The latest in this medical cost saga comes from new data released last week by National Nurses United (NNU), the nation’s largest nurse’s organization. In a news release, NNU revealed that fourteen hospitals in the United States are charging more than ten times their costs for treatment. Specifically, for every $100 one of these hospitals spends, the charge on the corresponding bill is nearly $1,200.

NNU’s key findings note that the top 100 most expensive U.S. hospitals have “a charge to cost ratio of 765 percent and higher — more than double the national average of 331 percent.” They found that despite the enactment of “Obamacare” — the Affordable Care Act — overall hospital charges experienced their largest increase in 16 years. For-profit hospitals continue to be the worst offenders with average charges of 503 percent of their costs compared to publically-run hospitals (“…including federal, state, county, city, or district operated hospitals, with public budgets and boards that meet in public…”) which show more restraint in pricing. The average charge ratios for these hospitals are 235 percent of their costs.

According to NNU’s data, the top 10 Most Expensive Hospitals in the U.S. listed according to the huge percentage of their charges relative to their costs are:

1. Meadowlands Hospital Medical Center, Secaucus, NJ – 1192%
2. Paul B. Hall Regional Medical Center, Painsville, KY – 1186%
3. Orange Park Medical Center, Orange Park, FL – 1139%
4. North Okaloosa Medical Center, Crestview, FL – 1137%
5. Gadsden Regional Medical Center, Gadsden, AL – 1128%
6. Bayonne Medical Center, Bayonne, NJ – 1084%
7. Brooksville Regional Hospital, Brooksville, FL – 1083%
8. Heart of Florida Regional Medical Center, Davenport, FL – 1058%
9. Chestnut Hill Hospital, Philadelphia, PA – 1058%
10. Oak Hill Hospital, Spring Hill, FL – 1052%

The needless complications of the vast medical marketplace have provided far too many opportunities for profiteering. Numerous examples of hospital visit bills feature enormous overcharges on simple supplies such as over-the-counter painkillers, gauze, bandages and even the markers used to prep patients for surgery. That’s not to mention the cost of more advanced procedures and the use of advanced medical equipment which are billed at several times their actual cost. These charges have resulted in many hundreds of millions of dollars in overcharges.

When pressed for answers, many hospital representatives are quick to defer to factors out of their control. It’s the cost of providing care they might say, or perhaps infer that other vague aspects of running the business of medical treatment add up and are factored into these massive charges. Cost allocations mix treatment costs with research budgets, cash reserves, and just plain accounting gimmicks. These excuses shouldn’t fly in the United States.

Few in the medical industry will acknowledge the troubling trend. One thing is undeniably certain however — the medical marketplace is not suffering for profits. Health-care in the United States is a nearly 3 trillion dollar a year industry replete with excessive profits for many hospitals, medical supply companies, pharmaceutical companies, labs and health insurance vendors.

Americans spend more on health care than anywhere else in the world. One would hope and wish, at the least, that this enormous expenditure would provide a quality of healthcare above and beyond that found in the rest of the western world. The reality is that the results on average are no better than in France, Germany, Canada and elsewhere, which manage to provide their quality treatment without all the overcharges.

Much like our similarly wasteful, bloated military budget, the U.S. spends more on health care than the next ten countries combined — most of which cover almost all of their citizens.The United States spends $8,233 per person, per year according to a 2012 figure from the Organization for Economic Co-operation and Development (OECD). The average expenditure of the thirty three other developed nations OECD tracked is just $3,268 per person.

It gets worse. Harvard’s Malcolm Sparrow, the leading expert on health care billing fraud and abuse, conservatively estimates that 10 percent of all health care expenditure in the United States is lost to computerized billing fraud. That’s $270 billion dollars a year!

And unlike other commercial markets, where the advance of technology routinely makes costs lower, the reverse trend is in effect when providing medical care — the prices just keep soaring higher and higher. The flawed, messy Obamacare system will do little to help this worsening profit-grab crisis, which is often downright criminal in the way it exploits tragedy-stricken people and saddles them with mountains of debt.

Steven Brill’s TIME magazine cover story from February 2013 titled “Bitter Pill: Why Medical Bills Are Killing Us” gives an in-depth and highly-researched rundown of the severity of the medical cost problem and provides some of the worst, most astonishing examples of profiteering off of the plight of the sick or injured.

Here’s a fact that puts the full scope of this troubling trend into perspective — Brill writes: “The health-care industrial complex spends more than three times what the military industrial complex spends in Washington”. Specifically, the medical industry has spent $5.36 billion on lobbying in Washington D.C. since 1998. Compare that expenditure to the $1.53 billion spent lobbying by the also-bloated defense and aerospace sector.

One line summarizes the breadth of Brill’s enormous piece: “If you are confused by the notion that those least able to pay are the ones singled out to pay the highest rates, welcome to the American medical marketplace.”

Americans who can’t pay and therefore delay diagnosis and treatment are casualties. About 45,000 Americans die every year because they cannot afford health insurance according to a peer-reviewed report by Harvard Medical School researchers. No one dies in Canada, Germany, France or Britain because they do not have health insurance. They are all insured from the time they are born.

