"911. What is your emergency?"
"My wife has been kidnapped. I found a note saying that I have to pay $500,000 by midnight tonight. Can you help me? Please!"
"Yes, sir. Just tell me how the ransom is to be delivered and we will provide the money for you."
"What? Don't you want to catch the bad guys?"
"Oh, no, sir. That would require some real police work, which is very expensive. And it would also require us to make a judgment as to who is to blame. People would be embarrassed and jobs would be lost in the kidnapping and blackmail sector of the economy. Now we just use taxpayer money to pay ransoms. The money flows through the economy. We don't have to hire so many police officers. And you do want your wife back. Don't you?"
That's not exactly how the discussion went the other day at the Utah House Health and Human Services Committee. But the decision made there, to forward a bill that seeks to weaken the state Medicaid Office of the Inspector General, is based on the same idea. Namely that we'd rather pay whatever the health care providers demand than crack down on overcharges accidental or deliberate and get our ransomed lives back without any more argument.
For all the fuss and bother about the Affordable Care Act, expanding Medicaid and setting up those magical online exchanges that are supposed to bring down the cost of health insurance, very little has been done to cut the cost of health care.
The bad guys in the battle for Obamacare, deservedly, were the health insurance companies, the ones that increase their premiums by double digits every year, even as they cover less and require higher co-pays, all in a run-up to canceling your coverage when you need it most. But giving those companies a much-deserved whack in the CEO was treating the symptom rather than the disease.
The disease was laid out in, well, sickening detail in last week's issue of Time magazine, where a long and detailed report by Steven Brill laid out how hospitals, even "nonprofit" ones, routinely rake in giant profits, building glass and steel monuments to themselves, providing a necessary service that can't be off-shored.
Patients, literally facing life-and-death situations, either have insurance to pay the bulk of the cost (and face huge premium hikes later). Or they run up six-figure bills (on their way to bankruptcy court). Or they die.
Unless, of course, you are on Medicare. That's the national, government, evidence-based operation that pays fractions of hospital list prices because, by their calculations, that's how much the service is worth.
Even if you accept the complaints by hospitals and doctors that Medicare reimbursements aren't enough, and assume that those rates would be significantly boosted, Medicare would still provide good care at a small fraction of what the medical-industrial complex drags out of the insured and private payers.
Medical practices, too, would save a bundle, and have no excuse for multiple errors, if they only had one set of billing codes Medicare's to deal with.
If the United States is going to pay less for health care and, if we are going to have any hope of balancing government, corporate and family budgets, we have to pay less for health care then health care providers are going to have to make less money. A lot less.
And, if they say they can't survive on less money, ask how every nation in Europe provides their citizens with better outcomes for far less money.
Medicare for all. It's time we refused to pay the ransom.
George Pyle, a Tribune editorial writer, and just about everyone else he knows, is counting the days before he becomes eligible for Medicare. firstname.lastname@example.org