There's no such thing as an unpaid bill in US healthcare

OPINION: IT’S EASY to get distracted by the vaudevillian aspects of the US healthcare debate, writes CARL HIAASEN

OPINION:IT'S EASY to get distracted by the vaudevillian aspects of the US healthcare debate, writes CARL HIAASEN

My favourites are the few beet-faced droolers who show up at town hall meetings to rail against government involvement, while simultaneously warning President Obama to “keep your hands off my Medicare” – the biggest, costliest, most socialistic government programme in US history. It’s also a programme that happens to work, although not as efficiently as it could.

Nobody with an IQ higher than emergency-room temperature could ever believe “death panels” would be appointed to nudge the elderly toward euthanasia. Yet for idle entertainment, it’s hard to beat Sarah Palin’s ignorant nattering on the subject.

Informed opponents of Obama’s healthcare initiative have expressed dismay at the lowly level of discourse. John Goodman, president of the conservative National Center for Policy Analysis, told the New York Times: “I think the critics have approached this in the wrong way; saying there’s to be a death panel is not the right way. The right way to approach it is to put the burden of proof on the administration – tell us how you’re going to do without denying care to people who are really in need.”

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Once the volume is turned down at the town halls, you can hear plenty of smart questions about the direction of healthcare reform, and implications for families, businesses and medical providers. Anyone who’s been in a hospital knows the cost of care is so insanely high that, without some form of coverage, many people would find themselves pauperised by a health crisis.

A close member of my family recently had an accident – it was painful, but not life-threatening. She was taken to the nearest hospital, monitored for a few hours in intensive care and then sent to a private room. Next day, she was moved to a hospital nearer home. She spent barely 24 hours as a patient in the first hospital. Yet the cost for that stay – not including doctor fees – was $11,392.56 (about €7,800). The bill, which wasn’t itemised, didn’t arrive for two months. It had first been sent to our insurance company, which covered most of it. The remaining balance was, relatively speaking, small change.

I called the insurers and said that, while we greatly appreciated the bill being paid, it was hard to comprehend how those particular 24 hours of medical care could cost so much. The woman taking my call said the hospital room was “only” $750. The bulk of the charge, for two scans, totalled more than $6,000.

Our family is fortunate because the company I work for offers a pretty good insurance package at a reasonable cost. Nobody knows for sure how many Americans don’t have medical coverage, but frequent estimates range from 43 million to 47 million. Some carry no insurance by choice, but the majority simply cannot afford it.

We’ve already spent more on Iraq than the Democrats’ current healthcare plans are projected to cost over the next decade. Yet some of the same bright bulbs in Congress who were excited to bankroll that foolish invasion are now huffing indignantly about the price tag for insuring our citizens.

Reform can’t work without including the uninsured – not just because it’s humane but because it will save taxpayers a fortune. The public cost of treating uninsured patients is boggling. If one day in the hospital can cost 11 grand, the tab for a week or month could crush an average family. Whether a patient is uninsured or underinsured, if he or she can’t write a cheque, the rest of us will. That’s one reason hospital expenses are so astronomical – we’re subsidising a sick, bloated system. It would be far cheaper to make sure everybody had a decent health plan. In medicine, there’s really no such thing as an unpaid bill. Somebody always gets stuck with it. – (Tribune Media Service)


Carl Hiaasen is an author and columnist with the Miami Herald . Garrison Keillor is on leave