Tag: Insurance Industry

Medical Bankruptcy in the US Even With Insurance

Cross posted at The Stars Hollow Gazette

In the United States, 62% of all bankruptcies in the United States are due to medical bills. It is not among who you would think but most often effects middle aged, middle class, college educated homeowners. 80% of those people had health insurance, so why are they filing for bankruptcy? No other industrial country has this problem.

Our fellow blogger, lambert, writing for naked capitalism, featured this video from Real News Network:

Paul Jay of the Real News Network interviews Dr. Margaret Flowers, a pediatrician from Baltimore who advocates for a national single payer health system, Medicare for all, and Kevin Zeese, co-director of It’s Our Economy, an organization that advocates for democratizing the economy.

At his blog, Corrente, lambert continues to document the atrocities of the Obamacare ClusterFuck.

Health Care Costs: The Hard To Swallow Pill

Cross posted from The Stars Hollow Gazette

Journalist Steve Brill wrote brilliant cover story for Time magazine, Bitter Pill: Why Medical Bills Are Killing Us, which lays out the reason US health care costs are out of control, just follow the money. He explains how the hospitals and their executives are scamming the system through billing to maximize profits. As an examples of the absurd charges, for a 15 cent Tylenol tablet hospitals charge as much as $1.50, $6 for a marker used to mark the body before surgery and as much as $77 for each of four boxes of gauze used. In hospital a patient can be charges as much as $450 for an electrocardiogram that in a doctor’s office would only cost $150.

This doesn’t happen in other countries where costs are controlled by government set rates for what both private and public plans can charge for various procedures. The problem here in the US isn’t that we don’t have single payer, it’s that the government doesn’t regulate the prices that health-care providers can charge. But in an article at the Washington Post by Sarah Kliff for the Wonkblog writes that we don’t need to look to other countries:

Maryland has succeeded in controlling costs for about four decades now. It is the only state that sets rates for hospitals, with the state government deciding what every Maryland hospital can charge for a given procedure..

That system started in 1976, when Maryland had hospital costs 26 percent higher than the rest of the the country. In 2008, the average cost for a hospital admission in Maryland was down to national levels. “From 1997 through 2008, Maryland hospitals experienced the lowest cumulative growth in cost per adjusted admission of any state in the nation,” the state concluded in a 2010 report (pdf).

Here is a brief summery of the article and what you should know about why health care in this country costs so much (and it isn’t malpractice lawsuits, as some would have you believe):

  • Hospitals arbitrarily set prices based on a mysterious internal list known as the “chargemaster.” These prices vary from hospital to hospital and are often ten times the actual cost of an item. Insurance companies and Medicare pay discounted prices, but don’t have enough leverage to bring fees down anywhere close to actual costs. While other countries restrain drug prices, in the United States federal law actually restricts the single biggest buyer-Medicare-from even trying to negotiate the price of drugs.
  • Tax-exempt “nonprofit” hospitals are the most profitable businesses and largest employers in their regions, often presided over by the most richly compensated executives.
  • Cancer treatment – at some of the most renowned centers such as Sloan-Kettering and M.D. Anderson – has some of the industry’s highest profit margins. Cancer drugs in particular are hugely profitable. For example, Sloan-Kettering charges $4615 for a immune-deficiency drug named Flebogamma. Medicare cuts Sloan-Kettering’s charge to $2123, still way above what the hospital paid for it, an estimated $1400.
  • Patients can hire medical billing advocates who help people read their bills and try to reduce them. “The hospitals all know the bills are fiction, or at least only a place to start the discussion, so you bargain with them,” says Katalin Goencz, a former appeals coordinator in a hospital billing department who now works as an advocate in Stamford, CT.

    Recently, Mr Brill sat down with Hardball guest host Michael Smerconish  and Neera Tanden from Center for American Progress to discuss how the rising health care costs are killing Americans:

       And it actually that bears on the conversation we’re having, because a chunk of that money is paid by Medicare. Medicare is I point out in the article is very efficient at most things. It buys health care really efficiently, which is a great irony, because it’s supposed to be the big government of bureaucracy.

