"If we had set out to design the worst [health] system that we could imagine..."

Former New England Journal of Medicine editor-in-chief Marsha Angell has said:

If we had set out to design the worst [health] system that we could imagine, we couldn’t have imagined one as bad as we have…

Our health care system is based on the premise that health care is a commodity like VCRs or computers and that it should be distributed according to the ability to pay in the same way that consumer goods are. That’s not what health care should be. Health care is a need; it’s not a commodity.

Angell doesn’t even mention the most perverse, infuriating fact about health-care-as-a-commodity. Unlike a product in a store, with a single price for all, hospitals charge patients who can least afford to pay much higher prices for the very same treatment!

The uninsured are disproportionately poor, unemployed and uninsurable (due to advanced age or pre-existing medical conditions). The uninsured pay much more — for the exact same treatment — than wealthier people with insurance. Insurance companies routinely settle with hospitals for 20% or even less of officially billed charges whereas the uninsured are billed 100% and expected to pay in full or given only minor discounts off the totally outrageous charge master list prices that are many times higher than the hospital’s actual costs of providing services.

Posted by James on Wednesday, May 27, 2009