Archive for "Mar 06 2013"

My tales of the greedy, heartless healthcare industry

Paul Krugman mentioned a lengthy Time magazine article — “Bitter Pill: Why Medical Bills are Killing Us” — in his column Monday.  It’s by Steven Brill and describes in depth the utter piracy that has become the norm in the medical industry.

There’s no question that dealing with insurance companies is a nightmare for most people these days, but the real villains are the hospitals, Big Pharma, medical equipment makers, and greedy doctors that keep raising their prices well ahead of the inflation rate. Read the article.

Everyone has their stories. A few of mine:

I was “lucky” to learn what really motivates the  do-no-harmers  long ago. When I was 29, I landed in the emergency room at Piedmont Hospital, so sick I literally could not lift my head off the examination table. After an hour, the doctor who first examined me came in the room and announced, “You’re extremely ill. We don’t know what is wrong with you, but you have to leave because you have no insurance.”

Can you imagine? For years afterward, I dreamed that the assholes arrived on my doorstep dying of hunger. “I’m sorry, you’ll have to leave because you cannot pay for the food I have,” I’d tell them. Then, I began to choke as heavy winds blew hail and rain against my windows. The door flew open and the storm ceased. My breathing became easy. I took the doctors in and fed them.

No such humane stories occur in the real life of hospitals like Piedmont. After my parents gave the vultures $10,000, I was admitted and a doctor was assigned to my case. He couldn’t diagnose me and, after 3 days, I was near death. I’m not exaggerating. Only then, was an infectious-disease specialist called in. It took him about three minutes to diagnose Scarlet Fever. I was far sicker than I needed to be, thanks to the assigned doctor’s hubris.

Interestingly, weeks later, the specialist told me I would have been better off leaving  Piedmont and going to Grady, Atlanta’s public hospital. At Grady, he told me, there is always a specialist in every field on duty in the ER. My Scarlet Fever would have been quickly diagnosed.

I was in Piedmont over a week. Maybe a month after I checked out, they turned me over to a collection agency whose lawyer threatened me repeatedly. Apparently, my parents had “underpaid” them $100 for my initial ER visit. I was dirt-poor but embarrassed to tell my father what was happening. So I sold some possessions and drove to the lawyer’s office to give him the cash before he threw me into small claims court.

Seven years ago, I had emergency surgery at Piedmont and they botched it. But here’s my favorite scene: Languishing in monstrous pain in the emergency room, completely unattended for hour after hour.  I apparently blacked out after five hours and came-to screaming. At that point a doctor hurried over and I went off. I told her I was in the worst pain imaginable and that I couldn’t believe that they wouldn’t give me even aspirin to help deal with it. Her reaction? She burst into tears. I was mean to her. That’s okay, Doc., you go ahead and torture me by not addressing my pain and I’ll be nice.

And I loved this: Soon after I was admitted, someone thrust a paper in my face that said it was my responsibility to tell nurses to wash their hands (to avoid staph infection?) before touching me. Hello? I was on morphine and I thought my urine bottle was my cat half the time. I was supposed to tell the nurse,”Warsh yer hands, dammit!”

About a year ago,  Kaiser referred me to an outside cardiologist on the Piedmont campus. Everyone promised that my tests would be covered under my ($700 monthly) insurance. However, because it turned out that the hospital owned the equipment the doctors used, I was charged $2000. Kaiser, refused to pay (but eventually did).  I’m happy to say they no longer refer people to that practice. Meanwhile, I had to have all the tests redone at Kaiser’s own facility. Why? Because we couldn’t get all of the results from the Piedmont-campus doctors. “She just won’t give us the results,” the office manager said to me one day.

That our equally disgusting legislators enable this needlessly bloated and corrupt excuse for “free-market” medical care is particularly galling. (That reminds me, but I won’t get into my gall-bladder removal and the nurse who called me a wimp repeatedly at another, equally awful hospital.) There’s nothing free-market about this system. Congress won’t let Medicare negotiate drug prices, for example, thus raising taxpayers’ cost of the program by billions of dollars. Why? For no reason other than to protect the obscene profits of Big Pharma. Oh, those fiscal conservatives.

Obamacare is going to increase access to the system for lots of people, but it’s not going to do much to stop the increase in costs. In fact, the program is in many respects a huge score for the fat cats in scrubs.

Steven Brill’s article discloses several things new to me. One of them is the existence of something called “the chargemaster.” It’s a list of charges for everything a hospital does. Nobody Brill interviewed could give a coherent explanation of how the shockingly inflated prices are set.

Of course, insurance companies have the privilege of paying costs substantially below those on the chargemaster. But uninsured people or people who have exhausted their benefits are not told they have the freedom to do the same.

The most baffling thing of all is the way so many ordinary consumers do not support a single-payer system. Meanwhile, the national deficit that makes the same people so angry grows and grows and would be substantially reduced by a single-payer system.

Please read Brill’s article and pass it on to friends.