Oh, the games we play when it comes to health care affordability. The winners keep winning, and the losers keep losing because the winners set the rules of the game. Winners (insurers, hospitals, doctors, pharma) win by sharing some information about how to play the game while keeping the most important information hidden. But don’t blame the winners for their success; it wouldn’t be possible without the consent of the losers (individuals, small and large employers, and to a lesser extent, government).

For decades, the losers placed their trust, and dollars, in the hands of the winners, and went about their business. Health care costs were a once-per-year conversation and the goal was to get through it. Meanwhile, for the winners, health care was their business, and they spent every day trying to grow it. Now, we ask, has this unequal relationship reached its tipping point or are we all still all-in?

People like me have been saying for years that health care prices are unsustainable and insurers, hospitals, doctors, and Big Pharma should expect a backlash any day now. Wrong. Any day now has turned into ten years and insurers and hospitals are reporting record profits.

It’s So Hard To Say Goodbye To The Health Care Status Quo

Our relationship with the health care status quo has all the characteristics of an emotionally abusive relationship. The relationship started out well enough. About 100 years ago, Baylor University Medical Center in Texas offered a local teachers’ union a deal for hospital services. “For $6 per year, teachers who subscribed were entitled to a 21-day stay in the hospital, all costs included. But there was a deductible. The “insurance” took effect after a week and covered the full costs of hospitalization.” Soon, millions entered into insurance relationships, as the Blue Cross Plans expanded to other states. Continue Reading...

Tags: health care , health care costs, health care choice

To shine a spotlight on America's outrageously expensive health care system, two media firms that are great at explaining health care policy, asked individuals to share their medical bills with them. Kaiser Health News (KHN) and National Public Radio's (NPR) "Bill of the Month" series does exactly what its name implies. It takes a medical bill submitted by an individual and dissects it to better understand how, for example, four tiny surgical screws or one extensive urine test can cost as much as a car. Vox Media, the other news organization requesting medical bills, performs a similar review, but for hospital emergency room bills only.

Both the KHN/NPR and Vox projects started in 2018, but stories about inexplicably high medical bills are not new. Major news organizations have been shocking readers with reports of shameless health care price gouging for years. Journalist, Steven Brill's 2013 article, "America's Bitter Pill…" in Time Magazine, grabbed the nation's attention like no other health care price article has before or since. In fact, Brill's blockbuster article likely inspired NPR and Vox's current medical bill review projects, as well as several bestselling books on the subject.

Meanwhile, a similar information campaign about income/wealth inequality is also cause for outrage. But if the response to news about income/wealth inequality is any indication, what can we expect the stories about health care price gouging to accomplish? Remember Occupy Wall Street and Fight For $15—how participants in these movements were mocked as naïve losers out to take from the makers? And how Republican lawmakers enacted tax cuts for corporations and wealthy individuals to punctuate the defeat of these groups? It's not hard to believe that this is the fate of the health care price outrage campaign. For every successful teachers' strike there is an annual health insurance premium increase to gobble up any negotiated benefits increase. Continue Reading...

Tags: Bill of the month, Vox.com, America's Bitter Pill, health care costs, health care cost inequality

Republican Congressman Mo Brooks of Alabama wants us to "take into account our financial limitations" in providing health care to every American. Some people interpreted his remarks as meaning that we can't afford to provide health care to every American. I want to give Congressman Brooks the benefit of the doubt and assume he meant that not everyone could have unlimited medical care at any price paid for by the government. But I can understand how others would translate his words negatively. Brooks is the same guy who talked about "people who lead good lives" as part of the health care reform debate.

This healthy people lead good lives, sick people lead bad lives is just updated phraseology for the same old moralizing nonsense conservatives use to demonize the poor and revere the rich. This type of thinking is so stupid and inapplicable in the real world. There are millions of healthy people who lead good lives that get sick. My best friend in the world was one of those people. She was active, did yoga regularly, ate organic, had an active social life and had a sharp mind. But one day she was diagnosed with cancer, and I lost her. This is a story repeated many times every day yet we still have jerks like Brooks that would rather use hateful language against the poor than address the unnecessarily high prices charged by hospitals and medical care providers.

You see politicians and doctors want us to believe the problem of unaffordable health care is our fault. If we only lead good, healthy lives, no one would need expensive, government-paid health care, says the politician. If we engaged in healthy behaviors and avoided unhealthy behaviors, we wouldn't suffer from expensive chronic diseases, says the doctor. And these politicians and doctors may have valid points—health care would be less expensive if we all lead healthy lives. But what world do these politicians and doctors live in? Who are these perfect, healthy people who do everything right in life? So instead of promoting this myth of the good, healthy, righteous, never need health care super-human being that does not exist, I wish Congressman Brooks and others like him would join us in the real world. A world where real good people, rich and poor alike get sick, sometimes really sick, and need expensive medical care.

The Alabama Congressman could address the financial limitations of high-cost medical innovations. About how much is too much medical innovation for the nation's pocketbook to cover? He could bring up for conversation why we require American doctors to obtain a Bachelor's degree before starting their medical degree education when many other industrialized nations do not. The cost of a medical education in America is the main justification doctors use for their high salaries. Mr. Brooks could learn more about the impact of socioeconomic factors on a person's health and support public policies to address these issues. He could also say that Americans should not pay hundreds of thousands of dollars for heart attack treatment. But he doesn't focus on any of these issues. Continue Reading...

Tags: health care costs, American Health Care