Tuesday, June 30, 2009

Whose Paying for Health Care Reform

Two questions that kept popping up during the health care service events in Connecticut this past weekend were "How is the President going to pay for this new health care reform?" and "Who will pay for it?" I was encouraged to find that 90% of the people I spoke with realize that doing nothing is not an option. But there is worry and concern on where the money to fix our broken system will come from.

We are already paying for health care, and dearly. We pay for procedures that are unnecessary. We are charged exorbitant fees for emergency room and hospital stays. We pay marked up rates for hospital supplies. Take a look at an itemized bill and see how much a box of tissues cost (makes you want to bring your own). These items are purchased in bulk at wholesale rates. The larger the quantity, the lower the wholesale unit price. Hospitals often charge the patient/consumer for these items at two to three times their retail value, and more. This is true for more than just boxes of tissues. It seems that any item that is provided by a hospital to the patient/consumer goes through a price markup that is higher than the retail value.

And who pays for those "goody bags" when a new born mother leaves the hospital? Something in my gut tells me the new born mother's health care provider is paying for that "gift."

Granted, these items noted above cannot be "shared" by patients, but that still does not justify the price hike. These costs are then paid for by the health care providers, who then in turn raise their rates. Obviously, the hospital is making a profit from charging these items to the patient/consumer. This is permissible in a free-market society.

So what do we as patient/consumers do? Do we brown bag for our hospital stays? That is to say, bring our own "goody bags" with our own tissues, lotion, plastic surgical gloves, cotton balls, tongue pressers, our own aspirin, etc. imagine telling your dentist, "Wait. Use my surgical gloves. I got them on sale at the local dollar store." While that might make good press to have people "brown bag" their hospital supplies for a day, it is highly impractical, since most trips to the hospital are not planned. Nevertheless, the gnawing feeling of being "taken in" remains.

It would be great if our lawmakers could take a look at hospital pricing in the same manner as was most recently done with credit card interest fees. We have to look at how we are charging the patient/consumer from all angles.

It is great to see that our administration is making headway on cutting costs and eliminating waste within our current system. Most recently, the US Dept. of Health and Human Services brought charges against various groups, involving $82 million dollars of Medicare/Medicaid fraud.
Turning up the HEAT to Stop Medicare and Medicaid Fraud
Most health care providers are doing the right thing and providing care with integrity. But sadly, due to the illegal actions of a small but active group of heath care fraud perpetrators, billions of dollars are stolen from taxpayers each year. Medicare fraud schemes have grown bolder and more elaborate, resulting in billions of dollars in false billings and fraud schemes which are robbing Medicare and Medicaid blind and leaving our most vulnerable citizens at risk ...
Some schemes that have been uncovered include:
Miami Physician Sentenced to 97 Months in Prison for Role in $10 Million Medicare Fraud Scheme

Eight Miami-Area Residents Charged in $22 Million Medicare Fraud Scheme Involving Home Health Care Agencies

Medicare Fraud Strike Force Operations Lead to Charges Against 53 Doctors, Health Care Executives and Beneficiaries for More Than $50 Million in Alleged False Billing in Detroit
No doubt, these efforts of our current administration will save us billions of dollars and allow us to spend money wisely.
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