By Fareed Zakaria, CNN
David Goldhill, the CEO of the Game Show Network, is an unlikely agitator in the health care debate. He got involved after his father went to the hospital with pneumonia - and died from an infection while he was there. He says now:
"I saw a hospital with less impressive information technology than my dry cleaner has, than my auto mechanic has - a couple of times, my father was taken for procedures meant for other patients. There's trash on the floor. Almost everywhere it overflows in patients' rooms. There's an erratic nature of scheduling of personnel. You're endlessly dealing with personnel who don't know anything about your case. This is the intensive care unit we're talking about."
The fate of Goldhill's father is all too common. Every year, an estimated one hundred thousand Americans die from an infection they got in a hospital. Goldhill continues:
"Once I got beyond, obviously, the personal elements of the tragedy, I thought that there's something very unusual about this, just in the scope of how the world works today. And as I spent time thinking about health care, I began to think about the lack of real accountability to customers and the incentives to bad behavior that really dominate the way the industry is structured."
Unlike many markets, customers don't really pay their own bills in health care. Instead, it's a private insurance company, or the government, that pays. In the case of Goldhill's father, Medicare picked up most of the tab - which was over six hundred thousand dollars before a hospital discount. Goldhill says:
"To all of us, that seems terrific, right? I look at it a different way. If Medicare had said to my mother, 'You pay the bill,'and the hospital had come to my mother and said, 'Here's what we're charging you for killing your husband,' the collection would have been zero. There's no way my mother would have paid that bill. There's no way any of us would pay that bill."
Goldhill summed up his worldview in an article in The Atlantic, How American Health Care Killed My Father. He says if patients spent more of their own money on health care, prices in the industry would come down. Goldhill says, "The problem with insurance is that it's very costly. It's a very costly way to finance anything, which is why it's never used to finance anything outside of health care that isn't major and rare and unpredictable."
So what can be done? I explore that question and more in depth in "Global Lessons: The GPS Road Map for Saving Health Care," which will debut on Sunday, March 18, at 8:00pm and 11:00pm ET & PT on CNN/U.S. It will air on CNN International on Saturday, March 24 at 9:00pm ET. My companion article for TIME will be in the edition that hits newsstands on Friday, March 17.
When my brother became paralyzed, we just wanted answers and we didn’t want to be treated like mental patients or criminals.
America is a class society. Money determines the care and attention a patient gets. David Goldhill, the CEO of the Game Show Network should have taken his father to a pricey, private hospital.
Since money is no indication of moral high ground, there are better solutions needed. Preventative care, like diet, exercize, and annual check-ups are key to not loading down the system. Vigilant preventative care, coupled with staying out of the hospitals, unless absolutley necessary, is key.
I kissed my way up to VP at a health insurance company. Now I take over $500,000 of your health care dollars for NO VALUE ADDED to your health care. And that’s just me. Now think about how many other VPs, Directors, Managers, etc. are at my company alone. Now multiply that by thousands of others at hundreds of other health insurance companies. From 10 to 25% of your health care dollars go towards administration that adds NO VALUE to your health care. But my company’s PAC dollars will continue to fool you little people into thinking that a single payer system will be bad. Little people like you are so easy to fool. Little people also don’t realize that a single payer system is the ONLY system that would allow little people (as an entire country) to negotiate better health care prices. Little people don’t realize that the Medical Cartels already know that. And that is the reason why the Medical Cartels spend so much PAC money from the hospitals and doctors lobbying against a single payer system. Some little people say that a single payer system would cost you little people more. But if that were true, then wouldn’t the hospitals and doctors WANT that extra money? Yes they would. So why do the Medical Cartels lobby against a single payer system? It’s because the Medical Cartels know it would allow little people to negotiate better health care prices. And that’s what the Medical Cartels are afraid of. Period.
