for close to $3,000 for six stitches after she tripped running up a path. Insurers and patients negotiated lower prices, but those charges were a starting point.

That’s right the price is not even the price.  What is the price?  We don’t know.  Hospital keep that info confidential. 

None of this will change until the economics of the system change.  We economists know this, we just don’t know why the rest of the population doesn’t know this.  We do know that the medical profession knows this, which is why they will fight any change. 

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