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Home Health Care Cost of health care is the real issue for Congress

Cost of health care is the real issue for Congress

The number was eye popping: $1.8 million in medical care costs for a former jail inmate’s six-month stay at IU Health Ball Memorial Hospital.

The hospital presented that claim last week and is seeking payment from the Delaware County sheriff. I’m sure there will be much negotiation before this case is settled. But that’s not what this column is about. Set aside that it was a jail inmate. Just focus on the number: $1.8 million.

The patient was diagnosed with “septic shock,” and was intubated because of respiratory distress. Septic shock is basically widespread infection that can cause organ failure. It’s a serious, life threatening condition.

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I don’t know how this patient was treated at the hospital. Perhaps that $1.8 million figure is a relative bargain for this condition, though it’s still a lot of money. Of course, some will argue that a price can’t be placed on saving a life. That’s a valid argument.

I can’t help wondering, though, if the American public is getting ripped off by the health-care industry, including by the insurance companies. That ought to be the real health care debate in Congress. Let’s have some discussion on why care costs so much more here than it does overseas. Let’s focus on a real issue instead of obsessing over early-morning tweets from the Oval Office.

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We’re told that health savings accounts will soften the blow of paying for care. For example, how many working families can save the thousands necessary to pay for an appendectomy? Doubtful it’s many. One source, the Cost Helper Health website, lists the price of an appendectomy from $10,000 to $35,000 or more, depending on the procedure and any complications. That doesn’t include doctor fees and the costs of needed tests.

If you or a loved one need such an operation, there’s no time to shop around for a health bargain. You go to the nearest hospital and figure out how to pay for it later, even with health insurance.

If the health consumer is willing to shop for the best price on a non-emergency procedure, trying to make sense of the charges takes a herculean effort. Besides, if you need a knee replacement, do you want it done on the cheap, or do you want it done by “the best”? That’s not to say it’s always an either/or choice, but I’d sure want it done “right” if it were my knee going under the knife. The point is, health care costs are well hidden from the consumer, or come with so many conditions that making a comparison is difficult.

Plus, the true cost of any procedure might not be known until weeks or months after it was performed, as bills work their way through the health, government and insurance systems, discounts applied, deductibles deducted, etc. It’s impossible for the consumer to know the true cost of the care they receive. 

Americans in 2016 spent per capita $9,892 on health care, according to the Organization for Economic Cooperation and Development. That’s more than any other nation.

It’s no secret that health care outpaces the annual inflation rate, despite Obamacare. And health costs are a major factor in filing of personal bankruptcies, though the exact figures are hard to pin down because the problem has been overstated in the past.

Some of the factors that raise our health costs include administrative costs that contribute to 25.3 percent of all health care spending in the U.S., according to a 2014 study published in the journal Health Affairs.

Another is we want the latest and best medical care, which often means using the most expensive equipment, or taking the newest medication. The table has been set so that hospitals and health care providers have no choice but to continually offer the latest in technology, but somebody has to pay for it. Actually, everybody pays for it.

And there’s also what’s known as “defensive medicine,” where doctors, out of fear of facing patient-filed lawsuits, order more tests than might be needed. Somebody’s gotta pay for that, too.

If you’re looking for a solution, I’m afraid I don’t have one. As much as government’s role should be limited, this is one time where government ought to take the lead to reform health care. Maybe it actually does make sense to have more people enrolled in insurance plans instead of trying to kick people out of the system.

I will point this out: An article from CBS News mentioned that Duke University Hospital has about 900 beds — and 1,500 billing clerks. That’s how many it takes to get the bills paid.

There has to be a better way to provide health care.

Email Ward at jward@muncie.gannett.com with tips, suggestions or story ideas. Follow him on Twitter: @JeffWardTSP.

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