Monday, March 11, 2013

About the “Bitter Pill”

     Rusty Simon helps us with our crop fields every year!

Dear Senators, I am writing about the filthy-high cost of health care in America and I am asking you to hold hearings about this matter and bring the health industry in America down a notch or two!
by Charlie Leck

The March 4 issue of Time Magazine pretty much sold out all across America – and that is a good thing!

For those of you who have not read the major explanation of how health care costs are arrived at, I’m first going to beg you to get the article somewhere and then read it [you can read it on-line here]; but if you don’t think you can or will, then I’m going to ask you to read my following summarization of it… (but I’d much prefer you read every word of the article).

The excitement was caused by a long and brilliant article by Steven Brill, called Bitter Pill: Why Medical Bills are Killing Us. Let’s hope that each one of those purchased magazines was read by at least one person and, more hopefully, possibly by many more. Let’s also hope a whole bunch of these readers unleash letters to their congressional representatives, asking them to do something, for heaven’s sake (I mean it) about the high cost of health care in America – that is, the unnecessarily high cost of health care in America. The operative word is unnecessarily!

And, how sincerely I hope that my Congressman has read this article and you have also, Senators Klobuchar and Franken. If you haven’t, you have failed your constituency; for Steven Brill alerts us to a very serious problem that must be solved.

I read the bulk of the long, long story (more than 50 pages) at my sister-in-law’s lovely house in Florida. It was her magazine and I vowed to finish it so I could leave it behind for her, but several times I cautioned her about it.

“You may not want to read this,” I said. “It’s pretty tough to take and it really makes me angry at the system.”

“Oh, no,” she responded vociferously, making sure I knew she wanted the magazine left for her, “I definitely want to read it.”

You will read about real people in Brill’s remarkable article – real people with real medical and disease crisis in their lives. They are people who are financially ruined by the American pharmaceutical, medical and hospital industry. Ruined – case after case of ruin that would make you cry if you could stop screaming in anger.

Health care costs in America have reached the outrageous stage and they create one of the saddest stories in American social history.

Steven Brill tells this story – or, more correctly, he reports it. My reaction when I finally put down the magazine was to go to a window and open it, so I could shout out to the birds and the bees… “I’m madder than hell and I’m not going to take this anymore!”

MD Anderson is a non-profit hospital at the University of Texas. It reported an operating profit last year of $531 million. It had revenue of over $2 billion. That’s a profit margin exceeding 25%. The President of MD Anderson (remember, a non-profit hospital), Ronald DePinho, was last year paid $1,845,000. None of this includes funds that Mr. DePinho is allowed to receive from three major pharmaceutical companies. Yes, yes, yes! I said it and it’s true. Does it smell to you of conflict of interest?

The above financial figures are not unusual and they are not necessarily at the top of the scale for such hospitals and their operating officers. Brill points to many others that exceed or rival these numbers.

“In hundreds of small and midsize cities across the country – from Stamford, Conn. to Marlton, NJ, to Oklahoma City – the American health care market has transformed tax-exempt nonprofit hospitals into the towns’ most profitable business and largest employers, often presided over by the regions’ most richly compensative executives. And in our largest cities, the system offers lavish paychecks even to midlevel hospital managers, like the 14 administrators at New York City’s Memorial Sloan Kettering Cancer Center who are paid over $500,000 a year, including six who make over $1 million.
“Taken as a whole, these powerful institutions and the bills they churn-out dominate the nation’s economy and put, demands on taxpayers to a degree unequaled anywhere else on earth. In the U.S., people spend almost 20% of the gross domestic product on health care, compared with about half that in most developed countries. Yet in every measurable way, the results our health care system produces are no better and often worse than the outcomes in those countries.” [Steven Brill in Bitter Pill]

Even while hospital after hospital is raking in unbelievable amounts of money, paying astounding amounts of money to their top executives and making most of their physicians very rich people, they are virtually raping the general public in order to provide these astonishing paychecks to their top employees. These hospitals have no qualms about under-paying their nurses, technicians and custodial employees. Nor do they have qualms about financially breaking many of their uninsured or under insured patients.

I don’t want to retell the stories of those several patients about whom Brill wrote. He tells their tragic stories perfectly and explains how the particular hospital to which they turned for help left them financial broken to the bone – finished and dried up and without recourse.

The Chargemaster
Be sure to pay special attention to the section of the article sub-titled, Pay No Attention to the Chargemaster!
It seems to me that the pricing scam behind the Chargemaster system (about which Steven Brill writes so much) can be attacked and regulated so that it is somewhere within the realm of reality. It seems that the hospital bills we receive are all pie in the sky and we are not even to take them seriously. Our job is to negotiate them down. Those skilled at negotiation, like the trained employees of large health care insurance companies, get the biggest discounts. Those of us who can’t negotiate are, to put it bluntly, screwed!

