Health Care Costs In America

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Deceased patient's family owes $81,000 for a single air-ambulance flight​

Debra Prichard was a retired factory worker who was careful with her money, including what she spent on medical care, said her daughter, Alicia Wieberg. "She was the kind of person who didn't go to the doctor for anything."

That ended last year, when the rural Tennessee resident suffered a devastating stroke and several aneurysms. She twice was rushed from her local hospital to Vanderbilt University Medical Center in Nashville, 79 miles away, where she was treated by brain specialists. She died October 31 at age 70.

One of Prichard's trips to the Nashville hospital was via helicopter ambulance. Wieberg said she had heard such flights could be pricey, but she didn't realize how extraordinary the charge would be — or how her mother's skimping on Medicare coverage could leave the family on the hook.

Then the bill came.

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Jacobin

How Medical Debt Destroys the Lives of Millions of Americans​

The United States lags behind almost every wealthy country in not having a health care system that is either free at the point of use or affordable. Instead, millions of people are saddled with medical debt that they will never be able to afford to pay back. Even on its own terms, this system is irrational. The revenue raised for private hospitals and debt collectors by issuing patients with bills is a relatively insignificant proportion of income. However, the costs of these debts to patients, who are often summoned to court because of delinquent payments, are life wrecking.

Luke Messac, a doctor and historian of medical treatment, spoke to Astra Taylor for Jacobin’s the Dig podcast about the causes of the United States’ medical debt crisis. At the heart of it is, he argues, not just ruthless profiteering of the private insurance and medical establishment, but the refusal of charity and public hospitals to live up to their legally mandated commitments to patients.

However, the fact that doctors, historically hostile to efforts to create single-payer health care, have joined picket lines in recent years is a welcome sign. The struggle for free health care in the United States must, as Messac argues, rely on a recognition of the hospital as a site for labor organizing and mobilization.

This interview has been edited for length and clarity.

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Denying You Health Care Is Big Business in America | NYT Opinion​

Mar 14, 2024

Should your insurance company be allowed to stop you from getting a treatment — even if your doctor says it’s necessary?

Doctors are often required to get insurance permission before providing medical care. This process is called prior authorization and it can be used by profit-seeking insurance companies to create intentional barriers between patients and the health care they need.

At best, it’s just a minor bureaucratic headache. At worst, people have died.

Prior authorization has been around for decades, but doctors say its use has increased in recent years and now rank it as one of the top issues in health care.

To produce the Opinion Video above, we spoke to more than 50 doctors and patients. They shared horror stories about a seemingly trivial process that inflicts enormous pain, on a daily basis. The video also explains how a process that is supposed to save money actually inflates U.S. health care costs while enriching insurance companies.

Prior authorization has come under intense scrutiny in Congress in the past few years, but bipartisan proposals have repeatedly stalled. Under public pressure, some insurance companies — like United Healthcare and Cigna — have said they would reduce the use of prior authorization. And in January, the Biden administration finalized a plan to put limited guardrails around this practice. But doctors say that these efforts only scratch the surface and should go further.

This issue is ultimately about the role of insurance companies in American health care: Should they have more power than your doctor to decide what’s medically best for you?


8:37
 

The US doesn’t have universal health care — but these states (almost) do​

Universal health care remains an unrealized dream for the United States. But in some parts of the country, the dream has drawn closer to a reality in the 13 years since the Affordable Care Act passed.

Overall, the number of uninsured Americans has fallen from 46.5 million in 2010, the year President Barack Obama signed his signature health care law, to about 26 million today. The US health system still has plenty of flaws — beyond the 8 percent of the population who are uninsured, far higher than in peer countries, many of the people who technically have health insurance still find it difficult to cover their share of their medical bills. Nevertheless, more people enjoy some financial protection against health care expenses than in any previous period in US history.

The country is inching toward universal coverage. If everybody who qualified for either the ACA’s financial assistance or its Medicaid expansion were successfully enrolled in the program, we would get closer still: More than half of the uninsured are technically eligible for government health care aid.

www.vox.com

The US doesn’t have universal health care — but these states (almost) do

Ten states have uninsured rates below 5 percent. What are they doing right?
www.vox.com www.vox.com
 

Imagine if the government offered dental care. New federal rule could make that a reality.​

Even when she had a massive infection and grueling pain from a cracked tooth, Nicole Sutton could not get a dentist to provide timely care.

Sutton, a single mother based in Tampa, Florida, could only get herself on a waitlist where she got in line to see one of the few dentists who take Medicaid, the government insurance for low-income families. She visited a hospital emergency room and a federally funded community health center, but those appointments only yielded prescriptions for antibiotics and pain pills. Neither offered to treat her dental crisis.

It wasn’t until she secured a loan from a friend that she could afford to see a specialist and an oral surgeon who extracted her tooth in an emergency procedure. Both demanded cash upfront.

It took months to clear the infection and return to health. The protracted dental episode two years ago exposed Sutton to the lurking disaster millions of Americans face because they don’t have robust dental insurance that guarantees access to oral care. A solution from the federal government may be forthcoming, which could have made a huge difference for Sutton.

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www.usatoday.com

Imagine if the government offered dental care. New federal rule could make that a reality.

Millions of Americans can't afford or get routine dental care. A Biden rule will let states cover adult dental care under the Affordable Care Act.
www.usatoday.com
 

Clarence Thomas, a $267,000 RV, and Why American Health Care Sucks​

Earlier this week, two Democratic senators announced they have requested a criminal investigation into Supreme Court Justice Clarence Thomas - regarding, in part, a loan for a luxury RV provided by a longtime executive at UnitedHealth Group, one of America's largest health insurers.

Thomas apparently recused himself in at least two cases involving UnitedHealth when the loan was active, according to a Rolling Stone review. Yet, he separately chose to participate in another health insurance case and authored the court's unanimous opinion in 2004. The ruling broadly benefited the industry - shielding employer-sponsored health insurers from damages if they refuse to cover certain services and patients are harmed. Thomas' advice to patients facing such denials? Pull out your checkbook.

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Federal court tosses Chamber of Commerce’s Medicare negotiation challenge​

Afederal district court Thursday threw out the U.S. Chamber of Commerce’s lawsuit challenging the Medicare Drug Price Negotiation Program established through the Inflation Reduction Act, with a judge finding that several plaintiffs in the suit lacked standing.

U.S. District Judge Michael J. Newman for the Southern District of Ohio found that the Chamber’s argument it could sue on behalf of its members through associational standing was incorrect.

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US will still pay at least twice as much after negotiating drug prices​

  • U.S. pays higher drug prices, gets priority access
  • Medicare's negotiated prices most significant for drugs with little competition
  • Goal is to balance affordability and innovation
Sept 3 (Reuters) - The U.S. government's first-ever negotiated prices for prescription drugs are still on average more than double, and in some cases five times, what drugmakers have agreed to in four other high-income countries, a Reuters review has found.

The U.S. Medicare health plan, which covers more than 67 million people, recently unveiled new maximum prices, opens new tab for the first 10 high-cost medicines negotiated under the Biden Administration's Inflation Reduction Act.

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www.propublica.org

The Hospice Hustle

Half of all Americans now die in hospice care. Easy money and a lack of regulation transformed a crusade to provide death with dignity into an industry rife with fraud and exploitation.
www.propublica.org www.propublica.org
 
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