Obamacare-Colluders Anonymous: Stop the cycle of addiction to the lifeblood of the American patient
Kris Held, MD ^ | February 17, 2014 | Kris Held, MD
Americans must understand that our federal government has chosen to collude with insurance companies, hospitals and drug companies to take total control of our healthcare system and one sixth of the US economy rather than collaborate with patients and physicians to achieve good healthcare reform that benefits each individual patient. This unholy alliance is facilitated by lobbyists bearing gifts of money and power. Individual patients and physicians are by comparison penniless and powerless. We are nothing more than pawns in a game which we can play no more. This is the ultimate game of life, and the only way not to lose is not to play.
A very bad national healthcare law has now been spun and woven within and throughout a very bad national tax policy, strangulating and choking the life out of the American patient and American medicine. Patients and doctors must stand and say “No more!” First, we must understand the disease, so we can fight it.
There are two components to a medical bill. One component is the bill for the hospital or outpatient facility services/supplies; let’s call this the hospital bill. The second component is the bill for the physicians’/surgeons’ services; let’s call this the doctor’s bill. We must make a very clear distinction between the “Bill” and what is actually paid and by whom. When Americans talk about our staggering medical bills, we are predominantly referring to the hospital bill, which is nothing more than a usurious, manipulative tool.
The hospital bill is staggering. It is enormously, artificially, and intentionally inflated to produce phantom losses resulting in tax-exemption for the hospitals and scaring patients to death, into believing they cannot survive without expensive, comprehensive health insurance. Dr. Keith Smith of The Surgery Center of Oklahoma gives a good explanation of how this is achieved and contrasts his model for excellent care at a fraction of the cost t.co .
Here is my real life example: the hospital “bills” $12,000.00 for a minor procedure on a woman with a gynecologic condition. The woman gasps at the bill when she open the envelope, and then concludes “Thank goodness I have health insurance; everyone needs health insurance.” In reality, the intentionally hard-to-decipher bill cloaks the billing game/tax scam. While the hospital shows the patient the $12,000.00 bill, the hospital has actually agreed to accept far less from the insurance company; this is called an allowable, which in this case was $5000.00. By billing $12K but accepting $5K from the insurance company, the hospital recognizes a $7K phantom loss, which it reports on its tax return, thus maintaining a “non-profit”, tax-exempt status. The individual patient, now with a huge $5000.00 deductible because of Obamacare, must write a check to the hospital for the entire $5000.00, on top of her monthly $250.00 premiums ($3000.00 annually). The patient has come out of pocket $8000.00 with Obamacare style insurance. In stark contrast, if the patient was uninsured, she could have negotiated a direct fee with the hospital for $1200.00.
So, follow the money. The hospital got $5000.00 from the patient plus a $7000.00 tax write-off in return for less than $1200.00 of services/supplies. The insurance company got $3000.00 in premiums from the patient and paid $0 to the hospital, while the patient paid all of the $5000.00 allowable because of the high Obamacare-induced deductible. The patient ended up paying $8000.00 ($5000.00 deductible plus $3000.00 in premiums) for the privilege of paying more than if she had no insurance (the $5000.00 insured negotiated allowable v. the $1200.00 uninsured cash price) and gets no tax benefit for her health care expenses. Understand this: the individual spent $8000.00 with no tax break because she was mandated to buy Obamacare, and she would only have had to spend $1200.00 if she was uninsured. If business gets a tax break, most certainly should the individual as well, but with Obamacare the individual patient is in essence penalized. $6800 of this woman’s livelihood was essentially laundered to sustain a Government-Lobbyist-Insurance Company-Hospital-Drug Company Collusion Scam. The government, insurance company and hospital profit and get tax breaks- from our health, our bodies, and our lives- by manipulating us and scaring us. This is just wrong.
Now, what about the doctor’s bill? The surgeon’s insurance company allowable was $600.00. For a relative pittance, the doctor assumes all the risk and must practice under oppressive, punitive, coercive, innovation-stifling, mind-numbing, ever-changing-at-the-whim-of-a-politician government control. This $600.00 must then be spent toward overhead (taxes, employees, rent, supplies, malpractice, continuing education, computers…) into which it doesn’t make a dent. Doctors don’t get tax breaks either. Doctors love their patients. We are all patients. Americans are generous, compassionate, and self-sacrificing. Physicians and surgeons are willing to accept ridiculous agreements to retain our patients, who in reality have now been bought by government from insurance companies in collusion with hospitals. Hospitals, insurance companies, and government now own the doctors too. Doctors and patients must refuse to play this deadly game anymore. Stop and look at who actually paid what to whom, not just what the hospital “bills”. Expose the truth.
Americans are smart. When everyone understands what is going on, we can call out these gamers, get rid of their fixed game, and implement true patient-centered healthcare reform at dramatically lower cost with increased choice and access to good doctors and state-of the-art care for all. In the meantime, we are complicit enablers. They cannot do this without us. You can’t get your appendix out or broken hip fixed without a surgeon. Doctors and patients, together we must acknowledge the problem and stop enabling. Only tough-love can stop this cycle of addiction of the colluders to the power and money sucked from the lifeblood of the generous, compassionate, self-sacrificing, scammed, and scared-but very smart- American patient. We need our own version of AA and a twelve step plan for the recovery of American medicine. |
