Monday, January 18, 2010

Skyrocketing Health Care Costs Need Reforming, Too

Despite the months of lip service and mounds of paperwork that have come to symbolize the health care reform debate, very little has been said about controlling costs associated with health care delivery. Not only are these costs hurting workers and the economy, they are bucking the deflationary trend by rising faster than any other indicator (except, perhaps, the unemployment rate).

A blurb in our local paper Saturday stated that despite last year's low inflation rate of 2.7%, college tuition and health care were two costs that continued to rise far above that meager rate. I recently read an article about a local girl with a rare disorder, whose treatments were expected to cost tens of thousand of dollars each month. A letter to the Editor of the Valley Advocate last week praised the state-funded MassHealth insurance for paying for treatments costing $3500 per month. Over $40,000 a year for medical care? What "treatments" can possibly cost that much?

Unfortunately, this is reality. The health care industry and the insurance industry have developed a symbiotic relationship whereby each makes gargantuan profits off of spiraling health care costs. Imagine if there was no such thing as health insurance. Would people purchase these overpriced and often marginally helpful treatments? Most probably, they would not. No matter how much you feel you need it, thousands of dollars out-of-pocket for health care is not workable for most of us. We would do without, find alternatives, or stay sick, maybe even die. Medical professionals don't give health care away for free.

Such high costs are only sustainable on a large scale when people have insurance that will cover most of the costs. The higher costs become, the more people need insurance. The insurance industry thrives because without the high costs, people wouldn't need their services. Remember, no matter how high medical costs become, there are only a small percentage of claims paid compared to the millions of customers paying exorbitantly high premiums each month. At any rate, insurers raise their rates each time health costs rise, so they don't ever lose; either do the hospitals and doctors charging these rates. The only losers are you and me, the customer/patient. Oh, and don't forget that insurers are exempt from anti-trust laws, as well.

An article by Stephanie Kraft in the September 24, 2009 Advocate presents some sobering statistics. According to the California Department of Managed Care, six of the largest health care insurers rejected, on average, nearly 32% of all claims submitted in the first half of 2009. That's an extraordinary percentage of refusals for an industry whose reason for existence is to pay medical claims. Not only that, but the number of insurance administrators has increased 3,000% since 1970, while the number of doctors has only risen by 200%. The greatest surge has occurred within the last 20 years.

As long as this profit-taking alliance exists, there will be no real reform in health care delivery. Our lawmakers had another chance to rectify this situation, but did not. In fact, they have succeeded in making it worse for us, by now guaranteeing increased revenue to these monoliths in the form of a requirement that each of us buy their products. Government by and for the corporations strikes again!






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