The poor pay more
If you want to emphasize this, express the figures as percent of income. For example, if you make $100,000 per year and buy a six-pack for $10, that’s 0.01% of your income. For your neighbor who makes $50,000, the same beer costs 0.02% of his income. Twice as much! Let’s have a government subsidy! Or fine the beer companies.
Some things do cost poor people more in actual dollar cost. Try buying your groceries at the local convenience store rather than Safeway. Or go to the hospital. A study just posted on the Health Affairs blog reports uninsured patients are charged 2.5 to 3 times more than Medicare patients. (Study not available to the public) Is anyone surprised? This points out the increasing differential between hospital charges and what insurance companies pay. The other factor in this equation is collections. Hospitals collect about 40% of charges on uninsured patients, but that still puts them above Medicare reimbursement.
Responses from hospital groups so far consist of whining about all the free care they provide and how tough life is. “We still have more people who can’t pay for the care they need.” Let’s see. Last time I looked, hospitals were non-profit entities. That means they don’t pay taxes, and the idea was that they would spend that money taking care of the poor. Guess they changed their minds.
Did anyone in the hospital industry think about becoming more efficient as a strategy to reducing costs? My recent hospital experiences suggest ample opportunities for a Toyota engineer. But where’s the incentive to become more efficient when they get paid for doing it poorly? Transparency may do this, and hospitals are afraid of any move to measure and publish their costs for a given service. This is one of the reasons they hate ambulatory surgery centers and specialty hospitals.
Maybe the day of the hospital is over. Maybe they are too cumbersome and inefficient to exist in a competitive climate. Maybe we need to wipe the slate and design a new system for providing efficient healthcare. This could probably be done for half the current cost of hospital care.
