Discussion in 'Economics' started by Banjo, Jun 27, 2017.
I still have the knuckle scars
Awwww, Jeez, v-z!
I was in grad school when all this shiete came down, and we (policy, econ, political science students) would all be sitting around, discussing the (public policy) news of the day -- and it was so often followed by "Really?!? *That* sounds dumb." And then I'd call home, and get the same thing from the (academic/nursing) parents. "But why are they *doing* that, Thomas?" like I was supposed to come up with the sensible economic answer as to why, what they knew to be medically or economically non-sensible, somehow made sense.
And this is *decades* ago.
And now my parents are passed on, but as they were "aging" and a lot of palliative care was going on, my father would show me MediCare bills (as long as your arm) of which, one would entail a 30-minute visit, and go $10,000 - $20,000, and the other would involve an overnight inpatient visit or two, and specialists out the wazoo, and run under $5,000. My father's eloquent question, "Thomas, WTF?" Dad..... Dad, I don't know. I just don't know.
(The Old Man -- a teacher's teacher, knew how to cut to the chase, eh?)
Anyway -- thanks for the reminder about Sister Mary Discipline -- my folks had many tales to tell about her. Thank The Entity, I don't.....
Not at all. Like billionaires can afford their own hospitals, every individual should aspire to that, or perish like the lazy bums they are. Let's face it, if you can't afford your personal hospitals, doctors, firedepartments and everything else you require, you're trash and get what you deserve when nobody lifts a finger for you! Anything less than full funding, and you're living off on charity.
I had an emergency appendectomy operation last summer. After being in the waiting room for hours they took me in around 7 in the morning on a Saturday. Operation at 9 or 10. Out by Monday. My cost was 54,000 dollars.
I have health insurance for my family that I pay over a thousand dollars a month for ( it doubled under obamacare) I have a 10,000 dollar deductible. I am very happy to be alive and would have paid the 54,000 up front if I had to. I thank the surgeon for being skilled enough to save my life an allow me a relatively quick recovery.
My question is... is that price reasonable. I was charged 11,000 dollars for I.V. fluids.
On one hand I would have mortgaged any amount to live. I was so grateful to be alive. I told my kids to go into medicine... but on the other hand... that system needs to change its cost structures. Not the medical care but the costs. I mean I was already paying over a grand a month for insurance.
let me be clear though. I am not in way complaining about the medical care. And, I am not really complaining about the insurance. The insurance was much cheaper before obamacare.
Maybe the free market could bear much higher costs, have you thought about that?
It obviously means nothing to society / other people.
Being grateful, what does it really help? Only money and lots of it, to fund personal hospitals and police departments will do!
BE #1, or perish. Amen!
What you didn't know, jem, was that you were one of three appendectomy patients that came in at the same time.
The first was your Representative to the U.S. House -- they paid not-a-penny out-of-pocket, were seen immediately, and their House-provided insurance was charged $25,000, you know, "cuz." You were the second patient, $11k out-of-pocket, $43k to your "Big Name" insurance company, who'd already negotiated it down to a flat $33,333 -- the hospital "absorbing" the rest -- cuz, like, "'Gee!' they have all those (patient) numbers they can bring, and isn't medicine cheaper when you can do it in bulk?" Yeah. The third patient was a migrant laborer, who lives hand-to-mouth, whose everyday labors put the meal on the (fast food) table in front of themselves and their loved ones. They had a bellyache on their way through town, hurled every meal they tried to eat for the last 18 hours, and shortly (Thank God!) before their belly burst, they rolled themselves into the ER, and got triaged right after you. Their bill -- a flat $60,000 -- will bankrupt them if they have the moral backbone to stick around, and will be laid upon every other patient, along with the Rep's shortage of $30,000, and your own bill's slippage of $10,000, so when the books are tallied, the hospital comes up being short $100,000 per every three appendectomies.
