The True Cost of a Flawed Health Care Paradigm
October 05, 2013
By Dr. Mercola
Americans spend twice as much on health care per capita than any other country in the world; in fact, according to a series of studies by the consulting firm McKinsey & Co, the US spends more on health care than the next 10 biggest spenders combined: Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain, and Australia.
Other astounding statistics include:
- The US spends more than 17 percent of our gross domestic product (GDP) on healthcare1
- If the US health care system was a country, it would be the 6th largest economy on the entire planet2
- While the US makes up only five percent of the world's population, Americans consume over 50 percent of all the world's pharmaceutical drugs
- Overall, Americans also pay 50 percent more than other countries for identical drugs, as a result of laws and regulations preventing the US government from reining in drug prices like other nations do
Despite all of this spending and pill-popping, the US ranks dead last in terms of quality of care among industrialized countries, and Americans are far sicker and live shorter lives than people in other nations. Clearly, we have taken a wrong turn down the wrong road somewhere...
The US Health Care System Is Fundamentally Flawed
A review of US healthcare expenses by the Institutes of Medicine3 (IOM) revealed that 30 cents of every dollar spent on medical care is wasted, adding up to $750 billion annually. For perspective, the defense budget proposed by the Pentagon for 2014 was just under $527 billion.4
The IOM report identifies six major areas of medical waste: Unnecessary services; inefficient delivery of care; excess administrative costs; inflated prices; prevention failures; and fraud. Also, as stated in the featured Time Magazine article5:
"A central reason U.S. health care spending is so high is that hospitals and doctors charge more for their services and there's little transparency about why.
There is no uniformity to the system, in which public and private insurers have separate, unrelated contracts with hospitals and doctors. The result is a tangled, confusing and largely secretive collection of forces driving health care prices higher and higher.
This isn't possible in many other countries either because governments set prices for health care services or broker negotiations between coalitions of insurers and providers."
The True Cost of Health Care
The documentary film The True Cost of Health Care6 by Dr. David Belk, MD (featured above) also reveals a number of shocking details that help explain the exorbitant cost of American health care. For example:
- Generic medications can cost 100 times less than their brand-name equivalent, and usually cost less than most insurance co-pays. This means you might actually pay LESS by purchasing a generic medication out of pocket, compared to using your insurance if you have a co-pay. In essence, going through your insurance amounts to paying extra for the privilege of being overcharged...
- Hospitals routinely bill 10 or more times what they expect to be paid for any given service. As I discussed in a previous article, most hospitals end up receiving just 35 percent of what they bill, yet they still manage to make tens of millions of dollars in operating profits each year. Some hospitals, including Sloan-Kettering and MD Anderson, who are tougher in their negotiations with insurance companies, end up getting around 50 percent of their total billings.
- Most diagnostic tests and procedures are inexpensive to perform. However, the charges for these tests and procedures typically have no relation to the actual cost. Each hospital has an internal price list called a chargemaster, which contains every single item you may be given or come in contact with during your hospital stay. The problem is, no one quite knows how the prices in the chargemaster are created. What is clear is that there's absolutely no market feedback to regulate and control the prices that are charged.
- Health insurance companies deliberately manipulate these costs to maintain their profits. As explained by TheTrueCostofHealthCare.org:7 "Health insurance companies can manipulate a patient's out of pocket payments to make it appear as though health care is more expensive than it really is. Insurance companies sell security against financial risk. If no one really understands what that risk is (because all prices are hidden or deceptive) then the price of the security (insurance) can be grossly inflated."
The Chargemaster: What You Need to Know if You Want to Avoid Medical Bankruptcy
Each hospital has an internal price list called a chargemaster, which contains every single item you may be given or come in contact with during your hospital stay. That includes the little white paper cup you get your medicine in, every box of tissue and band-aid, even a toy to a child (which many mistake as a "gift") can be billed at upwards of $200. The problem is, no one quite knows how the prices in the chargemaster are created. What's worse, there seems to be no real rationale or process behind this important document. As journalist and author Steven Brill has stated:8
"That so few consumers seem to be aware of the chargemaster demonstrates how well the health care industry has steered the debate from why bills are so high to who should pay them... [T]he drag on our overall economy that comes with taxpayers, employers and consumers spending so much more than is spent in any other country for the same product is unsustainable. Health care is eating away at our economy and our treasury."
