The Problem With Healthcare

a reply to: intrptr

I think that may contribute to the cost, but my a neurologist I know has a nurse/secretary/everything else. One person. There is some truth to what you say, and I'm sure there could be a small % savings if it were streamlined.
You stay in the hospital, a Dr. literally will stick his head in the door, and say how you feelin? Cha Ching 180$.

Carpul Tunnel Surgery- 8,000$ per hand-20 min consult-Dr prep for case (don't know how long) Surgery 15 min-15 saying all is well after. Of course there is 2 nurses-I was awake no anesthesiologist-cleaning staff (maybe nurses)-brick and mortar costs. And we were stacked up like cord wood in the waiting room.

In many cases medical costs so much be cause they charge so much.

And you are right, drugs is another goat screw all together.

a reply to: DBCowboy

Actually, because they essentially buy in bulk, insurance companies typically pay a lower cost for standard procedures than an individual would. I actually don't necessarily find anything wrong with that.

a reply to: Edumakated

All those markups on the prices are to balance the budget.

Not just for the hospital, either. The "adjustment" represents what the actual price is. They mark it up so they can discount it for the insurance companies. If you pay cash, you can get the same discount.

Insurance companies are the worst thing for the price of healthcare to ever exist. They've made it where private pay is an impossibility.

originally posted by: eluryh22
a reply to: DBCowboy

Actually, because they essentially buy in bulk, insurance companies typically pay a lower cost for standard procedures than an individual would. I actually don't necessarily find anything wrong with that.

What is wrong with it is the artificial inflation that causes. For my doctor to make the $80/visit he targets, he has to charge $140. This way when the insurance company settles up on its "bulk purchase", the discount doesn't bring him below the reasonable amount of $80.

If you don't have insurance, then you are stuck with nearly twice the cost. Sure seems like a good way to encourage enrollment in health insurance, huh? Lock out the ability of people to pay for even an office visit by forcing doctors to give a discount? If you are a doctor and don't comply, you are dropped from the plan. If you fudge it to help private pay patients, you go to prison for fraud.

On the surface, it may seem fine. In practice, its a major source of misery for everyone.

originally posted by: Blue Shift

originally posted by: BlueJacket
Are you familiar with the elderberry tree? Not trying to take away from your thread. Just so you know, Elderberry leaves bruised with say a rock...will fix a sprain in a jiffy.

As long as we have a huge, expensive, science-based medical community in place, I'd prefer not to have to treat myself with sticks and twigs, bug poop and witchcraft.

Let me help you a little bit here, because you seem to be confused.

It's not sticks and twigs, bug poop and witchcraft.

It's leaves. You know.. a natural remedy.

It does actually work... I grow elderberries on my property for a number of uses.

Let me tell you about your huge, expensive science-based medical community that you have access to.

My mother (72 years old) had a little black spot that she had on her ankle since birth that started to hurt.

19 months, 687,000 dollars worth of chemo, surgery, painkillers and an amputation later she died because her liver gave out while my Dad was picking maggots out of her wound. There is your modern medicine.

My wife has Leiomyosarcoma. She was given 3-6 months to live and was a stage 4.

That was about 5 years ago... she told her oncologist to stuff it and cured herself, quite naturally. Cost us about $500 a month for 2 years.

You have a 1/2 chance of getting cancer now in the US as a male, 1/3 as a female. it's 50% now in Canada.

I personally think this is social Darwinism... keep your science-based medicine. I'd rather live.

Don't make fun of what you don't understand. Instead try to understand it. Statistically, you or a family member are next on the chopping block.

originally posted by: eluryh22
a reply to: DBCowboy

Actually, because they essentially buy in bulk, insurance companies typically pay a lower cost for standard procedures than an individual would. I actually don't necessarily find anything wrong with that.

I agree, and if insurance companies are allowed to cross state lines, prices may actually drop more.

a reply to: DBCowboy

I have never understood how that is supposed to work, I understand the across state lines. But why are hospitals suddenly going to take less for procedures and things they do?

I don't see how it will drop, why would it drop?

a reply to: seasonal

Part of it is a cascade effect.

Hospitals lose a surprising amount of money due to people not paying. Hospitals are obligated to treat everyone. (How well is debatable.)

If more people are covered, and have more of a say in what their coverage includes, then hospitals can still generate their income and actually charge less.

a reply to: bigfatfurrytexan

In practice, its a major source of misery for everyone.

I would say it is a source of misery for some... but that may just be semantics.

I understand what you are saying but I still feel comfortable with the bulk-purchase rates in general. What I would like to see is that group-coverage model expanded beyond employers.

For example, I would like to see something along the lines of people being able to buy into a "group" based on geography from one of the three closest public/community hospitals. This opens up that strength-in-numbers purchasing power to a greater number of people and can create some competition between hospitals. Of course, this will be dependent on population density, number of public/community hospitals and some other factors (and may work better in cities and suburbs than in more rural areas). I have mentioned public/community hospitals because I'm not sure how comfortable I would be if we were to create laws forcing private hospitals to do this (although it may be worth discussing).

