In the United States, the charge master, or charge description master (CDM), is a comprehensive listing of approximately 45,000 items billable to a hospital patient or a patient’s health insurance provider. In practice, it usually contains highly inflated prices at several times that of actual costs to the hospital. The charge master typically serves as the starting point for negotiations with patients and health insurance providers of what amount of money will actually be paid to the hospital. It is described as “the central mechanism of the revenue cycle” of a hospital. Although Americans and foreigners alike tend to think of the U.S. health care system as being a “market-driven” system, the prices actually paid for health care goods and services in that system have remained remarkably opaque.
Each U.S. hospital has had its own charge master.
There is no universal formula to determine charges
Charges vary by as much as 17 times across all hospitals in just California.
Charges are much higher than the prices hospitals are actually paid.
Hospitals accept different payments from different payers for identical services
Until recently, uninsured or self-paying U.S. patients have been billed the full charges listed in hospitals’ inflated charge masters, usually on the argument that the Medicare rules required it. What prevailing distributive ethic in U.S. society, for example, would dictate that uninsured patients be billed the highest prices for hospital care and then be hounded, often mercilessly, by bill collectors? Many hospitals now have means-tested discounts off their charge masters for uninsured patients, which bring the prices charged the uninsured closer to those paid by commercial insurers.
Resource Depletion: The Costs of Industrial Agriculture
From mechanized feedlots to automatic irrigation systems to agricultural machinery, North American agriculture has become increasingly industrialized, placing ever-greater demands on fossil fuel, water and topsoil resources. Petroleum not only fuels trucks and mechanized farm equipment, but also serves as a base for synthetic pesticides and fertilizers, tying the cost of growing food increasingly closer to the price of oil.
Land Management: Degrading and Undervaluing Farmland
Throughout much of North America, especially in the United States, land management techniques have been draining the soil of nutritional value. Monoculture, the practice of continually planting the same solitary crop on one plot of farmland, removes nutrients from the soil that must be replenished with additional fertilizers.
Food Waste: Compromising Food Security
The United Nations estimates that one-third of the world’s food goes to waste, either during agricultural production, post-harvest handling and storage, processing, distribution, or consumption. In North America, a large percentage of this loss comes from consumers wasting food. Additionally, North American consumer expectations that fruits and vegetable should be pristine and without blemish means that supermarkets and restaurants are forced to reject produce that is edible yet aesthetically imperfect due to an unusual shape, size or color. Further demand for extensive selection causes supermarkets to purchase an excess of produce, driving prices up and increasing potential for spoilage.
Demographic Changes: A Disconnected Public
In North American, the last 50 years have brought a major cultural shift that has removed consumers further and further away from their food sources. U.S. Census data from 2010 showed around 80% of Americans living in urban areas. Entire neighborhoods, known as food deserts, have no fresh produce for sale. As urban areas grow, farmers receive increasing pressures from encroaching developers and communities to sell their land.
Political Issues: The Business of Food
While consumer habit has a profound effect on food, government policy bears just as heavily on the industry. Agriculture is a multi-billion dollar industry with powerful lobbyists. In the United States, untold amounts of food remained rotting on the vine due to a shortage of migrant workers. Recent tightening on immigration policy has drastically cut down on the nation’s imported workforce at a time when very few Americans have any connection to farming let alone a desire to work on one.
IoT Healthcare: RepWatch
RepWatch proposes a real time monitoring system to track a patient’s workout routines by using sensor technology. This data is delivered wirelessly to the patient’s physical therapist so that any adjustment that is needed can be made quickly. The data also allows the patient to visualize actual versus desired. RepWatch believes this system can significantly enhance the effectiveness of physical therapy, thus reducing a patient’s recovery time and the cost of therapy. RepWatch has also been awarded $10,000 in seed fund. Team Lead: Rob Kyler firstname.lastname@example.org
IoT Agriculture: Bye Bye Birdie
Bye Bye Birdie proposes using sensor technology and Autonomously-driven Robotic Vehicles (ARVs) to reduce crop lose caused by birds. Motion sensors placed amongst the crops to be protected will be used to activate the ARVs in the field. When birds are detected near the crops, these sensors will wirelessly signal the ARVs with geo coordinates of the birds. The ARVs will move autonomously to where the birds are and use predatory sounds to disperse the birds. Team Lead: Greg Monterrosa email@example.com
People’s Choice: Veggie Bot
Veggie Bot proposes a robot, equipped with sensors, local memory and a wireless transmitter, to track the delivery of fresh produce. The robot will take on the form of the produce to be tracked and will be placed in the farm with the real produce. Come harvest time, this robot will be harvested, sorted, packed and shipped just like the real ones. Veggie Bot thus enables the conditions of the produce to be known on a real time basis from farm to shelf. Team Lead: Bryan Went firstname.lastname@example.org