Sunday, June 2, 2013

The New York Times Explains Why U.S. Health Costs Are So  High

Colonoscopies Explain Why U.S. Leads the World in Health Expenditures

Elisabeth Rosenthal, Subtitle in front page 4700 word expose, “The $2.7 Trillion Medical Bill,” New York Times, June 2, 2013

The New York Times why U.S. medical bills are so high:  It’s those inflated, profit-protected, prices charged for colonoscopies and other common procedures, as shown by these comparisons to other nations.

·         Colonoscopies,  US price, $1185, Switzerland, $655

·         Angiograms,  U.S. price, $914,  Canada, $35

·         Hip repair, U.S. price,  $40,634, Spain, $7731

·         Lipitor,  U.S. price, $24, New Zeland, $6

·         MRI scan, U.S. price, $1121, Netherlands, $319

In the case of colonoscopies, says Ms. Rosenthal,  is that colonoscopies have moved from being an office procedure to surgery centers, often owned by doctors, which, like hospitals, can charge a “facility fee” and charges by anethesiologists, who may not be present during office procedures.

This was the situation with Deirda Yapaleter, a Long Island woman, who received the following $6385 bill for a routine colonoscopy.

                          Gastroenterologist ,Anesthesiologist.Facility Fee .Total

Billed                      $1075 ,$2400 , $2910 =$6385

Paid by Insurer      $179 , $1569 ,$1751= 3498

The Times  piece goes on to explain that the U.S. does not interfere with or regulate private fees, only Medicare and Medicaid.   Other countries treat private fees as a public utility or negotiate rates for providers and insurers.   The implication is that if only the U.S. would do the same, costs would be lower for the U.S.

The Times implies this lack of federal regulation may be main reason U.S. costs are so high. Other key reasons are that rates vary from one region to another, depending on the facility performing the procedure, with surgery centers charging higher rates than office-based procedures, and hospitals charging the highest rates of all.

The top ten cities with the highest colonoscopy  rates are;

·         New York City  $8577

·         Austin, Texas, $7471

·         Billings, Montana, $5978

·         Dallas-Fort Worth, $5902

·         Indianapolis, $5847

·         Detroit, $5674

·         San Antonio, $5665

·         Los Angeles, $5559

·         Orlando, Florida, $5210

·         St, Louis, $5012

The ten countries with the highest per capita health care costs are:

·         U.S,  $8233

·         Switzerland,  $5270

·         Netherlands, $5056

·         Canada, $4405

·         Germany, $4335

·         France,  $3974

·         Sweden, $3758

·         Britain, #433

·         Spain,  $3058

·         Italy, $2964

The Times fails to mention other significant reasons for high U.S. health costs:

·         The high costs of federal and health  regulations in U.S, which comprise as much as 35% of hospital costs and as much as 50% of physician practice overheads.

·         The high costs of medical education (often paid for in other countries), which leave fledging doctors with debts of $150,000 to $200,000 upon medical school graduation.

·         The high direct costs  (malpractice premiums) and  high indirect costs (defensive medicine), which may run $50 billion to $100 billion no knows how much.

Tweet:   For various reasons, some governmental, some private, the U.S, leads the world  in health care expenditures.

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