Psychics like Sylvia Brown are immoral frauds

In the wake of the dramatic events surrounding the discovery of three women including Amanda Berry, being held captive for a decade by a monster, it’s important not to forget another sociopath played a role in this drama. That sociopath is the psychic who told Amanda Berry’s mother that her daughter was dead:

Her mother, Louwana Miller, never gave up hope that the girl known as Mandy was still alive, according to the Cleveland Plain Dealer. The case attracted national attention when Miller went on Montel Williams’s nationally syndicated television show in 2004 and consulted a psychic.
“She’s not alive, honey,” the psychic said. “Your daughter’s not the kind who wouldn’t call.”
After Berry’s mother died in 2006, there were occasional clues in the search for Berry, and police have conducted a number of searches over the years. All proved fruitless — until Monday night, when Berry, Gina DeJesus and Michelle Knight were rescued from the house in Cleveland.

As Ben Goldacre reminds us, that psychic was Sylvia Brown, speaking out of her ass, surely “just for entertainment purposes” when she told Louwana Miller her daughter was dead. As the Wiki shows, her predictions aren’t reliable, and not surprisingly, she has a history of criminal behavior, including indictments and convictions for fraud and grand theft.
Psychics are by definition frauds. They don’t have magic powers. No human has the ability to read minds or see into the future. If you then take money under such known false pretenses that is the definition of fraud. If they truly do think they have magic powers, they should submit themselves to James Randi’s 1 million dollar paranormal challenge to determine if they can perform in a blinded, controlled test (which none of these frauds has ever come close to passing). Not surprisingly, Sylvia Brown has refused, many times, to take this challenge. This is because psychics know they’re frauds. Worse, Brown has even been previously convicted of fraud but sadly not for giving psychic readings. As a criminal, I guess she smartened up since 1992, the question is, why don’t we treat all psychics as criminals all the time? The burden of proof should be on them to prove they have this exceptional ability under controlled circumstances. Until then, we should simply arrest people that take money from others on the basis of such lies.

Obama Makes Hospital Charge Masters Public

And the best article on the implications of this, surprisingly, comes from Huffington post authors Young and Kirkham:

The database released on Wednesday by the federal Centers for Medicare and Medicaid Services lays out for the first time and in voluminous detail how much the vast majority of American hospitals charge for the 100 most common inpatient procedures billed to Medicare. The database — which covers claims filed within fiscal year 2011 — spans 163,065 individual charges recorded at 3,337 hospitals located in 306 metropolitan areas.

Within the nation’s largest metropolitan area, the New York City area, a joint replacement runs anywhere between $15,000 and $155,000. At two hospitals in the Los Angeles area, the cost of the same treatment for pneumonia varies by $100,000, according to the database.

We discussed this issue before when it was brought to the public’s attention by Brill’s “Bitter Pill” piece in Time. Hospitals have a wildly-irrational billing scheme that represents a war they are in with payers. However, Brill was wrong to attribute excess costs of US healthcare to the charge master problem, while the HuffPo piece gets this issue right. It’s not a problem for insurance companies, or government, since they don’t pay these bills. It only screws payers without negotiating power or knowledge of how to navigate these bills – the uninsured:

“The charge masters are totally irrational,” Robert Laszewski, a former health insurance company executive who consults for health care companies as president of Alexandria, Va.-based Health Policy and Strategy Associates, wrote in an email to The Huffington Post.
Hospitals used to base prices on health care costs and on the need for profit that would, among other things, enable them to make investments in their facilities, Laszewski explained. “They became the baseline from which the hospitals started,” he wrote. But over time, hospitals raised charges in anticipation of negotiating discounts with private health insurance companies while maintaining their revenue streams, he said.
Prices have continued growing over decades to the point where there is no plausible justification for them, according to Laszewski: “Over the years, the charge masters have become more and more disconnected from reality.”

And since they haven’t been public or shared before now, I suspect each hospital probably has some set of services that appear to be priced excessively compared to their near neighbor. The costs haven’t grown so much from a response to the treatments they provide, so much as the perceived ability to force insurers to pay a larger portion. Each hospital has probably independently evolved a strategy to do this, hence the wide variability in pricing.

The charges are the prices hospitals establish themselves for the services they provide. Although Medicare and Medicaid don’t base their payment rates on these figures, private health insurance companies typically do, which means they usually pay more for the same health care than the government does. That translates into higher premiums for people with insurance. And uninsured people are expected to pay the full list price or a discount from that number, which tends to mean they pay more than anyone else.
When a hospital doesn’t get paid as much as it wants from one source, it tries to make up the difference in other ways, such as billing so-called self-pay patients — almost always the uninsured — for the full list price of a service, said Robert Huckman, a health care expert at Harvard Business School. Even when hospitals agree to huge discounts for patients who can’t pay the bill, those discounts are taken from inflated prices much higher than those the government or private insurance companies pay, he said.
“The charge master is complete nonsense that really doesn’t matter — unless you are an uninsured person and you’re getting these huge bills driving you toward bankruptcy,” Laszewski wrote. “The biggest irony of the U.S. health care system is that only the uninsured — often people who don’t have a lot of money — are the only ones the hospital expects to pay these incredibly inflated list prices!”
Hospitals also inflate charges to raise money for things that aren’t related to treatments, said former Sen. David Durenberger (R-Minn.), who is senior health policy fellow at the University of St. Thomas in Minneapolis.
“The biggest factor by far, in my experience, is what are you trying to cross-subsidize,” he said. Hospitals will increase charges to finance things like technology upgrades and education and research and to compensate for their operational efficiencies, Durenberger said.

We’ve discussed extensively the sources of excess costs in US healthcare. It’s not the chargemaster. It’s excessive administrative costs of private health insurance, excessive drug costs (everything from direct-to-consumer advertising, the fact US citizens are charged more and GWB made it so medicare can’t negotiate for lower drug prices), inefficient delivery (primary care in the ER), redundant delivery, lack of a government-implemented or regulated standardized electronic medical record (EMRs from private companies actually increase costs), defensive medicine, excessive end-of-life care, and excessive reimbursements of procedures and diagnostic testing.
What will this data release mean for health care costs? Probably not much as the hospitals will now just normalize excessive bills to each other, rather than just having their own individually-irrational billing scheme. The charge master is unjust, but it’s not why we pay more for healthcare overall.
There is a solution to the charge master problem though, and it was found in New Jersey. Force hospitals to charge the uninsured what they charge Medicare. It’s that simple. It’s that easy.