But us big wigs at insurance companies, hospitals, and pharmacy companies don’t ever need to worry about health care no matter what it costs. We get our health care paid for one way or another by you little people. And we get the little people that work at our companies to contribute to our PACs. And us big wigs say it’s to protect the little peoples’ jobs. But in reality it would be in the little peoples’ best interest to NOT contribute to the PAC. Again, little people are so easy to be fooled. I won’t ever have to worry about losing my job with so many little people being brain washed by the Medical Cartels’ PAC money. Not only that, the Medical Cartels’ PAC money is used to elect so many republicans that will never allow a single payer system. Republicans have always fought against any meaningful health care reform. But that’s what our Medical Cartels’ PACs pay them for. Politicians can be bought so easily.
Pretty soon the only people that will be able to afford health care is us big wigs. And that’s the way it should be. We don’t want you little people using up the resources when we need them. And once again, I thank you little people for capping my SS tax at the $106,800 level. Now I only pay 1.3% SS tax and you little people pay 6.2%. Also, thank you for extending my tax breaks. I’m using the extra money on my vacation houses.
Timmy, I am going to state I think you are a shill for the left, throwing out all the things that the left wants the less informed to believe. Why don't you tell us exactly where it is you are a VP. Give us your name so we can look your credentials up on the web. I am sure if you are a VP, I should be able to look up your stock options and such. I know I can pretty much look up a VP at any other company in the US.
Dear Javaboy: I am always so happy to see the likes of you calling everything you are too ignorant to understand "lefties", "socialists" or some other ignorant label because you can't supply a decent arguments presenting facts instead of some b.s. you've picked up by more ignorant asses. The facts are out there and the entire industrialized world is more than happy to share them with you if you would just have the intelligence to look. Universal health care does work if we'd give it a chance, but as long as morons like you buy into the crap that's given you by the insurance companies we'll stay the same selfish, ignorant fools that we're so proud of being. As a Disabled American Veteran I get health care for free thru a socialistic system called the VA which beats the hell out of having no health care at all like so many of my countrymen, but I still care deeply about them because I have compassion. I guess that, thank goodness, makes me a "lefty". A little more "we" and a lot less "me" would make this country what the founders intended it to be.
For those who are successful, healthy, and careful, most forms of insurance almost seem like another tax. The concept of insurance is worthy, however, many forms are mandatory. How can one justify rewarding failure and penalizing success, and then profit from it at the same time?!? This should be illegal !! Insurance, like banking, has a lot of problems, and chances are such systems will fail before they would ever have a chance of being corrected.
Less is more... http://www.aolnews.com/2010/01/01/solution-to-killer-superbug-found-in-norway/
I have worked for those people and they were real proud.
I believe much more die. Hospitals in large US cities, especially NY are not up to par, except for NYU. I had a heart procedure and had to overnight in one of the largest hospitals in NYC. I needed to take a shower and believe it or not, I myself cleaned the bathrooms to the best of my ability in order to stand and take my shower and avoid acquiring any virus. Expect much more to die and much more filed lawsuits
Did someone at some in sensitive hospital forget to tell him about "Penny Health". Also If you aren't employed and have no means of paying for treatment the hospital will file the form and get reimbursed by medicaid.
It is MUCH WORSE in other countries!!!
In France, in the 1990s, they built a huge new hospital in Paris. 1 month after the inauguration, it was already infected with legionnaire's disease.
The high infection rate has nothing to do with there being something wrong with the US medical system, it is an inherent problem with the principle of hospitals itself, i.e. with putting a lot of sick and weakened people together in a small space.
If you can come up with a system to prevent illnesses from spreading under such conditions, you're a genius. Or, more likely, a fraud.
I read this article from the Atlantic several years ago, I am not from America, but I thought the economic arguments made was facinating, and it was VERY interesting to read. David Goldhill is very interesting, and capable iindividual.
