Signs of Life at P-G: Sabatini, Mauriello, Norman (!)
Today, I'll focus on two Sunday articles -- one by Tracie Mauriello on excessive spending by PA state legislators ("Legislators' spending include $7,932 for nuts"), one by Patricia Sabatini on the absence of "transparency," information about prices and service quality, in health care ("Pricing a colonoscopy? We Tried; it isn't easy").
Regular readers of this blog will see that these are two of my favorite subjects, the corruption of elected officials and the out-of-control costs of health care. Also, Mauriello and Sabatini are doing exactly what a newspaper should: providing useful information about subjects of great significance to readers.
Before he or she writes on a subject, any good journalist should be asking: Why is this of interest to readers? Even beyond that, how is this article (or column) going to save the readers money or improve their quality of life? One reason the Mauriello and Sabatini articles are so compelling is that the women can provide very good answers to the questions I raise.
Do most Pennsylvanians know there's a good deal of cynicism and corruption in Harrisburg? Yes. Do most Pennsylvanian know there's a big problem with the cost and availability of health care. Yes. However, most Pennsylvanians presume that they're powerless to do much about the issues. Typical articles in the P-G and other outlets don't do much to convince readers that such problems are fixable -- at least in our lifetimes.
I fear most people in the Keystone state don't know what PA legislators make as salaries -- and I'm one of those ignorant of the exact figure. We don't know how much they make in travel expenses, and, more significantly, how much they're overcharging for them.
Also, we don't know how much their per diems (expenses for days spent in Harrisburg) are, although we get that figure in Mauriello's piece (ranging from $126 to $152 a day). We don't know how much double-dipping there is on meal expenses -- in cases where the meals get paid for by someone else, but the legislator still pockets the personal expense money. Finally, we don't know how much they'll get in pensions or life-time health insurance.
Mauriello answers some of these questions. The suggestion is she's onto something and will provide other answers in the days ahead. The lead in her piece reads: "Democratic House Majority Bill DeWeese paid a part-time chauffeur to drive him around his Greene County district at a cost of $32,000, not including an estimated $20,000 in mileage, which he recouped separately."
Shameful, but probably normative. In my next column, I'll discuss Mauriello's article at length. Overall, it's superb.
In the case of Sabatini, her article begins with these words: "Imagine buying a house without any idea how much it costs until after the closing. Or buying a new SUV not knowing what or how many monthly payment you owe -- until you get the bill." Her point is that those scenarios reflect the way most of us "consume" health care.
Sabatini adds, "It may sound crazy, but that's how it is when it comes to health-care services. Need a cholesterol test, chest X-ray, or your gall bladder removed? Chances are, you won't know how much the procedure costs until after it has been performed."
The article points out that doctors -- she cites some unnamed pediatricians -- and hospitals give information about prices and medical treatment grudgingly, if at all. If you don't know what you're getting or how much it costs, you as a consumer are at a real disadvantage.
The are some great physicians and hospitals that provide excellent service at reasonable costs, but good luck if you can find out who they are. In my columns, I've pointed to five doctors (Chiesa, McFarland, Osten, Craig, and Karp) who provide superb, patient-centered care, but 99.99% of people in the area have never heard of them.
I've also pointed to some terrible care my wife received in St. Clair Emergency, allowing her to suffer for many weeks with severe gall bladder pain. I've pointed to a $20,000-plus bill my brother received at UPMC for some basic tests related to "syncope" (a feeling of faintness and temporary low blood pressure). But aside from a few readers of this blog, who knows about such things?
The pharmaceutical industry offers free drugs (branded variety only) to people with very low-incomes, one of whom was my brother. The industry insists on sending such freebies to physicians or other health care centers, presumably because it doesn't trust sending them directly to patients.
One doctor in Carnegie LOST three such prescriptions, 90-day supplies of each. At retail, which was the only other way we could have obtained them, the cost for such medicines was about $1,000. I believe the doctor, a wealthy one but with a very limited staff, lost the meds because he received no payment for handling them.
That is very poor care, but who know about it?
The five wonderful doctors I've talked about, including Nicollete Chiesa and Kathleen Osten, probably make about the same amount of money -- maybe less -- than the mediocre physicians. The doctor who lost the three prescription (and failed for years to diagnose my adult onset diabetes) probably thinks the current situation is just fine.
Sabatini suggests that transparency -- information -- about health care is growing in importance. I've said that without a great deal of information there's no way to solve the health care "crisis." If people don't know what they 're paying for, then it doesn't matter whether we have the Rendell Plan or the Hillary Clinton Plan. None of them will make much difference.
However, if it's as hard as Sabatini indicates for a daily newpaper to get information, how much more difficult is for the average Joe or Jill?
Some states (New Hampshire being a leader) and insurance companies (especially Aetna) are providing more pricing information. Sabatini says, "Some [New Hampshire] providers who viewed the state [listing of prices] prototype were shocked at how expensive their prices were compared to the rest of the pack . . . ." One assume their patients might have endured even greater shock.
As I've been saying for months, if people don't know they're being overcharged, they can't exactly make wise decisions. Much of what I've written has been about my own experience comparing drug prices -- and how that's helped me and my family save thousands of dollars annually.
I've mentioned how I switched from one diabetes med (Avandia) that costs $160-plus per month at CVS to another drug (Metformin) that Wal-Mart sells for $4.00 per month.
In the past weeks, I ordered a three-months supply of 10 mg. generic Hytrin (Terazosin), a prostate drug, at Wal-Mart for $12.00. Because Wal-Mart didn't have enough in stock, it sent me the supply by mail a week later.
In the meantime, I got a one-month prescription for FIVE mg, Terazosin refilled at CVS. It cost me $6.00 in out-of-pocket costs (co-payment), plus $8.92 paid by my Medicare Plan D health insurance.
You're reading right: The overall cost of a THREE month supply of larger dosage cost less a ONE month, lower dosage supply at CVS (8th and Market in Ambridge, PA).
The costs involved don't exactly constitute a fortune. However, mutliply them by thousands of drugs and hundreds of millions of daily drug-consumers, and it adds up to tens of billions of dollars -- in prescription meds alone.
The kinds of homely examples I use should become a staple of newspapers like the P-G. A lot more information is coming out about medical costs, but there's a long way to go.
When someone reads a newspaper, he or she should be able to say that one or more articles saved him or her a lot of money. Sabatini is more than half way there with her piece, and she should take a bow. So should Tracie Mauriello, as I'll discuss soon.
Admittedly, some people have stopped reading newspapers or even listening to the news on TV. They believe the "news" confronts them with a multitiude of sad things about which they can do little or nothing. Yet they can do something about corrupt legislators -- find out who they are and vote them out of office.
Also, they can do a lot about high costs for health care and mediocre treatment. They can find the good providers and the best prices and then do their part.
Note: My plans are to analyze Tracie Mauriello's article on Tuesday (Feb. 6) and Tony Norman's column on Thursday. Soon after that, I'll discuss the "Forum" section, which is under a new editor whose early performance suggests he needs a few political and economic reality sessions with people like Mauriello and Sabatini. Future P-G-centric pieces will deal with Bill Toland, a talented journalist but a cynical one, and Jerome Sherman, another talented writer but one too willing to give a free-pass to some seedy Western PA politicians.