While is it convenient for journalists and policy pundits to constantly point fingers at doctors who order too many tests as the sole cause of the explosion in health care costs, we must not forget other reasons our health care costs in Chicago might be uniquely situated to assist in that process.
- It is an inconvenient truth that the city of Chicago has the highest total sales tax of all major U.S. cities. It is also one of the most complex. 10.25% is levied on all non-perishable goods purchased, while 2% is levied on qualifying food, drugs, medicines and medical appliances.
- Chicago health care, although principally run by "non-profit" health systems sheltered in many ways from large tax obligations, is still "taxed" through secretly cloaked "hospital assessments" on gross revenues folded into insurance payments made to the hospitals. This asessment was approved recently by none other than the federal government whose commander in chief is serving as the Principle Spokesperson to promote the 2016 Olympic games.
- Chicago has, and continues to have, an almost limitless ability to add billion dollar health care facilities to its metropolis. Construction projects have historically been the thing of big unions, and no one knows big unions like health care. While many of these facilities have been substantally supported through philanthropic doles at their outset, the amount of money required to "keep the lights on" at such huge, expensive facilities mandates that beds be full and admissions processed. Need I say more?
- With the increasing consolidation of health care, especially in the lucrative, higher-income areas of Chicago, the ability of insurers to demand concessions on health care pricing has dwindled. Further, the adoption of the electronic medical record (EMR) has profited health care systems greatly by reducing insurance claim denials and shortening the times accounts are in collections. This leads to more revenue, which in turn, leads to more construction. More contruction leads to more... well, you know.
- And last, but not least, are hospital parking rates. I challenge just about any city in the nation to find rates as high as ours. Oh, and those rates are taxed by the City of Chicago.