The health care system in the US is broken. Greed have replaced the moral imperative of providing health care for all equally. There is not one person in the US who has not contributed to research from diabetes research to cancer. Yet when there is a medical discovery affecting the majority of the population, only those who can afford it get the benefit of that research. Due to a complete privatization and the AMA (American Medical Association) and unions like it which their main objective is to fix prices for doctors and hospitals to charge. That is why there is little difference between office visits prices and hospital prices. Until we demand that a better moral value is place toward all individuals and prices be regulated, we will continue to see the injustice of our health care system. There is a reason why 10 minutes of time at the doctor's examining room be priced at $120 when there is not insurance, and where there is insurance, it is priced at $200 (insurance) and $40 to $60 co-pay. Hospitals charge $15 to serve an aspirin to a patient and when a person complains to the insurance, the insurance company does not do anything about it. Their answer "if there is a benefit and a claim it has to be paid," Except that you end up paying at least 20 to 40% of the price of that aspiring as deductibles and out of pockets. Some times the insurance ends up paying only $2.
Another one is the deductibles and out of pockets amounts. A person pays at least $500 per month for a family of 3 in premiums but the deductibles have to be met first. By the time you meet $2500.00 in deductibles per year the insurance ends up paying nothing while you are really out of $6000 per year. People are being fleeced by the health care providers, insurance companies and pharmaceutical companies. They all get a piece of your pie.
The 100K lives campaign being implimented in hospitals across the country is addressing this very issue. I am extremely sorry for this gentalman and his family. Especially that he felt his health care providers were not consistant in staffing and knowing his case. Hospital acquired infections are not going to go away! When you treat every bacteria that comes through the door with antibiotics, bacteria become resistant, "super infections", or hospital acquired infections. But be sure your healthcare providers do care for you, and your families, and we will continue to improve so we can do what we do best, save lives!
And to Timmy (bloodsucker) death comes for all of us and he doesn't take insurance;)
Why did Mr. Zakaria ignore the elephants in the healthcare reform room. Even president Obama in his healthcare reform bill did it. Any guesses? One of the elephants is Defensive medicine practiced by doctors throughout this nation. They order unnecessary tests or scans to make certain that the patient does not come back to sue them for some obscure illness. In places such as Taiwan, lawyers are not breathing down doctors necks as they are in US. This is one of the biggest reasons for healthcare bills to be as high as they are. The second biggest elephant is the hospital lobby and pharmaceutical lobby that have congressmen in their palms. Their lobbies are much more powerful than the AMA. Fareed mentions the patient with over $630,000 in hospital bills that medicare paid for. That is the norm these days. The hospital bills are ridiculous. But most patients have no idea how much a hospital charges or the amount their medicare or insurance company pays for their hospital stay. Doctors may get paid anywhere from $30-100 dollars for a visit which is probably less than what you would pay your plumber or mechanic. Compare that to the minimum of $3000 for one night stay in the hospital. Or even a simple blood test like your blood count that costs $300 in the hospital vs. $30 in an independent lab. That is no exaggeration. How is this justifiable? And Mr. Zakaria, I am not comparing Chevys with BMWs. here. These are facts.
I totally agree with your assessment of the elephant in the room. Fareed, you make a claim about "what causes the high cost of healthcare in America" and bring up Korea (I forgot which one it was) as having a good solution. Not to put doctors on too much of a pedestal, but where are you going to find doctors in the US to work 66 hours a week making approximately $140,000/year ($14 x 200 patients/week x 50 weeks) when they have medical school bills of upwards of $300,000 and more importantly malpractice insurance bills that will take the majority of that $140K before they pay their first dollar in taxes.
One of the worst problems we face is that most health care is paid for via mechanisms that transfer insurance risks to health care providers.
Medicare/Medicaid Prospective Payment Systems for physicians, hospitals, nursing homes, home health agencies pay with flat amounts irrespective of actual care costs. Capitation contracts do the same as would episode based care, and bundled services. So do the Diagnosis Related Groups schemes.
I call such transfers "Professional Caregiver Insurance Risk."
