Let me count the ways.
Here are three recent stories that highlight what's wrong with our medical system.
An in-depth report by the Tampa Bay Times found that hospitals in Florida are charging exorbitant fees for patients arriving at trauma centers. It led with an account of a patient who spent 40 minutes in a Fort Pierce trauma center before being transferred to another institution for a higher level of care. After some diagnostic tests were done, he was on his way. The tab for the 40 minutes? $32,727.
The Times found that the average charge for a trauma center activation was over $10,000 and the highest was $33,000. For-profit hospitals tended to charge the most. These charges were billed regardless of nature of the injuries, be they minor cuts or abrasions. And as is customary today, the uninsured were charged the full amounts.
Hospital administrators admitted that the charges were based on what other hospitals charged and had no relationship to what resources were used. The fees did not include bills for physician services, which were separate.
One interventional cardiologist was paid $4.8 million by the hospital in 2012. The article also stated that failure to do enough procedures might result in a reduction in pay for other cardiologists.
A medical scribe's post on the website KevinMD stated that he or she was told to indicate that things like smoking cessation counseling and a full review of systems had been done for patients in an emergency room regardless of whether they actually had occurred. Checking off these activities among others raises the documented level of care and results in increased reimbursement for the hospital and physician.
As I pointed out in a post in December 2012, an electronic medical record facilitates such activity. This is not to say that fraud could not have occurred when charts were on paper. It's just easier to do with an electronic record by checking a box.
There are many other examples of excessive costs and wasted money, but these are just some that have appeared recently.
A final thought on how screwed up our medical system is.
I googled "Affordable Care Act costs," and a website called "ObamaCare Facts" came up on the first screen. Although I am not certain, it seems to be an official government site. It says, "ObamaCare's cost is estimated at up to net cost of $1.36 trillion dollars by 2023." [sic] But later, it admits that the cost could be "between $1 [trillion] and $2.6 trillion."
The following is not my original idea, but despite a thorough search, I cannot find its source.
As pointed out by Mike, an astute commenter with math skills, the previous paragraph is misguided and utterly wrong. It did prompt me to rethink the whole thing.
People with insurance through work don't need any subsidies. But consider this. If you take the estimated 47 million uninsured and give them just $500/month to help them buy insurance for the next 10 years, the cost would be $2.8 trillion and that's just for the insurance. The cost of administering the program would be extra.
ObamaCare Facts also says that the law will decrease the growth in health care spending by tens of billions each year, but it's not clear whether some ACA provisions like establishing Accountable Care Organizations will really reign in spending. This is not just my opinion.
To me, the ACA seems like a windfall for insurance companies and hospitals.
Until we do something about controlling costs and unnecessary procedures like those I mentioned above, the ACA will be a money pit.