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Medical Costs Bankrupt Patients; It's the Computer's Fault
nbauman writes "Don't get cancer until 2015. The Obama health reform is supposed to limit out-of-pocket costs to $12,700. But the Obama Administration has delayed its implementation until 2015. The insurance companies told them that their computers weren't able to add up all their customers' out-of-pocket costs to see whether they had reached the limit. For some common diseases, such as cancer or heart failure, treatment can cost over $100,000, and patients will be responsible for the balance. Tell me, Slashdot, how difficult would it be to rewrite an insurance billing system to aggregate a policyholder's out-of-pocket costs? 'A senior administration official, speaking on condition of anonymity to discuss internal deliberations, said: "We knew this was an important issue. We had to balance the interests of consumers with the concerns of health plan sponsors and carriers, which told us that their computer systems were not set up to aggregate all of a person's out-of-pocket costs. They asked for more time to comply."'"
The rollout is being delayed until after the 2014 congressional elections. The problem is political, not technical.
quiquid id est, timeo puellas et oscula dantes.
It's just another example of bought and paid for politicians sucking the dick of corporations. The famous words "of the people, by the people, for the people" are such a sick joke if you look at the USA government. Coming from a country that covers 100% of such common procedures, I just can't imagine how people can live like that. And Americans still think they have the most superior country in the world. America! Fuck Yeah! Please stop spreading your ideas of freedom to the world and try spreading those ideas at home instead.
How the heck does this happen?
Technical people don't understand politics.
Which is what Obama has wanted since day one.
1) Pass a bunch of rules with an unreasonable compliance schedule that no insurance company on Earth could hope to meet
2) Blame insurance companies when the new "free healthcare for all" law fails miserably
3) Use it as an excuse to ram single-payer down everyones' throats
4) Government now has the power to decide who lives and dies, based on political ideology, which is what leftist despots like Obama want.
Businesses exist to maximise profits, all profits, even those derived from delaying compliance activities. It becomes a simple cost benefit case. Is it cheaper to pay some politician's wage and go moan about how hard it is for your one programmer to re-write the software within a timeframe, or is it cheaper to simply hire the right number of people to do the job properly and quickly.
The answer is nearly universally the former. Major companies (not just healthcare) will rather moan about how hard done they are by the government than actually step up to comply with the new regulations. If a large fine is linked with non-compliance they'd have the software modified by the end of the month.
I've seen similar cases in industry too. Companies will replace truly horrendous parts of their plant like-for-like because installing what they want is tied with meeting the new standards of the day rather than the easier standards of when the equipment was originally designed, and thus we have a plant basically half replaced as new with no gear that meets any modern emission standards.
There's simply no motivation to go down the more expensive route.
By what legal authority did Obama delay this implementation?
None.
But then again, what legal authority did he (or HHS Secretary) have for:
None are legal because the law itself doesn't give anyone the power to change it willy-nilly, as each changes the law without the necessary legislation to modify the existing law.
jerry
"Software is the difference between hardware and reality"
The USA health care system has some of the worst possible perverse economic disincentives. At literally no point is there a clear economic incentive for you to be healthy and taken care of.
1) Consumers have no interest in keeping costs down. They pay the same deductible no matter what happens. Unfortunately, this is only up to a point (see #4 below) but that's not going to enter casual consideration.
2) Hospitals have no interest in keeping costs down. They blatantly inflate their costs knowing that the insurance companies will only pay a fraction anyway. They also have no incentive to keep supplies costs down since they are paid "cost +" by insurance companies. They'll tend to buy whatever sponge or soap dispenser is in "the catalog".
3) Providers of supplies to hospitals have no interest in keeping their costs down. Hospitals get paid on a "cost +" basis by the insurance companies so charging $35 for that "medical grade" sponge that cost them $0.35 wholesale has 99% profit margins as its incentive.
4) Insurance companies have some incentive to keep costs down, which they generally do by axing their most expensive customers with any of the myriad of technicalities written into their eye-gouging 10 page contracts full of inverted double negatives and exceptions. A good example is somebody with a job who gets cancer. Sure, he/she may have excellent health insurance, but what about when he/she loses his/her job because they didn't show for four months while undergoing chemo therapy? Even so, the myriad of regulations in place (and a legal department that ensures that one plan can't be compared to another) provides an opaque enough service offering that customers are unable to distinguish which plan is actually "cheaper".