SO A THIRD CURE, for the falsely-titled "Heathcare Crisis" (when sensibly, it is a Health Care FINANCE crisis...), is to
3) have SINGLE, POSTED, TRANSPARENTLY-DERIVED, UNIFORMLY-APPLIED A'LA CARTE MENU of healthcare services, which allows price-shopping amongst non-discriminating service providers. An "Expedia.Com of Healthcare," if you will. Maine (and I think another state or two) does this already.
The question is not whether single payer is a great system. The question is whether single payer is better than what we have now. The U.S. does not have too many other easy alternatives:
* Fixing malpractice won't because malpractice only consumes about 0.5% of total health care spending;
* Selling insurance across state lines won't, because we already have 6 states that allow this and none has ever had an insurance company willing to do it. Georgia just passed their 5 year anniversary of allowing this, and in the 5 years no insurance company even asked to see the application.
* Comparison shopping for healthcare is virtually impossible because most hospitals won't give a quote beforehand.
The only way for healthcare costs to go down is for somebody to get paid less. Either the hospitals, doctors, nurses, pharma, insurance, etc. What single payer does is to say that the insurance companies will be the ones that will be paid less.
And for those that say this will put us on the road to socialize medicine, you need to wake up. Between Medicare, Medicaid, the VA, federal, state and local employees, 66% of all the people with health insurance, and 62% of all healthcare spending is already provided by the government.
Not quite. The cost of medical malpractice alone is more than 2% of the healthcare sector's share of GDP. But there's also hidden costs, specifically, when a Doctor orders a very expensive and probably unnecessary test not to rule out the possibility of the disease in question, but to rule out the possibility of getting sued. This pushes up health costs across the board because now these unnecessary treatments must be contemplated in the cost of personal health insurance. That means more underwriting, more bureaucracy, more claims potential, more premiums....
When you consider than only about 60% of health insurance costs go towards treatment (and depending who you ask, 20-40% of that is rolled back into insurance bureaucracy for med-mal), you get a good idea of the actual cost of health care. Compare the L&H insruance sector to the healthcare sector, and remember their earnings are a fraction of the costs of premiums, the picture of the true expense of med-mal starts to fill in quite starkly.
True the cost of medical malpractice is about 2%, but the 0.5% I am referring to is what the insurance companies actually pay out in claims and legal fees. The 2% is what they collect in premiums. A very profitable business.
As for unnecessary tests, fear of malpractice is not the only reason. More than 50% of the time that a doctor sends a patient for a test, the doctor has a financial interest in the lab or hospital where the he sends the patient to get the test done.
Just my two cents on the situation from the perspective of drug costs, as someone who used to work in the pharmaceutical industry...
Way back in the year 2000, my former company (prior to me working there) developed and launched a novel treatment for a certain type of cancer that typically affects adults over the age of 55...at the time, 75% of people diagnosed with this form of cancer would die within 5 years of diagnosis, so this particular drug was welcomed by oncologists and went on to prolong numerous lives.
Part of the problem with the cancer described above is that approximately half of all patients treated with my company's product will eventually go on to relapse at some point, and therefore will require additional treatment in the future if they want to prolong their lives further.
This reality has not been lost on competitor pharma companies - today there are 9 competing products designed to treat the cancer my company pioneered treatment for. In many cases, competitors were able to gain approval for their drugs from the FDA by showing that their product prolonged life by 2 months vs a competitor.
So in essence what this has created a situation where we have gone from the following in a twenty year period:
1999 - minimal treatment available - people died quickly after receiving low-cost subpar generic drugs.
2000 - my former company launches wonderful life-prolonging drug - people live longer, but payers are now shelling out $60,000 for treatment.
2017 - 9 competitor products have emerged - people live as if they do not have the cancer, but often receive numerous types of therapy, each requiring payers to come up with $100,000 per therapy.
So in reading all of the above, it would appear that we have a victim of our own success in terms of advancing medicines and prolonging life (i.e., people not dying from these terrible diseases is wonderful news, but is actually part of the problem in terms of cost.)
The example I described above is only detailing the patient experience for a cancer that only affects 80,000 Americans annually, but I am sure that similar situations can be found across numerous disease types. When you think of things in those terms, it is no wonder healthcare costs are skyrocketing.
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