While walking down the street one day I heard the most God awful racket. Bang! I heard, then a blood curdling scream, bang and then another scream. I rushed to see what it was and when I turned the corner I saw the most unusual sight. There in the clearing was a grown man, in a business suit. He was standing in a clearing with a table in front of him. As I approached he raised the hammer and slammed it into his already throbbing thumb. The scream that followed was of anguish rather than pain.
I ran up to inquire about this bizarre behavior and to hopefully prevent anymore pain but when I asked the man what he was doing he just repeated over and over again, "My Foot, My Foot!". Not the answer I had expected but then I was able to calm the man down and explained that when he awoke this morning his foot was so painful that he couldn't stand it. He asked his wife, his kids and even his best friends and as crazy as it might seem, all suggested that he take a hammer and smash his thumb with it. He chose the vacant lot with the table so as not to bring too much attention to himself and he did have to admit that just after he would strike his thumb with the hammer he lost all recollection of his injured foot. Of course the pain would subside and the foot would begin to throb and now he'd not only have a sore foot but now he had a sore thumb.
Of course the man in my parable is a congressman and the pain in his foot is our broken health care system but instead of addressing the problem to alleviate the pain he would rather hammer away at Medicare and Medicaid. This has never been more evident than in our recent budget negotiations. The chorus of Republicans lining up to call for cuts to both Medicare and Medicaid is deafening but are cuts actually what we need?
Very few people realize just what Medicare actually does. Here is a simple definition.
The key Phrase in there is "Single Payer" Yes folks Medicare is "Socialized Medicine"! Make no mistake that is what bothers Republicans. The fact that Medicare is Socialized Medicine and is working very well. As well as funding will allow.
Now we come to the Elephant in the room. The American Health Care Industry or For Profit Heath Care;
Health care in the United States is provided by many separate legal entities. Health care facilities are largely owned and operated by the private sector. Health insurance is primarily provided by the private sector, with the exception of programs such as Medicare, Medicaid, TRICARE, the Children's Health Insurance Program, and the Veterans Health Administration.
The U.S. Census Bureau reported that a record 50.7 million residents (which includes 9.9 million non-citizens) or 16.7% of the population were uninsured in 2009.[1][2] More money per person is spent on health care in the USA than in any other nation in the world,[3][4] and a greater percentage of total income in the nation is spent on health care in the USA than in any United Nations member state except for East Timor.[4] Although not all people are insured, the USA has the third highest public healthcare expenditure per capita, because of the high cost of medical care in the country.[clarification needed][5][6] A 2001 study in five states found that medical debt contributed to 46.2% of all personal bankruptcies and in 2007, 62.1% of filers for bankruptcies claimed high medical expenses.[7] Since then, health costs and the numbers of uninsured and underinsured have increased.[8]
I worked in the "Health Care Industry" for seven years, in various occupations. I started in collections then went into purchasing where I used the internet to sell the hospitals old equipment. My last position was in maintenance. I was able to see the industry in a way that most people don't and it allowed me to critique the system from within.
Collection proved to be the most depressing of my positions. By the time accounts got to my desk they had exhausted all hope of being covered by any form of insurance and the burden of payment was on the patient. Calling people who can't speak English, elderly that for some reason or another fell through a crack and owe thousands of dollars in unpaid medical bill but religiously sending me twenty dollars a month. It was heart breaking calling patients who were just able to make ends meet and having to cajole, coax beg and sometimes threaten them in order to get a payment. I couldn't help but reflect on the fact that in other countries, like Canada, England, Norway, Japan, Germany in fact most developed nations, my position wouldn't even exist. Only in America would we create jobs where you can suck blood money out of the sick and call it an occupation.
It was in collections where I learned about an EOB (Explanation Of Benefits). It's that little accounting tool the hospital uses to mask what they are actually charging for their services. It's a very innocuous document, it even states right on the front that it's not a bill, but it is, it tells you who is going to pay what and the outcome all depends on insurance and what agreement your hospital made with the insurance company. To give you an example I once had a stress test done. When I got my EOB they explained that the total cost of the procedure was around a thousand dollars. The hospital contracted with my insurance company to write off half of the procedure, my insurance company paid nothing and I was left with paying the other half of the procedure. There is no rhyme or reason as to what they pay and don't pay, the percentages they use and how they assign liability and they like it that way.
My second job allowed me a sense of satisfaction, at least I felt that I was contributing to the good of the system. My job consisted of working with the different departments in the hospitals, gather their old medical equipment and posting them to a web site. I was able to assist third world country's in getting equipment they wouldn't be able to ordinarily afford. The dark side of this job was the waste. The money that was paid for equipment such as an open MRI I sold for just five thousand dollars when it cost the hospital in the six figures. The money I received in fact only covered the expense of getting the machine out of the hospital. The robot surgical arms, three all together, that the hospital just had to buy. Within a few years they were obsolete and the surgeon who demanded them had moved on to private practice. Because the voice activation tapes were no longer available we had to throw these machines in the trash. Half a million dollars down the drain.
The most disturbing position I had was maintenance. Being able to see behind the scenes was like going through the kitchen at your favorite restraint, once you've been there you'll never eat there again. I witness things in this department that should be a crime. I was told to take a desk, with a top that was half inch think wood, solid wood, dismantle it and throw it in a dumpster. I watched as patch after patch was put on first one problem after another, all with the excuse that we needed to cut expenses. This worked as long as nothing happened, but then something happened. Something happened in the form of a spring deluge. One of those things you never think of but should. Needless to say the patches blow out the band aids came off and the hospital experienced a flood of biblical proportions.
Hospitals are only interested in aesthetics. They want eye candy for the sick because here's the kicker, they don't want you to get well. If you have good insurance they want you coming back over and over again. They make no money off healthy people, they want you sick and in their hospital. I actually heard something to that effect in a departmental meeting once. It's a hard fact but our nations hospitals want the people who have insurance to remember them when they get sick again, they just love repeat business.
In short until we address the elephant in the room there will never be a true fix for Medicare/Medicaid. The bills are controlled by the health care providers. I have shown three brief examples as to why they are culpable in the problems facing Medicare not to mention unscrupulous doctors over billing the system to Hoveround dealers selling scooters for seniors. Medicare would be fine if the private sector wasn't milking it like a cash cow.