5) Doctors had to just about kill their mother to get through medical school, and are saddled with enough debt to make anybody contract stress-related symptoms. Since they get paid for the work they actually perform, they have every incentive to declare a medical emergency and take you under the knife, regardless of whether or not it's necessary or even beneficial. I'm not saying every doctor will give you heart surgery when you come in with a rash, but I'm not alleging something that doesn't happen. Citation 2.
The majority of bankruptcies in the United States are for medical reasons, and the majority of *those* are by people who had health insurance at the time they got sick. Anybody who says this ridiculous would-be-laughable-if-it-wasn't-true system is lying or misinformed.
I have no problem with your religion until you decide it's reason to deprive others of the truth.
Typical 'merican outrage over a perceived yet fictional generalization. Face it middle America, you will never be rich so stop blindly supporting policies you think will some day benefit you. You are only hurting yourself. The lazy American sucking off the tit of society that you are so scared of is either you today or you in the near future. You are unsophisticated, undereducated, and unprepared for the future and that is just the way they want you and imaging, chances are, you live your life through part of the 60's. You had the great privileged to experience some of America's fat years, as long as you were white and somewhat educated. Those days are not coming back and your children will have an ever increasingly hard time.
just do away with insurance companies and switch to single payer. We all need health care to live and stuff. What we don't need is a middle man that adds no value between us and our doctors.
Face it, health 'insurance' made since when the only thing a doctor could do was a) amputate and b) give out aspirin. It didn't matter that they only did a few big things that were mostly comfort before you died. Now we want to _use_ insurance. Insurance can't be profitable if we're all going to use it. The entire _point_ of insurance is that most of us aren't going to use it.
It's like hurricane insurance in Florida. Good luck buying it.
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they don't get to decide. Doctors do. It's single PAYER, not single INSURER. It doesn't work the way you're thinking in Europe, Canada, Germany or any of the other single payer systems where people are entitled (whoops used a bad word) to health care. The only purpose of the gov't is to pay doctors. And they can be well paid and still provide great service.
:).
But far be it from me to let a little thing like facts and the failures of the US healthcare system get in thy way of irrational fear mongering perpetuated by a multi-billion dollar insurance industry. Viva la death panels (well, the private ones anyway)
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Yeah, ever so much better to let a vastly overpaid CEO make that decision.
BTW, what was this basic "human right" again? I can't seem to place it from what you're saying. You've just been yacking about "socialized health care".
Question: Do you believe that someone without insurance, or who otherwise has no ability to pay, who is suffering from an acute medical emergency, should be turned away from a hospital emergency room and left to die on the sidewalk?
If the answer is "Yes," then you're some kind of barbarian, and we're done here.
If the answer is "No," then I've got some even worse news for you: we already have "socialized medicine." The patient will, in fact, be treated, and you and I will, in fact, pick up the tab. It just costs us several times more than it would in any other civilized nation on Earth, because unlike those nations, we insist on kidding ourselves.
When there is only one payer, they control absolutely what things they will choose to pay for.
And you honestly don't think this happens today? Seriously?
Make no mistake: There are death panels in existence right now, this very moment. They work for the private insurance companies, doing their damned best to figure out how to kick people off of insurance rolls and rescind coverage for whatever reason will legally scrape by. Or even illegally, if they think that it would be cheaper to fight the battle until you die than to pay out your claim. The big difference is that today, you frequently don't find out what's not covered until after you're sick and need the coverage.
You don't trust government, I get it, I really do. And to some extent, neither do I. But you know what I trust even less than government? For-profit companies with a perverse incentive to deny you coverage you're paying for using whatever underhanded tactic they can and an historical willingness to do so, especially when the people being denied coverage don't have time or the money for a protracted legal battle and are at a physical or mental disadvantage that directly impacts their ability to fight such battles.
So yeah, I'd take a single-payer system over the crappy system we have today any time. Ultimately, that is the solution to our health care system, not private insurance, not employer-paid insurance, not even Obamacare, although it's a hell of a lot better than what we had. Maybe one of these days if you have the gut-wrenching experience of watching your mother fighting her insurance company for payment of cancer treatments while suffering from the "downtime" effects of chemotherapy, you'll prefer the general incompetence of government over the outright malice of for-profit insurance companies. Personally, I'm nice enough to rather you use common sense to arrive at the conclusion that having for-profit insurance companies responsible for funding your health care is and always has been a dumb idea.