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Horror Care: How Private Health Care Is Shortening Our Lives
http://www.alternet.org/personal-health/horror-care-how-private-health-care-shortening-our-lives
Steven Brill's article in Time Magazine about the cost of private health care is likely to make most of his readers very angry. Angry about the prices we pay, about the lives that are devastated, and about the fact that we're one of the few developed countries without adequate health care for its citizens.
Economists have told us that the profit motive of privatization comes with an "invisible hand" that automatically corrects inequities in the market. It hasn't worked that way for health care. The personal stories recounted below, and some additional facts to complement them, make it clear that an essential human need has been turned into a product that benefits a few people at the expense of many others.
$15,000 for Blood Tests
Brill's article begins with the story of a 42-year-old Ohio man named Sean Recchi, who traveled to MD Anderson Cancer Center in Houston for treatment of non-Hodgkin's lymphoma. He and his wife Stephanie had paid $469 a month, or about 20% of their income, for insurance that covered $2,000 per day of hospital costs. His financial troubles started when MD Anderson told him, "We don't take that kind of discount insurance."
But he had to go to the hospital. His wife recalled that he was "sweating and shaking with chills and pains. He had a large mass in his chest that was..growing. He was panicked."
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Government and Medical Costs, Continued
I’ve spent some more time going through Steven Brill’s magnum opus on medical prices, and am even more amazed at (a) the quality of the reporting (b) his weird refusal to draw the obvious conclusion...Brill highlights the extent to which Medicare is able to get better deals than private insurers, who in turn get much better deals than individuals. Somewhat puzzlingly, he says almost nothing about Medicaid, which does even better at bargaining because of its greater ability to say no. The best available research says that Medicaid — if provided directly — is way cheaper than private insurance:
So the obvious answer is to expand public insurance, and give Medicare more bargaining power.
But somehow Brill veers off at the last minute. He gets all politically realistic about the prospect of expanding Medicare; I’m all for realism, but shouldn’t the overwhelming message of his piece be that what passes for realism in American medicine is disastrous? And he argues that
This is, from everything I’ve read, a highly dubious proposition — and everything Brill has said up to this point reinforces that position. After all, the argument that hospitals will raise fees if they make less on Medicare patients only works if hospitals are currently charging less than the traffic will bear — and Brill has just spent 20,000 words telling us that they squeeze every dime they can out of patients.
Anyway, read his reporting, but turn to health-care economists for the analytical implications.
http://krugman.blogs.nytimes.com/2013/03/03/government-and-medical-costs-continued
I’ve spent some more time going through Steven Brill’s magnum opus on medical prices, and am even more amazed at (a) the quality of the reporting (b) his weird refusal to draw the obvious conclusion...Brill highlights the extent to which Medicare is able to get better deals than private insurers, who in turn get much better deals than individuals. Somewhat puzzlingly, he says almost nothing about Medicaid, which does even better at bargaining because of its greater ability to say no. The best available research says that Medicaid — if provided directly — is way cheaper than private insurance:
So the obvious answer is to expand public insurance, and give Medicare more bargaining power.
But somehow Brill veers off at the last minute. He gets all politically realistic about the prospect of expanding Medicare; I’m all for realism, but shouldn’t the overwhelming message of his piece be that what passes for realism in American medicine is disastrous? And he argues that
trying to cut the deficit by simply lowering the fees Medicare and Medicaid pay to hospitals will not work. It will only cause the hospitals to shift the costs to non-Medicare patients in order to maintain profits — which they will be able to do because of their increasing leverage in their markets over insurers.
This is, from everything I’ve read, a highly dubious proposition — and everything Brill has said up to this point reinforces that position. After all, the argument that hospitals will raise fees if they make less on Medicare patients only works if hospitals are currently charging less than the traffic will bear — and Brill has just spent 20,000 words telling us that they squeeze every dime they can out of patients.
Anyway, read his reporting, but turn to health-care economists for the analytical implications.
http://krugman.blogs.nytimes.com/2013/03/03/government-and-medical-costs-continued
Eye-opening stuff in Brill's report, which makes three things clear:
- The new MLR is going to make a big difference (though not mentioned).
- The government should be negotiating drug prices.
- We need single payer.
At one point I slammed the magazine shut & tossed it on the table. The receptionist looked at me & asked, "Are you reading the Time magazine issue on health care?" She told me I was the third person to react that way in the two days the magazine had been out.
This is criminal, what is being done to the American people. 
