Why Does Health Care Cost So Much?

[Ps104_33]

1) We pay more for our medical services. But though the pharma industry is important, the real action is in wages. Our medical personnel cost vastly more than their counterparts abroad in almost every category.

2) We consume more services. Americans get shiny new facilities--my British colleagues once derisively commented that American hospitals are "like hotels". American hospitals don't have open wards for almost anyone. They staff at very high levels. Doctors conduct an inordinate amount of tests. We use an expensive machine rather than watchful waiting. And often, those expensive machines catch conditions that never would have turned into anything, which we then treat. Natasha Richardson probably would have lived if she'd had an accident here, because doctors would have done a cat scan, and there would have been a Medevac helicopter available. That's tens, maybe hundreds of thousands of dollars to save a single life.

3) There are inefficiencies. I don't mean "compared to other systems"--every system has some screwed-up illogicality that costs it money and makes patients worse off. But compared to what we could have. For example, Medicare pays for procedures, not wellness, which means that there's a chronic undersupply of geriatricians, because the specialty isn't particularly well paid even though the nation's largest healthcare provider is specifically designed for old people. This is madness. But every real-world system that has attempted to pay physicians for wellness has ended up giving up in disgust.



http://business.theatlantic.com/2009/04/ask_the_editors_why_does_health_care_cost_so_much.php

 

[JustChristian]

1) We pay more for our medical services. But though the pharma industry is important, the real action is in wages. Our medical personnel cost vastly more than their counterparts abroad in almost every category.

2) We consume more services. Americans get shiny new facilities--my British colleagues once derisively commented that American hospitals are "like hotels". American hospitals don't have open wards for almost anyone. They staff at very high levels. Doctors conduct an inordinate amount of tests. We use an expensive machine rather than watchful waiting. And often, those expensive machines catch conditions that never would have turned into anything, which we then treat. Natasha Richardson probably would have lived if she'd had an accident here, because doctors would have done a cat scan, and there would have been a Medevac helicopter available. That's tens, maybe hundreds of thousands of dollars to save a single life.

3) There are inefficiencies. I don't mean "compared to other systems"--every system has some screwed-up illogicality that costs it money and makes patients worse off. But compared to what we could have. For example, Medicare pays for procedures, not wellness, which means that there's a chronic undersupply of geriatricians, because the specialty isn't particularly well paid even though the nation's largest healthcare provider is specifically designed for old people. This is madness. But every real-world system that has attempted to pay physicians for wellness has ended up giving up in disgust.



http://business.theatlantic.com/2009/04/ask_the_editors_why_does_health_care_cost_so_much.php

I think doctors are required to do many things that a doctor's assistant or a nurse could handle. I also think our whole medical system is way behind most other segments of the economy in computerization. When I walk into a doctor's office and see those motorized file cabinets filled with paper records I just can't believe they're operating in the same way they were 50 years ago. Prescriptions should be electronically transmitted with encryption and a secure signature. My health insurance first has one doctor, then two, and finally three try to read my physician's scribbled prescription. That's inefficient and also dangerous.

 

[rbell]

I agree that we need to get things online medically...but we must perfect the security measures needed. We just think it's bad when we have our ID stolen. Just wait until someone "doctor shops" for opiates, using your medical condition to feed their habit...then you get busted for it.

This must be addressed before online records will become viable, IMO.

 

[annsni]

One issue about what doctors are paid - I have a good friend who's an orthopedic surgeon. The first $200,000 he makes goes to his malpractice insurance. Yeah - $200,000 a year. Can you imagine? He's an orthopedic surgeon yet they're still struggling and his wife needs to work to help pay the bills (they have 2 sons in college right now). I don't think every doctor is overpaid but they need to make a lot of money to make ends meet.

 

[billwald]

Health care costs so much for the same reason that government costs so much: every person is pleased to spend money that someone else pays.

