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Smart Bombs: Hidden health costs scary

Steven Brill’s in-depth article for Time magazine about why health care prices are so high – particularly for people who are uninsured or underinsured – is like a horror movie. In it, he unearths a dark, mysterious force called the chargemaster that would be right at home in a Stephen King novel. Hospitals use this computerized leviathan to determine the prices for its services and products, but few people can explain the basis for the figures. Suffice it to say that if you don’t have the government or an insurance company negotiating prices for you, the chargemaster becomes more menacing than Cujo.

One of Brill’s examples was an uninsured Stamford, Conn., woman who was feeling chest pains and called an ambulance. After a number of hospital tests, she was diagnosed with indigestion. Then she had to swallow a $21,000 bill.

Medical costs are well-hidden, which is one of the reasons they’re so high. Doctors can’t even tell you how much procedures cost, so Brill’s article was probably eye-opening for them, too. Now they know that Lipitor, a cholesterol pill, is three times more expensive here than in Argentina, and Plavix, a heart medication, is four times more expensive than in Spain. Meanwhile, an MRI scan in the Washington, D.C., area costs anywhere from $400 to $2,183, according to a recent investigation by the Washington Post. In Japan, it’s about $100. In France, it’s $280.

The Post notes that if we had the per-person medical costs of Germany, France or Canada, it would wipe out our budget deficits.

When the prescription drug benefit for Medicare was adopted, some lawmakers wanted the government to bargain for lower prices, which is what Veterans Affairs does to keep prices down. If you want to know why that didn’t occur, look no further than these numbers: From 1998-2012, the pharmaceutical industry, medical products companies and health care providers spent $5.36 billion lobbying Congress. That’s five times more than defense-related industries spent.

It’s investment that pays off handsomely, and ought to make the rest of us scream.

Firepower. The Senate majority caucus in Olympia warned that it was going to focus on jobs, education and the budget, so unrelated measures could fall by the wayside. This was a strong hint that bills related to guns, even highly popular ones, could be killed.

And sure enough, a bill calling for background checks for private guns sales didn’t make it past Wednesday’s midsession cutoff. However, some off-topic bills did pass. Examples are measures that: allow livestock and pet owners to shoot endangered gray wolves without a permit; let students under 21 taste (but not swallow) wine in wine-tasting classes; and prohibit employers from asking workers and job applicants for their social media passwords.

Did these bills have the same level of support as background checks, which are backed by 79 percent of Washingtonians, according to a recent Elway Poll, and 90 percent of Americans, according to recent national polls? It’s doubtful, but neither did they face an opponent as powerful as the gun lobby.

Getting warmer. In arguing against a panel that would advise on the best ways to curb greenhouse gas emissions, Sen. Mike Carrell, R-Lakewood, said proponents were dabbling in “pseudoscience.”

“You’re making an assumption that it is carbon dioxide that’s causing the Earth to warm. It could be the other way around,” he said during a hearing on the bill.

Carrell is suggesting that the planet has been warmed by natural forces, which would unlock the carbon dioxide in the oceans. This isn’t an uncommon assertion for politicians, but Carrell used to teach science. In 2010, the National Academy of Sciences reported that 97 percent of 1,372 climate researchers who are actively publishing papers agree that climate change is tied to man-made causes.

This dispute over the cause is uniquely American. The science that explains this is political science.

Associate Editor Gary Crooks can be reached at or (509) 459-5026. Follow him on Twitter @GaryCrooks.