The Sorry State of Health Care in America
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The Sorry State of Health Care in America by Ralph Nader
Posted on May 5, 2008 by dandelionsalad
http://dandelionsalad.wordpress.com/2008/05/05/the-sorry-state-of-health-care-in-america-by-ralph-nader/
Dandelion Salad
by Ralph Nader
Monday, May 5, 2008
This is the grim story of a cancer patient, Lisa Kelly, and the famous, well endowed, non-profit M.D. Anderson Cancer Center of the University of Texas.
Barbara Martinez, a reporter for the Wall St. Journal, related the billing hurdles that Mrs. Kelly has been confronting since late 2006 in a shocking front-page story on April 28, 2008.
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. 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 – “Are they going to send me home?” “Am I going to die?”
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 Journal explains – “The bad debt is driven by a larger number of Americans who are uninsured or who don’t 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 patients also have trouble paying hospitals.”
It isn’t 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 “blocked” 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’s 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’s 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 “but we have the best medical research centers in the world, like M.D. Anderson.”
Clearly much is wrong with the nature of pricing health care.
Like other hospitals, M.D. Anderson is caught in a macabre spider’s web of cost allocations mixing treatment costs with research budgets, cash reserves, and just plain accounting gimmicks that burden patients. (Documents from Mrs. Kelly’s case are available at http://online.wsj.com today.)
When a friend showed the Journal’s article to a Dutch visitor, the latter blurted in anger – “you are a nation of sheep.” Not a very flattering description of “the land of the free, home of the brave.”
Someday, soon maybe, Americans will finally band together and say “enough already,” we’re 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’s leukemia has come back.
Posted on May 5, 2008 by dandelionsalad
http://dandelionsalad.wordpress.com/2008/05/05/the-sorry-state-of-health-care-in-america-by-ralph-nader/
Dandelion Salad
by Ralph Nader
Monday, May 5, 2008
This is the grim story of a cancer patient, Lisa Kelly, and the famous, well endowed, non-profit M.D. Anderson Cancer Center of the University of Texas.
Barbara Martinez, a reporter for the Wall St. Journal, related the billing hurdles that Mrs. Kelly has been confronting since late 2006 in a shocking front-page story on April 28, 2008.
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. 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 – “Are they going to send me home?” “Am I going to die?”
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 Journal explains – “The bad debt is driven by a larger number of Americans who are uninsured or who don’t 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 patients also have trouble paying hospitals.”
It isn’t 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 “blocked” 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’s 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’s 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 “but we have the best medical research centers in the world, like M.D. Anderson.”
Clearly much is wrong with the nature of pricing health care.
Like other hospitals, M.D. Anderson is caught in a macabre spider’s web of cost allocations mixing treatment costs with research budgets, cash reserves, and just plain accounting gimmicks that burden patients. (Documents from Mrs. Kelly’s case are available at http://online.wsj.com today.)
When a friend showed the Journal’s article to a Dutch visitor, the latter blurted in anger – “you are a nation of sheep.” Not a very flattering description of “the land of the free, home of the brave.”
Someday, soon maybe, Americans will finally band together and say “enough already,” we’re 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’s leukemia has come back.
If you want to tell people the truth, make them laugh, otherwise they'll kill you.
Man is least himself when he talks in his own person. Give him a mask, and he will tell you the truth.
-Oscar Wilde
Man is least himself when he talks in his own person. Give him a mask, and he will tell you the truth.
-Oscar Wilde
Post edited by Unknown User on
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Comments
they'll have no need to research if we're all dead
My husband was diagnosed with diabetes three years ago. It took two years for his condition to level out to a point at which he's been able to stop experimenting with different medications.
When we still had our other health care provider, we would spend up to an hour at the pharmacy counter trying to hold "conference" calls with us, the pharmacist and the fucking (IP) insurance provider to convince the IP that the medication was vital and they were to cover their portion of the cost.
I wonder how many people give up and just pay out of pocket.
I'm thankful for the health plan we have now. They have been incredible. I want the entire country to have the kind of coverage I've been afforded. That can only be achieved under a single payer health care system.
This is one of the many reasons I will be voting for Nader this November.
***********************
"We've laid the groundwork. It's like planting the seeds. And next year, it's spring." - Nader
***********************
Prepare for tending to your garden, America.
I'm sorry to hear about your husband and all the problems and stress you guys were put through. :(
Man is least himself when he talks in his own person. Give him a mask, and he will tell you the truth.
-Oscar Wilde
Thanks.
If we got anything out of it, it's the drive to make a difference whenever/wherever we can.
We ALL deserve health care.
It's ridiculous. I knew one couple that had to divorce to save their assets while the wife was battling cancer. I could see that their marriage certificate was NOT just a piece of paper to them.
This is what we do to survive???
***********************
"We've laid the groundwork. It's like planting the seeds. And next year, it's spring." - Nader
***********************
Prepare for tending to your garden, America.
I know. I think it's a crime to look at human lives as secondary to the amount of money they can pay for treatment. It's just disgusting.
Man is least himself when he talks in his own person. Give him a mask, and he will tell you the truth.
-Oscar Wilde
Many polls have shown the overwhelming majority support a UHC program
Man is least himself when he talks in his own person. Give him a mask, and he will tell you the truth.
