Rhetorical Analysis – The Bitter Pill

Paper details:
Read the The Bitter Pill then write a short essay describing how all the following four rhetorical strategies work together: “Personal stories/case studies of patients,” “Technical and/or company documents,” “Interviews/references to medical/political personnel,” “Comparison/contrast organization”

Bitter Pill: Why Medical Bills Are Killing Us | TIME.com
http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/print/[2/26/2013 7:31:26 AM]
HEALTH INSURANCE
Bitter Pill: Why Medical Bills Are Killing Us
By
Steven Brill
Feb. 20, 2013
1. Routine Care, Unforgettable Bills
When Sean Recchi, a 42-year-old from Lancaster, Ohio, was told last
March that he had non-Hodgkin’s lymphoma, his wife Stephanie knew she
had to get him to MD Anderson Cancer Center in Houston. Stephanie’s
father had been treated there 10 years earlier, and she and her family
credited the doctors and nurses at MD Anderson with extending his life by
at least eight years.
Because Stephanie and her husband had recently started their own small
technology business, they were unable to buy comprehensive health
insurance. For $469 a month, or about 20% of their income, they had been
able to get only a policy that covered just $2,000 per day of any hospital
costs. “We don’t take that kind of discount insurance,” said the woman at
MD Anderson when Stephanie called to make an appointment for Sean.
Stephanie was then told by a billing clerk that the estimated cost of Sean’s
visit — just to be examined for six days so a treatment plan could be
devised — would be $48,900, due in advance. Stephanie got her mother to
write her a check. “You do anything you can in a situation like
that,” she says. The Recchis flew to Houston, leaving
Stephanie’s mother to care for their two teenage children.
About a week later, Stephanie had to ask her mother for $35,000 more so Sean could begin the treatment the doctors had
decided was urgent. His condition had worsened rapidly since he had arrived in Houston. He was “sweating and shaking
with chills and pains,” Stephanie recalls. “He had a large mass in his chest that was … growing. He was panicked.”
Nonetheless, Sean was held for about 90 minutes in a reception area, she says, because the hospital could not confirm that
the check had cleared. Sean was allowed to see the doctor only after he advanced MD Anderson $7,500 from his credit card.
The hospital says there was nothing unusual about how Sean was kept waiting. According to MD Anderson communications
manager Julie Penne, “Asking for advance payment for services is a common, if unfortunate, situation that confronts
Health & Family
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Bitter Pill: Why Medical Bills Are Killing Us | TIME.com
http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/print/[2/26/2013 7:31:26 AM]
CLAUDIA SUSANA FOR TIME
Sean Recchi
Diagnosed with non-Hodgkin’s lymphoma at age 42.
Total cost, in advance, for Sean’s treatment plan and
initial doses of chemotherapy: $83,900. Charges for
blood and lab tests amounted to more than $15,000; with
Medicare, they would have cost a few hundred dollars
hospitals all over the United States.”
The total cost, in advance, for Sean to get his treatment plan and
initial doses of chemotherapy was $83,900.
Why?
The first of the 344 lines printed out across eight pages of his hospital
bill — filled with indecipherable numerical codes and acronyms —
seemed innocuous. But it set the tone for all that followed. It read, “1
ACETAMINOPHE TABS 325 MG.” The charge was only $1.50, but it
was for a generic version of a Tylenol pill. You can buy 100 of them on
Amazon for $1.49 even without a hospital’s purchasing power.
(
In-Depth Video
:
The
Exorbitant Prices of Health Care
)
Dozens of midpriced items were embedded with similarly aggressive
markups, like $283.00 for a “CHEST, PA AND LAT 71020.” That’s a
simple chest X-ray, for which MD Anderson is routinely paid $20.44
when it treats a patient on Medicare, the government health care
program for the elderly.
Every time a nurse drew blood, a “ROUTINE VENIPUNCTURE”
charge of $36.00 appeared, accompanied by charges of $23 to $78 for
each of a dozen or more lab analyses performed on the blood sample.
In all, the charges for blood and other lab tests done on Recchi
amounted to more than $15,000. Had Recchi been old enough for
Medicare, MD Anderson would have been paid a few hundred dollars
for all those tests. By law, Medicare’s payments approximate a
hospital’s cost of providing a service, including overhead, equipment
and salaries.
On the second page of the bill, the markups got bolder. Recchi was charged $13,702 for “1 RITUXIMAB INJ 660 MG.” That’s
an injection of 660
mg
of a cancer wonder drug called Rituxan. The average price paid by all hospitals for this dose is about
$4,000, but MD Anderson probably gets a volume discount that would make its cost $3,000 to $3,500. That means the
nonprofit cancer center’s paid-in-advance markup on Recchi’s lifesaving shot would be about 400%.
When I asked MD Anderson to comment on the charges on Recchi’s bill, the cancer center released a written statement that
said in part, “The issues related to health care finance are complex for patients, health care providers, payers and
government entities alike … MD Anderson’s clinical billing and collection practices are similar to those of other major
hospitals and academic medical centers.”
The hospital’s hard-nosed approach pays off. Although it is officially a nonprofit unit of the University of Texas, MD
Anderson has revenue that exceeds the cost of the world-class care it provides by so much that its operating profit for the