Obamacare, which has already confused and infuriated many Americans — and even some experts — with its complexity made up of thousands of pages of legislation and regulations is clearly not the answer to the problem. Long before the internet, President Lyndon Johnson enrolled 20 million elderly Americans into Medicare in six months using index cards. Canada’s single-payer system was enacted with only a thirteen page bill — and it covers everyone for less than half of the cost per capita compared to the U.S.’s system. (Check out 21 Ways the Canadian Health Care System is Better Than Obamacare)

Enacting a single payer, full Medicare-for-all system is the only chance the United States has of unwinding itself from the spider web of waste, harm, and bloat that currently comprise its highly flawed health insurance and health care systems. It’s time to cut out the corporate profiteers and purveyors of waste and fraud and introduce a system that works for everybody.

Ralph Nader is a consumer advocate, lawyer and author of Only the Super-Rich Can Save Us! He is a contributor to Hopeless: Barack Obama and the Politics of Illusion, published by AK Press. Hopeless is also available in a Kindle edition.

Republicans had nothing to do with passing Obamacare, and they will not bring the program down. The falsely named Affordable Health Care Act is coming undone on the strength of its own contradictions. It’s not a national health program, at all – “just Obama working a scam for the insurance companies.”

“Private insurers make money by betting against the health interests of their customers.”

Obamacare is unraveling, not because the administration is particularly incompetent or unlucky, and certainly not as a result of the Republicans’ unrelenting hostility to the Obama health insurance plan. Indeed, ever since the bill’s passage in early 2010, the GOP’s holy war against Obamacare has served to solidify reflexive Democratic support for what has always been a Republican-inspired bill.

The truth is, the Affordable Health Care Act is coming undone because of its own, tortured internal logic. At root, it is a fraud on the public: a scheme to subsidize and more deeply embed a private insurance system that can only make profits by denying sick and vulnerable people health care, and playing different demographics of Americans against each other. As every other industrialized country in the world has already learned, it is impossible to build a genuine, universal healthcare system on a cut-throat capitalist foundation. Private insurers make money by betting against the health interests of their customers. Obama served his corporate masters by conspiring to make tens of millions more Americans into customers of private insurers. He tried to dress up one of the greatest corporate subsidies in history as if it were a solemn national mission, a rebirth of the social compact between the American people. But of course, Obamacare is no such thing; it is a racket to prop up private insurers with public money, while allowing the profiteers to continue to run the show.

“It is a fraud on the public.”

You can’t hide a truth that big. The Obamacare website has suffered from terminal complexity because white collar crime is usually quite complex. The web site attempts to reconcile the profit margins and various products of a universe of private insurance corporations, while at the same time pretending to serve the health needs of the people at an affordable cost. Obamacare claims to be in the business of serving both the public and corporate stockholders. But that’s mission impossible. If Obamacare is based on making profits for private corporations – if that is what keeps the system going – then the public’s health care needs will always be an afterthought. And, that will be obvious in the way that the website is organized as a sales platform that matches federal subsidies with corporate products, rather than matching people with the medical resources they need to survive and thrive.

Website complexity and failures aside, Obamacare can never become part of a national social compact, something of which all Americans can be proud. That’s because, by definition, corporate insurance schemes divide people into “winners” and “losers” – although, of course, the big winner is always the corporation. Young, healthy people know they are the fatted calves of the insurance business, and they are avoiding Obamacare like the plague. If this were really a national health care program, like Medicare for All, then most young people would join in the national health care mission. But this is just Obama working a scam for the insurance companies, and young folks know it. Anybody who manages to get access to the web site knows it.

The fatal flaw in Obamacare can’t be fixed. The best thing that could happen would be a quick and total collapse. Large majorities of Americans still support Medicare for All, but Obamacare stands in the way of a real national health plan – just as the Republican right-wingers that invented Obamacare back in 1989 intended.

For Black Agenda Radio, I’m Glen Ford. On the web, go to BlackAgendaReport.com.

BAR executive editor Glen Ford can be contacted at Glen.Ford@BlackAgendaReport.com.

Comments

It’s satisfying to watch rats flee a sinking ship.  This is because onlookers knew the ship was doomed long ago, and swimming rats signify that the drawn-out tragedy is nearing an end.  A collective sense of relief is a natural response.

The rats who propped up the broken boat of Obamacare are a collection of liberal and labor groups who frittered away their group’s resources—and integrity— to sell a crappy product to the American people.

Those in the deepest denial went “all in” for Obamacare— such as some unions and groups like Moveon.org— while the more conniving groups and individuals—like Michael Moore— playacted “critical” of Obamacare, while nevertheless declaring it “progressive”, in effect adding crucial political support to a project that deserved none.

But of course Obamacare was always more barrier than progress: we’ve wasted the last several years planning, debating, and reconstructing the national health care system, all the while going in the wrong direction— into the pockets of the insurance mega corporations.    A couple progressive patches on the sails won’t keep her afloat.  It’s shipbuilding time.

