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1 Skip Intro  Sat, Feb 23, 2013 12:19:11pm
MD Anderson’s clinical billing and collection practices are similar to those of other major hospitals and academic medical centers.

i.e., Anderson has studied the loan sharking operations of the Mafia and found a way to make them more profitable.

Greatest country in the world, unless you get sick.

2 EiMitch  Sat, Feb 23, 2013 2:20:30pm

Still in the middle of reading this. I’ve already got two comments so far:

1 - You are quoting wa-a-a-ay too much of the article here, EC.

2 - It wasn’t that long ago there was a debate in another lgf page over whether its reasonable to get price estimates over the phone. Here is why the “no” side is completely wrong:

Stamford Hospital spokesman Scott Orstad told me that the $199.50 figure for the troponin test was taken from what he called the hospital’s chargemaster. The chargemaster, I learned, is every hospital’s internal price list. Decades ago it was a document the size of a phone book; now it’s a massive computer file, thousands of items long, maintained by every hospital.

In other words, the hospital has set those prices in advance. Even the “non-profit” hospitals do this. Our health is in the hands of f***ing thieves!

3 calochortus  Sat, Feb 23, 2013 3:07:11pm

re: #1 Skip Intro

There are classes for doctors and administrators on how to code bills to maximize your payments from insurance companies and presumably random uninsured patients as well.

4 Eclectic Cyborg  Sat, Feb 23, 2013 3:49:19pm

re: #2 EiMitch

Still in the middle of reading this. I’ve already got two comments so far:

1 - You are quoting wa-a-a-ay too much of the article here, EC.

2 - It wasn’t that long ago there was a debate in another lgf page over whether its reasonable to get price estimates over the phone. Here is why the “no” side is completely wrong:

In other words, the hospital has set those prices in advance. Even the “non-profit” hospitals do this. Our health is in the hands of f***ing thieves!

I’m surprised you say that, since it’s less than 3 pages of an 11 page article. I also wanted to quote a fair bit so that those who didn’t want to read the whole thing could at least get a sample of all it contained. There were a lot of things in it that shocked and saddened me so I felt compelled to share a fair bit of it.

5 EiMitch  Sat, Feb 23, 2013 4:37:50pm

re: #4 Eclectic Cyborg

Some publishers take exception to quoting 3 paragraphs, nevermind 3 pages. I don’t remember the exact word count, but there is only so much we can legally quote before we risk being accused of copyright infringement. I dunno if Time is cool with going over. But I know that alot news and journalist companies aren’t.

6 aagcobb  Sat, Feb 23, 2013 5:35:33pm

Looks like there is a lot of fat that can be cut to keep healthcare costs under control.

7 Achilles Tang  Sat, Feb 23, 2013 6:12:33pm

I only skimmed this, but the truth is there is nothing new here that hasn’t been just as true for years. The simplest example is how one uninsured person in a bed next to one that is insured can be charged twice as much for identical treatment (because they can screw the government easier?).

The other example in the news recently was an “experiment” calling hospitals all over the country to ask for a “quote” on a hip replacement. None of the hospitals were able to give an answer without repeated calls, but those who did gave numbers ranging from $11,000 to $129,000.

8 spiderx  Sat, Feb 23, 2013 7:50:28pm

The American health care system is pretty damn evil. I know evil is a strong word but I don’t know what other word to use here. Deranged? Psychopathic?

I have family in the UK and they are amazed that we put up with our health care system here. They can’t understand the mind set of the right wing in America. Most of my family in the UK are conservatives and even they support the NHS. The NHS isn’t a perfect system (right now there is a horrendous scandal with poor care resulting in deaths in Staffordshire) but neither is it s a system that is designed to suck as much money out of the sick as ours is.

It’s shocking that the hospital wouldn’t begin cancer treatment until they received payment in full. And even more shocking that the head administrator at this hospital receives a salary close to $2 million dollars. That kind of position in other western countries would never be paid that kind of money. I think the highest paid NHS manager makes 280k (in pounds) and that was a huge controversy in the UK.

Compare that to CEO’s of American health insurance companies where the average salary is several million.

9 EiMitch  Sat, Feb 23, 2013 11:18:02pm

re: #8 spiderx

Compare that to CEO’s of American health insurance companies where the average salary is several million.

Ironically, insurance companies used to help keep costs relatively low (for themselves and their own customers) compared to now. After all, it was obviously in their best interest to not pay more than they had to. But they’re now losing that battle. From the article:

But insurers are increasingly losing leverage because hospitals are consolidating by buying doctors’ practices and even rival hospitals. In that situation — in which the insurer needs the hospital more than the hospital needs the insurer — the pricing negotiation will be over discounts that work down from the chargemaster prices rather than up from what Medicare would pay.

In other words, even the for-profit health-insurance industry is getting price-gouged by hospitals. Thats one more painful irony, and another sign of how bad the situation has become.

Any reform effort that focuses on who’s paying instead of bringing the damn prices down is doomed to fail. Its that simple.

10 Renaissance_Man  Sun, Feb 24, 2013 11:39:14am

Every bit of this is true. Especially the conclusion:

Over the past few decades, we’ve enriched the labs, drug companies, medical device makers, hospital administrators and purveyors of CT scans, MRIs, canes and wheelchairs. Meanwhile, we’ve squeezed the doctors who don’t own their own clinics, don’t work as drug or device consultants or don’t otherwise game a system that is so gameable. And of course, we’ve squeezed everyone outside the system who gets stuck with the bills.

We’ve created a secure, prosperous island in an economy that is suffering under the weight of the riches those on the island extract.

And we’ve allowed those on the island and their lobbyists and allies to control the debate, diverting us from what Gerard Anderson, a health care economist at the Johns Hopkins Bloomberg School of Public Health, says is the obvious and only issue: “All the prices are too damn high.”

The US medical system is neither free market nor designed to provide health care. It is simply a very effective vehicle to transfer public wealth into the hands of a few people. Those of us that work in it struggle to actually care for patients despite the obstacles.

I have asked many times for the prices of the tests and procedures I personally order and perform, both so I can educate patients and for the purposes of research. I have been told, point blank, that I am not allowed to know. I find that unbelievable and repugnant.

Any characterisation of the US health care system as ‘free market’ is laughable. And yes, any reform effort that does not include price control does nothing about the core problem.


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 Frank says:

I think "when" is a very important thing, but "what the f*ck!" is also a very important thing to ask. Just keep asking "what the f*ck?" I mean, why the f*ck bother? See what i mean? The important thing is, deal with the "when". "When" will open a lot of shit for you. "What the f*ck" really makes it easier to deal with it when you understand the "when".