My mom passed away when I was a junior in college, and she got sick when I was in high school. There were a lot of trips to doctors, many close calls at the ER, and many out-of-pocket medical expenses.
How signing up for Obamacare is going, reported by John Dickerson at Slate.
In Salon, Alex Halperin reports on the "Memphis model," a health network partnership between hospitals and congregations in Memphis, Tenn.—one of the poorest metro areas in the U.S. and one of the "least healthy"—that has resulted in treating more people and saving hospitals millions in annual costs. Essentially, getting more people treated through the network has resulted in fewer expensive hospital stays for patients who avoid help until the last minute, and partnering with congregations has created a support network for patients to turn to before and after they receive treatment.
Sergio Branco, a 33-year-old father of three, discovered that he had leukemia just before he was fired from his job. Thankfully, he could treat his cancer by extending his health insurance coverage through COBRA, which would cost him $518.26 per month. His wife sent in a check for $518. Without notifying the family that they still owed 26 cents, Sergio Branco's health insurance was terminated. Although the Broncos were still ahead of their payment deadline, they were told they could no longer make any payments. The contacted a lawyer. The Department of Labor had to get involved. The amount of effort it took for a man dying of cancer to maintain his health insurance policy was absurd.
Kohn was able to find a better and cheaper plan on the health insurance exchange sites. Kohn's lesson: Try the exchange, and look at the options that are available to you—it might surprise you.
A story on the homepage of the Times this morning is looking at how millions of poor people will be unable to afford insurance in states that have declined to participate in the expansion of Medicaid under the Affordable Care Act.
In May 2012, a food poisoning outbreak struck upstart New York, causing more than 100 people to seek hospital treatment. Times reporter Nina Bernstein attempted to figure out what individual patients were charged for an IV bag with sterile saltwater to replenish their lost fluids. You will be surprised to learn (or not surprised at all) that this proved to be much more difficult than expected because of our opaque system of pricing where the charges appear to be mysterious. One woman who paid $100 for her visit sums it up for a lot of patients: "Honestly, I don’t understand the system at all."
Elizabeth Rosenthal, who is writing a series of articles for the Times examining why the U.S. leads the world in health care expenditures, reported a story about medical tourism for her third piece, which begins with 67-year-old Michael Shopenn discovering he needed a hip replacement and learning that it would cost him more than $65,000 in the U.S. because his health insurance determined his degenerative disease as a pre-existing condition and would not cover the surgery. Shopenn looked for places outside the U.S. for a more affordable solution and eventually found himself at a hospital outside of Brussels, which charged him $13,660 for his hip joint replacement. One of the reasons for the higher price tag in the U.S. was due to transparency.
David Lazarus's L.A. Times column this morning takes a look at how the prices of generic drugs fluctuate depending on which pharmacy you go to. A 45-year-old man named Bruce Lowther who takes five different generic drugs for a heart condition he has wanted to figure out if he could lower his prescription medication costs by visiting a different drug store. Each pharmacy said they would require a prescription from a doctor first that would have to be filled before he got to know what the prices were—meaning he'd have to commit to a pharmacy before learning what his medication cost.
Elizabeth Rosenthal's series in The New York Times on why the U.S. leads the world in health care expenditures has been really good—she's previously tackled colonoscopies, pregnancies, and joint replacements—and her fourth story is on prescription drugs, namely, asthma medication. The high costs are due to patents, which have prevented generics from competing in the market, and, yes, lobbying from pharmaceutical companies.
Hey ladies, the ACA dropped today, have you heard, and Ann Friedman figured out what that means for your uterus and uteruses everywhere so you don’t have to. THANKS ANN!
Depending on what kind of health insurance plan you have, there are certain cases where it's just cheaper to "self-pay" without insurance to take advantage of the markdown given to patients who pay in cash. This is a story about one of those cases, though it's a story that is politicized in the end.
Haley Sweetland Edwards has a really terrific investigative piece in Washington Monthly looking at the American Medical Association's committee of doctors who meet three times a year to determine the value of the medical procedures they perform and how much Medicare should be paying them. The committee's meetings are closed to the public and the press, and even though there is a clear conflict of interest—the doctors are telling the government how much they should be paid—it's all completely legal.
New York Times reporter Elisabeth Rosenthal went on The Leonard Lopate Show today to discuss her first article in a series investigating why the U.S. leads the world in health care expenditures. One of the many problems: Nobody really knows what things cost ("even doctors often do not know the costs of the tests and procedures they prescribe"), and the cost of procedures vary widely from state to state depending on things unrelated to quality. "The variability doesn't really have to do with quality, it has to do with these negotiations between insurers—how powerful your doctor or your hospital network is," Rosenthal says.