Obama Speech in Chicago to AMA

Posted on June 18, 2009 by Greenberg & Bederman

 

On June 15th, President Obama gave a speech to the American Medical Association in Chicago. Considering that a big part of the President’s agenda involves health care, it can be assumed that he attached a great deal of importance to this speech. Any kind of health care reform would be very difficult to pull off without the support of the biggest and most influential medical advocacy group in the country.

Right off the bat, Mr. Obama offered a real example as to the realities of our health care system when he described the working day of a doctor in New Hampshire:

“Our costly health care system is unsustainable for doctors like Michael Kahn in New Hampshire, who, as he puts it, spends 20 percent of each day supervising a staff explaining insurance problems to patients, completing authorization forms, and writing appeal letters; a routine that he calls disruptive and distracting, giving him less time to do what he became a doctor to do and actually care for his patients.”

He also gave an example as to how things were going among those of us who have to pay for the premiums:

 

“Small business owners like Chris and Becky Link in Nashville are also struggling. They've always wanted to do right by the workers at their family-run marketing firm, but have recently had to do the unthinkable and lay off a number of employees - layoffs that could have been deferred, they say, if health care costs weren't so high. Across the country, over one third of small businesses have reduced benefits in recent years and one third have dropped their workers' coverage altogether since the early 90's.”

It doesn’t take much to find the flaw in the system for both the doctors and the small business owners. The doctors’ waste precious hours during their working days either trying to get paid by the insurance companies or explaining to their patients why the insurance company won’t pay for services, and the small business owners have to either cut benefits or lay people off because the premiums are so high.

And according to President Obama, it isn’t just the small businesses that are struggling with premium costs:

“A big part of what led General Motors and Chrysler into trouble in recent decades was the huge costs they racked up providing health care for their workers; costs that made them less profitable and less competitive with automakers around the world.”

For all the people who are against government involvement in health care, the constant refrain seems to be “I think health care decisions should be between you and your doctor, and no one else.” The implication there is that if the government gets involved there would be some faceless bureaucracy telling you what treatment you can have, which doctor you can see, and which prescriptions you can have. It is very difficult for us to see how that differs from anyone with your average insurance plan.

If you think the government is a faceless bureaucracy, try getting in touch with your insurance company for anything other than paying your premiums. If you think that you can see whichever doctor you choose, see what happens when you try to go see a doctor who isn’t part of your insurance plan. If you think that you can have whichever pills you want, see what happens when the pills you need aren’t on the approved list of your insurance company.

It seems that many of the folks on the anti-reform side believe that there is something profoundly unpatriotic about the idea of getting sick without going broke. But we believe that there can be no health care reform without insurance reform. Insurance is the only business in America (and possibly the world) where you pay an arm and a leg for services that might be rendered, but only if those services aren’t too costly and inconvenient for the people providing them. Plumbers don’t work like that. Carpenters don’t work like that. In fact, if anyone else worked like that they wouldn’t be in business at all.

If you were a fly on the wall over at one of the more expensive offices on K Street, you would see insurance company lobbyists using every number in their considerable rolodexes, and you would hear these lobbyists urging members of Congress to either kill health care reform completely or to fill it with compromises that either render the reform meaningless or make life easier on the insurance companies. Chief among these compromises is “caps,” which is a set limit on the amount of compensation that victims of medical malpractice can receive. They are probably contending that if only there were a limit on compensation, then health care costs would immediately drop like a stone. This is fiction.

According to the Congressional Budget Office (via the New York Times:)

“The office estimates that caps on damages would ultimately reduce malpractice premiums for medical providers but would have a “relatively small” impact on total health spending, reducing it by less than half a percent.”

As usual, the main concern of the insurance company is profits. And if they can maximize those profits by connecting two completely unrelated things (malpractice premiums and healthcare costs,) why wouldn’t they? These caps have maximized insurance profits in Texas, Nevada, and countless other states. But we can’t help but notice that people in these states are still paying just as much as they used to.