A lot of us are being ripped off and we shouldn’t take it anymore! It’s time to get mad as hell and let someone know about it.

“Unlike those of almost any other area we can think of, the dynamics of the medical marketplace seem to be such that the advance of technology has made medical care more expensive, not less. First, it appears to encourage more procedures and treatment by making them easier and more convenient… Second, there is little patient pushback against higher costs because it seems to result in safer, better care and because the customer getting treatment is either not going to pay for it or not going to know the price until after the fact.”

This is not a short article. It will take some patience to read it thoroughly – but thoroughly you must read it.

But, what a shame it would be if you read it, and get upset by it, and then do absolutely nothing at all. If you’re not up to anything more, at least print out this blog and send it with a brief note to your U.S. Senators. That’s what I’m going to do. I’ll ask Senator Amy Klobuchar and Senator Al Franken if they’ve read the article by Steven Brill. I’ll ask that they do if they haven’t. I’ll tell them I want to know their reaction to the article.

“What do you think can be done about it?” That’s what I’ll ask them. And, I’ll tell them that we must do something about it. If either one of them is unwilling to do something about it, I’m going to assume they are receiving big campaign donations from people within the health care industry – people who want to protect their ridiculously and undeservedly high incomes.

“Senator Franken,” I’m going to ask, “why aren’t you speaking up about this matter on behalf of the ordinary U.S. citizen? Are you being paid-off to keep your mouth shut about what’s going on?”

A section of the article, sub-headed “The Way Out of the Sinkhole,” is important and it’s vital reading. My Senators should look seriously at Brill’s suggestions. There is a way to improve the system and to control costs. We’ve got to look at the possibilities seriously.

Steven Brill says we are being ripped off by a health care cost system that is out of control. He says that one of the worst culprits is the non-profit hospital. And, he shows us that many of the administrators of these so-called non-profits are making obscenely high salaries (pay-offs) for non-profit organizations (organizations that go out fund raising and claiming they need your help to get along).

Steven Safyer, Montefiore Medical Center, was paid $4,065,00 in 2011
    (and his three top officers were paid $3,243,000, $2,220,00, and $1,798,000).
Robert Trefry, Bridgeport Hospital, was paid $1,800,000 in 2011,
Marna Borgstrom, Yale New Have Health System, was paid $2,500,00 in 2010

These are only a few of the dozens of highly paid hospital executive in America. Brill mentions many of them and lists their outrageous salaries.

Medtronic’s CEO, Omar Ishrak received total compensation in 2012 totaling 25 million dollars. He deserved it, I guess, his company has been returning whopping profits to its shareholders.

I’ve only been showing you the tip of the iceberg here. There is much more to see and understand. Somehow you’ve failed a lot of people if you don’t read this extraordinary article. Again, you can read it on-line here.

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  1. Alright. This is something that can really get a person worked up. The costs are devastating, indeed. What I can't figure out is why the independent workers, the self-employed, the ones with the part time jobs that can barely afford milk have to pay so much just to have insurance! We do not live in a country that values life.

  2. "Yet in every measurable way, the results our health care system produces are no better and often worse than the outcomes in those countries.”

    I take extreme umbrage with that statement. America is without a doubt the leader in specialized medicine. That is why executives and government officials in other countries (Britain and Canada specifically) will fly across oceans and over borders to have their surgery done here. Look at the flawed studies which rank the US far below our socialist brothers in Europe, they include all types of death including homicides and car accidents in calculating the "health care rankings."

    You won't find any argument that billing practices are flawed and are designed to try to actually get fairly compensated by the insurance company, leaving patients to do the same shuffle, but this came about primarily because of the insurance company's desire to find any reason not to pay a quoted rate.

    Doctor's deserve every penny they can get, as they undergo the most grueling intellectual selection process and challenges of any profession as a whole. Nurses, technicians, and custodial staff, are trained far below the level of a doctor, so for what reason should they command a salary near that of any doctor? Do you not believe in the free market or is "from each by ability, to each by need" more idealistic?

    All Obamacare is doing is creating a need for more administration in the hospitals to where they will out-populate the doctors and nurses... you have sewn the seeds of expansion for the people you seem to be rallying against in this post... congratulations my liberal brother, another win!

    And finally... the main problem in this country is the food industry. Wonder why so many people are so fat? look to the meat industry and what taints our food these days. The rise of super bugs stemming from animals pumped full of antibiotics and lead and mercury pervasive in all our waters and fish (even found in Antarctica!) are directly contributing to our healthcare woes.

    Vegetables and beans are some of the cheapest items found on the planet and yet no one is willing to save money and eat healthy at the same time... the real question is when will people take responsibility for themselves?

    You want to leave your grand kids a legacy, and that's a noble endeavor, my grandparents were all passed on by the time I was 20 and that left me knowing next to nothing about them. Good luck to you!

    PS for anyone looking to take control of their own health through science based research visit an invaluable source for me in attempting to be healthy!