Be INFORMED

Tuesday, June 05, 2012

HEALTHCARE: What It Costs Versus What Insurance Companies Have To Pay

  I make note to readers that I am currently in the process of surveying the local area hospitals here in the Tampa Bay area in order to see how much of a cost difference between paying in cash and using insurance exist. As of this time, it seems that nobody wishes to discuss the subject unless they are forced to.

By  Joan McCarter on Tue May 29, 2012

Yes, we still need a Medicare for all option for health care in this country. A Los Angeles Times story from the Memorial Day weekend spells out what happens when you have competing market interests intersecting, both hoping to maximize profits. In this case, hospitals and insurance companies.

la-fi-medical-prices-20120526-g

That chart shows what a CT scan basically actually costs—the cash price if a patient wanted to bypass (or didn't have) insurance and paid the provider directly, versus what's basically quoted to insurance companies versus what insurance companies are actually billed.

The difference in price can be stunning. Los Alamitos Medical Center, for instance, lists a CT scan of the abdomen on a state website for $4,423. Blue Shield says its negotiated rate at the hospital is about $2,400.

When The Times called for a cash price, the hospital said it was $250.

"It frustrates people because there's no correlation between what things cost and what is charged," said Paul Keckley, executive director of the Deloitte Center for Health Solutions,a research arm of the accounting firm. "It changes the game when healthcare's secrets aren't so secret."[...]

In the view of Robert Berenson, a senior fellow at the Urban Institute and vice chairman of the Medicare Payment Advisory Commission, big hospitals are exerting their market power to charge ever-increasing rates and major insurers go along with it because they can pass along the costs to employers and consumers. Insurance industry officials say that health plans negotiate the lowest prices they can, but that they also need to include prominent hospitals favored by customers in the network, and those institutions can command higher prices.

Providers say they jack up the prices of treatments to cover the uncompensated care they provide to the uninsured. They argue that they can avoid overhead and keep costs lower by offering a cash price for treatment, bypassing the insurance company billing process, and that, generally, they only offer the cash price to the uninsured. But it still all boils down to this: A thousand percent increase in the cost of a treatment versus what a patient and insurance company ends up paying for it happens. It might be greater or less depending on your hospital and your insurance company. Which is insane. It is no way run a health care system. Which, of course, outside of Medicare (and to a certain extent Medicaid) we don't really have in this country anyway.

The Affordable Care Act will help to level out some of this. For example, basic preventative services will provided for free to patients (well, "free" when they've already paid their premiums). But that doesn't mean those insurance companies won't end up being charged varying rates by varying providers of those services. The advantages will mostly be on the consumer side, which is critical, but the huge driving factors of this mess are barely touched, and the inefficiencies and irrationality of what we like to call a health care system in this country pretty much continue. It's a start, and it is helpig people, but it's not nearly enough.

Which again leads to the basic premise here: A single payer health care system that makes price-setting for procedures uniform, that takes out the vagaries of insurance billing and all the overhead involved in managing that billing for all the possible permutations of coverage, is the only rational option for controlling health care costs for everybody.

Originally posted to Joan McCarter

 

Sunday, June 03, 2012

RELIGION: Key Architect of Religious Right Warns of "Christian Jihad"

   Since it is Sunday and many people are/were doing their church thingy today, I figured that I’d find something on “ religion “ for you to think about. I say “ religion “ because there really is not much of true Christianity left in America and certainly not in her churches.

By  Troutfishing 

"I realized that the main difference between "our people" and "their people" (Islamic fundamentalists) was that ours (with the notable

exception of bombing abortion clinics and assassinating doctors) had not (yet) resorted to violence."

[...]

"While many fear the Islamic fundamentalists' plot to place the world under Islamic Law, the Sharia, most Americans may not know that Christian conservatives, long the dominant wing of the Republican Party, are increasingly falling under the spell of theocratic utopianism with its goal of establishing "God's Law" as the law of the land." -- Colonel V. Doner, author of Christian Jihad: Neo-Fundamentalists and the Polarization of America

Back in 2005, when I first began studying (and writing on) the religious right in earnest and when I co-founded, with Frederick Clarkson, Talk To Action, I wouldn't have dreamed that one day I'd have the opportunity to talk with one of the architects of the politicized Christian right, or that such a leader would cite my work... or that we would agree on so much.

Last Thursday, I had a thoroughly enjoyable hour and a half talk with Colonel Vaughn Doner (note: "Colonel" is his name, not a title) and I hope to have the opportunity again.

Colonel V. Doner is hardly a household name. But in the creation of the modern, politicized Christian right, Doner can claim a surprising number of firsts - he created the first "Congressional Report Card" to tell evangelicals how exactly they should vote. He played a major role in mobilizing evangelicals to elect Ronald Reagan, in 1980.

