nyceve is my dKos heroine...champion of those who are too weak, too ill, and often too poor to find someone to listen to them or to help them as they face the challenge of this nightmare we call healthcare in America. I know when I read one of nyceve's diaries I'm going to be either heartsick, angry as hell or, more likely, both.
Also, it's personal. My beloved wife has an extremely rare chronic disease that, while not life threatening, can often be very debilitating. If you ever meet my beautiful, talented, articulate, and loving wife you'll never know she's ill. She doesn't talk about it and is one of the bravest and most stoic ladies around. She and Elizabeth Edwards are my idea of what courage means.
I'm extremely fortunate to have worked for a very fine company that continues to provide retiree's with assistance in paying for medical and dental insurance that includes a prescription drug plan that helps pay for the drugs my wife must take every day for the rest of her life. Both the drugs that help control her disease and drugs she must then take to counteract the effects on her body of the first set of drugs. Still, we have a sizable outlay. Our expenses for health insurance, drugs, and other routine medical and dental care commonly run into five figures. And, of course, the insurance coverage is not hassle-free. For example, I had a dental problem this year that required a bone graft. MetLife denied any benefit for mild general anesthesia. They prefer local anesthesia for the patient who has to have bone chipped out of the jaw in one place and implanted elsewhere. It's cheaper. (The CEO of MetLife earns over $15,000 a day.)
We live in a small town in Southeastern North Carolina. I'd like you to read this editorial printed recently in the Wilmington Star-News....and shown in it's entirety with permission from the Editorial Page Editor, Chuck Riesz. It's about the cost of free medial care here. Then follow me below for a quick analysis and a closing thought or two.
It's sick, getting sicker
New Hanover County Social Services workers were caught off guard recently by a spike in the number of people applying for Medicaid. Most of these new clients were clearly ineligible - young, able-bodied people with no dependents.
The clients said they were told they must apply for Medicaid before the hospital would cover the cost of their care. It was, as it turned out, a miscommunication that was easily cleared up.
But the incident was yet another reminder that too many people cannot afford to be sick or injured. They have no health insurance, or their policies carry high out-of-pocket costs. They don't qualify for government assistance.
As a public hospital, New Hanover Regional Medical Center is obligated to provide care regardless of a person's ability to pay. This fiscal year, it will spend more than $40 million on charity care. That doesn't include writing off an expected $64 million in "bad debt" - owed mainly by people who didn't qualify for financial assistance but still cannot pay thousands in medical bills.
The money comes out of the hospital's budget, but we all know who really pays: patients lucky enough to have good health coverage.
Meanwhile, tens of millions of Americans aren't that fortunate. Free-market advocates will point to reports that some workers turn down their employers' health benefits even though they could presumably afford their share of the premium.
But they overlook other truths. The number of employers who even offer insurance continues to drop, and costs continue to rise for both employers and workers. Even when employer-based insurance is available, it's often too pricey for lower-wage workers.
Our health care system is critically ill, and the suffering is widespread - the uninsured, who may wait until they're very sick to seek the care they need; the insured, who are paying more for less coverage and who, because of rising costs, may one day find that their employer no longer offers the benefit; and people on Medicaid or Medicare, who often find their care choices limited as the government ratchets down reimbursements to doctors and hospitals.
Politicians have found little common ground on health policy, except in finding excuses not to act.
Now to the analysis:
The New Hanover Hospital average daily bed census is 486 patients. (This does not include the Emergency Room which I'm told sees 100K people a year and has 50 beds...)
486 beds X 365 days/year = 177, 390 patient-bed days per year.
The average length of stay is 5.32 days (again, not including the ER)
$104,000,000.00 spent this year to provide care to those who can't afford health care services...divided by 177,390 patient-bed days/year = $586.00 per patient-bed day.
That means a paying customer who stays the average 5.32 days in the hospital is being billed an additional (5.32 X $586) $3177.00 to help pay for care provided to others. I know this isn't the complete story...and that this cost of care is spread in other ways to other paying customers through ambulance and ER services, etc. But even if I'm off by 50% it's still a lot of money. (It was a way for me to quantify the costs and get them into practical terms I could understand and communicate.)
I wouldn't deny anyone needed medical care for any reason, but it's important for everyone to understand how this "free" care is being paid for. It's coming out of the pockets of those who actually pay...insured or not. Or, from local property taxes, and it's very big bucks. $104 Million in our little city? My god, what is it in Atlanta or Chicago, or LA or NYC?
I suspect what we're already spending today across the nation would more than pay for UHC or Single Payer if we simply slashed the profits to the insurance industry. No damned health care Insurance exec should be earning $250,000 a DAY every working day (CEO - United HealthCare) when others, including children, are dying for lack of care.
And Mr. Riesz was right, "Politicians have found little common ground on health policy, except in finding excuses not to act." And as John Edwards said, Congress shouldn't be enjoying the health care they continue to deny us. Us being the people who pay for all their perks and benefits, and us being those who also pay to care for those unfortunates Congress has completely forgotten in their headlong rush to kiss the behinds of the ultra rich and corporations who finance their relection campaigns.
Damn them..Damn them all!!