There is no real marketplace as such, as you the buyer is completely separated from the seller. There's absolutely no market feedback to regulate and control the prices that are charged. For the most part, the hospitals charge as much as they want, which plays a large role on why these charges have gotten so outrageously out of control. This simply doesn't happen in countries outside of the US.
In response, a small grassroots-type industry has emerged as a result of shell-shocked patients reaching out for help to understand their medical bills. Referring to themselves as medical-billing advocates, they help you not only read and understand the content of your bills, but also negotiate with the hospital to reduce the charges. The problem with that, of course, is: what about the people who don't realize they CAN bargain with a major hospital? And should we really accept "bills of fiction" to begin with?
Even with the help of a medical-billing advocate (who of course charges a fee for the service), many uninsured patients still overpay. After all, getting a 50 percent discount on a test billed at $200, which should cost $15 is not necessarily a great bargain, although it's certainly an improvement if we only take fictional numbers into account. The sad thing is, as mentioned earlier, the overcharges are SO grossly inflated that even if you get the bill cut in half, the hospital still makes out like a bandit!
Conventional Medicine Is Actually One of Your Greatest Health Risks...
There's no shortage of evidence that the US health care system is in need of urgent transformation. Over a decade ago, Professor Bruce Pomerance of the University of Toronto concluded that properly prescribed and correctly taken pharmaceutical drugs were the fourth leading cause of death in the US!
In 2000, the Institutes of Medicine reported that medical errors were the eighth leading cause of death in the US, killing between 44,000 and 98,000 people each year. This was followed by a 2003 article aptly titled "Death by Medicine", authored in two parts by Carolyn Dean, MD, ND, which described in excruciating detail how the modern conventional American medical system has bumbled its way into becoming the leading cause of death and injury in the United States, claiming the lives of nearly 784,000 people annually!
These iatrogenic deaths (meaning deaths resulting from the activity of physicians) include everything from adverse drug reactions to medical errors, to hospital-acquired infections and surgeries gone bad—including 37,000 deaths from unnecessary medical procedures. The authors took statistics straight from the most respected medical and scientific journals and investigative reports by the Institutes of Medicine (IOM), showing that on the whole, American medicine is causing more harm than good. In 2010, two additional reports published in New England Journal of Medicine9 and the Journal of General Internal Medicine10 respectively, showed just how little things have changed since 2003. For example:
- Out of 62 million death certificates dated between 1976-2006, almost a quarter-million deaths were coded as having occurred in a hospital setting due to medication errors.11
- An estimated 450,000 preventable medication-related adverse events occur in the US every year.
- The costs of adverse drug reactions12 to society are more than $136 billion annually -- greater than the total cost of cardiovascular or diabetic care.
Taking Control of Your Health Is Part of the Solution
Hundreds of thousands are killed by medical care itself, while others are walking around with far less than stellar health due to conventional treatments. Rates of chronic diseases are through the roof, and we're facing epidemics of obesity, heart disease, diabetes, depression and too many others to list. As a whole, Americans are not healthy – they're tired, depressed, stressed out and often in pain.
Out of sheer desperation, many people have taken their health into their own hands by abandoning this fatally flawed medical model and embracing holistic modalities that can help heal on a body-wide level. It is through their many success stories that we can discern a clear way out of this flawed and outright deadly paradigm.
