Congratulations, America, you’ve done it again! Healthcare as a percentage of our gross domesticated product has risen again… from about 17% three years ago to a whopping 19%+ in 2020! That’s about double what the rest of the developed world spends, and just under 30 million Americans do not have any health insurance at all. That just does not happen in any other developed country on earth, where universal healthcare is now considered a fundamental right. Even where states have opted into full coverage, and where they have created viable healthcare exchanges under the Affordable Care Act, the proscription against using their full bargaining power (because of the scope of the programs) to reduce the cost of prescription drugs still leaves Americans literally paying double or more for those medicines. Suckers!
The nation is distracted now – political polarization, inflation, COVID containment, hardscape and social infrastructure issues, voter suppression, evangelicals controlling the Supreme Court on social issues (like abortion), Chinese and Russian aggression and our climate emergency and disasters, etc., etc. – but that healthcare elephant is bellowing in the background. Where physicians once uniformly opposed universal healthcare, family practitioners found that during severe COVID surges, their patients (hence income generators) stayed away in droves. Hmmm.
Maybe a reasonable universal healthcare policy for America needs to move back to the front burner, along with affordable childcare and a system that no longer produces abusive elder care where profits are buried under a legal but grossly absurd industry practices… where owners of nursing homes create separate profitable entities to generate revenues while saddling their other company, the nursing homes, with the costs. Result: understaffing with unqualified servicing personnel, elders dying unnecessarily from neglect, and prices for nursing homes soaring. You just have to look at where COVID was a most efficient killer.
Even as they accept federal grant money for research and spend colossal sums on advertising for their prescription products, big pharmaceutical companies scream that if they were subject to fair bargaining for their medicines – comparable to what people in other developed nations pay – they could not afford the expensive process of research and development needed to create the cutting edge in next-generation meds. Take a look at their share prices and stated earnings! Seriously, they have made out like bandits in the last few years. Healthcare is more expensive than ever in this country.
The main arguments against universal healthcare still resound, virtually all from the “keep my taxes low” Republican Party. Government programs will cause inflation, they say, even as healthcare costs continue to be one of the most expensive costs facing average Americans. In fact, it is necessary to have a government program to get those soaring costs under control!!!
It’s creeping “socialism” they scream, perhaps providing a vocabulary impaired proof of the sorry state of underfunded public education in this country. Like the rest of the developed world are all socialists and we are great preserver of a “free market”? LOL… if you don’t look at a taxation system that almost never taxes wealth, just income, with a tax code with loopholes for the rich all designed by experienced lobbyists paid by special interests through an uncapped Citizens United campaign contribution right that exists nowhere else in the democratic world.
A simple resort to a dictionary (yes, they still exist) will tell you that the only commonality between true “socialism” – where the government owns and controls land, factories and the means of production directly – and “social” programs (like public education, universal healthcare, Medicare, etc.) is the root word “social.” If we weren’t busy fighting culture wars and banning some weird notion of “critical race theory,” whatever that is, our schools just might be able to spend more time teaching subjects like… er… English. What this resort to a false narrative on “socialism” accomplishes is a very profitable industry at the expense of most of us. Medical costs in the country are absurdly high! Stop the lies and deal with it!
For those in Washington who still proselytize that the United States has the best healthcare on earth, they are simply lying… again. Like our public schools, US healthcare does not compare favorably for most of us (read: other than the rich and those with Cadillac healthcare benefits) with the best systems in Europe, particularly in Switzerland and Germany (that also cover hearing aids, vision care and dental), which operate at half of our average cost. Some of these foreign governmental programs access benefits through private insurance companies, hence vitiating the notion that universal healthcare puts entire insurance companies out of business.
Hospitals complain that legal requirements require them to service uninsured people, so the rest of us must pay more. Sorry, hospitals, but universal healthcare would eliminate that. Nothing screams cost outrage like the pricing practices of most American hospitals, as David Larazus points out in his contribution to the December 10th Los Angeles Times: “Ridiculous, seemingly arbitrary price markups are a defining characteristic of the $4-trillion U.S. healthcare system — and a key reason Americans pay more for treatment than anyone else in the world.
“But to see price hikes of as much as 675% being imposed in real time, automatically, by a hospital’s computer system still takes your breath away… I got to view this for myself after a former operating-room nurse at Scripps Memorial Hospital in Encinitas [California] shared with me screenshots of the facility’s electronic health record system… What they show are price hikes ranging from 575% to 675% being automatically generated by the hospital’s software.
“The eye-popping increases are so routine, apparently, the software even displays the formula it uses to convert reasonable medical costs to billed amounts that are much, much higher… For example, one screenshot is for sutures — that is, medical thread, a.k.a. stitches. Scripps’ system put the basic ‘cost per unit’ at $19.30… But the system said the ‘computed charge per unit’ was $149.58. This is how much the patient and his or her insurer would be billed… The system helpfully included a formula for reaching this amount: ‘$149.58 = $19.30 + ($19.30 x 675%).’… You read that right. Scripps’ automated system took the actual cost of sutures, imposed an apparently preset 675% markup and produced a billed amount that was orders of magnitude higher than the true price.
“This is separate from any additional charges for the doctor, anesthesiologist, X-rays or hospital facilities… Call it institutionalized price gouging. And it’s apparently widespread because the same or similar software is used by other hospitals nationwide, including UCLA, and around the world…
“Janice Collins, a spokesperson for the hospital, declined to answer beyond confirming that the higher amounts shown in the screenshots reflect the hospital’s ‘chargemaster,’ the inflated list prices used for haggling with insurers… Collins sent me a statement that characterized Scripps as a victim of circumstance, a reluctant player in a healthcare system ‘that was established decades ago and which is outdated.’
“‘Healthcare providers, including Scripps, negotiate with health insurance companies for what we will be paid for these services,” the statement said… ‘Health insurance plans determine separately from healthcare providers what they will cover vs. what patients will pay,’ it said. ‘Neither the insurance company nor the patient typically pay list price.’… None of this is inaccurate. But Scripps’ response merely danced around the edges of the issue at hand — namely, a major medical facility deliberately, and systematically, imposing huge markups that in no way reflect its actual treatment costs.”
None of this is unique to Scripps. It is in fact this standard practice across the land, reflected in automated billing routinely used by American hospitals: “Scripps’ software is from a Wisconsin company called Epic, which says its programs have compiled medical records for more than 250 million patients worldwide… Epic’s healthcare systems include MyChart, the patient portal used by many hospitals, as well as a wide variety of applications intended for clinical settings… Epic’s clients include UCLA, UC San Diego, UC San Francisco, Stanford University, Johns Hopkins University and Yale University.” Lazarus. You can believe the standard lies promulgated by the healthcare profit centers and a bastion of GOP doctrine (with more than a few Democrats slorping at the campaign contribution trough) or you can believe cold, hard facts.
I’m Peter Dekom, and in a world where universal healthcare is a standard right in some of the most capitalist nations on earth, Americans are the world’s biggest healthcare suckers.
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