Thursday, February 28, 2013

Understanding the Cost of Health Care Makes for a “Bitter Pill”

By E'Louise Ondash, RN

If you haven’t read it, you should.

It’s the article featured on the cover of the Feb. 20 edition of Time Magazine called “Bitter Pill: Why Medical Bills Are Killing Us,” and it has a lot of people talking, especially the medical community.

While the topic of health care and its costs often morphs into a political debate, journalist Steven Brill manages to present hard facts and numbers and to keep the discussion out of the political realm. What he presents and explains affects every citizen and potential patient.

I’ve always known that hospitalization is an expensive experience. It’s also common knowledge that everything costs more in a hospital, the argument being that those who can pay must cover the costs for those who can’t pay. We have accepted this argument for a long time; still, Brill’s investigation found that charges for services and supplies go way beyond what any of us could have imagined. His revelations unfold through the stories of seven patients in various areas of the country and their hospital bills, both massive and mostly indecipherable.

The journalist also discusses the differences or lack of differences between profit- and nonprofit hospitals; how the “chargemaster” determines the prices for drugs, services and supplies on a patient’s bill; the potential power of Medicare to reduce these out-of-control costs; discounts (that are not really discounts) that are afforded insurance companies; what happens when patients owe hospitals hundreds of thousands of dollars; and how health care charges and expenditures cost taxpayers mightily.

I’m not sure what nurses can do to change the outrageous system under which our health care industry operates. We just do our jobs at the bedside, in the clinic, at the office or in the homes of our patients the best we can. Perhaps we can take a larger role in efficiency programs and quality initiatives that can save health care dollars through such things are reducing preventable hospital readmissions, but even then, we can’t control where any savings may be applied.

We are not the ones making the decisions about the cost of care; our focus is patients and their families. But we should be aware of and understand health care’s big picture, not only because we are caregivers, but because we also are consumers. Eventually and inevitably, we and our families and friends will be patients facing the same difficulties and challenges as those we care for today.

Are you ever surprised at the cost of health care and how it affects patients?

Tell us about it.



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