The more you take responsibility for your own health – in the form of nurturing your body to prevent disease – the less you need to rely on the "disease care" that passes for health care in the United States. In the majority of cases, you'll likely find that you can prevent or resolve common health conditions by following these basic tenets of optimal health:
- Eat a healthy diet focused on fresh, whole foods (ideally organic and/or locally grown). Try to eat a large portion of your food raw. You want to pay careful attention to keeping your insulin levels down, which means avoiding sugars and grains of all kinds, and replacing the lost carbs with healthful fats. Also be mindful of your protein sources, making sure they're of high quality (ideally organically-raised and pasture-fed). A high fat, moderate protein, low carb diet is likely to improve the health of most people. My optimized Nutritional Plan can guide you, whether you're at a beginner's or advanced level.
- Consume healthy fat. The science is loud and clear on this point: omega-3 fats are essential for optimal health. Unfortunately, most fish commercially available today are polluted with mercury, PCBs and other toxic substances, which is why I recommend you take a supplement like krill oil instead of getting it from your food. Other healthy fats include coconut oil, avocados, olives, olive oil, butter and macadamia nuts. All these fats are low in protein and carbs and will not impair insulin, leptin or mTOR.
- Make clean, pure water your primary beverage, and steer clear of all sweetened and/or flavored beverages, including those that contain artificial sweeteners.
- Manage your stress.
- Exercise regularly. Ideally, you want a comprehensive fitness regimen that includes stretching, high intensity interval training, core strengthening exercises and strength training.
- Get plenty of appropriate sun exposure to optimize your vitamin D levels naturally. UV exposure also has additional health benefits beyond vitamin D production. A robust and growing body of research clearly shows that vitamin D is absolutely critical for your health. The D*Action project has been initiated by GrassrootsHealth along with 42 leading vitamin D researchers to demonstrate how health can be achieved right now with what's known about vitamin D with a combination of vitamin D measurement and health outcome tracking. To learn more, please see this recent article.
I encourage you to participate in the D*Action Project, which has multiple concurrent vitamin D programs going on. Not only will you be able to take control of your own health by participating, you'll also become part of one of the most profound public health projects of the 21st Century. To participate, simply purchase the D*Action Measurement Kit and follow the registration instructions included.
As a participant, you agree to test your vitamin D levels twice a year during a five year program, and share your health status to demonstrate the public health impact of this nutrient. There is a $65 fee each 6 months for your sponsorship of the project, which includes a test kit to be used at home, and electronic reports on your ongoing progress. You will get a follow up email every six months reminding you "it's time for your next test and health survey."
- Limit your exposure to toxins of all kinds. The number of toxic chemicals and their sources is so large, addressing them all could easily require an entire library, but I believe you can help you keep your toxic load as low as possible by becoming an informed and vigilant consumer. This includes tossing out your toxic household cleaners, soaps, personal hygiene products, air fresheners, bug sprays, lawn pesticides, and insecticides, just to name a few, and replacing them with non-toxic alternatives.
- Get plenty of quality sleep. Scientists have discovered that your circadian rhythms regulate the energy levels in your cells. In addition, the proteins involved with your circadian rhythm and metabolism are intrinsically linked and dependent upon each other. Therefore, when your circadian rhythm is disrupted, it can have a profound influence on your physical health. For example, research has also linked disrupted sleep cycles to serious health problems like depression, coronary heart diseases, and even cancer. If you have any kind of sleep problem, whether you're having trouble falling asleep or staying asleep, my article 33 Secrets to a Good Night's Sleep is packed with great tips to help you finally get some good rest.
8 Things Your Grandparents Did That Could Save Your Life
For even more inspiration and guidance, check out the following eight "forgotten wisdoms" your grandparents adhered to that could quite literally save your life. To learn more, please follow the hyperlinks provided:
In the event you do need medical care, seek out a health care practitioner who will help you move toward complete wellness by helping you discover and understand the hidden causes of your health challenges, and create a customized and comprehensive – i.e. holistic – treatment plan for you.
What's more, you can have a positive influence on your doctor's tendency to recommend natural alternatives, as when you inquire about them, some health care providers do in fact listen and do the research. Remember, when you do go to the doctor, know that it's OK to ask questions and opt for less medical intervention while choosing a more natural way of healing your body. If your physician is not open to such options, it may be time to find one who is, who can help coach you and your family to take control of your health.