Health Care Costs: Go Figure

Within hours of the U.S. Supreme Court's narrow 5-4 decision upholding most of the President's health insurance law, a telling example of why the American health care system is probably beyond repair appeared in the mailbox. It was not unexpected. A close relative had spent seven days (and nights) at Peninsula Medical Center in Burlingame, the result of a nasty fall and broken hip. We all knew the bill would be significant. But no one anticipated its magnitude. How does nearly $118,000 sound? And that doesn't include a variety of pending charges that are still to come. Now, in fairness, that mammoth figure was retail. Those with health insurance (like our patient) would pay a lot less. There was a shorthand breakdown in general cost categories but no itemized accounting. There was no detail at all. No doubt, such a complete tally would require any number of pages. So it was impossible to examine the bill with any sort of accuracy at all. There was no way to figure out what was valid and what wasn't. We had to take it all on faith. That seemed OK when the bottom line payout for this comprehensive care was just $200, courtesy of Medicare and a terrific supplemental group insurance policy. So, frankly, there was utterly no incentive at all to double-check the bill, to question it, to pore over it. Why worry? Other than the paltry $200, it was going to be paid, certainly at a healthy negotiated discount. It was another example of the lack of transparency in all of this. The system simply isn't rational. The consumer has no idea what he or she is actually paying for much of the time. It's a formula for economic chaos.