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.

Prison as an engine for recovery?

Poor peoples value

Bill Maher was during the 2012 Election cycle using the term “bubble” to describe the Republican candidates for President, and often Republican voters.. They held ridiculous views because they were in a bubble, they either did hear, didn’t see, or didn’t know the truth behind the issue.

I’m like that with Prison. I’ve done a few things I’m not proud of; written a few blog entries that when I look back on, I wish I hadn’t written; I’ve never done drugs, unless red wine counts; speeding, yeah some; have not been in a fight since, well probably 1979, etc. So I’ve never really been exposed to prison, the prisoners, staff etc. It turns out on bike rides I do cycle near two pretty decent size prisons, but thats it.

I’d heard the claim that “America has the highest rate of incarceration in the world” and that the Womens rate on imprisonment for drug offences had gone up a staggering 828%. I guess thats what equality really does. Among the US States with the highest percentage of their population jailed, they are all southern states, with Texas at number 4, with some 639 people out of every 100,000 in jail. Doesn’t seem a lot until you understand the implications, cost and business behind that.

This American Life, episode 501 on July 26th carried a remarkable interview. You can hear the full 1-hour program here, but I’ve taken the liberty of editing just act-1 “Weeds of Discontent” and posting it .

It is, as their website says, “A recording of a very unusual conversation that came about in an unusual way. Filmmaker named Eugene Jarecki made a documentary about the drug war, prisons and the criminal justice system called The House I Live In. He’s been taking it around the country and showing it in prisons, and producer Brian Reed went to one of these screenings where an inmate and a corrections staff member ended up talking face-to-face.”

Until I heard this, I’d been ambivalent about the cost and impact of the war on drugs, notwithstanding Bill Maher often “banging on” about it. This has changed my mind completely. And then today, in that way things seem to inexplicably link themselves together, The Texas Tribune posted an article on how Texas is leading the US in looking for alternatives to prison. That has to be applauded. The article was written by Brandi Grissom, who coincidentally cycled with us last Saturday, when I was last riding by a prison. I never knew Brandi was a writer for the Trib’ and by that part of the ride we’d split-up.

In her article, Brandi writes

More than half of the 20,313 Texas prisoners serving time for drug-related crimes were convicted of possession, not delivery or other offenses, according to a February report by the coalition. Texas spends more than $500,000 per day to incarcerate those offenders