Sunday, 12 October 2014

An example of how dysfunctional the US healthcare system is

US academic Molly Worthen has written about her experiences of negotiating the privatised US healthcare system during her pregnancy.

It is not a happy story.
"My husband and I pulled into the parking lot for our first prenatal appointment 15 minutes early, excited to see the first ultrasound of the gummy-bear-sized creature in my belly. But before we laid eyes on a nurse or an ultrasound technician, the receptionist ushered us in for a meeting with a far more important person: Tami, the “financial counselor.”

where an administrator handed them a worksheet and explained the $1,100 fee that they had to pay up front - and which did not include hospital charges or many other items. When Molly's husband asked how much they would have to pay in total, assuming it what a routine birth, the response was :
“Oh, I couldn’t tell you that,”

Nor was their insurance company any more helpful, and neither could anyone give a cost for a specific treatment, saying that such information was "confidential". This level of dysfunctionality, of course, does not come cheap - US citizens paid some $200 billion in excess administrative fees in 2009, much of which could be emininated if the US adopted a public single-payer system of the kind that most developed countries favor.

And the US system does not even really provide much healthcare - Molly found out that her family could have to pay up to $20,000 per year if a health crisis struck them after the child was born. Molly sums up her findings thus :
"A truly free market requires all parties to have access to the same information—and the time and expertise to interpret that information. Healthcare, by contrast, is an economy of specialized goods that most lay people don’t fully understand, in which insurance companies and many healthcare providers have a vested interest in concealing prices from consumers....

...What we have here is not a free market, but a failed one. Healthcare seems to be the only unpriced good in America. Most of us wouldn’t even buy groceries without comparing prices first. Imagine a store with no price labels at all—only the products aren’t corn flakes and cantaloupe, but appendectomies and hip replacements. Even in non-emergency cases, when consumers might have the luxury of comparing hospitals rather than calling an ambulance, most of us would rather trust the advice of our doctors than shop around for, say, bargain-basement chemotherapy.

If I, with my fancy PhD and free time to spend on the phone with clerks and bureaucrats, haven’t been able to figure out the cost of something as commonplace as having a baby, how must other people fare? "

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Report on a Broxtow Save the NHS meeting
Falsification of data at SERCO
Report on a talk on Financial Incentives for Healthcare
Challenging the BBC on their coverage of the NHS Bill
This is what is wrong with the NHS Bill



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