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.
I would add that the govermental bodies in and around Illinois are some of the major purchasers of health care, whether it is the Cook County Health Care System and the costs of Stroger Hospital, the Chicago public health system, state Medicaid payments that are a major part of state goverment costs, not to mention all these govermental bodies employ people for which they provide health insurance. All these teachers, fireman, police, and other goverment employees are getting their insurance at this higher rate than surrounding states thus driving up local and state taxes. and think about all thoses incarcerated people in our jails, alot of them with psychiatric and chemical dependence problems. Who do you think pays for that!
So just maybe you have the argument backwards. It is not higher taxes that make health care more expensive; it is higher health care costs that require higher taxes to pay all these inflated health care costs.
Adding injury to insult is the fact we have all these non profit hospitals with supposed missions to care for their communities, but we then have to pay all these taxes to support all these govermental health systems for people that are underserved by the non profits. So we give them tax breaks so they can build shiney new hosptials to attract the paying customers while doing there best to minimise any exposure to charitable care.
This is why frankly I am so diappointed with our profession and it's whining about not making enough money and the fact we as doctors have allowed this to happen. What truely is our mission; profit maximization ro improving the health of the community. Lets try to be more focused.
All those things you speak of (fireman, police, government employees, people with psych and chemical dependence - heck, even doctors - are in those other cities outside Chicago, too, but their costs aren't as high as ours are they? And yet here we are, a full 25% higher.
I think there are individuals on both side of the political aisle who are genuinely interested, like you, at improving the situation for those less fortunate. What differs is philosophy on how to get there and keep it sustainable.
But that is the point! Yes, other areas have these personel, but we have to pay 25% more for their health insurance in the Chicago region. that adds up to some major money for many of these govermental bodies.
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