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.

Texas, It’s not like anywhere else

austin_bumper_stickerLiving in Austin it’s all to easy to think you are in Texas, but really like it’s often said “Austin is a liberal oasis in Texas“. More often, Austin isn’t in Texas, but you can see it from here!

One of the first things I had to get used to is the Texas Legislator only being in town once every 2-years. That’s right, in what seems a total anomaly  the elected officials of the State of Texas are only in the capital to make/pass law every two years.  I’d guess this stems from the days when they had to ride horses to get to and from their constituents?

So while they work on the bi-annual budget as a key part of their initial work this year, there are a few key things that Texas does differently…

  • The Texas execution machine took a break over the year end, with near-weekly executions scheduled and most carried out. In all, Texas put to death 15 men in 2012. The state will kick off 2013 with the rare execution of a woman, Kimberly McCarthy on January 29th.
  • In all, Governor Rick Perry has presided over 239 execusions, surpassing all modern governors and marking the 478th Texas execution since the reinstatement of capital punishment in 1976.
  • While we await the outcome of Vice President Joe Biden to report back on gun control, Texas and Austin resident Alex Jones demonstrated perfectly why people are right to be concerned about “nut jobs” with easy access to legal guns when he “discussed” it with Piers Morgan on cnn.com.
  • Talking of “nut jobs”, over in Lubbock County Texas, Judge Tom Head claimed on local TV that a proposed tax increase would be needed to put down civil unrest and defend the country from invading UN forces should President Obama be reelected.
  • Down the street from me is a closed restaurant, Jovitas. It’s waiting the return of its owner, Amado Pardo. The restaurant was closed when Pardo was arrested by the FBI with 15-others for allegedly running a longtime heroin-dealing operation out of his eatery. What was really surprising was that Pardo was a twice convicted murderer, even more of a surprise was that Pardo was released on bail today, he has terminal cancer. Where’s the tough on crime, three strikes and you are out, when you need it?
  • Not quite as close to home, across Austin, in the Hot Bodies Mens Club, Victoria Perez, 21, was arrested for aggravated assault with a deadly weapon following a fight among seventeen women in the dressing room. A Male strip club employee was seriously injured when Perez hit him in the face with a spike heeled shoe and may have blinded him. As Alex Jones might have it, should we ban high heeled shoes? Hell no.
  • As a final vote of confidence, Buzz Bissinger, author of the book, Friday Night Lights about an Odessa Texas high school football team, tweeted that “if Dallas slid into a sinkhole, nation’s IQ would raise by 50 points”.

So, much for calm, rational people with legal access to guns. It’s interesting now that Texas has stricter controls over a womans uterus than guns. Texas now prescribes invasive gynecological procedures for Texas women, while at the same time making even harder for many thousands of Texas women to even visit a gynecologist.

And finally, it looks like the governor and the legislator don’t read my blog, otherwise they might have focused on what’s going to happen to all those children that are going to escape an unwanted death in Texas. The Governor continues to make it clear he is diametrically oppossed to any expansion of Medicaid in Texas, that pays for most of these births, and will do everything in his power to undermine national health care in Texas.

@pointaustin, writer and Editor Michael King points out that in Governor Perrys political universe, “Fetal pain” has an expiration date. Once that new Texas citizen takes his or her first breath, they are on their own. Writing in the Chronicle, King says “When the Governor says Suffer the little Children – he really means it.”