We Interrupt This Blog To Bring You An Important Message

A new starting point for our national conversation.

One of the key points of this blog is that the health care debate has never been about health care.  Never.  Money isn’t the prime driver.  Money is the only driver.  How do the hospitals, doctors and other medical providers get paid, and how much, are the real issues. 

Except for a couple of purists, no one really cares who pays the doctor or hospital as long as it isn’t you, the patient.  Do you really care if your $300,000 bill from the Cleveland Clinic or University Hospital is paid by Anthem Blue Cross or the federal government?  Honestly?  No.  All you really want to know is how much, if anything, you will owe once the dust settles.  And the providers?  The insurers pay more, but have a lot of paperwork.  Medicare pays less, but quickly.  Based on the number of medical providers that accept Medicare (darn near everyone), I’m guessing that there are no serious complaints.  The hospitals may even like having two major funding sources to play against each other. 

I have tried to teach my clients what I know of the game.  My senior clients learn about the origins of Medicare Parts A and B, the backroom deals that gave us Part D (Rx), and why costs are out of control.  Countless clients have been clued in that those obscene charges are negotiable before and after services have been rendered.

Your perception of our system changes today thanks to Time magazine.  Blessed with budget, time, and amazing persistence, Steven Brill has given us Bitter Pill, Why Medical Bills Are Killing Us.  Mr. Brill tracked claims and laid bare the abomination that is our system of billing for services – real or imagined.  Straightforward in his prose, laborious in his detail, Mr. Brill presents a system of overpaid executives and hyper profitable not-for-profits.

The real issue isn’t whether we have a single payer or multiple payers. It’s whether whoever pays has a fair chance in a fair market. Congress has given Medicare that power when it comes to dealing with hospitals and doctors, and we have seen how that works to drive down the prices Medicare pays, just as we’ve seen what happens when Congress handcuffs Medicare when it comes to evaluating and buying drugs, medical devices and equipment. Stripping away what is now the sellers’ overwhelming leverage in dealing with Medicare in those areas and with private payers in all aspects of the market would inject fairness into the market. We don’t have to scrap our system and aren’t likely to. But we can reduce the $750 billion that we overspend on health care in the U.S. in part by acknowledging what other countries have: because the health care market deals in a life-or-death product, it cannot be left to its own devices.

Steven Brill – Bitter Pill, Why Medical Bills Are Killing Us

You won’t agree with all of Brill’s conclusions.  I certainly don’t.  But read his work.  This should be the new starting point of our national conversation.

This post is contributed by a community member. The views expressed in this blog are those of the author and do not necessarily reflect those of Patch Media Corporation. Everyone is welcome to submit a post to Patch. If you'd like to post a blog, go here to get started.

Murphy-Solon March 20, 2013 at 01:38 AM
I just completed Jon Meacham's biography on Thomas Jefferson. It's an excellent read and I would recommend the book to all. My point is that you can pull a quote from Jefferson and apply to any context that suits your fancy. A deeper insight into Jefferson yields a feud bordering on hatred towards Alexander Hamilton and the Federalists. Jefferson was against the Bank of America because of the power it placed in the hands of the aristocrats. Jefferson was a staunch supporter of the common man. The type of political power that Corporate America, including the healthcare industry, enjoys with our government is anathema to everything Jefferson stood for. He did not envision a government that was a playground for the rich and powerful. Just the opposite.
Mark Zetzer March 20, 2013 at 01:40 AM
Murphy-Solon, I'll try to read the article before posting again. But I can tell you right now that the reason the medical industry overcharges is because most consumers don't directly pay for medical goods and services, they don't get to choose their insurance plan, and even their choice of providers is artificially limited. Only with more choices will come lower medical costs for those who can pay, and more charity providers for those who can't.
Mark Zetzer March 20, 2013 at 01:48 AM
Murphy-Solon, I agree with you on the Republicans' disastrous 'deregulations'. They're all just more crony capitalism dressed up to look fair. I also stand with Jefferson in opposing a central bank. For the record, I am a Libertarian and rarely vote Republican.
Danarino April 11, 2013 at 02:56 AM
Mark - do your research before you sign onto empty liberal straw man propaganda. "Those evil Republicans" is code for inept governance - but your safe, you're a libertarian. The propagandist media counts on good Americans to back down, and sit down and shut up. The truth is the S&L deal started by in Carter's term w/ Volckers policy but the wheels were in motion since the 1930s for the S&L crisis. Banks wanted them gone anyways- and they got their way. Clinton got the ball rolling in the Banking melt down repealing GlassSteagall and tinkering with the CRA more than needed. Throughout history ONE CONSTANT proves true over and over- and that is THE GOVERNMENT does a sucky job at doing THEIR JOB when it comes to oversight. (Read: Fannie/Freddie) That is THEIR RESPONSIBILITY- no one elses. Your childish blame game generalization usually is nothing more than propagandist lies repeated over and over by a liberal "ends justify the means" censoring media. Nunquam Deditionem, good buddy.
Murphy-Solon April 11, 2013 at 11:18 AM
Danario, you are right that Glass-Steagall was enacted in the waning days of the Clinton Administration. That said, to blame the media while holding Republicans blameless for deregulation is silly. Even today, the banks, mortgage lenders and payday lenders are paying good money to the Republicans to water down Dodd-Frank. Thy have fought the re-enactment of Glass-Steagall and "too big to fail" still exists. The banks and not Fannie/Freddie were the drivers of the mortgage mess. You should read Sheila Bair's book "Bull by the Horns". After reading that book, there's no way you can hold the Republicans harmless.


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