According to the Health Care Cost Institute, an academic institute started two years ago, the rising health care spending of Americans under 65 in the last two years has been driven entirely by rising prices; not by more use:
And again, despite what we've been led to believe, these prices may not actually be the dirty work of the evil health insurance companies or of the runaway Medicare program. A few months ago, Time Magazine published an article entitled "Bitter Pill: Why Medical Bills Are Killing Us" all about the financial practices of hospitals. Hospitals, which we (okay, at least innocent I) just assume by the nature of the services they provide are solely motivated by the prospect of making the sick well, are actually quite motivated by money - and lots of it.
To be fair, hospitals are businesses and they, like any other, deserve to make money and if they are "for profit," deserve to make a profit. But the lengths to which they go to do so make you think more than just twice. Especially since their customers (aka patients) are arguably more vulnerable than the customers of any other business - sick, scared and, when it comes to medicine and treatments, largely uneducated. Why else would they pay $77 for a box of gauze pads, $108 for Bacitracin and $18 for Accu-chek diabetes test strips when they only cost $.55 on Amazon? Apply those kinds of mark-ups to actual medical procedures and it spells DEBT for the average American incredibly quickly. That stress alone is surely enough to send one right back to the hospital. (Perfect strategy for a repeat customer, actually!)
More disturbing in the Time article was the exposure of incredibly large variances in costs between a procedure in one hospital, and the same one in another. Depending on the procedure, a 20% variance can mean thousands of dollars. I know when I go to Whole Foods, the same milk may cost a dollar more than if I buy it at Costco, but I didn't know I could save thousands on heart surgery 50 miles up the road. And if I need heart surgery, is price-shopping what I should be focused on? Or should I instead by finding a surgeon with whom I feel comfortable entrusting my life or that of my loved one. Surely the latter, no?
And still more disturbing was that, when pressed, many of the interviewed hospitals admitted the fees they charge are just starting points for negotiation. So... just like when I'm buying a faux Gucci at an NYC street fair? I don't know many great hagglers, but those I do get off on the game. The problem is that health isn't a game.
In this world, there are those you trust implicitly, those who always leave you with a little question in your mind, and those you don't trust at all. Hospitals always fell into the first bucket for me - in fact, Children's Hospital in Boston saved my life when I was 18 months old and then saved one of my best friend's daughter's life six years ago. But I'm sad to say hospitals in general, after having read this article and a few others that have trickled in since, now fall into bucket number three.
I'm certainly not going to solve this alone, and nor are you. But we're not powerless either. Each of us can do our damnedest to steer clear of hospitals and their exorbitant price tags. Obviously, not everything is preventable, but a LOT more than you think is.
To quote Dr. Andrew Weill, with most subjects, the deeper you go, the more complicated it gets. With nutrition, however, it's the opposite. Prevent the preventable with healthy relationships, real food - especially fruits and veggies, exercise and water. Because they can't charge us for goods and services we don't use.
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