Rooney On Health Care
October 25, 2009 5:00 PM
Andy Rooney weighs in on the health care debate.
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See all 55 CommentsHealth Care Fraud, Waste and Abuse is out of control. The Government promotes a pay and chase model that does not work.
You should consider reporting on the Health Care Fraud, Waste and Abuse solution being championed by the Government?s prestigious Oak Ridge National Laboratory, in Oak Ridge Tenn. Someone needs to see what these folks are promoting.
Love the show.
Tom Basile
Gaithersburg, MD
We used to receive an annual Red Book listing average wholesale drug prices and manufacturer suggested retail prices. When precedents for keeping monopolies in check were lifted, most businesses joined 'buying groups' offering group discount pricing depending on the organizations' drug usage patterns.
Other factors that promote milking the system include obvious incentives to artificially increase the bills for those not paying cash, such as Medicare contract sweetheart deals with drug manufacturers available for reimbursement to facilities that deal with a lot of patients using Medicare benefits to State financial incentives with Medicaid.
Hospitals are required to not turn any patient away based on financial status, so we see the mother on welfare with a risky pregnancy yet again the fifth child by a different father, or a woman to deliver in her last week who's never seen anyone for prenatal care and miscarriage is threatened, and then there's the young mother on Welfare or Medicaid with a leg cancer that refuses to use birth control so in two years after 4 rounds of chemotherapy and radiation picked up the State and other resources, her unplanned pregnancy results in birth of a child with multiple handicaps and congenital birth defects whose care ultimately will be covered by Welfare from Medicaid, or the pediatric patient who doesn't have any form of health insurance that is taken to the Emergency Room triage for a respiratory ailment requiring admission as an in-patient and treatment for pneumonia, and whose bills for hospital equipment, room, labs, tests, respiratory evaluation, monitoring and treatment, never mind the diagnostician and drugs, will not be paid by the patient, but by State Medicaid funds for reimbursement to the hospital at a fraction of the charges for other patients with insurance. It was explained to me when I started my career that a lot of the time, pharmacy provides a tangible evidence of care and treatment, and though its price was nominal it could be flexed a bit based on what Medicare would pay for it. Depending on the practice, physicians may or may not receive a fair compensation for what they do, and what their business needs to stay afloat. We've long heard about the exhorbitant costs of doing business as physician from supportive personnel in the practice, liability insurance, etc.
Ultimately, it starts out with inflated costs to cover for uninsured expenses (patients without insurance), to inflating prices, to fuel inflated expectations. Business monopolies in drug manufacturing, pharmacy, health care benefit management organizations, and the financial strength of health industry currency--involvement in ubiquitous health insurance policies. Wal-mart can get away with undercutting drug costs only so long before it forces other drugstore chains out of business, just because they have the capability from their vast resources to do business and purchase drugs at lower rates than other drug stores. Many independent pharmacies quietly folded up and went out of business when despite financial incentives for patients with Medicare Part D benefit to shop at a Mom-n-Pop, the independent could not run based on the piddling reimbursement that Medicare could get away with paying the bills.
This convolution only becomes more entangled and snarled in discussion of any of the aspects of the industry. That is why as a pharmacist, I'm inclined to throw the whole lot in the fire and start over with suggesting reform that in essence evens out costs so that patients are not almost randomly, and unpredictably gouged. As a licensed healthcare professional going back for additional schooling to broaden scope of practice, I also don't feel really glad knowing my work efforts don't translate into added benefit. Pharmacists graduating nowadays are tens of thousands of dollars in debt, It's irritating to know my wage as a more experienced pharmacist is not commensurate with the untried new grad because they are still paying off the college loans and debt.
But then, maybe we should expect nothing less from the left wing liberal media including Andy Rooney and 60 Minutes.
Oh the Hypocrisy!!
I have seen it reported that the same exact procedure (colonoscopy) in the same exact hospital ranges anywhere from $450.00 to nearly $5,000 depending on what the insurance is. This makes no sense. Just for fun, try calling your hospital to see what a colonoscopy costs? Good luck.
How can any business exist that won't disclose or justify their prices?
Having a doctor come in and making small talk should not be a billable event. Happens all the time. (Sometimes the doctors charge for the visit and don't even come in the door). How is this justified? Mr. Rooney's point was that the system is overpriced and does not make sense. I believe he is correct in that assessment. Instead of objecting to his methods, why not see what needs to be done to correct the problems he and others have pointed out? We need to admit the problems exist before they can be addressed.
Should read. " The ER Doctor charged another $921.00, and the Radiology Doctor charged another $390.00. The Cure, a prescription available at Wal-Mart for $4.00 for antibiotic, and $10.00 for pain."
I don't usually take the time to write commentaries, but I was offended by your remarks about the doctor who charged you $250.00 for seeing you 5 minutes.
As a doctor who sees many patients at the hospital, I can tell you that there is so much more that I do besides that patient visit. I am responsible not only for a history and physical of my patient and a plan of care, but besides this, on a daily basis I review the lab work, the results of tests, speak to other consultants, speak to the family and above all place my heart and soul on the care and well being of my patients.
I don't want to debate doctor's fees, but I do want to enlighten you about
all that goes on before and after that 5 minute visit.
Ada C. Rahn, M.D.
250 dollar doctors bill is less than 3% of your 9000+ hospital bill. It would have been more educational and useful to your audience if you went through the detailed bill from hospital and see how much money was spent on paying administrative costs, billing and collection staff as well as the cost of drugs and equipment used for your procedure.
As a physician, I am surprised to see how media never looked at different layers of adminstrative costs of medical care including insurance company administrators, hospital administrators, clinic administrators and finally billing and collecting agencies. I am sure you will not be surprised to learn that the top three highest paid people at our local hospital are all non-physicians who never see a patient.
We are not all cheats and dishonest. Most of us in health care are just trying to get through the maze of roadblocks to get paid for services. We also are trying to keep up with technology - check the latest price on an MRI or the cost of drugs if you wonder about what a hospital charges. I noticed your EOB is from Medicare. Based on the $9000+ in amount billed, the hospital will be lucky to get a third of that. What is received has to cover the staff, equipment, facilities, sterilization of areas, supplies and anything needed for standby. Reimbursement also needs to have an overhead to cover the cost of replacing equipment over and above what the current equipment costs, charity allowances and bad debt expenses. And, let us not forget legal fees. The liability insurance that health care providers need to carry is astronomical. It all comes out of the monies received. Trying to bill Medicare is a nightmare in itself. The rules are so complex, even the intermediaries are not sure what they mean. The provider better know, or it is labeled fraud or abuse. Even if the provider does what the intermediary says, they are still accused of fraud or abuse and treated as such.
Mr. Rooney, there is a lot you do not know. Come out to the real world as a provider sometime and get some facts. I cringe at the thought of government run health care.
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