Health care: The medical cost crisis will outlast Covid
Few would disagree that “much-reviled Big Pharma pulled off one of the great achievements in medical history,” said Geoff Colvin in Fortune—quickly developing multiple effective Covid-19 vaccines. Hospital workers, too, “have been heroes in the truest sense” in the fight against the pandemic. These are not groups America “wants to punish” right now. But something has to give. A system of “perverse incentives,” from drug distribution to insurance rebates, has made health-care costs “maddeningly untamable.” In the six years since the Affordable Care Act was passed, health-care spending per capita has increased faster than it did in the six years prior. Three-quarters of Americans say that the quality of the health care they get isn’t worth what they are paying for it. Big Hospitals and Big Pharma are “at each other’s throats” over who is to blame, but the trend in costs “isn’t about to reverse.”
Poorer hospitals have “limped through the year,” straining under the costs of Covid, said Jordan Rau and Christine Spolar in Kaiser Health News, but many wealthier ones have done just fine. The U.S. has budgeted $178 billion in aid for health-care providers, and even profitable hospitals have gotten help. After receiving $454 million in federal aid, Baylor, the biggest nonprofit hospital system in Texas, “accumulated an $815 million surplus, $20 million more than it had in 2019.” Despite this, hospitals have devised ways to pass on costs, said Sarah Kliff in The New
York Times. Lenox Hill, one of the oldest and best-known hospitals in New York City, has “repeatedly billed patients more than $3,000 for the routine nasal swab test” for Covid, “about 30 times the test’s typical cost.” The hospital “advertised its Covid-19 testing on a large blue-andwhite banner,” then charged each visit as an emergency room procedure. Federal legislation mandated that coronavirus testing be free for patients. “But eventually, American patients bear the costs in the form of higher insurance premiums.”
While you generally won’t get charged for testing and vaccinations, treatment is much hazier, said Maria La Ganga in the
Los Angeles Times. Patricia Mason’s Covid hospital bill was $1.3 million—with $42,480 in co-pays. “Many insurance companies have waived all out-of-pocket costs for coronavirus treatment. But those waivers are entirely voluntary.” Figuring out if your plan has waived fees has been difficult: Most waivers don’t include the “self-funded” plans used by many large employers. Roughly “61 percent of Americans who get their insurance through their jobs are covered by these kinds of self-funded plans.” That has left many Covid patients unsure of what costs they will ultimately be responsible for. “When the hospital bill arrived, Mason’s husband asked her what they were going to do about it. Maybe pay a dollar a month for the rest of her life, she told him.”