Initiates series of front-page reports about our health care looting: For years, we’ve been making a non-negotiable demand in the form of a question:
When would the New York Time do the obvious? When would it publish a series of front-page reports about the way the American public gets looted in the costs of health care?
We’ll guess we started asking this question in 2009, the year when the press corps pretended to stage a year-long debate about health care. This morning, to its credit, the New York Times has finally submitted to our will.
In the early going, the Times has already screwed up one part of the deal. It has failed to post Elisabeth Rosenthal’s lengthy front-page report in the Nexis archive. Unless this error is corrected, the piece will be lost to one band of future researchers.
That said, Rosenthal’s piece appears above the fold on the front page of this morning’s Times. It appears there beneath these headlines, as you can verify here:
The $2.7 Trillion Medical BillIn fact, colonoscopies only help explain that unfortunate matter, as Rosenthal correctly writes in her actual text. In that report, Rosenthal details the way Americans get looted on this procedure, as compared to people elsewhere in the developed world.
Colonoscopies Explain Why U.S. Leads the World in Health Expenditures
Under a dateline of Merrick, New York, this is the way starts:
ROSENTHAL (6/2/13): Deirdre Yapalater’s recent colonoscopy at a surgical center near her home here on Long Island went smoothly: she was whisked from pre-op to an operating room where a gastroenterologist, assisted by an anesthesiologist and a nurse, performed the routine cancer screening procedure in less than an hour. The test, which found nothing worrisome, racked up what is likely her most expensive medical bill of the year: $6,385.In other developed countries, this common procedure costs “well under $1,000.” Citizens here are getting looted, to the very substantial degree Rosenthal described in that passage.
That is fairly typical: in Keene, N.H., Matt Meyer’s colonoscopy was billed at $7,563.56. Maggie Christ of Chappaqua, N.Y., received $9,142.84 in bills for the procedure. In Durham, N.C., the charges for Curtiss Devereux came to $19,438, which included a polyp removal. While their insurers negotiated down the price, the final tab for each test was more than $3,500.
“Could that be right?” said Ms. Yapalater, stunned by charges on the statement on her dining room table. Although her insurer covered the procedure and she paid nothing, her health care costs still bite: Her premium payments jumped 10 percent last year, and rising co-payments and deductibles are straining the finances of her middle-class family, with its mission-style house in the suburbs and two S.U.V.’s parked outside. “You keep thinking it’s free,” she said. “We call it free, but of course it’s not.”
In many other developed countries, a basic colonoscopy costs just a few hundred dollars and certainly well under $1,000.That chasm in price helps explain why the United States is far and away the world leader in medical spending, even though numerous studies have concluded that Americans do not get better care.
Rosenthal’s report is lengthy and detailed—and she says there are more reports to come! In response to the non-negotiable demands we have advanced for several years, Rosenthal makes this pledge:
“In coming months, The New York Times will look at common procedures, drugs and medical encounters to examine how the economic incentives underlying the fragmented health care market in the United States have driven up costs, putting deep economic strains on consumers and the country.”
Unfortunately, you see the downside to Rosenthal’s work to date in that polite formulation, in which she attributes the obvious looting of American citizens to “the economic incentives underlying the fragmented health care market in the United States,” incentives which have “driven up costs, putting deep economic strains on consumers and the country.”
That formulation isn’t wrong; it’s just extremely polite. A cynic would say it represents a form of, “Hey, look quick! Look over there!” In the end, such excessive politeness may tend to keep readers from grasping the depth of the looting which is being described here.
Indeed, it may keep readers from understanding the fact that looting is being described here at all. Rosenthal never uses that unpleasant term, which may seem like a sensible journalistic decision.
