How much for an amputation or checkup? It takes a complex formula and a committee of doctors to set the price for every possible health care procedure

  Modern medicine is remarkable.

  Conditions like HIV/AIDS and hepatitis C were once virtual death sentences. Both can now be treated easily and effectively.

  But for Americans, the wonders of modern medicine come at a steep cost: Total U.S. health spending exceeded US$4.1 trillion in 2020, or $12,000 per person. How those trillions of dollars are spent can seem like a mystery.

  The biggest portion of that – hospital care, which makes up 31% of total spending – is now subject to transparency rules that are supposed to make it easier for patients to understand what their treatments cost. But so far hospitals’ compliance has been minimal.

Long wait times in ERs drive up costs, signal health care distress

  Wait times in emergency rooms are so out of control that researchers recently tested whether aromatherapy would make waiting in the ER more tolerable.

  It didn’t.

  Over a decade ago, the Institute of Medicine offered an ominous warning: “Underneath the surface, a national crisis in emergency care has been brewing and is now beginning to come into full view.”

  Now the view is quite clear. ERs are packed and wait times are growing longer each year. In fact, even if you’re having a heart attack, you may have to wait to get to the doctor.

Meaningful protection from surprise medical bills

  Many Americans purchase health insurance under the impression that doing so will protect them from exorbitant, one-time costs associated with medical care. Insured patients pay premiums every month rather than having to worry about paying a large medical expense at once. In some instances, however, insured patients visit their doctors and receive a costly, unexpected bill. This is a consequence of the current structure of health insurance and provider networks, wherein insurers and health care providers negotiate to accept discounted payments as payments in full for services in exchange for sending patients to those providers. When patients visit out-of-network providers—those who haven’t agreed to these discounts—they can lose the benefit of their insurance. The provider may charge them the entire, non-discounted price for a service—and insurance may not cover any of the bill.

‘Feel-good’ holiday stories are actually just a symptom of a crumbling society

  Over the Black Friday weekend, Mother Jones editor-in-chief Clara Jeffery saw a need on the popular education crowdfunding site DonorsChoose, where teachers request financial assistance for classroom supplies. For 22 hours, Jeffery tweeted out fundraiser after fundraiser, until her followers raised $60,000 by responding to the lone Twitter thread. They sent paper and pencils to San Francisco, books to fire evacuees in Chico, an instructor’s computer to a tribal school in South Dakota, warm weather gear to East Flatbush, and much more.

  Throughout the thread, Jeffery expressed frustration that teachers’ needs were so dire. “She [is] asking for pencils and glue sticks,” Jeffery commented on a fundraiser for a low-income San Francisco school. On a request for help buying laundry equipment, she said: “These asks for ways to help kids and their families get and clean clothes are so sad. We need to serious[ly] overhaul our society.”

Crowdfunding is a symptom of America’s sick health care system

  “I nearly went to the hospital for the 22nd time in 7 months. As you can imagine this has depleted all of my money,” writes Tara. She continues: “My family has done so much and will help me once I’m there, but I need to move on my own…So look, I’m a responsible girl, I’ve been holding it down for 16 years while feeling like I could be taken at any time.”

  Tara is running a campaign on the popular crowdfunding site GoFundMe. She has fibromyalgia and a host of complications and needs to relocate to access health care. She started fundraising in March 2017, and a year and a half later, she’s raised less than a quarter of what she needs. She’s not alone. Medical expenses are already the leading crowdfunding cause and donations can’t keep up with demand; a 2017 study showed that 90 percent of medical crowdfunding campaigns failed to reach their goals.

The Great Cost Shift: Why middle-class workers do not feel the health care spending slowdown

  In recent years, the growth in overall health care costs has slowed dramatically. But for millions of Americans with employer-sponsored insurance, or ESI, this slowdown is illusory. From 2008 through 2013, the average annual growth rate of employees’ monthly premium contributions and out-of-pocket expenses, adjusted for inflation, was more than double that of average annual growth in real per-capita national health care spending, which was less than 2 percent per year. This growth has also outpaced employers’ costs of offering these benefits by more than 40 percent.

  Employees experiencing higher health care costs tend to blame the Affordable Care Act, or ACA, even though the law largely leaves the employer-based system alone. In fact, many employers report that the ACA has had only a negligible influence on their health care costs.