"Joy and pleasure are as real as pain and sorrow and one must learn what they have to teach. . . ." -- Sean Russell, from Gatherer of Clouds

"If you're not having fun, you're not doing it right." -- Helyn D. Goldenberg

"I love you and I'm not afraid." -- Evanescence, "My Last Breath"

“If I hear ‘not allowed’ much oftener,” said Sam, “I’m going to get angry.” -- J.R.R. Tolkien, from Lord of the Rings

Sunday, August 04, 2013

Medicare for All

Interesting article, via Susie Madrak at Crooks and Liars, about what "Medicare for all" would really cost:

Upgrading the nation’s Medicare program and expanding it to cover people of all ages would yield more than a half-trillion dollars in efficiency savings in its first year of operation, enough to pay for high-quality, comprehensive health benefits for all residents of the United States at a lower cost to most individuals, families and businesses.

That’s the chief finding of a new fiscal study by Gerald Friedman, a professor of economics at the University of Massachusetts, Amherst. There would even be money left over to help pay down the national debt, he said.

Friedman says his analysis shows that a nonprofit single-payer system based on the principles of the Expanded and Improved Medicare for All Act, H.R. 676, introduced by Rep. John Conyers Jr., D-Mich., and co-sponsored by 45 other lawmakers, would save an estimated $592 billion in 2014. That would be more than enough to cover all 44 million people the government estimates will be uninsured in that year and to upgrade benefits for everyone else.

“No other plan can achieve this magnitude of savings on health care,” Friedman said.

Half a trillion. You won't hear about that from the teabaggers in Congress.

Aside from the fact that we pay three to four times as much as anyone else in the world for prescription drugs, the costs of medical care are staggering. I've just come off a series of visits to the hospital and various specialists (the official word is that I'm alive), and the bills are starting to come in. (And thank the beneficent gods for Medicare.) My co-pays are pretty minimal, and nothing that I can't handle, but the way these costs are billed and "adjusted" is intriguing.

For example, three days in the hospital with pneumonia, $40,932.32. (This included an angiogram for $25,000.) This was adjusted down about 65%, right off the bat. The ambulance that got me to the emergency room the second time was $959, which was adjusted down 61%. The bill for the second visit to the emergency room was adjusted down 75%. A series of electrocardiograms was adjusted down about 80%. This is all before the insurer is billed. So the bills to Medicare (and me) were not very large. You have to wonder, where do they get these numbers, and how can they write off such major portions of the costs? Part of them are going to be covered by people with no insurance. (Yeah, right. Good luck with that.) But in the back of my mind is this little voice that keeps saying "Most of these costs are bullshit." I keep remembering the story about a hospital charging $1.50 for a Tylenol. That's just a little bit above cost. Ahem. (My hospital charged $.11 for an aspirin, which costs about a nickle -- retail -- at the pharmacy.)

And this is not peculiar to Medicare. I had a similar situation a few years ago (pneumonia and I have a long history), when I had insurance through my employer. The hospital bill was discounted 75%.

A big part of the outrageous costs are due to the fact that more and more hospitals are for-profit these days. I remain firmly convinced that there are some things that should not be subject to the profit motive -- education, prisons, medical care come to mind. What tends to happen when profit is involved, particularly now, in the Age of the Sociopath, is that quality of service suffers in the interests of the bottom line. The whole thing is subject to other abuse, as well.

Sadly, this report -- and I urge you to read the whole article at the link above -- will get soundly ignored. The majority in Congress is not interested in providing decent, affordable medical care to the American people. They have no arguments against it, just buzzwords. And the administration is too much committed to compromising with people who aren't interested in compromise. (I'd love to play poker with Obama -- I'd clean up.)

So write your congresscritters. And your senators.

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