       Where Medicare is not efficient is where Congress, because of lobbyists have handcuffed Medicare. Medicare can’t negotiate what it pays for any kind of drugs. It can’t negotiate what it pays for wheelchairs, diabetes testing equipment. And if Congress took those handcuffs off of Medicare, you could get about half of the spending cuts that we’re sitting around here talking about.

    Raising the eligibility age and/or applying a means test as ways to reduce the cost of Medicare will not fix the rising costs. Only government regulation of the hospitals and the ability of Medicare to negotiate pricing for procedures, equipment and supplies will cut the cost for the patient and the tax payers. Take the profit motive out of saving lives and keeping Americans healthy.

    The Extraordinary Cost of Health Care

    Cross posted from The Stars Hollow Gazette

    In an a cover story  for Time magazine, journalist Steven Brill spent seven months examining how medical bills are what is really killing us: the extraordinary costs of health care is a “bitter pill”  that nickels and dimes even the insured patient for every pill, band-aid and blanket:

    Simple lab work done during a few days in the hospital can cost more than a car. A trip to the emergency room for chest pains that turn out to be indigestion brings a bill that can exceed the price of a semester at college. When we debate health care policy in America, we seem to jump right to the issue of who should pay the bills, blowing past what should be the first question: Why exactly are the bills so high? [..]

    · Hospitals arbitrarily set prices based on a mysterious internal list known as the “chargemaster.” These prices vary from hospital to hospital and are often ten times the actual cost of an item. Insurance companies and Medicare pay discounted prices, but don’t have enough leverage to bring fees down anywhere close to actual costs. While other countries restrain drug prices, in the United States federal law actually restricts the single biggest buyer-Medicare-from even trying to negotiate the price of drugs.

    · Tax-exempt “nonprofit” hospitals are the most profitable businesses and largest employers in their regions, often presided over by the most richly compensated executives.

    · Cancer treatment-at some of the most renowned centers such as Sloan-Kettering and M.D. Anderson-has some of the industry’s highest profit margins. Cancer drugs in particular are hugely profitable. For example, Sloan-Kettering charges $4615 for a immune-deficiency drug named Flebogamma. Medicare cuts Sloan-Kettering’s charge to $2123, still way above what the hospital paid for it, an estimated $1400.

    · Patients can hire medical billing advocates who help people read their bills and try to reduce them. “The hospitals all know the bills are fiction, or at least only a place to start the discussion, so you bargain with them,” says Katalin Goencz, a former appeals coordinator in a hospital billing department who now works as an advocate in Stamford, CT.

    Mr. Brill was a guest on MSNBC’s “The Last Word“, he discussed with guest host Ezra Klein the costs of health care, who’s to blame and how we can fix the US broken health care system:

    Government’s Revolving Door

    Cross posted from The Stars Hollow Gazette

    In a recent on air essay on his PBS program, Moyers & Company and an opinion piece at Huffington Post, Bill Moyers took a look at the revolving door of special interest groups and their lobbyists, how they win and the rest of us lose.

    Washington’s Revolving Door Is Hazardous to Our Health

    We’ve seen how Washington insiders write the rules of politics and the economy to protect powerful special interests but now, as we enter the holiday season, and a month or so after the election, we’re getting a refresher course in just how that inside game is played, gifts and all. In this round, Santa doesn’t come down the chimney — he simply squeezes his jolly old self through the revolving door. [..]

    The last time we looked, 34 former staff members of Senator Baucus, whose finance committee has life and death power over the industry’s wish list, were registered lobbyists, more than a third of them working on health care issues in the private sector. And the revolving door spins ever faster after a big election like the one we had last month, as score of officials, elected representatives and their staffs vacate their offices after the ballots are counted. Many of them head for K Street and the highest bidder. [..]

