With the increasing number of new cases, the number of COVID-19 hospitalizations in the United States is also setting a record, which has exceeded 90,000 this week, further amplifying the problem of high and arbitrary charges in the U.S. health care system.
According to the survey of some institutions, the high cost of treatment has become a heavy burden on many patients, and some people have even had to give up treatment.
Huge bills scare off patients
In a recent report, the National Nurses United, the largest registered nurse organization in the United, pointed out that inability to see a doctor has become a prominent phenomenon since the outbreak of the novel coronavirus, and the high fees in hospitals have caused heavy burdens for many patients and families. Burden.
The report measured the charging of the health care system and found that every $100 spent by the 100 most expensive hospitals in the United States translates into charges ranging from $1,129 to $1,808 for patients.
In other words, hospitals charge far more than their costs, up to 18 times. Hospitals have taken huge profits, directly driving up the costs of patients and society as a whole.
Nationwide, hospitals have converted an average of $417 per $100 cost into a fee, a profit bonus that has more than doubled over the last 20 years (as shown in the figure above).
Jean Ross, president of the National Federation of Nurses, said that there is no reason for such a “heinous” charge, because medical care is not an icing on the cake luxury, but a necessity of life.
Ross said that in order to avoid the debt burden caused by medical expenses, some patients are afraid to even go to the hospital and give up the necessary medical care, causing minor diseases into serious diseases and acute diseases into chronic diseases.
The 2018 survey found that 78% of adults try to avoid going to the hospital; 44% gave up medical services due to price reasons; and nearly 30% said they had to choose between paying for medical expenses or basic necessities such as food or housing.
High fees have also pushed up the cost of treatment for COVID-19. The study showed that the expenses of patients hospitalized with COVID-19 were about $42,486 (with no or few complications) to $74,310 (with major complications).
A survey by the Commonwealth Fund in the United States found that up to 68% of the respondents said whether they found that medical treatment would depend mainly on the amount of out-of-pocket portion of health insurance if they found themselves with symptoms of the novel coronavirus.
The whole society paid for the high fees for medical care.
The medical system in the United States is completely market-oriented. The upstream and downstream are controlled by interest groups such as medical institutions, pharmaceutical companies and insurance companies.
The pricing is not transparent, and the government will not regulate the price of medical care. As a result, seeing a doctor is both expensive and difficult. In the United States, most medical costs are two or three times that of other developed countries.
For example, the cost of common tailectomy in surgery is $3,050 in the United Kingdom and $6,710 in New Zealand, while in the United States, the average price is $13,000 (according to the 2017 International Medical Price Comparison Report).
Ultimately, these costs will translate into heavy social burdens. In 2018, the per capita expenditure on health care in the United States was $11,000, and health expenditure as a proportion of GNP is nearly one-fifth.
On the other hand, the interest groups in the medical chain have made a lot of money. The National Federation of Nurses reported spending, driven by rising fees, profits for U.S. hospitals have soared by 411% since 1999, reaching a record $88 billion in 2017.
The rise in fees is accompanied by the increasing mergers and acquisitions of large hospitals. As a result, the market monopoly has intensified, which further leads to higher hospital profits and fees.
Of the top 100 profitable hospitals, for-profit companies own or operate 95 of them, leading HCA Healthcare, the largest hospital system in the United States, which owns or operates 53 of the top 100 hospitals. In 2019, HCA ranked 241st among Fortune Global 500 companies with a profit of $3.7 billion.
Private medical insurance companies are also important links in the interest chain. Insurance companies will negotiate discounts with medical institutions on the bill of medical insurance patients, which is also a feature of the U.S. health care system.
The larger the insurance company, the stronger the bargaining power. Therefore, the hospital quotation does not reflect the actual payment of the insurance company, and the negotiations between the two parties are usually confidential.
Benjamin Handel, an associate professor of economics at the University of California, believes in an interview with CCTV reporters that in some cases, it is most profitable for insurance companies not to keep prices too low, and many costs will eventually be absorbed by patients and society. A 2017 study found that for every $1 increase in hospital fee tag, insurance companies pay hospitals an extra 15 cents,” the National Nurses Federation reported. When an insurance company pays higher fees, it is often passed on to consumers in the form of higher premiums, deductibles or out-of-pocket payments.”
The report points out that uninsured patients are the most vulnerable group, and “they have no negotiating ability when they receive full medical bills, which is also the main reason for the surge in medical debt litigation in the United States.
Once the hospital wins, they often ask for seizure of the patient’s house, bank account or salary. More and more hospitals are selling debt to collection companies for recovery, which is also one of the main reasons why medical debt has become a personal bankruptcy.
In Maryland, for example, hospitals have filed more than 145,000 medical debt lawsuits in the past decade, requiring patients to pay $268.7 million.
Similarly, there are racial differences in the impact of high fees. In 2019, Latino residents had three times the uninsured rate than whites, while African Americans had twice as much uninsured as whites. 19% of people of color have medical debt, compared with 15% of white people.
Now, the COVID-19 epidemic has further amplified the problems of the health care system. Most Americans’ commercial health insurance is provided by employers. However, tens of millions of people lose their jobs and many people lose commercial health insurance, and the out-of-pocket portion of medical expenses will increase significantly. In the face of the coronavirus epidemic, fear of seeing a doctor has become a heart disease for many people.
Everyone knows that the U.S. health care system is very problematic, and the calls for reform have never stopped. Establishing government-funded health insurance covering all is the goal pursued by many people, but since the beginning of the last century, this goal has never broken through the obstruction of interest groups.