 

[JustChristian]

One issue about what doctors are paid - I have a good friend who's an orthopedic surgeon. The first $200,000 he makes goes to his malpractice insurance. Yeah - $200,000 a year. Can you imagine? He's an orthopedic surgeon yet they're still struggling and his wife needs to work to help pay the bills (they have 2 sons in college right now). I don't think every doctor is overpaid but they need to make a lot of money to make ends meet.

My roommate in college became a doctor and he just retired. He wanted to continue to deliver babies but the malpractice insurance became almost unbearable. Not only that, but the insurance companies are really putting the squeeze on payments to doctors. I don't think doctor payments are really the problem at all.

 

[LadyEagle]

Providing health care for illegal aliens is bankrupting us. I read that over 80 hospitals in California alone have had to close their doors. We can't be everything to everybody who wants to enter this country illegally. Oh, and by the way, people with no insurance get free health care. (see Hill-Burton Act) Those of us who pay for insurance are picking up the tab.

 

[JustChristian]

Providing health care for illegal aliens is bankrupting us. I read that over 80 hospitals in California alone have had to close their doors. We can't be everything to everybody who wants to enter this country illegally. Oh, and by the way, people with no insurance get free health care. (see Hill-Burton Act) Those of us who pay for insurance are picking up the tab.

I agree that we need to send all illegals back home. We need to take care of Americans not illegal aliens.

 

[Pastor Larry]

Insurance costs so much in part because copays are too low. If copays are raised, people will be much more wary of going to the doctor at the drop of a hat. Higher copays and deductibles will also lower premiums.

I cut my premiums by more than 1/3 by going to a higher deductible, and my overall cost will be lower.

 

[swaimj]

I think there have been some good insights on this thread.

Another reason health-care costs are high is because of the third-party payer system. If I go to the grocery store, I look at costs because I am paying. If I buy a car, I look at costs because I am paying. But when I go to the Dr., I don't ask how much the treatment costs, because I have insurance and THEY are paying. Try walking into the Dr's office sometime and asking the receptionist how much a certain procedure will cost; she will have no clue! Believe me, if no one is asking how much the procedure costs, it is costing too much!

Insurance should be for catastrophic care and routine care should be payed out of pocket. If people payed for their care, they would make sure they were not being overcharged.

 

[Deacon]

That sounds good but with increasing specialization in medicine it gets very expensive, very fast.

Why is healthcare so expensive?

1) People are living longer = more time to use health care.

2) People are living longer = as they age more working people are needed to cover the cost of their care.

3)* The majority of health costs occur during the last months of a persons life, as technology improves, lives are saved: it’s expensive, costs multiply.

4) Increasing litigation means doctors are more likely to perform tests to cover their decisions.

5) Increasing government regulations means increasing overhead for physicians.

6) Increasing abuse of the healthcare system; using hospital emergency units for routine health problems.

7) Hospitals and physicians cover the costs of illegal aliens and the uninsured; the politicians failure to deal with immigration increases your healthcare costs.

8) and this has been mentioned, Third party rules differ from insurance company to insurance company making a regulatory nightmare for physicians; staff is hired just to deal with loads of paperwork before a patient is ever seen.

Rob

 

[Pastor Larry]

Another reason health-care costs are high is because of the third-party payer system. If I go to the grocery store, I look at costs because I am paying. If I buy a car, I look at costs because I am paying. But when I go to the Dr., I don't ask how much the treatment costs, because I have insurance and THEY are paying. Try walking into the Dr's office sometime and asking the receptionist how much a certain procedure will cost; she will have no clue! Believe me, if no one is asking how much the procedure costs, it is costing too much!

Insurance should be for catastrophic care and routine care should be payed out of pocket. If people payed for their care, they would make sure they were not being overcharged.

This is part of the point I was making. I recently skipped a doctor's visit I would have otherwise gone to because I would have paid it all out of my pocket under my new insurance. It was a follow up visit and I was not having any problems that were unusual. So I canceled the visit because I knew what she would say.

That's the advantage of high deductible plans. You pay more out of pocket, so you are more careful about going to the doctor.