Sure seems like a good way to encourage enrollment in health insurance, huh?

I think, in general, insurance is in its essence its own encouragement. Personally, I love insurance. Health insurance. Life insurance. Homeowners Insurance and even flood insurance (even though we aren't really in the "bad" flood plain). Having insurance is, as they say, something that you buy that you hope you never have to use. It's purchasing peace of mind, to a great extent.

originally posted by: DBCowboy

originally posted by: eluryh22
a reply to: DBCowboy

Actually, because they essentially buy in bulk, insurance companies typically pay a lower cost for standard procedures than an individual would. I actually don't necessarily find anything wrong with that.

I agree, and if insurance companies are allowed to cross state lines, prices may actually drop more.

It is completely absurd to me that this hasn't been corrected years ago.

a reply to: eluryh22

It just shows that the interests of the average American are ignored.

a reply to: DBCowboy

We have millions more insured now, and prices are going up, and not by 7%, like by 20%.

I don't know if I believe that the magic across state boarders is going to do anything.

There are 6 medical insurance companies, if I remember correctly. It would, and very well may already be, easy to collude.

a reply to: seasonal

Prices are going up primarily because the people that have (and HAD) insurance are now paying for the subsidies of those new enrollees that are barely paying in.

a reply to: eluryh22

I can see that, but we are told it is becasue of higher that initially thought cost of the sickly new arrivals to med coverage.

It is expensive, and it isn't going to go anywhere but up. There needs to be some restraints put on the gouging in both the service end and parma end.

They have an inelastic demand product and there needs to be protection to the consumers.

Read more: www.businessdictionary.com...

a reply to: seasonal

I can see that, but we are told it is becasue of higher that initially thought cost of the sickly new arrivals to med coverage.

I've heard a lot of different things but my general takeaway from it is..... basically... this is what happens when you get the government involved. Higher costs to "the people" with a diminished service.

For the rest of your post... I don't think I really disagree with you but I think it's a tricky tightrope to walk.

I'm reluctant, in at least some instances, to use the term gouging because I'm not sure that is a fair statement. Are there instances of gouging (particularly on the pharma side)? Yes. Definitely. There was that Epipen thing for example.

However, it really does cost a LOT of money for R&D to create these drugs, get them through the testing phase, get them through the various government agencies and into the hands of people that can benefit from them. I'm not an expert in this field so I can't say, at this moment, who is right and who is wrong but again, I'm very hesitant to use a blanket "gouging" statement.

I'm even less inclined to levy that charge against the hospitals themselves. This is, admittedly, very biased based on my own experiences but the times I've been in hospitals over the past decade (twice for my mother, twice for my father for major heart issues and then when my wife had her C-section with our son) I have ONLY had very positive experiences. The hospitals were clean. The equipment was (seemingly) new and state of the art. The staff (doctors and nurses alike) were extremely attentive. While everyone I mentioned had insurance, there were still portions of the bill that we (collectively) were responsible for and both of the hospitals we used were VERY reasonable in setting up payment plans. So again, while I'm not expert of the budgeting and finance issues of major hospitals, I'm not ready to make many accusations yet.

On that note, I have to admit I'm kinda irked reading some of the comments in this thread where people are attempting to say that X-doctor/tech takes 10 minutes to do this and then the next person spends 5 minutes on something else and all that. I don't have to manage a hospital to see the glaring ignorance in all that. A hospital needs to stay afloat and a lot more happens than any individual that walks in with a broken nose or sprained ankle. There are emergency rooms (which typically get abused) and NICU and maintenance and a whole host of other things that need to be looked at when trying to decide how much a hospital needs to take in.

a reply to: seasonal

It would lower cost of insurance plans because the insurance companies would be competing for best customers nationwide, not just states they do business in.

Govt also needs to decouple insurance from employers. These two initiatives alone would do winders to lower insurance costs. They also dont take much in the way of implementation. Insurance throuhj employers is left over from ww2 when there were wage freezes. I

a reply to: eluryh22

I would agree but there are studies of other countries with drastically lower costs and better outcomes.

I prefer free market solutions. Anytime govt subsidizes something it distorts markets and raises costs. When you want more of something you sibsidize it. When you want less you tax.

This is a really complex problem. It isnt just greed. Businesses have to make a profit to stay in businesss. The market has just been so distorted by govt intrusion its created a massive gordion knot.

I understand why people are frustrated.

a reply to: Edumakated

That makes a little more sense, but I see very few insurance companies. And the services cost what is charged, there is only so much wiggle room.

a reply to: Edumakated

Govt also needs to decouple insurance from employers.

I can not possibly disagree more with this statement. The government has exactly ZERO place inserting itself into the benefit package I negotiate with a potential employer.