Medical Cost Control
Anyone out there been hospitalized lately? Last year, I was hospitalized with a 103 degree fever after a trip to Tahiti left me with a rare case of pneumonia. For a week, specialists of all kinds huddled over me wondering what was wrong. I was tested for all kinds of tropical infectious diseases, gastrointestinal parasites, even AIDs, while getting a steady diet of intravenous antibiotics. That did a number on my stomach - nothing sets off my IBD quicker than antibiotics. On the fourth day my fever broke and the doctors agreed to discharge me, even though they couldn't figure out what caused my illness. My General Practitioner, however, was on the alert. During a follow up visit she did a blood test and figured out it was a rare type of pneumonia. Fortunately, the antibiotic cocktail I'd been injected with at the hospital included the right drug to kill the pneumonia bug, so I recovered anyway.
But this isn't about me - it's about the bills. Can anyone figure out the real price of a medical procedure? There's one price that shows up on the invoice. This is always an inflated price. Then there's what insurance covers for the procedure, which is anywhere from a steep to a mild discount off the inflated price. If you have Medicare, you're getting the best rate of all. And if you have no insurance, you get nailed to the wall with demands that you pay the full, non-discounted price - or else. Else, being, they sic the lawyers on you and they give you the choice to: pay up, go broke, or file for bankruptcy. This can happen to you even if you have great insurance that pays 100% - but your total costs climb over your lifetime limit of $1 million on the average policy.
The pat Republican response is to encourage people to get Health Savings Accounts (high deductible insurance where you pay the first $2,000 or so in medical costs) which, they say, will make patients better customers when it comes to choosing the best bargain in health care. Try this kind of bean-counting when you're flat on your back in a hospital with pneumonia. I have an HSA, and believe me on this, you can't bargain shop for medical services when you're in a health crisis. HSAs will never get our runaway health costs, which are climbing at 5 times the inflation rate each and every year, under control.
Democrats want to try to curb costs through all kinds of reforms, while simultaneously bringing more people into the health care system through insurance. The dirty secret here is that extending coverage is going to dramatically increase national health spending.
Costs are going up no matter which party wins the White House. The real question is which candidate has the most credibility in bringing about reforms to make sure that everyone who needs health insurance can get it. That's because until there's a bipartisan commission to figure out how to really bring medical costs under control, you, too, could be nailed to the wall unless you have insurance.