Cost of Health Care | St. Louis Public Radio

Cost of Health Care

Jonathan Ahl | St. Louis Public Radio

Eric Meusch, who farms 240 acres just outside Rolla, didn’t have health insurance for seven years until he recently got another job.

“We signed up for a plan under the Affordable Care Act right when it was passed. But two years later, we couldn’t afford the premiums,” Meusch said, speaking to U.S. Rep. Jason Smith, R-Salem, on the porch of his home last week.

Iron County Medical Center in Pilot Knob is at risk of closing. The USDA is opposing its plan to emerge from bankruptcy.
Iron County Medical Center

Iron County is one of the state’s least healthy counties, according to the Missouri Health Atlas.

So when Iron County Medical Center in Pilot Knob, about 85 miles southwest of St. Louis, filed for bankruptcy protection last year, there was great concern.

“We’re all people around here have. It’s a very impoverished area,” said Joshua Gilmore, the CEO of the hospital.

This article first appeared in the St. Louis Beacon, Aug. 5, 2009 - The country is in the midst of an intense debate regarding whether the federal government should make health insurance affordable for all. Such an expansion of the health-care system will likely cost between $1 trillion and $1.5 trillion over 10 years, according to the nonpartisan policy think tank, Center for American Progress (CAP). This, of course, comes on top of the financial sector bail-out and the economic stimulus package, each costing several hundred billions of dollars.

A pharmacist at Crider Health Center in Wentzville.
Durrie Bouscaren | St. Louis Public Radio

This week, Missouri transferred the state-run health coverage of about 240,000 low-income adults and children to managed care plans run by three companies: WellCare, Centene Corporation and United Health Group.

The move is part of an increasing privatization of Missouri’s Medicaid program, MO HealthNet. Legislators call it a cost-saving measure that improves efficiency in health care. Critics say the transfer happened too quickly, putting patient health at risk.

A map shows locations of retail pharmacies included in Dr. Paul Hauptman's study of heart failure drug pricing in St. Louis. Color coding corresponds to retail prices of a combination of digoxin, lisinopril, and carvedilol.
Paul J. Hauptman, MD, Zackary D. Goff, Andrija Vidic, et al

When St. Louis cardiologist Paul Hauptman got a call from a 25-year-old patient who couldn’t afford to buy his prescription for a generic drug to treat heart problems, he knew something was wrong.

“It was $100 at a local pharmacy. I thought surely, it was a mistake,” Hauptman said. “Most of the medications, we’re presuming at most pharmacies will be something like $4, $5, $6.”

This article first appeared in the St. Louis Beacon, Oct. 3, 2013 - In response to software glitches and heavy consumer demand on the health insurance marketplace website, federal health officials are offering other ways for people to learn more about the premiums for the new coverage.

The health insurance marketplace opened Tuesday at, but the large volume of consumers seeking to access information about premiums and co-pays caused the system to come to a crawl or stop running altogether, federal officials said.

This article first appeared in the St. Louis Beacon, Sept. 25, 2013 - Health policy analysts differ sharply on the conclusions of Wednesday's federal report, which says premiums in Missouri will be about 16 percent lower than previously projected for consumers eligible to buy their health insurance through the government-run marketplace or exchange on Oct. 1.  

Among those taking issue with this projection is Patrick Ishmael, a Show-Me Institute policy analyst who focuses on health care.  He says the report’s conclusions are flawed because they are based on an arbitrary cost projection.

This article first appeared in the St. Louis Beacon, May 30, 2013 - Gov. Jay Nixon has upped the ante in his criticism of a broad-based tax cut bill awaiting his decision, saying Thursday that it removes a sales tax exemption for prescription drugs that will raise taxes for millions of Missourians.

One sponsor of the bill says there’s plenty of time for the legislature to correct what he deemed a drafting error. The legislator was among several business groups who called for Nixon to sign the measure into law anyway, with the aim of correcting the problem next year.

This article first appeared in the St. Louis Beacon, April 24, 2012 - Annual medical spending in Missouri is expected to rise faster than the national average in the next decade, but the state has several options for lowering costs and raising quality during that period, according to a report commissioned by the Missouri Foundation for Health.

