Why are American Healthcare Costs so High?

[eljefino]

Originally Posted By: zrxkawboy
[
On a different note, I find it ironic when people complain about how the gov't handles this or that, but want to put the gov't in charge of their (and everyone else's) healthcare! No thanks! I've seen how incompetently they handle things much less important than my healthcare.


True, but I'd take incompetence over actively worming out of obligations like for-profit insurance companies practice. I suspect hospitals wouldn't mind a "single payer" as they'd wisen up to "the game", singular vs "the game" times however many insurance plans.

 

[Shannow]

eljefino,
there's an interesting phenomenon in my town that is happening in the last couple of years...Doctor's monopoly in tow, have their own case books, charging $65 for a 5 minute consult, you get $30-35 (IIRC) when you claim it back on medicare...male with the flu, and need a certificate for work...tough, we are full, see us in three days, and BTW, we don't backdate medical certificates.

was like that for 15 years, and pushed us into attending ER to get a certificate for work.

Last 3-5 years, clinics have moved in, open 8AM-7PM, 9PM Thursday/Friday, 8AM to 14:00 Saturday, and they "bulk bill", i.e. you sign for the service, and they lodge the bill electronically, and they get the $35 direct deposited...don't see the same guy/gal every time, but can get in depending on symptoms with a reasonably short wait.

Have recently opened pathology sampling services, and x-ray/ultrasound services, without having to drive 50 miles, and pay $200 and claim half back.

It's taken forever for another mindset that your 5 minutes is supposed to make the monthly payments on a his and hers mercedes, but for locum work, it's becoming more available, and more cost effective for the community as a whole.

 

[Trav]

Originally Posted By: zrxkawboy
Originally Posted By: rshaw125
I thought it was amazing how the ACA left out any attempt at all at increasing supply.


Exactly. It added 1000's of new IRS employees, but not one more doctor. This is a healthcare bill?

On a different note, I find it ironic when people complain about how the gov't handles this or that, but want to put the gov't in charge of their (and everyone else's) healthcare! No thanks! I've seen how incompetently they handle things much less important than my healthcare.


Don't forget the over 1800 new HHS detectives and investigators, then take into account that 50% of doctors are hanging up their coats.
I am glad i don't have to depend on this place in case i get really sick, my doctor is an 8hr flight away.

IMHO this has nothing to do with health care its about culling the baby boomer population.

 

[Shannow]

Trav, you need my signature

 

[SteveSRT8]

Originally Posted By: rshaw125
I thought it was amazing how the ACA left out any attempt at all at increasing supply. By that I mean increasing the number of doctors. Which is intentionally limited. You have thousands of good students that would love to be medical doctors.No place for them.
Try filling a prescription mail order from another country. Like Canada for example. Technically it's illegal.
Health insurance across state lines? Nope illegal as well. Want to add some hospital beds? No not unless approved by the state.

How about a Dentist? Nope intentionally limited again.

That's right the supply of healthcare is limited and heavily regulated by government. I am surprised it's not more expensive.


IMO the insurance companies have been cutting out competition for years by lobbying. All the stupid state line rules do is limit competition. Simply opening the market would have had a HUGE effect on our healthcare. Insurance companies STILL hold the ball in healthcare.

I have well over a hundred medical professionals in my client list. It is horrifying how many of them are retiring early due to the new law!

 

[rshaw125]

Just this morning yet another news story of another hospital cutting workforce numbers. USA Today.

 

[SteveSRT8]

One of my Daughters works as a nurse. Her Hospital has been cutting hours like crazy for ALL employees!

 

[cjcride]

Originally Posted By: dishdude
We're a fat, old, lazy country with poor eating habits and a sedentary lifestyle that likes to smoke, drink, do drugs and engage each others in acts of violence.
We take D*mn good care of our vehicles though. No One beats us.
LOL

 

[Trav]

Originally Posted By: dishdude
We're a fat, old, lazy country with poor eating habits and a sedentary lifestyle that likes to smoke, drink, do drugs and engage each others in acts of violence.

Your right. Its usually the ones on the public cow permanently that fit your description.
Go to Walmart and then go to Macy's, you see the difference in the customers.

 

[JHZR2]

Originally Posted By: Trav


Don't forget the over 1800 new HHS detectives and investigators, then take into account that 50% of doctors are hanging up their coats.
I am glad i don't have to depend on this place in case i get really sick, my doctor is an 8hr flight away.

IMHO this has nothing to do with health care its about culling the baby boomer population.


I keep hearing how so many are retiring or going out of business. Well, the reality is that workforce attrition is a MAJOR issue in many fields from professional to trades. So how much of this hanging up coats is due to ACA realistically (convenient argument, I know) is really TBD. Obviously medicine is lucrative enough to enable early retirement - lots of folks out there cant afford to (though insert my commentary about saving and not being a slave to debt).

