The good folks at Georgetown University Hospital sent me a document the other day informing me of the charges incurred for a recent major operation. It was a long procedure, mind you, but in a country where it costs an average of $16,000 to deliver a baby, would it really come as a surprise that the total cost for the surgery and one-week stay came to $83,000? Hell, I’m not sure I’m worth half that.
My part of the bill, thanks to the insurance I get through work, was only $500 and even that was covered by my flexible spending account. I cannot even imagine what the uninsured go through. Anyway, in order to make my claim, Georgetown had to provide me an itemized, highly detailed account of how we got to $83,000.
Turns out my semi-private room was $2,900 a day. Just the bed. I started thinking. If I need to go through this sort of thing again maybe I can make a deal with the hospital. After I wake up in the recovery room, they can tell me how it all went and then call a car service and send me directly to the penthouse suite at the Ritz-Carlton in Pentagon City. I’ll do green Jell-O for the first three days then switch over to the buttered lobster.
By the way, a hilarious thing happens when you google “hotel rooms for $2,900.” You get dozens and dozens of hits for the following headline:
Justin Bieber & Selena Gomez Share $2,900 A Night Suite In Brazil.
That’s right, a penthouse suite at the Copacabana Palace in Rio de Janeiro, Brazil costs two celebrities as much as one night’s stay in an American hospital.
Then there were the sponges. I saw three of them used for the procedure and each one cost $75. Again, here is another opportunity I can have to make a deal with the hospital. The night before the surgery, I will, personally, go to the local CVS and buy 6 sponges for $4.99. As I hand them to the surgeon the next day (still wrapped, of course) I will explain that these sponges have the very same sponge-like qualities as his special sponges. They absorb stuff.
Just for the record, I have absolutely nothing against Georgetown Hospital; to the contrary, I see them as a magic, healing collection of wise and skilled shaman who happened to save my life and hundreds of other lives every week. But it does seem to be a strange and arbitrary health care system we have where one hospital charges $5000 for a CT-scan and another will charge $8000. Where lying prone in a bed automatically costs you the equivalent of a penthouse suite and where sponges sell for $75. It’s the business side of the health care system and it’s kind of shocking, should you ever have the chance of seeing it.
Here’s to you not having that opportunity anytime soon 🙂
Intertrade had rejection of the individual mandate of the health care law a 70% certainty. Most people had followed CNN’s Jeffrey Toobin’s take on the arguments that seemed to have gone so terribly wrong for the White House back in March. And they were all wrong.
President Obama has Chief Justice John Roberts to thank for saving the Affordable Care Act. Astoundingly, Roberts, who has voted 90% of the time with the other four Republican appointees, joined the court’s four liberal justices.
What many apparently discounted, was the extent that Roberts cares about political appearances. It took some intellectual gymnastics, but, in the end, it seems the Chief Justice wanted, at all costs, to preserve the integrity of the court against perceptions it had become a blatantly political body. Or, in the true meaning of the word “conservative,” he’s the kind of judge who believes it should be very difficult to alter existing law. Or both.
The gymnastics involved was the majority of the court labeling the “fee” that would be imposed on Americans who do not get health insurance a “tax,” a word that was never actually written in the legislation and a characterization which the President vehemently denied. But basically the court’s majority was saying, if the politicians were obviously afraid to call a tax what it really is- as NPR’s Nina Totenberg put it in her analysis of the court’s action, regardless, “If it looks like a tax and acts like tax, it’s a tax.”
And that’s key because there were five justices, including Roberts, who were of the opinion that a universally charged “fee” would have been a violation of the commerce clause of the constitution; they would argue you can’t force people from all 50 different states to pay a fee if they don’t get insurance. But a tax is different. The notion that the Federal government has the right to levy a tax has long been established.
The other part of the gymnastics that seems pretty conflicted is that there’s a law Congress passed that says courts don’t rule on the constitutionality of taxes until they are actually levied and this part of the health care law has not gone into effect yet. In this aspect of the case though, Roberts deferred to Congress’ assertion in the law that it is a fee, they instituted, not a tax. To justify this decision, Roberts had to kind of have it both ways.
So where to now? President Obama gets to explain to the American public what it is that the high court saved today- because his previous communication efforts with the nation in regard to the benefits of the health care law have been widely regarded as abysmal.
And, of course, what many have called his singular accomplishment as President remains intact. Mitt Romney said earlier in the week that rejection of the health care law by the high court would have meant Obama had wasted his first three years in office. That one’s out the window.
But Republicans will likely be all fired up by what they see as a slap in the face by the court. There will be symbolic but ineffective efforts in the House to repeal the law (the Democratic-controlled Senate will never go along). Mitt Romney will make it a mantra in every speech from now until November. Republicans will now be able to use “tax increase” against the President, and overall, it seems the court’s decision will further the stark nature of the choices voters face in November- namely- the role of government in our lives.
Finally, there was a lot of ridiculous speculation and forecasting about how this ruling would go. And you know which one ended up being 100% accurate? There’s a company that makes a business out of analyzing facial expressions. According to their analysis of the way the justices reacted on the bench during the arguments- there were five justices who smiled the most. The four liberals and Chief Justice John Roberts.
For whatever reasons he took the path he did, it would appear it is John Roberts who gets the last laugh.
