Take two asprin and call me in the morning

I read an interesting article in the newspaper this weekend discussing the sky-high cost of the American health care system.  Because they are so visible and their fees seem so high (at first glance), doctors get the rap as the primary cause of our borderline-affordable medical care nightmare.  Turns out they aren't even close to being the highest paid links in the health care chain.

The story reported that the average surgeon makes $306K and a general practitioner makes on average $185K.  Considering all the education they must complete and the ungodly amount of medical school debt they assume, not to mention the literal life-or-death role they play, I don't think they are overpaid at all.  

And just FYI, the average nurse makes $61K and the average emergency medical tech makes $27K.  I think we patients are getting off cheap!

So where are the all the big bucks going?  The story suggested too much goes to administration / executive compensation.  For example, the average insurance company CEO makes $584K, the average hospital CEO $385K, the average hospital administrator $237K.  

Of course, the bigger insurance companies and hospitals pay WAAAAAY more than that.  Aetna CEO Mark Bertolini was given a salary in 2012 of $977K, with total compensation amounting to $36 MILLION!  Even the CEO of mid-sized New Jersey health system Barnabas Health made $21.7 MILLION total compensation in 2012 when he retired.  They also had 20 VP's who made over $350K each.

It seems the United States' $2.7 TRILLION health care system is top heavy with administrative costs, to the tune of 20-30% or $606 per American.  By contrast, health care administration in France costs $277 per person, Germany $237, and Canada $148.  (And for the record, citizens of those countries all have longer life expectancies than Americans.)

Doctors here are even protesting, too.  "Among doctors, there is growing frustration over the army of businesspeople (medical coders, claims adjusters, medical devise brokers, etc) around them and the impact of administrative costs which are reflected in inflated charges for medical services", they say.

So how can these guys justify their enormous incomes?  They say "large pay packages are necessary to attract top executives who have the expertise needed to cope with the complex structure of American health care, where hospitals and insurers undertake hundreds of negotiations to set prices."

Talk about job security!  You make the system so unbelievably complicated very few can decipher it, then demand a King's ransom to oversee the mess you created.

But when Obamacare was in the planning stage, who did they turn to for advice and political support?  The insurance companies and big hospital systems!  Well DUH!  (I guess they sorta had to, but still, their advice had to have been "cover your ass" biased.)


Maybe I'm getting way ahead of myself, but I'm wondering if that tiny little speck I see on the horizon coming headlong towards us isn't a single payer health care system....what its detractors call "socialized medicine"?  

My foreign friends say their system works well and we shouldn't be afraid of it.  Many Americans seem to think it will suck us all into a black hole of doom.  Me?  I have no clue.

I guess we'll just have to stay tuned.

S

The plot thickens... *cue the scary music*

I read a news story online this morning that began with the headline, "Treatment Cost Could Influence Doctors Advice To Patients".  It seems that "influential medical groups....are recommending that doctors weigh the costs, not just the effectiveness of treatments, as they make decisions about patient care."  

It's a slippery slope, to say the least.

This is the ammunition the "single payer" medical care advocates have been waiting for.  They have been pointing out with limited success that the best medical care is reserved for the wealthy, or at least the more well-to-do, while the rest of us have to make-do with something less.

It's a practice that has apparently been quietly acknowledged within the medical community for some time, but it hasn't become well known to the general population....yet.  I think it just stepped into the spotlight.

"Single payer" health care is a system in which the government, rather than private insurers, pay for all health care costs.  It's what they have in the UK, Canada, Australia, and many other, mainly European countries with a hefty "social safety net", supported by high taxes.

Proponents say it is the fairest way to see to it that everyone, regardless of their economic status, can get good quality health care.  Health care is a "right" we should all have equal access to, they say.  Detractors call it "socialized medicine", the key word being "socialized"....think "socialist".  *circle the wagons!*

On the one hand, the thought of our government administering anything sends cold shivers up my spine.  I can't imagine a more worthless work force than that mob of "civil servants" in Washington today pulling in bloated government paychecks. 

But on the other hand, I have friends in the UK and Canada and Australia and elsewhere who report that, all-in-all, the single payer model works well.  Wait times for elective procedures are often very long, but when they finally happen they won't send the patient straight to bankruptcy.

Not surprisingly my doctor, with whom I've had long talks with about this, and I would imagine my SIL "Doc" Chris, the insurers, etc. are scared to death of it.  But to an economically stagnant middle class it probably looks pretty good.

I think in the future, probably sooner rather than later, this will become a top burner political issue.  And it's gonna be a nasty one.

S