As a non-boomer, I have to say that culling the boomer population unfortunately is a must. Them and their parents bankrupted MANY systems long before ACA came along, creating unfunded liabilities that are just extreme. And these liabilities arent just some inner city welfare collectors... These are people all over, who allowed the "systems" (SSI, pensions, etc) to get gobbled up into general funds, raided, etc., in he interest of short term gain. All of this LONG before I was old enough to vote or have a say. So why should I be happy about paying taxes for the next 30 years of my working career to pay these HUGE liabilities? Especially when because of the damage of all this, my future and my ability to collect back is looking impossible.

Its a "bend over and smile" to the younger producers, no matter whether there is ACA or not. And Im absolutely unhappy about it. Boomer or my infant son, guess who I want to put money towards? Sorry boomers, had your chance. Blew it.

I know that's rough talk, but Im going to be the one geting harmed the most for all of this, ACA or not. Its really disturbing.

 

[Win]

100% of my physician clients have left medicine subsequent to the enactment of the act that was touted as fixing everything, even the parts that weren't broken.

It is a brain drain of catastrophic proportion.

When I was but a lad, my father discouraged me from medicine as a profession, with the admonition that one political party would never give up until it had socialized medicine. Well, he was right.

You can bet that if they socialize the practice of law, which will be next, I'll hang it up before the ink is dry on the enabling act.

The crazy tax code can be blamed for the health care debacle. When health insurance became an employment perk and non taxable income, and consumers were divorced from the cost of what they consume, it was just a matter of time before the train wrecked.

Our civilization is collapsing from the weight of the great society and the freebie mentality.

 

[eljefino]

Originally Posted By: Win

The crazy tax code can be blamed for the health care debacle. When health insurance became an employment perk and non taxable income, and consumers were divorced from the cost of what they consume, it was just a matter of time before the train wrecked.

Fun Fact, it was Nixon's wage & price controls that really helped employer based health insurance take off. I'd welcome most options that will bring employer-based insurance closer to open market rates so that people aren't slaves to their jobs that they may or may not be efficent at doing.
Quote:


Our civilization is collapsing from the weight of the great society and the freebie mentality.


Hang on there, straw-man! I'd like reasonably priced health care, defined by percentage of GDP: It's 18% and could be down to 10%. I'd like my insurance premium to be less than 150% of my monthly mortgage payment. I don't want "Free" and know there's no free lunch. The thread title is about overly high costs, not the ACA (directly.)

 

[javacontour]

I think we would all like reasonably priced health care.

There are a great number of us who simply don't trust that a federal system will provide that.

The same folks who brought us $600 hammers and toilet seats, the Viet Nam war, and WIN in the 1970's (Whip Inflation Now) are now to be trusted with 1/6th of the economy?

Frankly, I think we are just trading one set of problems for another.

If you want to correct health care costs, make insurance for catastrophic issues. I.E. all those check ups and so forth are paid for by the patient. But anything that would bankrupt the median income household is covered by such a policy.

You have $100 aspirin because a third party pays for it.

Would it happen overnight? Nope. But when medical providers figure out they have to justify the costs to the person visiting the office, costs will likely return to reasonable.

I think the other factor is give hospitals the right to turn patients away. ER visits should be for LIFE threatening conditions. I've been to an urban ER and 80% of the folks there do not appear to be on death's door. So why are they even admitted to an ER? Probably fear of lawsuits.

Provide reasonable protections to hospitals when they turn away those using the ER as a Primary Care Physician and we will see costs go down.

But as long as the bulk of the money in the system is OPM, the prices will remain high.

Having a government program just adds more OPM, adding fuel to the fire. Expect costs to rise, not fall with more government money in the mix.

 

[eljefino]

When someone invents a drug or medical device, the authority having jurisdiction in every other country negotiates a good price and buys what they need.

Here, every hospital wants a full body scanner (or whatever) and pays "whatever" to get it, knowing they can turn around and get reimbursed.

If there were some sort of "benevolent guidance" saying hospital A gets the open frame MRI, while B gets the nano-robots, there'd be less "waste" but tons of bruised egos in administration buildings. And of course there'd be extreme attempts to corrupt the source of that "Benevolent guidance."

In short, we invest the R&D hoping to get the money back from US payers... and the rest of the world buying our stuff at near cost is gravy.

 

[OVERKILL]

Originally Posted By: javacontour
I think we would all like reasonably priced health care.

There are a great number of us who simply don't trust that a federal system will provide that.

The same folks who brought us $600 hammers and toilet seats, the Viet Nam war, and WIN in the 1970's (Whip Inflation Now) are now to be trusted with 1/6th of the economy?

Frankly, I think we are just trading one set of problems for another.

If you want to correct health care costs, make insurance for catastrophic issues. I.E. all those check ups and so forth are paid for by the patient. But anything that would bankrupt the median income household is covered by such a policy.