I distinctly recall the attempts to make Ronald Reagan into some kind of dangerous, evil figure. He was an out-of-control cowboy. A B-movie actor whose claim to fame was making a film called Bedtime for Bonzo. He was an intellectual lightweight. Except that in the Presidential debates and in his news conferences, he actually looked rather affable, optimistic, and while no policy genius, certainly in command enough of his facts. His presence, his charm, his sheer skills as a politician, belied the epithets. He ousted an incumbent President then racked up one of the largest electoral majorities in American history when he ran for re-election.
The tirades against George W. Bush were truly venomous. He was a murderer, a buffoon, a fascist. And a two-term President. So was Bill Clinton who took more slings and arrows than George Custer. In the 2008 Presidential campaign, when his opponents tried to paint Barack Obama as a socialist and a possibly non-American interloper, just as in the Reagan example, his non-threatening demeanor just didn’t jive with the extreme rhetoric. All these four guys did was win election after election because no one could possibly live down to the nasty caricatures made of them.
A similar fate may well await the American public’s initial perception of the health care reform bill. “Armageddon,” was the phrase some Republican lawmakers were using after passage. Last time I checked- that’s a reference to the end of the world. Then there were the death panels; images conjured of faceless bureaucrats deciding to kill off Grandma in favor of saving younger lives.
Well, a health care reform bill has passed and there is a high probability it will not be the end of the world. Six months from now, Grandma will not have gone before even one death panel.
I’m not saying the bill’s perfect, effective, or the right or wrong thing to do; in fact, there are both liberals and conservatives who think the legislation is deeply flawed- that it goes too far or not far enough. To be honest, I don’t know what the hell is in it besides tax breaks for small business, tax hikes for those making over 200K a year, keeping your kid on your insurance until they’re 26, banning denial of coverage for children with pre-existing conditions and making all Americans get health insurance or face the equivalent of fines.
But it’s not the end of the world. Life will go on. You’ll get your mail. You’ll watch TV. You’ll go out with your friends and go to your neighbor’s barbeques. Some people may begin to wonder what all the fuss was about. That wouldn’t be because it’s a good bill necessarily. It would be because in the game of setting expectations, health care reform was demonized beyond all reasonable proportion and didn’t actually turn out to be the end of the Republic.
News from the U.S. Senate last night is that there will be no public option of any kind in the health care reform bill, not even the compromise Medicare-buy-in at age 55. It is, apparently, the only way to get the 60 votes necessary for passage, including that of Independent Connecticut Senator, Joe Lieberman. As I look into my clouded but still discernible crystal ball, I see the following wire service report on the final vote a couple of weeks from now:
Senate Passes Historic Health Reform Bill
By Scoop McNews
Associated Syndicate Writer
WASHINGTON (AS) – Taking an important step toward Congressional passage of a landmark health care reform bill, the U.S. Senate voted 60 to 40 late last night to approve a series of controversial amendments to give Democrats and the White House a victory in what has been a tortured path toward final passage, featuring numerous last-minute compromises.
The measure contains a provision that would declare December 25th, National Insurance Company Appreciation Day, garnishes wages to create a special fund to assist the beleaguered insurance industry, and allows insurance companies to raise premiums up to 35% during all months that end with an “R.” The bill also creates a national ambulance service under a new Department of Emergency Vehicles, with fleets of fuel-efficient hybrid cars specifically designated to transport poor Americans to hospital emergency rooms for all illnesses, ranging from common colds to heart attacks.
Senate Majority Leader, Harry Schreid, (D, Nevada) hailed the compromises as difficult but necessary steps to ensure a bill would be on the President’s desk by New Year’s Day. “It’s really not that important what the bill actually contains,” said Schreid at an early morning Capitol Hill news conference. “What matters is what the bill is called and it is clearly labeled in great big letters, ‘The Health Reform Act of 2009.”
Senator Joseph Schlieberman (I, Connecticut), the key and 60th vote for the historic legislation, proclaimed that he was “somewhat pleased,” at the final outcome. “I would like to have seen some additional measures to assist the downtrodden insurance companies of my state, but in the end, in the interests of both this historic legislation and my legacy as the single most important member of the world’s greatest deliberative body, I felt it important to give a little for the sake of compromise.”
Pressed by reporters on what elements of the bill he was unhappy with, Schlieberman would not be specific. “Look, what I think of when I go to bed at night, is the poor insurance company executive, holed up in his lonely estate in suburban Hartford, who himself cannot get a good night’s sleep, worried that he will not meet stockholder expectations of 200% annual profits. No American should go to bed worried at night,” said the Connecticut lawmaker.
Asked what possible chance there might be that the House would approve the Senate version of the bill, Schlieberman was optimistic. “This will be hammered out behind closed doors in the Conference Committee and I have been assured I will be able to remain in the spotlight by snagging a spot on that committee, giving me and my state unprecedented influence in whatever machinations and late night, last-second further compromises will be necessary to pass this important piece of legislation.”
The news conference was interrupted momentarily when Senator Russ Schfeingold, (D, Wisconsin) lunged at Senator Schlieberman with a scalpel, yelling, “Here’s a special medical device, just for you, Schlieberman!” U.S. Capitol Police stopped the scuffle before there were any injuries that would have caused any medical claims to be filed under the Congressional health insurance program that was amended last night to eliminate all co-pays and deductibles.
Robert Garcia tweets at garciamedialife