It was there I finally met the chargemaster face to face.
My first wife died of beast cancer after an eight year struggle. I served on the school district's board on self health insurance at that time. Coupled with my wife's medical journey, and my insurance board membership, I became a well versed person on the health care mess we have in this country.
The chargemaster is a perfect illustration on why the health care "industry" has utterly failed to regulate itself. The "free market" approach, keeping governmental regulations as far away from the health care and insurance industry as possible, has resulted in the most expensive and dysfunctional health care system on the planet.
Moreover, using universal indicators of wellness. the United States, in spite of the huge costs and profits in its health care system, ranks well down the line relative to other industrialized nations in life expectancy, infant mortality, obesity; etc. In short, we are paying huge premiums, and inflated prices for lousy care.
And the chargemaster sits right in the middle of this disaster. The idea, if you can call such a malignant concept an idea, jacks the prices up on everything, from a gauze pad, to intensive care stays, to play the "game" of negotiating with insurance carriers.
Actual fees for service, and that is broken out in agonizing detail, vary from insured to insured. If the patient is un-insured, as over 40 million are today in the country, then the full price is charged. Usually, in the pre-surgery conference, this lack of insurance means the chargemaster vastly inflated rates are charged, and the person gets up, and cancels the surgery; and dies; or checks into emergency, where the hospital is forced to treat, and then turns around and charges higher rates to the insured, which jacks up rates for everyone; which makes the rich richer!
The idea is to continue jacking up the costs, at every turn, blame everybody else, take no responsibility for your "industry", get rich in the process; and don't care.
It is "CARE" that doesn't care; pure and simple. Forget the nice commercials, American Health Care does not care...except for our wallets.
I can remember going over my wife's hospital bills (there were many) and finding a box of facial tissues for $25.00. The hospital knew we had insurance, but included this on the bill for one of dozens of hospitalizations.
They could have thrown the $25.00 kleenex in as a bonus for "frequent stays program", but oh no...the chargemaster ruled. This was in 1994, I suppose it is $35.00 now. THIRTY FIVE DOLLARS FOR FACIAL TISSUE?
Be we had insurance, and we were "preferred patients" of a "preferred provider" so we didn't have to pay anything. Insurance paid it. Tom paid it. Dick paid it. Harry couldn't pay it; he died!
Oh well!
That is the reaction of most people, when they have Medicare, or costly insurance through their employer, they rejoice when the "bill" actually is thousands of dollars less than the endless lists the chargemaster spews out; the vomit from the chronically ill American health care system.
And Harry dies.
Obama Care is being phased in. It is based on a conservative plan, incorporating free market principles. It is NOT a single payer system like Medicare. It was the only thing that could have squeaked through Congress. It took over 100 years to happen, and there are forces right now, pigs at the health care trough, who are trying to fool all of us into repealing it, so their binge of rip off can continue.
The more they yell, the more we should resist their corrupt advice.
Obamacare is NOT the sole answer to accelerating health care prices and costs for sure. But it is for sure a viable start; and the insurance industry, the hospital industry, the lab industry, are all quietly spending millions to discredit it. And they just might win again.
What is galling, is the total inability of health care professionals to stand up and stop the rip-offs, stop the shell game, that charges $25.00 for a box of tissue paper, or itemizes each service for a hospital room while up front charging thousands simply for being there; multiplying the costs by the power of 10. If Motel Six did that, I am buying stock in it tomorrow.
When will health care professionals stand up and stop this ridiculous shell game? Are there any good people out there who have read when Jesus went into the temple and threw out the money changers? Do any of them read what he did next? He healed the blind, tended to the sick.
We need to throw the money changers out, and heal patients!
And the only thing that heretofore has acted to pathetically reign in this bing of overcharging? Medicare and Medicaid.
When you get on Medicare you get it. The bill comes in, thousands of dollars more than Medicare pays, and you rejoice because Medicare "forces doctors and hospitals to take way less than their charges". What you might realize, is the charges are what a true free market would be. What you might marvel at is, why do doctors, labs and hospitals, always take Medicare?
Because Medicare IS the true free market value! And Medicare pays, without the volumes of red-tape that the private insurance cabal puts providers through. Next time you are in your doctor's office, ask to speak to the person who handles insurance billing. If the practice is of any size at all, you will find another office, staffed with several people; or the doctor has outsourced billing to another firm.
Insurance billing and collection have become an industry unto itself, spending millions on simply processing claim forms, and figuring out the malignant game of the chargemaster.
And the only thing standing between all of us consumers and their avarice is Medicare, Medicaid, and the Affordable Care Act.
And right now, that is not enough.
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