Rant of the Week

The Unspeakable Obscenity of the U.S. Health Care System

 

According to a New York Times article [2013-08-03], Michael Shopenn, a man living in Boulder, Colorado, needed a new hip and obtained a rock-bottom price of $13,000 through friends with connections in the industry.  Then he tried to arrange the operation at a local hospital: they quoted him $65,000.

That is an unspeakable obscenity.  

He chose, instead, to fly to Belgium and have it done in a private hospital there for $13,660.  That price included the air fare, surgery, five days in a hospital bed, physical therapy, and the hip itself.  From the same company that offered it to him for that rock bottom $13,000 in the U.S.

How is that possible?  America is the greatest country in the universe.  All Europeans are lazy, corrupt, and I forget the third one.  The American health care system relies on good old capitalism and free market competition to drive prices down give us the cheapest health care in the world.  The New York Times is lying.

What is the bigger obscenity?  That large numbers of Americans continue to believe it, or that doctors and hospital administrators continue to believe that they are good, decent people, with ethics and morals and principles, who do their best to "help" people like Michael Shopenn.  They are not like drug dealers, bank robbers, or, God help us, bankers.  No, they work very, very hard and deserve to completely ruin your life.  Shopenn's example is a trifling one.  I know of cancer patients who were charged $20,000 a day to stay in the hospital after breast surgery.

There is no country in the world where a health care system that charges these rates is sustainable.  It is a system designed to deceive Americans into thinking that if they work hard, improve their skills, show up on time, and manage their money wisely, they will be able to retire when they get old. 

No, you can't.  You will be robbed of every cent by hospitals and doctors who are unconstrained by morals or laws or regulations.  They can charge whatever they want and they do.

The actual cost of manufacturing that hip:  about $350.  I'm not making this up.  And Shopenn was quoted a bargain: many patients pay up to $50,000 or $60,000 for it.  Why?  Because every agency that handles or distributes or installs the artificial hip takes a huge cut, including the hospital.

There was a time when a man who charged you $13,000 for a device that cost $300 to make was committing "extortion".  I don't believe for one second that it is not still extortion, and criminal. 

But why the hell is the hospital marking up the cost?  Why the hell is a hospital in the business of making a profit from a medical device? 

Oh.  This is America.  Cue the anthem.  Wave the flag.  Get the marching band.  Let's remind the world that we are the greatest country in the universe and anyone who thinks otherwise should go live in North Korea!

It's the American medical industry that behaves like North Korea.  Hospitals are forced by secret agreements to not disclose the price they paid for devices like artificial hips because it would .... er... create competition among the manufacturers.  And this is allowed in a Republic that claims to operate on the basic of market competition. 


Michael Shopenn didn't even have to go to India or Indonesia to save money on this operation.  He only had to go to Belgium.  But the interesting thing about this is that the skills required to safely perform this operation are not worth $65,000.   They probably aren't even worth $13,000.  The skill set is not like oil or gold or an automatic transmission: it is something that can be taught to any reasonably intelligent, educated young person in most countries in the world. 

Now you should not look at society through the lens of class warfare, but if you did, it would look very much like this: in order to get you to work, in order to make the rich rich, they have to offer you this charade of a "good living", maybe even health insurance (more likely not), and let you invest in a house and in mutual funds so that when you get old you can retire on your savings.  That's the scam.  Once you have actually reached that age, they will take all of the money back through medical costs.  Breast cancer?  Hip replacement?  Heart surgery?  It doesn't matter-- you will be charged an incredibly obscene amount of money so the rich can get back all of the money they paid you for your work.  God forbid your children should inherit it!

What about insurance?  Ah, but that is exactly what the Republicans are working on right now!  They will tell you that America cannot afford health care, Medicare, Medicaid, or Social Security.  You see, we desperately need that money..... to cut taxes for the rich.  Oh-- and to buy more F-35 fighters and nuclear submarines.  And aircraft carriers, even if a drone from China or Russia or North Korea is going to be able to sink one in the next few years.

No, you couldn't make that up.  Nobody would believe it.  But it's right there in the Republican Party platform and re-election campaigns and policy conferences-- that is what they intend to do.

 

 

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