There doesn't seem to be much you can do to avoid the high cost of health care these days.

In 2008, total spending on health care was $2.8 TRILLION. In case you aren't sure how much that is, it's enough to pay for all the goods and services produced in Australia in one year. It's enough to fund the military of every country in NATO combined. It's more than the value of every stock on the Toronto Stock Exchange.

It is, in short, a whole lot of money.

For those of us who have health insurance, that $2.8 trillion doesn't just factor in the trips you make to the doctor or the deductibles that you have to pay. It also factors in your monthly insurance premiums, and any prescriptions that you have to have filled. Those of us without health insurance are also contributing a great deal to the overall total.

The vast majority of us in this country aren't too thrilled about this, but we can tell you with great certainty that HMO's, pharmaceutical companies and insurance companies are as pleased as they could possibly be with those numbers.

Most of our health care costs are artificial. There is no other aspect of society that prices services the way that health care does. In almost every other part of our economy, the prices are listed prominently for you to see. If you walk the grocery store, the prices of the goods are right there. If you walk into a dry cleaner, they list the prices for everything. If you walk into a bank, they tell you the percentage rates of their CD's or savings accounts. But when you go to the hospital for treatment you don't exactly get handed a menu. Instead, you hand over your insurance card, and the hospital then charges the insurance company…whatever. It could be $500 or it could be $5000. There are hundreds of factors involved. Did your insurance company negotiate lower prices? What is the hospital's billing policy that month? Or better yet, what is it that day? The free market works pretty much everywhere except for health care.

Then you have to factor in whether or not your insurance company will deem to pay the bill. Were all of the tests and procedures pre-approved? Were all the tests and procedures that were performed covered on your policy? And even if they are, will your insurance company decide to pay for them? That's a question that could go either way. Your average insurance company will usually deny at least one or two things initially and then hope you accept their denials. They are quite rightly working under the idea that many of you either haven't read or don't understand your policy.

In other words, the costs of health care are...whatever the hospitals and insurance companies say they are.

Fortunately, the one element of health care that does have a price list is the medication. Bear in mind that we say "fortunately" in a very loose fashion, because all this openness in pharmaceutical pricing does is tell us that the prices are ridiculously high. Again, there is usually insurance involved, but there is usually a list of pills that they won't cover, which are often pills that aren't available in generic form. This means that the latest, most groundbreaking medicines will cost you top dollar.

And Americans do pay a very high amount for their drugs. The pharmaceutical lobby has made it a priority to keep any government run health care plans like Medicare or Medicaid from negotiating for lower prices. This is why a pill that costs you six cents in Canada costs you six dollars in the United States.

For individuals, negotiation is impossible. The only way that an individual could negotiate for lower prices on a particular pharmaceutical is if he or she threatened to buy a different brand of that medication, but since the patent for any particular drug lasts for twenty years after FDA approval, there often is no different brand of that medication.

In other words, pharmaceutical costs are an enormous part of our health care expenses. In order to help people lower them, we would like to make you aware of a service that is being offered for free to Maryland citizens.

The Maryland Rx Card Program is offering a free service where anyone who presents a membership card at participating pharmacies can expect savings that range from 30% to 75%. According to the website:

"This program can be used by people who have Health Savings Accounts (HSA's), High Deductible Plan's, and Medicare Part D (non-covered drugs). The program can be used as a standalone benefit or to get discounts on non-formulary medications (prescriptions not covered by insurance)."

Considering how many prescriptions are not covered by insurance, saving between 30 to 70% could be a substantial amount of money. It costs nothing to join this program, and joining is as simple as visiting a website and filling out your name and address.

In the meantime, if you or a loved one in Virginia, Maryland or the District of Columbia has been injured in an auto accident, and if you feel that your insurance company has not lived up to its obligations to you, contact Greenberg and Bederman for a free legal consultation today.