Out of control drugs

For-profit hospitals appear to be better players in this price-gouging game,” says Bai, an assistant professor of accounting at Washington & Lee University. “They represent only 30 percent of hospitals in the U.S., but account for 98 percent of the 50 hospitals with highest markups.

Of the many things wrong with the US Medical system, and there are a great many, not least it is the most expensive in the world, are the prices of ancillary parts of the healthcare system.

I’ve just been catching up on my bills, one of which was a visit to a chiropracter. A single visit, with a company provided insurance, my out of pocket cost was $485. Yes, it’s complicated, it involves deductibles, co-pays etc. and of course since it’s my only healthcare visit so far this year, I got essentially nothing from insurance. You then start to question what you got for $485. 10-mins with the specialist; 15-mins electrical stimulation; and about the same ultrasound. Sigh.

I have a mild form of psoriasis which randomly appears(stress?) on my right elbow, left thumb and a couple of other areas. It’s really no big deal, I use maybe two or three small tubes of Fluocinonide per year; in a couple of days and it’s gone. I went to get a replacement tube of cream from CVS recently. It’s a prescription cream, which comes with its own problems. The pharmacist gave me the cream and announced they’d changed providers and the price was now $8. No big deal to me, I can afford it. I paid and left.

Out in the car, I stopped and thought about it. I’d just been stung with 62.5% price hike. Seriously same active ingredient, same size tube; different generic brand. And there you have it, you have no control, no choice, no free market, it’s effectively too difficult to shop around because it’s prescription only. Yet, strangely you can buy it online for pets, it’s about the same price, meaning again, my drug insurance is effectively worthless.

The problem in America is that there is no effective control for the price of drugs. This report by Johns Hopkins Bloomberg School of Public Health report, highlights how this is commonly exploited, let alone specific deliberate abuse.

The 50 hospitals, they found, charged an average of more than 10 times the Medicare-allowed costs. They also found that the typical United States hospital charges were on average 3.4 times the Medicare-allowable cost in 2012. In other words, when the hospital incurs $100 of Medicare-allowable costs, the hospital charges $340. In one of the top 50 hospitals, that means a $1,000 charge.

Of the 50 hospitals with the highest price markups, 49 are for-profit hospitals and 46 are owned by for-profit health systems. One for-profit health system, Community Health Systems Inc., operates 25 of the 50 hospitals. Hospital Corp. of America operates more than one-quarter of them. While they are located in many states, 20 of the hospitals are in Florida.

For-profit hospitals appear to be better players in this price-gouging game,” says Bai, an assistant professor of accounting at Washington & Lee University. “They represent only 30 percent of hospitals in the U.S., but account for 98 percent of the 50 hospitals with highest markups.

We all pay the price for this abuse. It’s nonsense to think that a single payer, public healthcare system would cost anymore. If we had it, there would be drug price control. Those against price control often argue that would stifle innovation and invention of new drugs, they role out the enormous cost of bringing out new drugs and using the profit of successful drugs to underwrite research, and failures during the process.

This is simply invalid. Anyone who thinks that humans won’t become involved because they are prepared to standby and watch their fellow citizens die, is just plain wrong. While medical innovations have progressed dramatically over the previous century, the last 20 years specifically have resulted in monumental advancements that substantially increased medical care standards and improved overall global health, but most of those advances didn’t actually come from the actual drugs(*), but from a better understand about the human body, how diseases spread and much about healthcare. The real ripoff in drug use is both at source, manufacturers, and those that sell the drugs.

Lets hope the next President take drug pricing as a priority.

* Not withstanding massive public health crisis drugs, like HIV, Ebola et al. These serve as exactly as an example of the invention that will still come.

FIFA vs The Government

I heard the BBC reporting the Governor of the Bank of Englands remarks that the “age of irresponsibility” in the City of London is over as the Bank of England promised a crackdown on rogue traders. In a speech on Wednesday evening, the Bank of England Governor said that banks, regulators and individuals had collectively failed to prevent the market rigging that has led to bank fines worth billions of pounds and he recommended tougher rules for the City and longer jail sentences for those who attempt to manipulate markets.

