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 The Bill To Fix Health Care - Permanently
Thorvold 268 posts, incept 2013-09-12
2017-04-02 15:57:25

The medical racket seems to be garnering more attention lately. From a 3/29/2017 article by Elisabeth Rosenthal in the NY Times:

"Each billing decision, then, can be seen as a battle of coder versus coder. The coders who work for hospitals and doctors strive to bring in as much revenue as possible from each service, while coders employed by insurers try to deny claims as overreaching. Hospital coders teach doctors and doctors pay to take courses to learn how they can upcode their charts to a more lucrative level with minimal effort. In a doctors office, a Level 3 visit (paid, say, at $175) might be legally transformed into a Level 4 (say, $225) by performing one extra maneuver, like weighing the patient or listening to the lungs, whether the patients illness required that or not. [Let that sink in.] E.R. doctors, for example, learned that insurers might accept a higher-reimbursed code for the examination and treatment of a patient with a finger fracture (usually 99282) if in addition to needed interventions a narcotic painkiller was also prescribed (a plausible bump up to 99283), indicating a more serious condition."

Coding has become an industry; 170k coders now in the American Academy of Professional Coders, up from 70k in 2008. These jobs pay well and we all pay for them whether or not we're the ones using the medical establishment.

The woman featured in the NYT article:

"Nearly simultaneously, she received a one-page bill for the hospital portion of her care, broken down only into the broadest categories, including $111,162 in room charges, $34,755.75 for pharmacy, $19,653 for labs, $8,640 for the operating room, $8,325 for anesthesia, $1,143 for the recovery room, $44,524 for medical supplies and $40,489 for radiology services, totaling $356,884.42. The bill informed her that the medical center was prepared to offer her its standard 20 percent discount for patients who are uninsured, leaving a what you owe now fee of $285,507.58."

If the problem is addressed at all other than by collapse, my guess is the Medicare for All "solution" rather than the simpler and more effective KD approach. There's just too much money to be made scamming people, even if the pot becomes a bit smaller.
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