Saturday, November 16, 2013

Our Health Care Dilemma - Part 2 - A Brief Medical History


This is the second in a 3-part series.  I could have put it all in one column, but it would have been too long to read in one sitting.  In this part, I'm going to go back to some of my medical records, all of which my wife has kept since we were married 51 years ago.

I'm not concerned about providing some personal and private medical facts about myself and my family.  After all, most of this stuff will soon be available online to anyone with a computer and the time to find it.

But first, the answer to some of those questions I posed in the first column.  How did we get to here from there; there being the days when health care was either provided in the home by some inventive and caring parents, or by a doctor who made "house calls" or saw you in his or her office without an appointment.  What's more, you weren't charged an arm or a leg for the treatment.  Here being... well, let's examine it.

To repeat the questions, "Why did the costs go up for treatment we sometimes wait hours, or days, or even months to receive?" Was it the greedy insurance companies?  Was it the high cost of modern technology?  Was it the greed of the health care providers?  Was it due to inflation of wages and prices in general? 

Fact: In 1965, President Lyndon Johnson signed into law a bill passed by Congress that established two national and government-sponsored health care programs, Medicare and Medicaid.  Medicare was for the elderly and Medicaid was for the poor.  What could be more fair?  Other than those people able to afford private health care, and those who were insured by their employers, seniors and the indigent were the primary segment of our society that needed help with the costs of that care.

I married in 1962 and our first child was born in 1966.  I wasn't eligible for either Medicare or Medicaid, but then, I really didn't need help with the cost of Judy's pregnancy or Brad's birth.  I still have the bill from Kenmore Mercy Hospital, dated 5/26/1966, for the 5-day stay ($180) plus the live birth ($175) with incidentals ($94), for a total bill of  $449.  Insurance paid all but $100.

While greed, technological advances, and inflation mentioned above might have had some influence on costs, none of them would, individually or in concert, account for the astronomical increase that took place from 1965 to today.  Even when my daughter was born in 1971, the cost-per-day for the hospital room was only $42.50, up from $25 in 1966.  But that increase was already fifty-eight-percent in less than 5 years. 

No, there is only one big contributing factor that would cause costs to rise so much: Government health care comes with very strict limitations on reimbursement, and those limits are not based on actual cost of treatment, but on a percentage of the cost.  So, if a specific procedure costs $500, a pencil pusher somewhere pegs the maximum payment for that procedure at 40-percent, or $200.  In order for the provider to recover the actual cost, the bill must be submitted for $1250.  That is 150-percent inflation.  And every time the cost of treatment goes up for the provider, it goes up 150-percent for the payee - in this case, the government.

When our beneficial government got involved in the providing of healthcare - something that was never authorized or condoned by the Constitution or any amendments thereto - they became the largest cause of inflated prices for that care, not only for the elderly and the poor, but for everyone.  After all, when you send a bill to one insurer, you also have to charge every other insurer that same price to dispel any hint of fraud or favoritism. 

From 1975 onward, the prices for hospital stays, tests, supplies, doctor visits, surgical procedures and just about everything else took off faster than a jet on afterburner.  To  give you an idea of how rapid it was, and how high it went, I had coronary bypass surgery in October of 1980, and the total cost for doctors, anesthesia, surgery and hospital stay was a shade over $9,700.

In a more recent case, my outpatient visit to the hospital in 2010 for implantation of a cardio pacemaker/defibrillator came to $81,340.20 and I didn't even spend a single night in the hospital.  Of course, Medicare and United Healthcare only paid a combined total of about $15,000 after discounts and adjustments, but still, you can see the effects of costs to payments.  I attribute about 90-percent of that to Medicare/Medicaid billing practices, which have leapfrogged with payment schedules in an endless upward, out of control spiral.

Now that I've established a valid reason for the high cost of medicine and healthcare today, we still have some other contributing factors.  I'll expose those in the final chapter next week, but meanwhile, think about where you stand on the current threshold of complete control of your well-being entrusted to some bureaucrat in Washington.

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