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.