This article first appeared in the St. Louis Beacon, March 30, 2012 - Dr. Louis W. Sullivan, former Health and Human Services secretary under President George H.W. Bush, feels a sense of deja vu about health reform -- of having been there and tried to do that.

This article first appeared in the St. Louis Beacon, Nov. 29, 2011 - Like the makers of brand-name grocery items, some drug manufacturers offer coupons in connection with the purchase of their products. The pharmaceutical industry and major drug companies, such as Pfizer, defend coupons and other discounts as a way to make some drugs more affordable to consumers. But the Pharmaceutical Care Management Association argued in a recent report that the savings aren't a good deal for taxpayers in the long run.

This article first appeared in the St. Louis Beacon, Aug. 17, 2011 - During a typical stay in a hospital, patients aren't usually required to pay their share of the costs before treatment because the hospital isn't always sure what the patients' portion of the bill will be. But at least one area hospital is fine-tuning its billing system with the expectation that patients will pay upfront in the same way that some people are expected to pay before being treated in a doctor's office.

Commentary: In defense of health care rationing

Dec 8, 2009

This article first appeared in the St. Louis Beacon, Dec. 8, 2009 - The cacophonous screed about pulling the plug on grandma may have been the product of know-nothing health-care activists and exploitive politicians. But know-nothing or not, their crude advocacy contained a bolus of accidental insight through an understanding that genuine health-care reform requires rationing.

This article first appeared in the St. Louis Beacon, Oct. 1, 2009 - In my last column , I discussed two issues that have galvanized opposition to government-sponsored health care reform: choice and privacy. Though these concerns are both reasonable and legitimate, I pointed out that many of the intrusions that critics fear the most are already taking place under the bureaucratic regulations of private insurance providers.

This article first appeared in the St. Louis Beacon, Oct. 8, 2009 - In an average year, inflation nibbles away a bit more than 3 percent of our buying power. But for health care, inflation takes a big bite -- about 6 percent a year, year in and year out.

What makes this inflationary afterburner kick in? Why does American health care cost so much?

This article first appeared in the St. Louis Beacon, July 2, 2009 - You've seen the problem too many times in too many ways already.

Maybe you've encountered it in the doctor's office where you found yourself digging deeper into your wallet because the co-pay has doubled since your last visit. Perhaps it hit you when a catastrophic illness, such as cancer, made you lose your job and your employer-paid health insurance. Or maybe your eyes were opened after a divorce when you realized you not only had parted company with a spouse but with health benefits.

This article first appeared in the St. Louis Beacon, June 26, 2009 - The quality of health care in Missouri is just "average," according to a report released today by Health and Human Services Secretary Kathleen Sebelius. Illinois, though, fares worse; the quality of its health care is rated "weak" in the same report.

This article first appeared in the St. Louis Beacon, June 12, 2009 - The success of any reform depends on the level of investment made in the new system. If policy recommendations are not adequately funded, those setting up the system will be forced to cut corners. That would mean insurance coverage only for selected groups, inadequate benefit packages or unaffordable premiums.

As discussions about health care reform continue in Washington, a key question is whether we are willing to pay for real reform that insures all Americans. The success of any reform depends on the level of investment made in the new system.

Commentary: Better information equals better health

Mar 23, 2009

This article first appeared in the St. Louis Beacon, March 23, 2009 - Health care in America costs too much. It's threatening the financial survival of our families, our employers and our economy.

Even more troubling, we're not getting our money's worth. Health care suffers from insufficient, inconsistent quality. Far too often, patients are harmed by the system that was supposed to help them.

This article first appeared in the St. Louis Beacon: July 28, 2008 - Let's say you're a recent transplant from Minnesota, now living in St. Louis, and as luck would have it, you're facing surgery with a hospital stay.

You've heard the hospitals in St. Louis are good -- some said to be among the nation's best -- but maybe you want to do some comparison shopping. In Minnesota, when your mother needed surgery, you went online to the state's health department website.

Store-based health clinics

May 16, 2008

This article first appeared in the St. Louis Beacon: Some retailer health clinics showing signs of decline while others flourish

The recent surge in walk-in health clinics at pharmacies, supermarkets and other retailers is showing signs of slowing. Yet many are surviving and even thriving.