A Dirty Little Secret

Year after year, the cost of medical care keeps rising, ever faster than anything else – even gasoline over the longer run.

Why? Rich doctors? Nurses on easy street? Perhaps it’s unnecessary tests – a lot of folks say that. Is it that we’re paying the cost for the rest of the world for pharmaceutical research? That’s certainly an argument for which one can find some support. Much of the hot air around the topic boils down to “we have the best system – of course it costs more,” and that contributes to a solution, it makes no difference whose – Obama’s, Hillery’s, or even Romney’s – that boils down to mandatory health insurance for all. In other words, "everything thing’s fine, just make sure everyone’s insured."

But is that right? Let me tell you about what looks like a dirty little secret to me.

Having been given an artificial heart valve in 2004 (no complaints about that care, by the way) I regularly have a blood test called a “Protime.” Basically, rate of clotting. PrimeCare, the lab associated with my general practitioner, billed my insurance, and later, me, $43. The breakdown on that was $23 for the test and $20 for taking by blood.

On he advice of a doctor, we – Jeannie and I – switched to Sanford Medical (yes, that Stanford) Labs. The cost there? $15 ($7 test, $8 taking blood). Enough of a difference? Sure. But that’s not the whole story. It turns out if Stanford were billing my insurance – or me – the cost would be $36 ($21 test, $15 draw), close to the PrimeCare number. The $21 difference? The cost of supporting the health car administrative structure, including, mostly, bloated insurance company costs (and perhaps margins?). The cost for supporting all that seems to be 140% of the real cost of the care.

So is our Protime test unrepresentative? It sure isn’t. Many of you (hopefully) get tested for cholesterol. That’s called a Lipid Panel. I had that today. Cost? $24. Also a metabolic C. $19.00. One charge for drawing all three, the same $8. Go ahead, ask your lab what your costs are. (Your doctor will likely not know.)

It looks to me like most of the money I’m paying is for the insurance industries’ ridiculous overhead. And we rail against oil companies?

Do I have a solution? I’ve been accused that I often don’t. I don’t here, either, but that demand is what sends us off to debate baloney – just as the politicians are doing. They all agree that the health insurance industry should remain untouched in the solution. Why is that? The health care lobby has them all by the short hairs? (I can’t say “balls,” can I?) If so, that includes Barack Obama. So much for “change.”