Should Rosenthal use a term like “looting?” Before you cheer her self-restraint, you might want to note that she does use terms like this, early in her report:
ROSENTHAL: While the United States medical system is famous for drugs costing hundreds of thousands of dollars and heroic care at the end of life, it turns out that a more significant factor in the nation’s $2.7 trillion annual health care bill may not be the use of extraordinary services, but the high price tag of ordinary ones. “The U.S. just pays providers of health care much more for everything,” said Tom Sackville, chief executive of the health plans federation and a former British health minister.We’re allowed to hear about “heroic care at the end of life.” But that flowery language isn’t balanced by an evocative term like “looting.”
In fairness, the Times has bent to our will; it says more reports will follow. So will the inevitable Pulitzer Prize, a point we have made in the past when we’ve marveled at the failure of major newspapers to undertake this blindingly obvious journalistic assignment.
But will these future reports go where the rubber meets the road? Will they help readers understand the depth of the scam Rosenthal is reporting?
Rosenthal is describing an astounding situation. Within the next week, we will issue new demands concerning the future reports she and the Times have promised.
"...even though numerous studies have concluded that Americans do not get better care."ReplyDelete
Ought to have been bolded as well. Ask just about any American, and they will thump their chest and proudly say we have the best healthcare in the world. They might -- might -- be dimly aware that it's more expensive; they probably know that many people don't have access to regular healthcare at all, but they are absolutely certain that the people who do have healthcare, are getting better healthcare than they would get anyplace else, so it's all a fair tradeoff. Attempts to cover more people will, so goes the mindset, result in degrading that wonderful standard of quality. Where that notion comes from is probably a combination of nationalistic chauvinism, and propagandistic tales of long waiting times for common procedures in countries with "socialized" medicine, and people from other countries coming here to pay for procedures they could get for "free" at home, because they know we would o the procedures better. If you want to do something about healthcare, pound on the costs, yes, but you also have to pound on the fact that what we get, even for those of us with coverage, is no better than what is provided in other developed countries, regardless of what they pay.
"Ask just about any American, and they will thump their chest and proudly say we have the best healthcare in the world."Delete
Well, the commenters in the comments after the article aren't saying that. Instead there is story after story of lack of insurance, insurance that doesn't cover enough of the cost, overpriced procedures, people simply not going to the doctor because they can't afford to.
Imagine that: the comments section of the New York Times (with a readership that is more liberal than the average American) on an article that is critical of the healthcare system is filled with comments from people who are ... critical of the healthcare system (none of the comments talks about quality, by the way, just cost and availability). Shocking.Delete
I've been having the healthcare discussion for almost twenty years. In that time the only people I've ever heard say that the quality of care offered overseas was equal to what they have here is people who actually lived overseas and used their services. And even then (I currently live in Utah, where lots of people serve a two year mission in foreign countries for their church), lots of people believe that the quality of care here is superior to where it is anywhere else, even though they've lived overseas. No amount of data or evidence I present changes their mind. But don't take my word for it, have the discussion yourself. In the event that you are on conversational terms with non-liberals, talk to them and see what they say. Keep price out of it, and focus on quality.
I agree with Bob. My colonoscopies are billing Medicare + Insurance around $3000. And, the doctors own the clinic. So, the high cost means that the doctors are making a lot of money -- probably a lot more than doctors in countries where the procedure is cheaper.ReplyDelete
I don't like the word "looting", simply because an American worker in some field gets paid more than foreign worker. By that definition, lots of Americans are "looters": university professors and administrators, movie actors, professional athletes, lawyers, accountants, computer programmers, etc. US workers generally get higher pay than average foreign workers. Are we all looters?
Furthermore, if, higher-paid workers are "looters", then are labor unions evil because they fight for higher pay?
Yes. And yes.Delete
Yes. And yes.Delete
If you are a right wing union hater, then of course unions are evil.Delete
Unions can be over-demanding but paying workers a decent wage to afford a decent life style (money in the bank, home ownership, fun stuff like vacations, etc.) is not the same thing as having a healthcare system where Americans pay 2-3 times the amount of any other nation on earth but ranks a lousy 35th in quality of care.Delete
Virtually all of the increase in GDP has gone to the top 10 percent. Everyone else has remained stagnant or are falling further behind. I'd call that looting.
