The horrendous cost of health care

These numbers from the Miliman Research Report are stunning. This situation cannot possibly be sustainable for most Americans, and I have little faith that the Affordable Care Act will reduce these costs. I want to believe that the ACA will address costs, but I simply can't believe this. It's also amazing that in light of these numbers, and in light of the recent blockbuster Time Magazine article, "Bitter Pill," America seems incapable of having a rational conversation about what it really needs to do to reduce these horrendous costs.

Last year, when healthcare costs for the typical American family of four exceeded $20,000 for the first time, the Milliman Medical Index (MMI) compared the cost of a family’s healthcare to the cost of an average midsize sedan. This year, with costs exceeding $22,000 ($22,030), we note that healthcare costs for our family of four are almost as much as the cost of attending an in-state public college ($22,261) for the current academic year. The total share of this cost borne directly by the family—$9,144 in payroll deductions and out-of-pocket costs—now exceeds the cost of groceries for the MMI’s typical family of four. The out-of-pocket cost alone—$3,600 for co-pays, coinsurance, and other cost sharing—is more than the average U.S. household spends on gas in a year.

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Pay for Delay

Why is it that generic drug makers sometimes delay entering the market, sometimes long after the drug patent expires? This is another tale in corporatocracy, told by Alternet:

[I]magine you’re a big-time drug company. You want to keep competitors off the market as long as possible. Your move is to basically sue the pants off the generic drugmaker for copyright infringement, setting in motion a long and tortuous legal process. And these usually end with “pay-for-delay” deals. The brand-name drug company pays the generic manufacturer a cash settlement, and the generic manufacturer agrees to delay entry into the market for a number of years. In the case before the Supreme Court, the drug company paid $30 million a year to protect its $125 million annual profit in AndroGel, a testosterone supplement. It’s hard to see this as anything but bribery, designed to preserve a lucrative monopoly for the brand-name drug maker. In fact, this is what the Federal Trade Commission has argued for over a decade. They consider it a violation of antitrust law, arguing that the exchange of cash gives the generic manufacturer a share of future profits in the drug, specifically to prolong the monopoly. As SCOTUSBlog summarizes from the FTC’s court brief, in the regulator’s view, “Nothing in patent law … validates a system in which brand-name companies could buy off their would-be competitors.” Indeed, everyone wins with pay-for-delay but the consumer: the FTC estimates that the two dozen deals inked in 2012 alone cost drug patients $3.5 billion annually, with the brand-name and generic manufacturers splitting the ill-gotten profits.

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Time Magazine explores the destruction of American health care

Check out the feature article in this week's Time Magazine. It's called "Bitter Pill," and it's written by Steven Brill, a savvy insider. In addition to making me apprehensive that health insurance costs are about to spike upward due to Obamacare's lack of any meaningful price controls on health insurance, it gives an insider's look into the massively arbitrary pricing of health care services. In the absence of any competitive market, big hospitals (including the so-called non-profit hospitals) are freely allowed to concoct the prices they charge. They quietly maintain their made-up pricing on their non-public "chargemaster" price lists.

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Delving into Obamacare

At Occasional Planet, Madonna Gauding takes a careful look at what Obamacare means for ordinary people and big corporations.

A generous (and seriously wrongheaded) view of Obamacare is that it was a progressive bill designed to be a steppingstone to single payer. But, in reality, it was designed to strengthen, expand, and more deeply entrench corporate control of healthcare delivery. What will happen when the ACA comes online in 2014? I think millions will decide (out of necessity) to take the IRS fine rather than go into further debt buying inadequate, high deductible insurance. The insurance companies, limited to a smaller profit margin, and not getting the numbers they want, will decide they can’t make enough money to keep their yachts afloat, and fold. Hospitals, tired of treating people in emergency rooms for free, will push for Medicare expansion, as will the general population. Slowly, in fits and starts, we will move to Medicare for all. That will be a huge improvement. But, in order for us to have humane healthcare for all, the profit taking throughout the system has to stop—the $200 a pill prescription, the $15 box of hospital tissues, the many unnecessary, but lucrative procedures that line the pockets of surgeons. The “free market” for-profit health care industry with its bloated costs is the underlying cancer of healthcare delivery in the United States.

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Corruption and Obamacare

I still don't see any evidence that Obamacare will reduce health care premiums for ordinary Americans. These cost controls were promised as the prime reason for Obamacare back when Barack Obama first ran for president. At Huffpo, Wendell Potter explains some of the reasons that healthcare premiums continue to skyrocket. It's a story permeated with corruption, involving the malfeasance of both Democrats and Republicans. Here's the introduction to Potter's article, "Why Americans Pay So Much for Health Care: Friends in High Places (Just Not Your Friends)":

If you wonder why we spend more money on health care than any other country but have some of the worst health outcomes, you need look no further than the halls of Congress to it figure out. And you need look no further back than the recent "fiscal cliff" drama for compelling proof of how decisions are often made, not based on protecting the public's interest and bringing costs down but on protecting the profits of pharmaceutical companies, insurance firms and other special interests that grease the palms of our elected officials.

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