You have $100 aspirin because a third party pays for it.

Would it happen overnight? Nope. But when medical providers figure out they have to justify the costs to the person visiting the office, costs will likely return to reasonable.

I think the other factor is give hospitals the right to turn patients away. ER visits should be for LIFE threatening conditions. I've been to an urban ER and 80% of the folks there do not appear to be on death's door. So why are they even admitted to an ER? Probably fear of lawsuits.

Provide reasonable protections to hospitals when they turn away those using the ER as a Primary Care Physician and we will see costs go down.

But as long as the bulk of the money in the system is OPM, the prices will remain high.

Having a government program just adds more OPM, adding fuel to the fire. Expect costs to rise, not fall with more government money in the mix.


Are you guys concerned about having a system that mirrors ours or do you think that it will play out differently?

I ask because the whole "100 dollar aspirin" thing doesn't exist up here. Medication is cheap, even if you don't have it covered through work.

ER visits, I don't think that's going to change. I went to the ER recently for a sinus infection. I had to wait three hours because it wasn't something seriously hazardous to my health. There were plenty of people there in the same boat as me. The regular physicians in town take turns doing cycles in the ER. They will be either in the hospital or in their clinics the rest of the time.

I went to the ER because of my work schedule; I'm not working in town and subsequently couldn't see my doctor during the hours she is open. Others go because they lack a family doctor.

I work in the healthcare industry and I think what we have up here is pretty bloody good considering. Healthcare seems to be more of an enterprising endeavour south of the border from what I've seen when stateside. There's a LOT of money changing hands; several orders of magnitude more than what we have up here. That's not a criticism, simply an observation. Just one of those things that is significantly different between our two countries.

 

[kb01]

Originally Posted By: Blaze
My doctor said those high deductible plans have become downright dangerous for some of his older patients when they sick and should seek hospital care but instead stay home to avoid an expensive trip to the ER etc.


If that's the case, then it's a real shame.

Low deductible plans make absolutely no financial sense unless a) an employer is subsidizing premiums and b) premiums are funneled through a tax-exempt cafeteria plan.

Otherwise, you're virtually always better off having lower premiums and higher deductibles.

 

[Blaze]

We had a positive experience a few yrs ago with the Canadian healthcare system...we were staying in a campground up near Banff BC. My step kids and another kid (friends in our party) had built a small wooden jump in the campground. Well our friends kid fell going over the jump and the brake lever ended up going through his groin area. Luckily a nurse nearby saw it happen and put pressure on the area and had advised us not to move him or take him ourselves to the ER. About 20 mins later an ambulance shows up and we all follow to the ER. Total cost for about 4 stitches and the ambulance ride was $150.00. $100.00 to the doctor and $50.00 to the ambulance outfit plus we were in and out of the hospital in less than an hour...not bad and at a VERY fair price for using their ER.

 

[SwampSurvivor]

Originally Posted By: DBMaster
Depending upon one's point of view there are drawbacks to a capitalist economy. An eventual single-payer system is in our future. Such a system would eliminate Medicare and Medicaid as well because all would be under one program.

The important thing to note here is that even though we pay the most, by far, our health is not better and our outcomes are not better.

So much for what one group called "the best heath care system in the world." They should have added, "if you are rich." Even in countries with socialized medicine the rich go outside the system.

We would all be well advised to add a good dose of personal responsibility as well!


DBmaster, with the passing of ACA, we lost the chance of ever getting a single payer system ... ever.

Healthcare costs are high because of private health insurance companies colluding with pharmecuticals and taking a lot of the money for themselves.

The government signing an "act" that guarantees them business ... just makes sure that they will have even more power.

 

[DBMaster]

Originally Posted By: Miller88
DBmaster, with the passing of ACA, we lost the chance of ever getting a single payer system ... ever.


I am no expert on the ACA by a long shot, but my doctor friends swear that it is step one on our journey to socialized medicine. I would be interested to hear the rationale behind your statement. I have no argument against it. I am just curious.

 

[MolaKule]

Originally Posted By: zrxkawboy
Originally Posted By: rshaw125
I thought it was amazing how the ACA left out any attempt at all at increasing supply.


Exactly. It added 1000's of new IRS employees, but not one more doctor. This is a healthcare bill?

On a different note, I find it ironic when people complain about how the gov't handles this or that, but want to put the gov't in charge of their (and everyone else's) healthcare! No thanks! I've seen how incompetently they handle things much less important than my healthcare.


+1 for those remarks.

I also find it interesting that he did not discuss technological advances in Health Care such as the advances in Robotic Surgery.

It may cost a bit more than some older style of surgery's, but the patient has less pain, goes home sooner, which means less cost to stay in the hospital, which seems to even things out.

As a recent patient of robotic surgery, it is much better than the alternatives.