To learn more about malpractice issues, please read our malpractice page, or read about our malpractice lawyer, John Sellinger, or view his malpractice video on Youtube, or get a free legal consultation.
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High Cost of US Healthcare

Posted on June 12, 2009 by Greenberg & Bederman

There doesn’t seem to be much you can do to avoid the high cost of health care these days.

In 2008, total spending on health care was $2.8 TRILLION. In case you aren’t sure how much that is, it’s enough to pay for all the goods and services produced in Australia in one year. It’s enough to fund the military of every country in NATO combined. It’s more than the value of every stock on the Toronto Stock Exchange.

It is, in short, a whole lot of money.

For those of us who have health insurance, that $2.8 trillion doesn’t just factor in the trips you make to the doctor or the deductibles that you have to pay. It also factors in your monthly insurance premiums, and any prescriptions that you have to have filled. Those of us without health insurance are also contributing a great deal to the overall total.

The vast majority of us in this country aren’t too thrilled about this, but we can tell you with great certainty that HMO’s, pharmaceutical companies and insurance companies are as pleased as they could possibly be with those numbers.

Most of our health care costs are artificial. There is no other aspect of society that prices services the way that health care does. In almost every other part of our economy, the prices are listed prominently for you to see. If you walk the grocery store, the prices of the goods are right there. If you walk into a dry cleaner, they list the prices for everything. If you walk into a bank, they tell you the percentage rates of their CD’s or savings accounts. But when you go to the hospital for treatment you don’t exactly get handed a menu. Instead, you hand over your insurance card, and the hospital then charges the insurance company….whatever. It could be $500 or it could be $5000. There are hundreds of factors involved. Did your insurance company negotiate lower prices? What is the hospital’s billing policy that month? Or better yet, what is it that day? The free market works pretty much everywhere except for health care.

Then you have to factor in whether or not your insurance company will deem to pay the bill. Were all of the tests and procedures pre-approved? Were all the tests and procedures that were performed covered on your policy? And even if they are, will your insurance company decide to pay for them? That’s a question that could go either way. Your average insurance company will usually deny at least one or two things initially and then hope you accept their denials. They are quite rightly working under the idea that many of you either haven’t read or don’t understand your policy.

In other words, the costs of health care are….whatever the hospitals and insurance companies say they are.

Fortunately, the one element of health care that does have a price list is the medication. Bear in mind that we say “fortunately” in a very loose fashion, because all this openness in pharmaceutical pricing does is tell us that the prices are ridiculously high. Again, there is usually insurance involved, but there is usually a list of pills that they won’t cover, which are often pills that aren’t available in generic form. This means that the latest, most groundbreaking medicines will cost you top dollar.

And Americans do pay a very high amount for their drugs. The pharmaceutical lobby has made it a priority to keep any government run health care plans like Medicare or Medicaid from negotiating for lower prices. This is why a pill that costs you six cents in Canada costs you six dollars in the United States.

For individuals, negotiation is impossible. The only way that an individual could negotiate for lower prices on a particular pharmaceutical is if he or she threatened to buy a different brand of that medication, but since the patent for any particular drug lasts for twenty years after FDA approval, there often is no different brand of that medication.

In other words, pharmaceutical costs are an enormous part of our health care expenses. In order to help people lower them, we would like to make you aware of a service that is being offered for free to Maryland citizens.

The Maryland Rx Card Program is offering a free service where anyone who presents a membership card at participating pharmacies can expect savings that range from 30% to 75%. According to the website:

“This program can be used by people who have Health Savings Accounts (HSA's), High Deductible Plan's, and Medicare Part D (non-covered drugs). The program can be used as a standalone benefit or to get discounts on non-formulary medications (prescriptions not covered by insurance).”

Considering how many prescriptions are not covered by insurance, saving between 30 to 70% could be a substantial amount of money. It costs nothing to join this program, and joining is as simple as visiting a website and filling out your name and address.

In the meantime, if you or a loved one in Virginia, Maryland or the District of Columbia has been injured in an auto accident, and if you feel that your insurance company has not lived up to its obligations to you, contact Greenberg and Bederman for a free legal consultation today.

To learn more about our car accident lawyer, please read about our car accident lawyer Jason Fernandez, or view his auto accident video on Utube.
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