I am still fuming from my encounter with a greedy little hospital a few days ago. Okay actually a huge hospital. What makes it worse is that they have one of the best spine doctors group affiliated with them. The Leatherman Spine Center. Just about all of the decent Neurosurgeons and orthopedic surgeons that specialize in spinal issues are affiliated with them. Many of these groups have actually been bought out by the hospital. Once they are bought they must terminate any affiliation with other hospitals. My orthopedic surgeon, who I really liked and trusted, was bought out by them just after my surgery. He used to do procedures at another hospital but no longer. He is not allowed to use any other hospital by the contract he has with his current hospital.
We have 3 large hospital groups here in the Louisville area. The largest is Norton's followed closely by Kentucky One which is run by the Catholic church. Kentucky One includes our former University hospital, U of L, Sts. Mary and Elizabeth and Jewish hospitals. Then there is Baptist Health Group. I like Baptist. The care there is awesome. Most of my doctors have an affiliation with them including my newest orthopedic surgeon who I have yet to meet. The main problem with this is that we have hospitals running around buying up all the doctor's groups in the city. There are very, very few physician groups that are truly independent anymore.
In the past a doctor's group may have been affiliated with many different hospitals. They had privileges at many hospitals and the patient could choose where they were treated. Now that choice has been eliminated from the equation. That has eliminated competition and thus squashed the best weapon patients had to voice their opinions about the different hospitals. Any time you eliminate competition it is bad for the consumer. Competition helps to keep prices low and quality high. Lack of competition hurts consumers. When there are fewer choices the remaining ones have no need to worry about quality or price. When you stifle that competition you can bet prices will go up and quality down. Why improve when you don't have to ?
This is happening across America, not just in my city. We have seen medical costs sky rocketing for the last decade and more. It is one of the fastest growing segments of the economy. Yes I do agree that we have seen a slow down in that growth, mostly thanks to the ACA or Obamacare if you insist. The problem is that it is still rushing headlong towards a peak. Our care here in America sucks when you look at what it costs in comparison to other civilized countries. We spend the most and get the least. Our average life span is less than other countries that have seen the light.
There are a bunch of news stories out there about the costs of similar operations and the cost difference in different states. There is a good article by the WSJ here:
WSJ HC Costs There is also a neat little interactive map for some common procedures here at CastLight
Neat Map: If you want to get real disgusted check out the story and all of the different charts by the Washington Post here:
WaPO story
What you should be seeing is that not only is there a huge difference in pricing just within the US but when compared to other countries our costs are completely ridiculous. Heck let's take a nice lower back MRI. The price ranges from about $450 in the Indianapolis area on up to over $3000.00 in the Boston area. Heck the price in Indianapolis ranges form the low $450 to above $2000.00 That is ridiculous.
How can there be that much difference in pricing ? Is one place using a home made machine put together in someone's garage and the others a brand new hi tech machine with the latest gadgets ? Can anyone explain the huge difference with a straight face ? This is not just limited to MRIs either. It is like this for all procedures, even office visits. Now hey my wife will tell you I am a cheap skate. Hell I have to be. It is hard to make the paycheck cover everything so I scour the ads looking for the best deals at the 3 different grocery stores we use, all within 5 miles of our house. Too bad we don't get ads from doctors and hospitals with their "sales". Okay I am joking but this really is so stupid. How can there be that huge of a difference in costs ? Is that $450 MRI being run by the 3 Stooges ? Does the $3000.00 MRI have gold plated controls ? DO they give you a massage before the MRI ? Maybe a complimentary bathrobe ? There really is no reason for that huge of a cost difference.
Here in America we spend roughly $0.17 of every dollar on healthcare. That is way more than any other country and we sure as hell are not getting our money's worth. We have a shorter life expectancy, Higher infant mortality rates and get less care for our money. Here in America we have the best Health care in the world. That's what we trumpet to the rest of the world. Well the rest of the world is calling BS justifiably. The only thing we are best at in health care is crushing people under the enormous weight of their medical bills. Oh and if you get a hernia from trying to lift them that will be cash in advance for the privilege of having them treat you and then over bill you for it.
The sole blame for these costs lays in the providers. Even not for profit medical centers will charge you an arm and a leg to treat the other leg. They set the prices by POOMA method. That stands for Pulled Out Of My Ass! They pull a number out and if people don't scream too much they double it then when people begin to scream more they double it again and say that's good for now. Next year we will have to raise it again. In other nations the Government steps in and sets prices or their is a commission that does or in some countries it is done by providers bargaining with the insurance commission and if they can't come to an agreement then the state steps in and sets them. Hell when the pushed through the Part D drug benefit for Medicare they made sure that they tied CMS's hands behind their back by making sure Medicare can not bargain for better drug costs. Bet that would sure hold down costs but the republicans bowed to the pressure of the Big Pharma lobbyists.
Over all there is but one way to fix this crap. Can you guess where I am headed ? Right down the path to Single payer. It is time we dragged America's Health care system kicking and screaming into the 21st century. Too bad so many politicians have their lips firmly planted on the backside of the lobbyists from so many different groups that don't want the system changed. They refuse to stand up for what the people want. Maybe it is time we tossed them all out and started over up there too. Let's get some politicians who will do the will of the people.