    Reforms were passed that are supposed to slow down the revolving door, increase transparency and limit the contact ex-officials and officeholders can have with their former colleagues. But those rules and regulations have loopholes big enough for Santa and his sleigh to drive through, reindeer included. The market keeps growing for insiders poised to make a killing when they leave government to help their new bosses get what they want from government. That’s the great thing about the revolving door: one good turn deserves another.

    The door continues to spin with the latest exodus from Commodity Futures Trading Commission (CFTC). DSWright at FDL‘s News Desk has the latest:

    Step right up and Spin the Revolving Door – and what is your prize? Why, a nice job on Wall Street working for the people you used to regulate – you wrote in the loopholes, now you get the cash for exploiting them! [..]

    Many Americans understood that the Dodd-Frank “reforms” were mostly worthless. They will not prevent another crisis or another massive TARP type bailout as the law did absolutely nothing about Too Big To Fail banks (which have actually gotten bigger).

    This should not have been a surprise given one of the law’s namesakes, Senator Chris Dodd, was caught red handed getting special loans from perhaps the worst offender in irresponsible mortgage origination – Countrywide. Senator Dodd barely survived an ethics investigation from his similarly compromised colleagues.

    But what critics may not have understood was that Dodd-Frank was apparently a jobs program for politically connected staffers.

    The last count of lobbyists, as of October, directly involved in advising the president, a member of his cabinet or campaign staff is 55.

    Champagne Corks are Poppin in the Insurance Lobby Boardrooms!

    6 Months Gains in Stock prices — 3 Health Insurance Giants



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    6 Months Gains in Stock prices — 3 more Health Insurance Giants



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    Notice the recent spike in price, in the last few weeks, when they knew “Santa got their wish list, and was making a special trip, just for them!”

    Olbermann’s call to Action: a Photo Essay

    Hopefully you saw Keith Olbermann’s Special Comment on the sorry state of the Health Insurance System in American.  And hopefully, you were moved to action, like I was.  There’s still time to pony up, if it slipped your mind.  Let’s give Keith some ammo when he resumes the fight next week.

    DONATE HERE: National Association of Free Clinics

    as linked on Countdown’s home page

    Time is a task-master, that waits for no one,

    We can only heed its call, as it marches, inexorably forward …

    Hopefully we will find compassion, as we turn its pages.

    If you missed the Special Comment, read on for some of the highlights …

    45,000 Deaths Each Year Associated With Lack Of Health Insurance

    Let’s talk numbers. Even the most policy-averse can understand basic numbers.

    From Reuters:

    Nearly 45,000 people die in the United States each year — one every 12 minutes — in large part because they lack health insurance and can not get good care, Harvard Medical School researchers found in an analysis released on Thursday.

    “We’re losing more Americans every day because of inaction … than drunk driving and homicide combined,” Dr. David Himmelstein, a co-author of the study and an associate professor of medicine at Harvard, said in an interview with Reuters.

    Overall, researchers said American adults age 64 and younger who lack health insurance have a 40 percent higher risk of death than those who have coverage.

    A 1993 study found that those without health insurance are 25% more likely to die. That study put the number of annual deaths at 18,00 a year. The new study used the same methodology. It excludes people over the age of 65, because they have health insurance. It’s called Medicare. A government run health plan. The increased number of deaths is due largely to the increased number of uninsured. 27,000 more, each year. Since 1993. Since the Clinton Administration’s attempt to reform health care was destroyed, largely by the insurance industry.