This is a very British approach to a problem, introduce tough penalties, regulations and make things illegal. It made me wonder, how would either the British or the US Governments deal with FIFA, if FIFA was either a UK or US Registered company.

FIFA_Logo[1]The contrast couldn’t be more stark. In the UK they would spend ages trying to bring FIFA to court under numerous, increasing complex and confusing rules. The trial would last years and cost millions, only to collapse at some point for legal reasons.

Meanwhile, the US Government, rather than push ahead with an Untouchables Style prosecution, as it seems to be. They would settle for a financial penalty, and we’d have never heard about the FIFA corruption until the settlement was announced. FIFA currently holds a reserve of $1.52bn, so no problem in paying US Governments fines. Ironically, paying fines is of course a form of legal bribery not to participate in the theater of court, the exact opposite of what FIFA stands accused of, taking money to allow countries to participate in bidding and holding the theater of the World Cup.

Healthcare – Points mean Prizes!

Back on April 6th I wrote a blog called “Healthcare Stupidity“. In a work email today it contained the following:

It may surprise you, but prices for medical services can differ depending on where you go. For example, identical cholesterol tests can run between $10 and $270 and an MRI can range from $300 to $3,000. Need a minor outpatient procedure? Searching in Castlight could save you hundreds. With Castlight, you can compare costs for doctors and medical services before you make an appointment.

Earn more points! Sign up, perform a search and review your medical plan in Castlight by June 30 for a chance to win 10,000 WOWPoints on e-Deals (valued at $100)*! For rules and more details please visit Castlight Rewards Sweepstakes.

Speechless, you can’t make this stuff up. As Bruce Forsyth used to say, Points mean prizes, play your card right!

Watch the video, If you are one of my US Friends… It will dispel any notion you have of the British being intelligent and articulate, much like the US Healthcare system it seems.

Healthcare stupidity

Only in America!

I’m an employed executive, I do OK. I have company provided healthcare insurance. I find the annual waste of time crawling through the policy details and trying to work out which one will pay out for real healthcare and which ones are just superficially attractive frustrating, annoying and the height of absurdity. If you make the wrong selection, you are screwed for the whole year. If you forget to make a selection you are possibly even more screwed as you’ll default into a plan which is totally inappropriate for your needs.

Then there is the whole debacle of co-pays, deductibles, out of network and a whole raft of other ways you can be screwed and charged even more. So, I’m guessing I’m not alone with this and in one of those only in America moments, there apparently is a business model for this.

My company has been promoting and I’ve been getting flyers in the mail, and emails at work in the HR Newsletter for a company called Castlight. The latest email from Corporate HR Said:

Castlight is your one-stop shop for healthcare. With Castlight, you can find a high-quality doctor at an affordable price before making an appointment. Already registered? Start searching today for the best healthcare options for your family. Castlight is provided to [—] team members, spouses or domestic partners enrolled in [—-] PPO 600 and Health Fund medical plans. Register for the Castlight Rewards Sweepstakes for a chance to win 10,000 WOWPoints redeemable at e-Deals@[—-]—a $100 value! For rules and more details please visit Castlight Rewards Sweepstakes

So, lets summarize.

  1. Healthcare providers are charging employees too much, otherwise why does the service exist?
  2. Healthcare Insurance companies are failing to negotiate the best deals.
  3. My employer is paying the company, or is getting a kick-back when employees use the service
  4. Company provided health insurance still isn’t affordable.
  5. None of this is important because you can get rewards and points for being sick and needing a doctor.
  6. If you pay by a cash back credit card, you too can make money, oops I meant save more money.

Yep, only in America would any of this be acceptable because hey, people are making good money out of it.

Abbotts Texas Miracle

This week Attorney General and Republican gubernatorial candidate Greg Abbott continued to demonstrate that the Texas Miracle is based only on smoke and mirrors.

Zap, Pow, Sock it to 'em Abbott
Zap, Pow, Sock it to ’em Abbott

First up, Abbott claimed victory over the evil empire, the Federal Governments’ Environmental Protection Agency. Abbott has time and time again sued the EPA to try to get relief for Texas based businesses, claiming almost everything except the dog ate their homework. The only thing Abbott hasn’t denied is that Texas is the worst state when it comes to air pollution, and given it’s size and position, that pollution is a major contributor to US pollution and to pollution in other states. But, hey, apparently that’s too bad as the regulations would be too costly for Texas businesses to implement.

