Kujebaku, what do you think?
This is a tale of pay or die that recurs again and again all over our
country and only in our country in the entire western world.
Advised by her physician to go to M.D. Anderson for urgent treatment
of her leukemia, Mrs. Lisa Kelly was told she had to pay $105,000 up
front before being admitted. The hospital declared her limited
insurance unacceptable.
Sitting in the business office with seriously advanced cancer, she
asked herself =96 =93Are they going to send me home?=94 =93Am I going to
die=
?=94
Time out from her torment for a moment. M.D. Anderson started this
upfront payment demand in 2005 because of a spike in its bad debt
load.
The Wall Street Journal explains =96 =93The bad debt is driven by a larger
number of Americans who are uninsured or who don=92t have enough
insurance to cover costs if catastrophe strikes. Even among those with
adequate insurance deductibles and co-payments are growing so big that
insured patents also have trouble paying hospitals.=94
It isn=92t as if non-profit hospitals like M.D. Anderson are hurting.
Look at this finding in an Ohio State University study: net income per
bed at non-profit hospitals tripled to $146,273 in 2005 from $50,669
in 2000. And you also may have noticed the huge pay packages awarded
hospital executives.
M.D. Anderson, exempt from taxation, recipient of funds from large
government programs and research grants has cash, investments and
endowment totaling $1.9 billion, with net income of $310 million last
year, the Journal reports.
Back to the 52 year old, Lisa Kelly. She and her husband returned with
a check for $45,000. After a blood test and biopsy, the hospital
oncologist urged admittance quickly. Then the hospital demanded an
additional $60,000-$45,000 just for the lab tests and $15,000 for part
of the cost of the treatment.
To shorten the story, she received chemotherapy for over a year. Often
her appointment was =93blocked=94 until she made another payment.
In a particularly grotesque incident, she was hooked up to a
chemotherapy pump, but the nurses were not allowed to change the chemo
bag until Mr. Kelly made another payment.
She endured other indignities and overcharges. Reporter Martinez cites
$360 for blood tests that insurers pay $20 or less for and up to $120
for saline pouches that cost less than $2 retail.
Imagine anything like Mrs. Kelly=92s predicament and pressures occurring
in Canada, Belgium, Germany, Italy, France, Switzerland, Holland,
England or any other western country. It would never happen.
These countries have universal single payer health insurance. No one
dies because they cannot afford health care. In America, 18,000
Americans die each year because they cannot afford health care,
according to the Institute of Medicine of the National Academy of
Sciences. Many more get sick or become sicker.
None of these countries spend more than 11% of their GDP on
healthcare. The U.S. spends over 16% of its GDP on health care and
does not cover 47 million people and tens of millions are under
covered
In the U.S. the drug companies charge their highest prices in the
world, even though we, the taxpayers, subsidized them in large ways.
In other countries like Mexico and Canada, they cannot get away with
such drug price gouging, with a pay or die ultimatum.
In the U.S., computerized billing fraud and abuse cost over $200
billion last year, according to the GAO arm of Congress. In other
counties, single payer prevents such looting.
In other countries, administrative expenses of their single payer
system are about a third of what the Aetna=92s and other insurers rack
up.
In other western countries, medical outcomes for children and adults
and paid family leave are far superior to that of the U.S. The World
Health Organization ranks the US health care system 37th in the world.
When apologists in Washington hear these statistics, they say =93but we
have the best medical research centers in the world, like M.D.
Anderson.=94
Clearly much is wrong with the nature of pricing health care.
Like other hospitals, M.D. Anderson is caught in a macabre spider=92s
web of cost allocations mixing treatment costs with research budgets,
cash reserves, and just plain accounting gimmicks that burden
patients.
When a friend showed the Journal=92s article to a Dutch visitor, the
latter blurted in anger =96 =93you are a nation of sheep.=94 Not a very
flattering description of =93the land of the free, home of the brave.=94
Someday, soon maybe, Americans will finally band together and say
=93enough already,=94 we=92re going for full Medicare for all- without
loopholes for corporate profiteers and purveyors of waste and fraud.
Last month after being in remission, Lisa Kelly=92s leukemia has come
back.
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