    There’s Trouble Dead Ahead — And the Band Played On …

    What the band played as Titanic slowly began to sink is never disputed – ragtime, waltzes, specific tunes noted by survivors included ‘Alexander’s Ragtime Band’ and ‘In The Shadows’. But a question mark still hangs over what the last song was as Titanic’s stern began to rise clear of the Atlantic Ocean, and indeed, would it be physically possible for them to play anything in those conditions?

    http://www.titanic-titanic.com…

    Is Health Care a Commodity, or a basic Human Right? with Poll

    Well according to this former HMO Medical Director, she traded Necessary Patients Care, for Career Advancement and a 6-figure Salary:

    Linda Peeno MD, testifies



    http://www.youtube.com/watch?v…

    Question: Are the Patients, who are Denied Care, to save the Insurance Companies Money — DO those Patients have a RIGHT to their Health Care?

    Or are Those Patients simply a Commodity — a “Cost Center” — that must be constantly constrained?  

    Some Folks on the Left Got a Little Excited

    In an interview last week with Michael Smerconish, The Undecider said, “Winning the election is just the start.  Victory in an election wasn’t the change that we sought.”

    I don’t know what change you sought, Barack, but letting the losers of the election dictate policy is not the change we sought.  That’s innovative change, no doubt about it, but it’s not change anyone who voted for you can believe in.  

    Philip Elliot . . .

    That election came with Obama’s promise of the government insurance option, a provision that Obama’s team now calls “preferred” but not mandatory.  Obama declined to call it a deal breaker.  He said “the press got excited and some folks on the left got a little excited” when he and top administration aides made statements indicating that a publicly run health insurance option was just one of several alternatives.

    Since then, Obama has faced increasing criticism from his left flank.  “And even though some White House advisers seem to have forgotten, the reason the public option has become central to reform is simple: We’re fed up with the insurance companies and we need real accountability for them,” liberal MoveOn.org said in a message sent to its 5 million members. “They’ve had decades to fix the problems with our health care system, but they haven’t done it.”

    One caller to Smerconish’s program said he sensed the administration was making a misstep. “I’m getting a little ticked off that it feels like the knees are bucklin’ a little bit,” said the caller who identified himself as Joe. “You have an overwhelming majority in both the House and the Senate, and you own the whole shooting match.  It’s very frustrating to watch you try and compromise with a lot of these people who aren’t willing to compromise with you.”

    Insurance Industry Exec admits Michael Moore was RIGHT about Health Care

    Former CIGNA Exec Wendell Potter, says Michael Moore was right!



    http://www.youtube.com/watch?v…

    WENDELL POTTER: I thought that he hit the nail on the head with his movie.

    But the [Insurance] Industry, from the moment that the Industry learned that Michael Moore was taking on the health care industry, it was really concerned.

    BILL MOYERS: What were they afraid of?

    WENDELL POTTER: They were afraid that people would believe Michael Moore.

    Insurance Companies Ready Themselves for the Battle over Profits

    The insurance industry in the United States of America is actively recruiting and hiring and training LOBBYISTS in huge numbers to ready themselves for the shit-storm that the American people and HOPEFULLY their elected Representatives are about to lay down on them in the very near future.

    As we are all well aware, medical insurance and the FOR PROFIT Insurance Corporations in the U.S. are out of control.  Millions of citizens are not insured at all, most citizens that do have some sort of medical insurance are under-insured and the sky-rocketing costs of medical insurance are becoming more and more prohibitive for the average American worker.  Add to that fact that employer based medical insurance is where most Americans recieve their insurance package and then consider the rising unemployment issue in this country, and things can only go from horrible to completely unacceptable.

    In an essay I submitted yesterday, US slips down development index, Citizens live shorter lives, we discussed the fact that the citizens of America are now only 42nd among countries in the world regarding life expectancy, even though we spend more money per person on medical care than any other country in the world.

    At some point, it should become obvious to even the Insurance Corporations that we are simply not getting our money’s worth with that dismal track record.  Yet, they simply don’t care.  The bottom line is profit, and they are going to spend an incredible amount of their profits on Lobbyists to make sure that no matter the quality of health care U.S. citizens might or might not receive is made to be a moot point.  Their continued profits are all they care about and they are going to fight tooth and nail to make sure those profits continue to flow into their coffers.