It was painful to watch otherwise intelligent people lend support to something that’s such an obviously bad idea.  So it’s with immense relief that liberals like Michael Moore, labor groups, and others are finally distancing themselves from Obamacare’s Titanic failure.   Now these individuals and groups can stop living in denial and the rest of us can proceed towards a rational discussion about a real health care solution.

The inevitable failure of Obamacare is not due to a bad website, but deeper issues.   The hammering of the nails in the coffin has begun:  millions of young people are suddenly realizing that Obamacare does not offer affordable health care.  It’s a lie, and they aren’t buying it, literally.

The system depends on sufficient young people to opt in and purchase plans, in order to offset the costs of the older, higher-needs population.    Poor young people with zero disposable income are being asked to pay monthly premiums of $150 and more, and they’re opting out, inevitably sinking Obamacare in the process.

Those young people who actually do buy Obamacare plans—to avoid the “mandate” fine— will be further enraged when they attempt to actually use their “insurance”.   Many of the cheapest plans—the obvious choice for most young people— have $5,000 deductibles before the insurance will pay for anything.   For poor young people this is no insurance at all, but a form of extortion.

At the same time millions of union members are being punished under Obamacare: those with decent insurance plans will suffer the “Cadillac” tax, which will push up the cost of their healthcare plans, and employers are already demanding concessions from union members in the form of higher health care premiums, co-pays, deductibles, etc.

Lower paid union workers will suffer as well.  Those who are part of the Taft Hartley insurance plans will be pressured to leave the plans and buy their own insurance, since they cannot keep their plans and get the subsidy that the lowest income workers get.   This has the potential to bust the whole Taft Hartley health care system that millions of union members benefit from, which is one of the reasons that labor leaders suddenly became outraged at Obamacare, after having wasted millions of union member’s dollars propping it up.

Ultimately, the American working class will collectively cheer Obamacare’s demise.   They just need labor and other lefties to cheer lead its destruction a little more fiercely.

Surprisingly, most of the rats are still clinging to Obama’s hopeless vessel, frantically bailing water.  Sure they’ve put on their life preservers and anxiously eyeing the lifeboats, but they’re also preaching about how to re-align the deckchairs.

For example, in his “critical” New York Times op-ed piece, Michael Moore called Obamacare “awful”, but also called it a “godsend”, singing his same tired tune.   Part of Moore’s solution for Obamacare—which was cheered on in the Daily Kos— is equally ludicrous, and follows his consistently flawed logic that Obamacare is worth saving, since its “progress” that we can build on.   Moore writes:

“Those who live in red [Republican dominated] states need the benefit of Medicaid expansion [a provision of Obamacare]…. In blue [Democrat dominated] states, let’s lobby for a public option on the insurance exchange — a health plan run by the state government, rather than a private insurer.”

This is Moore at his absolute worst.  He’s neck deep in the flooded hull of the U.S.S Obamacare and giving us advice on how to tread water.

Of course Moore doesn’t criticize the heart of Obamacare, the individual mandate, the most hated component.

Moore also relies on the trump card argument of the pro-Obamacare liberals: there are progressive aspects to the scheme—such as the expansion of Medicaid— and therefore the whole system is worth saving.

Of course it’s untrue that we need Obamacare to expand Medicaid.  In fact, the expansion of Medicaid acted more as a Trojan horse to introduce the pro-corporate heart of the system; a horse that Moore and other liberals nauseatingly continue to ride on.

But Moore’s sneakiest argument is his advice to blue states to  “…lobby for a public option on the insurance exchange…”

Again, Moore implies that it’s ok if we are “mandated” to buy health insurance, so long is there is a public option.  But that aside, the deeper scheme here is that Moore wants us to further waste our energy “reforming” Obamacare, rather than driving it to the bottom of the sea.

Moore surely knows that very few people are going to march in the streets demanding a public option at this point; he therefore knows that even this tiny reform of the system is unachievable. He’s wasting our time.  Real change only happens in politics when there is a surge of energy among large sections of the population, and it’s extremely unlikely that more than a handful of people are going to be active towards “fixing” Obamacare— they want to drown it.

Moore’s attempt to funnel people’s outrage at Obamacare towards a “public option” falls laughably short, and this is likely his intention, since his ongoing piecemeal “criticisms” of the system have only served to salvage a sunken ship.

Instead of wasting energy trying to pry Obamacare out of the grip of the corporations, Moore would be better served to focus exclusive energy towards expanding the movement for Medicare For All, which he claims that he also supports, while maintaining that somehow Obamacare will evolve into Single Payer system.

Most developed nations have achieved universal health care through a single payer system, which in the United States can be easily achieved by expanding Medicare to everybody.  Once the realities of Obamacare directly affect the majority of the population and exacerbates the crisis of U.S. healthcare, people will inevitably choose to support the movement of Medicare for All, the only real option for a sane health care system.

Shamus Cooke is a social service worker, trade unionist, and writer for Workers Action (www.workerscompass.org).  He can be reached atshamuscooke@gmail.com