Medical Technology, Health Care Facilities and Systems, Compassion:
Like pharmaceuticals, the medical technology industry has grown at a staggering rate, and the cost keeps pace with the newness. “Health care consumers rarely say no to a hot new product…that can extend or improve the quality of patients’ lives,” the New York Times reported. The Advanced Medical Technology Association, which includes 90% of the world’s producers, states that health care technology cost the United States $79 billion and was worth a total of $169 billion worldwide in 2011. The total cost of medical imaging worldwide in 2006 was $100 billion, a rise of $20 billion in two years, according to Stateside Dispatch. A Blue Cross Blue Shield Association study released in October, 2007 detailed the extent to which new technologies have become a major factor in cost increases for hospital expenditures. Hospital costs increased 11.8% from 1998-2000; of that increase, 19% was linked to the use of new technology. Necessity is the mother of invention, and technology is the product of creative minds to contribute to the health of our citizens. Upfront capital outlays are steep and must be factored into the equation and paid for by individuals and taxpayers when all debits are tallied. Since there is already a substantial customer base, sales boom, and the third party payers and a few unlucky self-insured individuals watch with alarm as the costs increase concomitantly.
Health Care Facilities and Systems:
Hospitals, nursing homes, hospice care, in-home care, and other long-term care strategies are costly; and the price goes up every year. American Hospital Association researchers identified “hospital mergers and industry consolidation that reduced competition” as the direct cause of 18% of the increase in hospital costs in 1998-2000. HMOs are regularly consolidating and becoming more profitable. We live longer, and many of us live healthier lives for a long period of time, and there is a price for that. We have added about ten years of longevity to both men and women over the past ten years. According to UMA research as reported by Dr. Blair, “In the 1st quarter of 2005, HMOs showed a $1.4 billion profit”. In 2006 the three largest publicly traded companies–United Health Group, Aetna, and WellPoint–showed a combined profit over expenses of $9 billion for the year. Weiss Ratings reported that more than half of the HMOs are financially strong, and the number of plans considered weak financially dropped from 40% in 1998 to 17% in 2004. In 2000 New York HMO profits climbed to $403 million, an increase over the previous year of 315%. By 2003, New York HMOs reported $1 billion profits, an increase of 32% over 2002. MarketWatch reported that WellCare of New York reported profits of $3.89 million for the first 9 months of 2003, a 32,575 % profit compared to $11,900 in 2002. This is significant because 13% of the nation’s HMO profits were produced in New York, according to the American Trial Lawyers Association. Similar stratospherical profit increases were reported the same year by Aetna Healthcare of Texas-9,724%, Kaiser Foundation of Ohio-3,467%, Health Plus of Michigan-2,434%, and HMO Health Plans of Colorado-2,295%. UnitedHealthcare, the nation’s largest health insurer, reported $28.8 billion in gross revenues in 2003 and projected $36 billion in earnings for 2004. The company’s quarterly profits in 2007 rose 15% to $1.28 billion a quarter. That same company dropped all individual health insurance policies in Florida, Kansas, Missouri, and Illinois on the grounds that they were not profitable enough.
However, nothing in the health care delivery quagmire is simple, and controversy abounds. Paul Ginsberg, an economist at the Center for Studying Health System Change, said, “Profits might explain part of why costs are rising…new treatments and increased demand are fueling the rise.” He went on to state, “The thing I find dismaying is the public doesn’t recognize that it’s the additional medical care they’re getting that’s driving costs up They have to come to grips with the fact that we won’t be able to slow the rise in costs without making trade-offs”. He believes the focus on profits is misplaced. “I once calculated that if you rebated all the drug company profits to patients, health spending would only go down by 1.2%,” he says.
Many physicians can remember the time before the advent of HMOs when the public decried the perceived excessive livings enjoyed by physicians. What happened to the American public was a trade off to a more impersonal, more hurried kind of medical care that costs more than ever before. HMO executives and administrators are well paid, and there are a considerable number of them. Company stockholders are highly satisfied with the profits turned by those administrators. Collectively, HMO administrators bring in for themselves far more than those doctors did in the “bad old days before HMOs”. Although governmental regulations are being put into place to change the early practice of HMOs to accept only the young, healthy, and affluent, many people still find it difficult to be insured by HMOs and other private insurers if they have any adverse health history. If those people and the presently uninsured and illegal aliens are to be fully covered, the general cost of medical care will escalate. Something has to give: either doctors and hospitals have to accept lower fees; patients have to get fewer services; taxpayers have to raise the amount allocated to states’ human services to cover high overhead costs; many fewer recipients of health care must be designated; or…there must be sweeping health care delivery reform.
Compassion:
Americans spend considerable money because of our compassionate ways. We regularly treat one pound or smaller premature infants and severely handicapped children which would have been considered unsalvageable not very long ago. The results are often sad with a life devoid of a meaningful quality—blindness, deafness, heart and lung problems, mental retardation, and a child who is weak and sick and who consumes a great deal of expensive health care over a life time. The cost for neonatal care for such infants can run into the hundreds of thousands, even millions of dollars. Cardiopulmonary Resuscitation (CPR) makes the news regularly; classes are readily available to the public, and there is pressure to have the majority of our citizenry learn this year’s and next year’s new changes in resuscitation. The salvage statistics are dismal. Less than 1% of patients who suffer a verifiable cardiac arrest and receive life saving CPR survive neurologically intact. The death rate from cardiopulmonary arrest, even with CPR in ideal situations, remains very high. Survive or not, there is a significant monetary cost.
Across the nation, businesses that provide health care for their employees pay a hidden 17% premium tax to cover the costs of all of the care described in this article for the uninsured, according to UMA, and for persons who enter the nation illegally and consume health care monies, sometimes preferentially.
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Carl Douglass – Author
Carl Douglass Books
www.carldouglass.com
“Neurosurgeon Turned Author Writes With Gripping Realism”
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