 

[Alcott]

Because it's the natural tendency for people to insist on saving their lives, saving their comfort, to 'look better' without having to do what is against their will [eat less, exercise more, avoid too much sun, et al], to have kids when the natural way isn't working-- or to not have them when it is-- and because doctors, employers, youth organizations, et al, are afraid of legal responsibility if they don't order physicals and various tests and routines, and because there are deadbeats who get medical services because the providers cannot legally refuse and somebody pays for it somehow... and more reasons. But all these circumstances require extremely expensive equipment which is extremely expensive to maintain and requires extremely highly educated and trained personnel to operate and interpret results who themselves are forced to fear legal responsibility for even the implication of the slightest mistake.

How can all that be done cheaply, no matter what the 'system' of delivery?

 

[FriendofSpurgeon]

This is part of the point I was making. I recently skipped a doctor's visit I would have otherwise gone to because I would have paid it all out of my pocket under my new insurance. It was a follow up visit and I was not having any problems that were unusual. So I canceled the visit because I knew what she would say.

That's the advantage of high deductible plans. You pay more out of pocket, so you are more careful about going to the doctor.

The concern with the higher deductible plans (HSAs, etc.) is that people will withhold treatment for themselves and/or their children, especially preventative care. If so, this will make everything (costs and outcomes) much worse. Currently, the jury is still out whether or not this will be better or not.

 

[blackbird]

Check this one out

Years ago our daughter needed tubes in her ears---says the pediatrican

We were "between" insurance carriers and did not have insurance to cover the operation

So we explain to the surgeon that we didn't have insurance to cover the operation-----------the surgeon understood and took his folder and "scribbled" something down and showed us what he wrote

"NO CHARGE!!"

But he did say that the hospital was going to charge------see??? THAT'S the "kicker!!!!"

Another time------last year-----I discovered a melanoma on my left arm and was sent to an oncology surgeon-----best in the south in Birmingham's UAB hospital

Outpatient surgery cost my insurance a whoppin' $18,000.00----it cost my deductable $3,000.00

Plus

Now get this

The surgeon------I forget what he charged------but when I got the bill from him----his name was on the list along with what he charged(though it was a FRACTION of what the hospital charged:BangHead::BangHead-----along with a team of doctors who(I suppose) "assisted"-----there was a list of doctors on that paper that I never laid eyes on-----and they all had their little "charge" there and they all got their money

Don't sit there and tell me that hospitals aren't there to "make money"

 

[Martin Luther]

1) We pay more for our medical services. But though the pharma industry is important, the real action is in wages. Our medical personnel cost vastly more than their counterparts abroad in almost every category.

2) We consume more services. Americans get shiny new facilities--my British colleagues once derisively commented that American hospitals are "like hotels". American hospitals don't have open wards for almost anyone. They staff at very high levels. Doctors conduct an inordinate amount of tests. We use an expensive machine rather than watchful waiting. And often, those expensive machines catch conditions that never would have turned into anything, which we then treat. Natasha Richardson probably would have lived if she'd had an accident here, because doctors would have done a cat scan, and there would have been a Medevac helicopter available. That's tens, maybe hundreds of thousands of dollars to save a single life.

3) There are inefficiencies. I don't mean "compared to other systems"--every system has some screwed-up illogicality that costs it money and makes patients worse off. But compared to what we could have. For example, Medicare pays for procedures, not wellness, which means that there's a chronic undersupply of geriatricians, because the specialty isn't particularly well paid even though the nation's largest healthcare provider is specifically designed for old people. This is madness. But every real-world system that has attempted to pay physicians for wellness has ended up giving up in disgust.



http://business.theatlantic.com/2009/04/ask_the_editors_why_does_health_care_cost_so_much.php

This is all about to change soon. Health insurance costs have gone to high for most people to afford and this will create demand destruction. It's already happening, but the down side is that "they" will not be as liberal with miracle medicine. Also, the pay doctors and nurses get will be dropping very soon.