The problem is that health providers become their patient's insurers and because they are such small insurers they are extremely inefficient: Much greater variation in costs, lower probabilities of reasonable profits than large insurers would be if they simply retained the risks.
Risk assuming health care providers als are more likely to sustain high losses, become insolvent, and must provide far lower benefits; all these being correlates of inefficient insurance operations.
Insurance efficiency is a function of portfolio size. The larger the insurer, the more efficient it becomes unless it is being mismanaged.
Inefficient insurers must cut patient benefits: Delaying and denying care, to compensate for their low probabilities of profitability, their exposure to high losses, and their need to be sure they will be able to continue to provide services for which they have been paid in advance.
Check out http:..www,afn,org.~mathstat and www,afn,org.~sfcommed
This topic is very misleading because it states that all the 100k patients were willfully exposed to deadly infections and that if these people just avoided going to the hospital they would be living. Please do propagate this myth so that we do not have so many people abusing overusing the er and health care professionals.
Obviously, the insurance debate will continue to be the bain of our existance. As someone who spent 17 years with medical device companies, I can tell you that you can go to the hospital and have the best care and still end up acquiring a nosocomial infection, most commonly Staph. There is so much free-floating, harmful bacteria, and unfortunately, these bacteria have become resistant to the disinfectants hospitals use to clean. The simple truth is that if you kill bacteria you make it stronger. There is a way, though, for every single person to take matters into their own hands and to avoid ever having the hospital make you sicker than you are. PIP (www.pipcleaners.com) probiotic products uniquely address the source of harmful bacteria by removing biofilm, the key ingredient necessary for harmful bacteria to thrive. With PIP probiotic technology, you can create an enduringly healthy, clean environment without every killing any bacteria – the good, probiotic guys actually stand guard to serve and protect. These products are available on the PIP website and will be in hospital and airport retail kiosks by the end of 2012. Join the probitioic revolution and stop bacteria from making you defenseless!
Irshad: The BBC reports that an ISREALI haeckr has hacked and released the credit card detials of hundreds of SAUDIS (Arabs). PLEASE NOTE: This was not done by an Iranian. I know something about computer security and this stuff is trivial. Compromise of thousands, even millions of credit cards, happens all the time. Experts say the attacks draw attention to the potential for virtual or cyber wars in the Middle East. These experts are idiots. This sort of thing goes on all the time in haeckr circles. The only distinguishing features of these two incidents is that it was done by haeckrs who are motivated by political disagreements rather than lulz (laughs). It\'s essentially no different than the attacks on U.S. police departments by the Anonymous haeckr group.In no way does this stuff amount to cyberwar , which is a term many computer experts such as Bruce Schneier believe is way over-used to discuss what is essentially cyber-crime or at worst cyber-espionage. Newspaper reports suggest OxOmer is an Israeli soldier serving in Military Intelligence. Quite possible. Or he could just be some Israeli civilian haeckr. Israel has plenty of them. At the weekend, Israeli Deputy Foreign Minister Danny Ayalon described the cyber attacks as terrorism and warned that Israel would “retaliate forcefully”. He later found his own website had been attacked. He\'s as stupid as the U.S. military that wants to respond militarily to hacking incidents. They have also shown the potential for politically motivated cyber attacks to escalate in the region with Arab and Israeli haeckrs warning of possible future action. Essentially little different from the same sort of conflicts between U.S. and Chinese haeckrs, or between the Anonymous haeckr group and other factions of haeckrs.
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The Global Public Square is where you can make sense of the world every day with insights and explanations from CNN's Fareed Zakaria, leading journalists at CNN, and other international thinkers. Join GPS editor Jason Miks and get informed about global issues, exposed to unique stories, and engaged with diverse and original perspectives.
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Check out all of Fareed's Washington Post columns here:
Obama as a foreign policy president?
Why Snowden should stand trial in U.S.
Hillary Clinton's truly hard choice
China's trapped transition
Obama should rethink Syria strategy
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