The truth is that Abbott won a battle to save small businesses from implementing these regulations, but lost the war, the coal plants and other major facilities will have to implement them. The EDF has a different perspective but comes to the same conclusion.

Meanwhile, Abbott(“What I really do for fun is I go into the office, [and] I sue the Obama administration.”) has been explaining the unexplainable, back-peddling on his order to restrict access to the hazardous Chemicals list. As posted last week “The Texas Freedom Illusion“, Abbott confirmed the ban of releasing information to the public as Tier II reports in the 1986 Emergency Planning and Community Right to Know Act (EPCRA).

Well it turns out, he’s explained his position. You, yes, you the people, have not lost your right to know under the EPCRA. If you want to know, apparently all you have to do is visit the plants or write them, and ask. Instead of letting concerned citizens check the state database, where businesses are required to register, the State is pushing handling costs on the business. The Daily KOS has a great piece on this, describing Abbotts remarks as “jaw dropping”. < Zap pow!

It can’t be because it’s more secure that way.because it sure isn’t anymore secure. I’m sure the terrorists would never think of that, after all, they didn’t think of taking private flying lessons pre-9/11… when they couldn’t get trained by the Government.

Meanwhile, Abbott has also been re-confirming that the Texas Miracle doesn’t come with workers compensation insurance, the only state in America to do so. The Texas Tribune this week published a damning report into the cost and effect of this on workers. For as little as $1.38, businesses could provide workers comp. but like that EPA cost, thats too much of a burden. The downside of this, i workers getting hurt, seriously hurt often have no medical coverage, that means you are and I are picking up the tab.

So, lets summarize. Abbott is running for Governor. He is

  • Not prepared to require businesses meet the same emissions standards they are elsewhere in the USA
  • Not prepared to require Workers Comp. insurance
  • Not prepared to provide citizens access to data the State has on dangerous chemical storage
  • Continues to sue the Presidents Administration, costing hundreds of thousands of tax payer dollars, for no real purpose and little result

I’ll be protesting in the morning, Taxation with no representation, I can’t even vote for someone else, let alone against him. Zap Pow – Robin’ the people to pay for business.

Dead Reckoning: The TDI rules don’t quite blind the navigators

1619139_10152188985535915_241142027_nMichael King sums up how I feel about what’s been going on in Texas in relation to Womens Health, the Affordable Care act. I don’t always agree with King, but when I do it’s always the same problem.

For entirely political reasons, Gov. Rick Perry has not only opposed and obstructed the federal health care law at every available opportunity, he has done nothing to offer a usable alternative or even to maintain the entirely inadequate existing state health care programs. It has been more important for Perry and his GOP allies to fight a holy war against Planned Parenthood than to sustain the Women’s Health Program; it has been a higher priority to cut property taxes than to provide local health care districts with state assistance; it has been politically more expedient to deny millions of Texans health care coverage through Medicaid than to accept federal funding for a program that would not only save lives but expand the state economy.

via Point Austin: Dead Reckoning: The TDI rules don’t quite blind the navigators – News – The Austin Chronicle.

The Great American Ripoff: The High Cost of Low Taxes

Americans pay almost four times as much as the citizens of other wealthy countries for things such as retirement security and health care on the private market – 10.6 percent of our economic output versus an average of just 2.7 percent among OECD member states.

via The Great American Ripoff: The High Cost of Low Taxes | Connecting the Dots, What Matters Today | BillMoyers.com.

Bill Moyers website has a great perspective on the whole state vs private industry, tax vs pay debate. It shows that Americans for the most part want what the government provides, well-maintained infrastructure, safe food and clean water, efficient firefighting and policing, Medicare and Social Security and virtually every other government-provided service you can name. Most Americans though think that a lower tax bill – especially for federal taxes — The article shows, with figures, that those low taxes actually work against the economic interests of most Americans.

That’s because we pay ridiculously high out-of-pocket costs for things that are provided by the public sector in other developed countries. The difference is quite dramatic.