Also worth reading:ReplyDelete
Just to note that for once (well, maybe twice or thrice by now) I agree with Dave in Cal.ReplyDelete
Would also note that the NYT story hints at many other complexities in the cost of health care. E.g., doctors in Germany being underpaid, even when you take into account that they don't have the med school debts our doctors do (which, in the long run, is a problem for Germany's excellent healthcare system). There are no easy answers here, but our system is clearly very very broken. One problem is the amount of debt our doctors must accrue in getting educated (in contrast to other developed countries, which subsidize medical education much much more), which leads them to think more in terms of monetary rewards than they might otherwise.
I agree mch that more subsidization of medical education would be good. In addition, more medical education would be good. That is, if the government created a bunch of new medical schools, we'd eventually have a greater supply of medical practitioners. Because of supply-and-demand, the greater supply would drive down charges.ReplyDelete
Also, there would be more total medical care available. After all, the amount of medical care received by Americans is equal to the total amount of care provided by medical practitioners. The Obama reform approach didn't create any additional pool of medical care.
Setting a up a bunch of med schools is a very expensive, difficult undertaking. But, in the long run, I think it would be cheaper and more effective than the actual Health Reform Act that was passed.
Dave in Cal, I don't think your free market model, of driving prices down through competition, is relevant here if only because the number of people who are qualified to become physicians is always going to be very small (relative to population). To attract some percentage of these qualified people, you have to pay them well. Not all of them obscenely well, just most of them reasonably well (most physicians are not paid anywhere near what people imagine them to be, and since so many years of training precede salaries of more than, say $30-$40,000/year, they often need to earn more than you might expect in their relatively few high-earning years, if they are to pay off their debts and save for retirement and such).Delete
I disagree with you, mch. We don't need to attract people into becoming physicians. There are plenty of qualified foreign doctors out there who want to come to the US, but are prevented from doing so because of restrictions written into our trade agreements with other countries. If we allowed more foreign doctors to emigrate to the US that would help drive doctor salaries (and health costs) down.Delete
Healthcare costs are bankrupting America!ReplyDelete
A lot of people say this, but it's based on conflating America with the American government. Health care costs are indeed eating up more and more of the federal budget. They also eat up quite a bit of state government budgets, because of Medicaid and employee healthcare.Delete
But, America the country isn't being bankrupted by healthcare costs. We spend almost 18% of GDP on healthcare, which leaves 82% for everything else. The US GDP is high enough so that 82% is plenty to cover items other than healthcare.
Talk to the Americans who are bankrupted by medical expenses, even those with insurance.Delete
We need Eco and Eso (C. G. Jung and Rudolf Steiner). Read more on my blog (please click on my nickname).ReplyDelete
No, no click for you, spam troll!Delete
We have a great medical system IF you have good insurance through your employer or IF you are wealthy. If you are uninsured or if you have crappy insurance with huge deductibles then you will have lousy sporadic health care. In the other advanced democracies, the governments negotiate for lower drug prices, their drug costs are as much as 50% cheaper than in the US. Our per capita medical costs are much higher than the other advanced countries but our medical outcomes are not two or three times better. We have the highest infant mortality rate amongst the wealthy countries and US longevity is not as long as in the other advanced countries. People do not go bankrupt from medical costs in Germany, Sweden, Canada, Norway, Austria, Finland, Denmark or Australia, for example. But in the US, millions are at risk of going bankrupt from medical costs. About 50%+ of personal bankruptcies in the US are due to medical costs.ReplyDelete
Americans don't know how bad their healthcare situation is because liberals don't want to tell them. Liberals are much more interested in calling people racists, misogynists, homophobes, islamophobes, etc. than explaining to the public why our policies are superior to those of conservatives. Then we're angry when white people vote Republican. Way to go, liberals.ReplyDelete
Yeah, It's always the 'liberals' fault!Delete
Hieronymous is correct, except he forget to put "liberals" in quotation marks.Delete
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