The Beacon recently published a letter from a Flathead mother who admitted she and her husband are “terrified” of losing Medicaid coverage for their toddler should Congress repeal Obamacare, and to “please think of us when you vote.” Well, why wait?
First, all of us have multiple thousands of reasons to be terrified — not necessarily of Obamacare repeal, but the cost of health care in general.
Let’s start at the beginning, with hospital childbirth, an everyday event: A “Costliest in the World” New York Times story pointed to a frightening analysis by Truven Health Analytics, which determined total charges to commercial insurers for a normal delivery were over $32,000 on average, and over $51,000 for Caesarean deliveries. Stupid crazy, right?
Keep in mind those expenses have quadrupled just since 2004. And, if there’s trouble, the final expenses average 11 times the basic bill — a half million dollars!
But it gets crazier. Those numbers so far are charges. Actual payments for commercially insured normal births ran $18,329. For Medicaid “normal,” charges were $28,900, with payments of $9,131. So, while hospitals bill both “insurers” basically the same, commercial pays half and Medicaid pays a third of what is billed — as a matter of routine.
Is something askew here? Oh, man, yes. Could any other industry routinely post prices two or three times the final amount paid and stay open? Just try to stay in business pulling such a stunt with pickup trucks, for example.
How can hospitals get away with such foolishness? Simple — if charges billed had any relationship at all to actual costs, hospitals simply could not stay open. Wow, no wonder there are so many medical care billing jobs available. Someone needs to track all the billing funny business.
Our terrified new mom writes that her kid “qualified for Healthy Montana Kids [HMK] because we found ourselves [otherwise uninsured and] in the low-income bracket.” The HMK website explains the program is “free or low-cost health insurance” for Montana children 19 and under with an annual co-pay of $215 per year. The HMK bracket for a household of three is $50,400 — for eight, $102,225.
For some more context, Montana’s average wage in 2013 was $39,034, according to the Montana Department of Labor and Industry, probably helped a bit by physician and surgeon wages of over $240,000.
Probably more illustrative is Montana’s median wage (half of jobs pay more, half less) of $31,970, and here’s another twist: the news that “millennials in Montana [those of childbearing age] earn a median annual income of $18,000,” the lowest in America.
Our terrified mom and dad are in a jam, where they darn well better not earn more than 50 grand altogether, or their HMK coverage, which almost certainly has paid bills in six figures the past two years, will go away. Mom now has every reason to avoid good-paying work that will use that master’s thesis she’s working on, at least until her son reaches age 19.
Perhaps they could have more children (paid for by HMK), which would raise their joint salary ceiling, but the perverse bottom line for them is clear: Coming off HMK, ever, carries a real risk of potential exposure to future hospital bills. What would I choose, between a $215 annual co-pay and the prospect of being on the hook for hundreds of thousands each year?
Well, those hundreds of thousands, overbilled or not, are now the responsibility of other people — that’s everyone reading this column and the millions who won’t. Is that fair? Does that make sense? Heck no. Yet that is what Obamacare enables.
Healthy Montana Kids has a noble goal, without question. But, like Medicare and Medicaid, HMK has the same flaw inherent in the “universal” government single-payer outcome that progressives lust after.
Under “single payer,” no matter your health care costs, no matter how crushingly ridiculous, someone else pays your bill. Have you ever heard of “free” medical care recipients asking if there’s a cheaper alternative or what steps are being taken to control the expense to “us?” Not when the “us” we’re supposed to be thinking about isn’t really us at all.