Thursday, February 21, 2013

Medical Bills: An obscene story of GREED!

Time Magazine  This is an incredible article that goes into great detail as to why American medical bills are so high despite not providing superior medical care. In particular it focuses on why the government is focusing on the question of "who should pay" rather than the more intelligent question "why charges are so high and largely unrelated to costs."
   [....] The total cost, in advance, for Sean to get his treatment plan and initial doses of chemotherapy was $83,900.  Why?

The first of the 344 lines printed out across eight pages of his hospital bill — filled with indecipherable numerical codes and acronyms — seemed innocuous. But it set the tone for all that followed. It read, “1 ACETAMINOPHE TABS 325 MG.” The charge was only $1.50, but it was for a generic version of a Tylenol pill. You can buy 100 of them on Amazon for $1.49 even without a hospital’s purchasing power.

Dozens of midpriced items were embedded with similarly aggressive markups, like $283.00 for a “CHEST, PA AND LAT 71020.” That’s a simple chest X-ray, for which MD Anderson is routinely paid $20.44 when it treats a patient on Medicare, the government health care program for the elderly.
Every time a nurse drew blood, a “ROUTINE VENIPUNCTURE” charge of $36.00 appeared, accompanied by charges of $23 to $78 for each of a dozen or more lab analyses performed on the blood sample. In all, the charges for blood and other lab tests done on Recchi amounted to more than $15,000. Had Recchi been old enough for Medicare, MD Anderson would have been paid a few hundred dollars for all those tests. By law, Medicare’s payments approximate a hospital’s cost of providing a service, including overhead, equipment and salaries.
On the second page of the bill, the markups got bolder. Recchi was charged $13,702 for “1 RITUXIMAB INJ 660 MG.” That’s an injection of 660 mg of a cancer wonder drug called Rituxan. The average price paid by all hospitals for this dose is about $4,000, but MD Anderson probably gets a volume discount that would make its cost $3,000 to $3,500. That means the nonprofit cancer center’s paid-in-advance markup on Recchi’s lifesaving shot would be about 400%. [...]


  1. the article is shocking. what can be done about this?


  2. Regarding the first case described, the patient apparently decided to go "out of network" and was therefore subject to paying full retail.

    The story does not tell us, but what would have happened had he stayed "in network," perhaps at one of the university medical centers in Ohio.

    Would they still have been subject to such exorbitant mark-ups?
    Would the medical outcome have really been all that different?

    Yes, the wife "believed" that Houston wsa the only place to go, but is that true?

  3. What does it mean when it says in the first sentence that Stephanie knew she had to get her husband to MD Anderson?

    I understand why she would believe that, but that does not mean that it's something she would know.

    The article does not say whether there was any basis to her believing that Ohio State University or Cleveland Clinic would not have been good options.

    And one would guess that that they could have been treated there at the negotiated rate rather than at full retail.

  4. @Daas Torah-Do you think they actually could find a cure for cancer (Rachmana L"Tzlan) but there is no money in a cure but billions in the medicines for the pharmecutical industry ?They are so powerful.In the US they recently banned primitinemist for asthma to make people buy their product.Our lives are so regulated here.You need to go to a doctor to get a script when you take there medicine.Before you could just walk into the drug store and buy what you needed without a hassle.

  5. I would like to know of cases like this more often. Thank you for sharing.


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