Stay Healthy, My Friend

 The other day I was with a good friend when me to look at a medical bill he had received. He had studied it for days, but still couldn’t figure it out.

“Okay,” I said. “Let’s have a look.”

He handed me a bill from a billing company for a local hospital. The only entry on it was that he owed $170 for a visit to the emergency room. I knew that his son had insisted on taking him there after a scratch on his arm from his dog’s claws would not quit bleeding. At the Emergency Room, they bandaged the arm, gave him a Tetanus shot, and sent him home. The whole visit took about two hours with the actual procedure taking a mere 20 minutes. “Looks about right,” I said. “A hundred-seventy bucks isn’t all that bad for an Emergency Room visit.”

“Look at this.” He said handing me a statement from Medicare.

It turns out the visit had actually cost $2700! Only his share of the bill was $170. A further study of the Medicare statement revealed that Medicare actually only paid $90 of the hospital bill. Who paid the difference?

I’m no CPA, but even I could see something didn’t make sense here. We decided to call the hospital billing company and ask for a detailed statement to see who paid the difference.

“ We don’t have a detailed statement to send.” I was told. Well, we chased our tails for several turns while the person at the billing office kept repeating the same thing.

“You are telling me that the hospital charged my friend $2700 for the ER visit, Medicare paid $90 and you billed my friend for $170.”

“That’s right.”

“Well this must have something to do with the new math because my figures show about $2440 floating around somewhere that still remains to be paid.” I said.

For the third time she said, “There was an adjustment.”

This time it dawned on me what she meant. “Do you mean the hospital ate the difference?”

“Yes.” She said in relief. “The hospital has a contract with Medicare that allows them to make an adjustment.”

I told my friend, and he still didn’t understand. “What was the two-thousand dollars for?”

I looked at the Medicare statement again. They had charged $1073 for bandaging the arm (actually applying one large bandage), $1136 for just putting his nose through the Emergency Room door,  $197 for a Tetanus vaccine, and $300 just to “administer” the shot.

It looks to me like the government tells hospitals they can charge whatever they like for services but will only receive a set amount from Medicare. That’s great! But if the original charges are valid, how can the hospital afford to eat $2440 in this case? And what do they do with other Medicare cases?

Questions? Yeah, I still have a few. Like is it valid to charge a thousand dollars for a band-aid? Why does it cost $300 just to give a shot, when they give them free at most pharmacies? Then why does it cost $1000 just to set foot in the Emergency room?

Well folks, here’s the bottom-line. If you don’t have Medicare or health care insurance, you are paying for the hospital to eat the difference on every visit of this nature. If you are fortunate enough to actually have healthcare insurance, you are still paying with your inflated premiums.

Oh, but you have Obama care? Well check out your premiums and compare them to those who are paying little or no premiums. Yep, you are making up the difference.

Is there a reason health care has to be so expensive? That is the question we should be asking. Not who will pay for health care.

Working the Con

There are famous con men, people who swindle for a living. Frank Abagnale kited some 2.5 million dollars worth of bad checks while posing as an airline pilot, doctor, and eventually a lawyer and a teacher. Abagnale’s life story was made into the movie Catch Me If You Can. Then there is the infamous Charles Ponzi – the one they named the Pyramid Scheme after. One modern day practitioner of this scheme was Bernie Madoff, the ex-NASDAQ chief who bilked investors out of an estimated 68 billion dollars.

You might recall the movie The Sting where con men were portrayed as heroes who bilked the mob out of a pile of money. That may make for a great Hollywood story. In real life, though, these people are merely thieves who pull the wool over the eyes of trusting and unsuspecting individuals. Although many people admire the way these con men gain the trust of their victims, the practice is in fact a despicable and highly illegal practice that leaves the victims with a traumatic sense of being violated.

Now comes Professor Jonathan Gruber, who, along with his accomplices Nancy Pelosi and Barrack Obama, may have pulled the greatest con in America’s history.

Let’s examine Gruber. He is currently a professor of economics at the Massachusetts Institute of Technology, where he has taught since 1992. He is also the director of the Health Care Program at the National Bureau of Economic Research, where he is a research associate. An associate editor of the Journal of Public Economics and the Journal of Health Economics, Gruber has been heavily involved in crafting public health policy, including the Massachusetts healthcare policy aka. “Romneycare.”

Why is Gruber important? Well, it turns out the good professor helped write and promote the 905-page Affordable Care Act, also known as Obamacare that President Obama signed into Law in 2010.

Yes 905 pages of “tortured language” that very few in Congress bothered to read, let alone understood. The then Speaker of the House, Nancy Pelosi, stood at the podium of the House and told Congress they will have to “pass the bill to find out what’s in it.”

Well we did find out – the hard way. As the newly minted law began to be implemented, the American public found out they had been scammed. “If you like your doctor, you can keep it -- if you like your healthcare plan you can keep it” soon became the lie Obama could not overcome or explain away. As insurance premiums began to grow and the official Web Site rollout proved to be a disaster, Americans started to wonder just what the government had gotten us into.

Well we found out what those 905 pages were all about when the well-paid consultant, Gruber, appeared on television and explained that the bill was intentionally written in a way to deceive the “stupid voters.” Even more significant was the revelation that the law was written to avoid the appearance of it being a tax – one of the first controversial points that went before the Supreme Court.

Of course, the White House and Nancy Pelosi denied even knowing Jonathan Gruber. Another co-conspirator HHS secretary, Kathleen Sebelius denied knowing the professor, even though they both sat on the same committee, and she signed his paycheck for several hundred thousand dollars.

Deception upon deception, this fraud was foisted upon the American public – many of whom bought into it in good faith – just to learn that it was a scam promoted by unrepentant con men, including the Speaker of the House and President of the United States.

Do you feel violated and taken advantage of? I do. But then again, I never believed any of Obama’s lies. This bill passed without a single Republican vote and was signed into law by a Democratic President. Since the Republicans gained control of the House, they have tried some 40 times to repeal this fraudulent law only to be thwarted by Democrats in the Senate. It’s apparent that it will take a Republican controlled Congress and Republican President to set the Affordable Care Act right. Until then folks, you will just have to put up with being taken for a ride by the Democrats, and being the victim of the Great American con called Obamacare.