-Oscar Wilde
Exactly. Not only do we all deserve health care, but we all deserve health care where we don't have to fight for coverage, divorce our spouses (wow!), settle for sub-standard treatment, etc. at every turn just to get it.
I don't disagree with you, because people's perceptions of the candidates' plans unfortunately hold more weight than the actual plans themselves. But are either Obama or Clinton proposing a socialized medicine plan? Personally, I don't see Clinton's plan as socialized medicine, but I don't know much about Obama's plan.
They need to take a page from the neocons and give it a term that is actually the opposite of what it really means and the people will eat it up (ie the Patriot Act). How about "Capitalistic Insurance for Average/Elite Joe American Act" ? Bet it would work.
http://seattlepi.nwsource.com/local/361794_scca05.html
Wife dies but new hospital bills keep coming
Husband got 4 invoices for donor search done after her death
Last updated May 4, 2008 11:54 p.m. PT
By CHERIE BLACK
P-I REPORTER
During the final two months of Melanie Smailus' life, she battled the leukemia ravaging her body.
Since September, her husband has been fighting to deal with not only his grief, but a pricey medical bill that won't go away.
The bill that Thomas Smailus keeps getting is for a procedure that the medical bureaucracy insists took place in June 2007 -- four months after his wife died.
"At this point it's gone from painful to comical," Smailus said last week in reaction to receiving his fourth bill for the procedure that wasn't.
"This is a level of grief that shouldn't be there. I shouldn't be getting a bill every few months reminding me of my dead wife."
In December 2006, Melanie Smailus was diagnosed with leukemia and underwent three rounds of chemotherapy. Doctors hoped the next step would be a bone marrow transplant, her husband said. But a genetic disorder made treatment difficult, and in February 2007, she died of complications from her chemotherapy at the age of 37.
In September, Smailus received a bill from the Seattle Cancer Care Alliance where his wife of six years had received treatment.
Insurance denied payment of the bill, for more than $2,700, because the coverage stopped after her death.
Smailus called the billing department number listed on the statement and explained the situation. The person on the other end of the line said the problem would be investigated.
A few months later, Smailus received another bill for the same procedure and the same amount. Again he called SCCA's billing department. Again he was told they were looking into the matter.
Since then, Smailus has received two more bills -- four total in the past seven months -- the most recent one last month. He called three times and said no one from SCCA followed up with him about any of his calls regarding the bill, even to tell him to disregard any future bills.
The Seattle P-I asked a spokesman from SCCA about the problem Friday morning. By Friday afternoon, Smailus received a phone call at work from a man in SCCA's financial department telling him he had a zero balance.
The man also said the SCCA had created a new policy as a result of his case to make sure it didn't happen again to someone else.
The man told Smailus that SCCA began looking into his claim in February after his second call to them. The policy at the time was to check if the service they billed for actually happened. The service turned out to be a donor search for the bone marrow transplant doctors wanted Melanie Smailus to have. Somewhere along the way, no one told the site doing the searching that the patient they were searching for was no longer alive.
SCCA said it couldn't tell exactly when and where the mistake occurred, but acknowledged there was a lack of communication internally and to Smailus.
But SCCA told Smailus on Friday that it couldn't make an adjustment when it first learned something was amiss because there was no official policy in place to allow a write-off of his bill. The policy only had them keep pursuing collection from the estate of the deceased -- the bills were addressed to "estate of Melanie Smailus" -- and there was no way for any of the employees in the billing department who handled the case to start a process to fix the issue, Smailus said he was told.
As of Friday afternoon, he said, the SCCA is writing off the amount of the bill, instituting a policy to not ding estates with the costs of services rendered after a patient's death, and will work to improve feedback to callers.
A spokesman for SCCA e-mailed the P-I Friday saying privacy issues prevented him from revealing details, but noted the director of patient accounting had contacted Smailus about his issue and would send him a follow-up letter about what was decided.
Smailus said while he's glad SCCA seems to have resolved his problem and promised to send a statement indicating the zeroed-out balance, he's still upset it took so long for them to recognize and address the problem -- and that they did so only after being contacted by a reporter.
"So now when the SCCA saw a possible PR problem, they jump to it and fix the problem," Smailus said. "They didn't avoid the problem in the first place. Nor would they fix it when I called them the first time, the second time or even the third time.
"I'd hope institutions would have mechanisms in place to allow internal employees to fix these problems before they impact the customer."
________________________________________
P-I reporter Cherie Black can be reached at 206-448-8180 or cherieblack@seattlepi.com. Read her To Your Health blog at blog.seattlepi.com/toyourhealth.
© 1998-2008 Seattle Post-Intelligencer
***********************
"We've laid the groundwork. It's like planting the seeds. And next year, it's spring." - Nader
***********************
Prepare for tending to your garden, America.
not suprising considering republicans are used to voting against their best intrests.
ha! ... brilliant!
The Defense Against Terrorist Viruses and other Diseases Act.
what about this?
from this day forward cancer cells will be refered to as "terror cells"
and doctors will be sent to liberate peoples bodies from them.
Hey, "freedom fries" caught on right? And this isn't nearly as dumb as that.
Or how about the Preservation of Humans for the Rapture Plan. We need to make sure that we are all healthy and alive to witness the second coming of Christ.
nice.