Doner then founded two of the three major Christian right organizations of the 1980s (Christian Voice and The American Coalition for Traditional Values (with Tim LaHaye). Later in the 1980s, he played a leadership role in the Coalition on Revival, the Christian Reconstructionist-dominated mega-gathering of movement leaders and intellectuals who mapped out how to "reconstruct" America and impose Biblical law.

As he describes in his new book, Christian Jihad: Neo-Fundamentalism and the Polarization of America, Doner also pioneered the use of "wedge issues", such as gay-bashing, as a political tactic to help get conservatives elected.

As late as 2002, an anthology published in honor of Colonel Vaughn Doner's 50th birthday featured glowing tributes from Tim LaHaye, founder of the Council For National Policy, and from R.J. Rushdoony, the intellectual father of the Christian Reconstructionism movement.

But, says Doner, the September 11, 2001 terrorist attacks were a wake up call.

Over the course of the next decade, as he describes in the book, Doner came to question basic tenets of fundamentalism underlying his worldview, and the worldview of the movement he'd helped create - the notion that humans, who of course are fallible and subjective, could possibly have the one, "correct" interpretation of scripture, then the claim that the Bible is the infallible, inerrant word of God.

Doner describes his train of questioning:

"I began to ask myself a basic question: just how was it that we were privy to God's objective truth and everybody else was so pitifully subjective or just plain wrong?"
Along the way, along this process of intellectual self-examination, Colonel Doner says he was reborn - as a "post-conservative", "post-fundamentalist", postmodern Christian.

One of the launching points for my talk with Doner was the image on the cover of his book. It would be easy to imagine that the symbolism is intended to represent a "Christian Jihadist", bombs strapped to his back, on route to blow up his chosen enemies.

But that's not it at all.

Taken in literal terms, I observed to Doner, what's going on is that someone, a real person external to the visual frame except for two fingers, is lighting explosives taped  to the back of a ceramic Jesus figurine.

What's really going on, what the image really symbolically represents - as Doner and I both agreed - was that the movement he writes on in his new book, the Neo-Fundamentalist movement that Doner warns could become a "Christian Jihad" has become so radicalized and consumed with its manichean "theology of war" (which NAR guru C. Peter Wagner discusses quite openly), it risks destroying the traditional Christian ethic, that Christians should be peacemakers - an ethic derived from the words of Jesus.

In symbolic terms, the Neo-Fundamentalists are blowing up the message of Jesus.

In his book, Colonel Doner devotes two entire chapters to Sarah Palin and her extensive connections to the New Apostolic Reformation, and cites pioneering research, by my colleague Rachel Tabachnick and I, covering the NAR and Palin's ties to it, following her emergence as John McCain's running mate in the 2008 election.

The NAR, which Doner now sees as uniquely threatening to American civil society, and to Democratic pluralism, was in a sense a movement he helped create--by politically organizing charismatic and Pentecostal churches in the late 1980s and 1990s, and by introducing "Dominion" theology to charismatic Christians and to C. Peter Wagner (who has been the most significant leader in the NAR.)

Christian Reconstructionism's Dominion theology helped politically mobilize an entire segment of evangelicals who had removed themselves from politics since the embarrassment of the 1925 Scopes Trial, who were waiting for the "Rapture".

The message to those evangelicals was this - "While you're waiting for the Rapture, why not become politically involved - to build God's kingdom? Christians, whatever their end-time eschatology might be, should nevertheless work, while they can, insofar as it is possible, to achieve dominion over all the Earth."

And, it worked - too well. 

The movement Doner's work helped give rise to, which has emerged as the New Apostolic Reformation, is driving the radicalization of American evangelicals to the point, warns Colonel Doner, that we could see the emergence of a true "Christian Jihad", and to the point that the rising polarization in American culture and society risks devolving into civil war.

Writes Doner,

"After 20 years as a Christian Right leader I then spent a decade within the wacky Neo Fundamentalist Movement that was birthed from the ashes of the old Christian right and that formed the worldview of social issue warriors like Sarah Palin and Michele Bachmann. The bizarre world of their Dominionist-Spiritual Warfare mentality is a new and much more dangerous manifestation of the old Christian right and it has the power to bring us to the brink of civil war. It is vital that we understand what is happening and what can be done to stop it before it's too late."
If you want to understand, really understand, what's driving the "culture wars" behind America's increasingly intractable political stalemate, there may never be a more useful, or timely, book than Christian Jihad: Neo-Fundamentalists and the Polarization of America. You can read more about the book at http://christian-jihad.com/. You can order the book through Samizdat and it is available in Kindle edition too.

[for a closely related story, with added details on the movement behind Sarah Palin, which Colonel Doner covers in two chapters of his book (citing my work, and my colleague Rachel Tabachnick's as well), see Templeton Foundation, Christianity Today, Oprah Network Promote New Apostolic Reformation]

Originally posted to Troutfishing on Thu May 31, 2012