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Health Care Costs

Are Your Health Benefits Cutting Your Pay?

This thoughtful and depressing article from the New York Times describes the actual health care costs to individuals in graphic terms; how it impacts their salary and how the political process ensures that the high costs continue.

The author closes with a modest proposal on how the system might change by only insuring for unexpected, catastrophic illness – leaving the remainder to individuals to self-insure.

Clearly such a suggestion would be resisted by most everyone. We currently consume health care in the context that we expect routine and affordable treatments such as teeth cleaning, eyeglasses, and contraception be paid for by someone else.

Most of us will drive a mile to save a couple of  cents on gas. If our car insurance paid for gas,  which it would if health insurance behavior applied to cars, not only would we go to the closest station, but the price of the gas would not be posted. Read More…

The Rising Need and Cost of Dialysis

The Seattle Times article, “The Dialysis Dilemma: Urgent Need vs. Overtaxed System,” gives an excellent historical account of the development, impact, and moral hazards involved in treatment of kidney failure.

In the early 1960s, dialysis became a long-term treatment option for select few. At $20,000 per patient, the three machines could treat nine patients. But money wasn’t the only issue.

Because of the limited number of machines available, a committee dubbed “The God Committee” or “The Life or Death Committee” was formed to decide who would be treated.

The committee members — a surgeon, a pastor, a lawyer, a banker, a state government official, a labor leader and a “housewife,” plus two physician advisers — were white. All but one were male.

Most patients they picked were well-off, white and male. Patients had to be able to pay for the treatment — $30,000 for three years, about $229,000 in today’s dollars. The committee also considered net worth, number of dependents, education and ‘future potential.’

Patients less than 25 or older than 45 generally weren’t eligible, nor were those with other illnesses.

Though our nation has seen significant progress in treating end-stage kidney disease since the “The Life or Death Committee, ” roughly 600,000 U.S. patients are affected by the disease and the costs are high.

In 2010, for each patient with end-stage renal disease on hemodialysis — the most common dialysis method — Medicare paid $87,561 on average, counting medications and other medical expenses. For those who dialyze at home, it was $66,751 per year, and for those who received a transplant, $32,914. Read more…

This once fatal disease has become survivable with dialysis and transplants. But the costs are high for society and the human lives involved very real.

America’s Health Care System: It is Not a Jobs Program

In a New York Times op-ed article, “We Can Be Healthy and Rich,” Ezekiel Emanuel writes about the impact of the health care system on our larger economy and points out that there are many vested interests in the status quo of high health spending.

These high health costs are not geared toward the public good, but rather the economic impact of the massive spending.

He rightly states:

“Health care is about keeping people healthy or fixing them up when they get sick. It is not a jobs program.”

According to the Council of Economic Advisers, reducing health care costs by just 1 percentage point every year would lead to a 4 percent increase in G.D.P. by 2030. In today’s dollars, that would mean an extra $600 billion for our economy and an extra $7,000 for the average family.

Various comments by readers illustrate many views on his article and a number of additional perspectives.

Electronic Medical Records: Promise vs. Reality – A Work in Progress

Electronic medical records were fervently promoted as a panacea to medical inefficiencies, medical errors, and cost.

The reality has been to date, anything but. The New York Times article, “In Second Look, Few Savings from Digital Health Records,” outlines some of the disappointments that the technology has delivered to date.

Clearly systems relying upon handwritten and typed notes and reports, repositories of paper, and lack of portability are not worthy of the future. Quality systems should be secure, interoperable on any platform via a common set of data standards, and should not permit meaningless content and boilerplate or inflation of fees and improper billing.

Given our ability to put a variety of data on the web, one must wonder why the move towards electronic medical records has been so disappointing to date and has failed to deliver as promised.

There is no turning back but we are still in version 1.0 it would appear. Perhaps Apple or Google should take it on? Could it be that because it is “medical” it has been made needlessly complicated?

MCNTalk thanks Richard Bensinger, MD for referring this article to us.

The Need for Transparency in Healthcare

When you’re making a major life decision, like buying a car or house, you will most likely research, compare, and find the best value for your buck.

With thousands of dollars on the line, we assume it is our basic right to have information like price, quality, and safety readily and easily available.

So why is it so different when we are purchasing health care services?

A recent Wired Magazine article, “Peeling Away Health Care’s Sticker Shock,” by Andy Grove, sheds light on our current health care marketplace and how transparency has never been more crucial.

“The health care industry plays a gigantic game of Blind Man’s Bluff, keeping patients in the dark while asking them to make life-and-death decisions. The odds that they will make the best choice are negligible and largely depend on chance. Patients need to have data, including costs and their own medical histories, liberated and made freely available for thorough analysis. What health care needs is a window sticker—a transparent, good-faith effort at making prices clear and setting market forces to work.”

Grove explains that as other marketplaces used to be opaque, most are now transparent and more efficient because of technology. You know what you are getting and what it will cost before you agree to pay out. He continues:

“Consider a recent study of the costs of routine appendectomies performed throughout California. Though the procedures were largely identical, the charges varied more than 100-fold—from $1,529 at the cheapest to $182,955 at the most expensive.”

Nearly 100 people commented on this article, many making valid points. One person commented about a new site called Clear Health Costs that aims “to bring transparency to the health-care marketplace by telling people prices for medical procedures and items. By revealing prices, we are empowering consumers to make informed decisions about the costs of their medical care and coverage.” The site, still in it’s early stages, provides doctor names and prices for specific procedures in different states.

“We are doing our part for transparency over at clearhealthcosts.com — comparing prices of common procedures. (How cost and price and payment became so disconnected is fascinating.) As more and more people have more and more skin in the game, it’s important to show these prices. Then we can have the conversation about quality — and then the conversation about value. But until price comes out of the shadows, patients won’t have enough information to wield the economic power Andy Grove talks about.” Read More…

Ultimately, our health is our most valuable asset. Shouldn’t we have the basic right to know health costs before making life-and-death decisions?