Pay $43,000 for an Appendectomy? Or less than $3,000?

[dblack]

Isn't that the purpose of deductibles being so high? So that the patient/consumer is made acutely aware of the costs of medical procedures that are not covered until they fulfill their deductibles? that was the whole purpose of high deductibles being allowed by our gvt in the ACA, that and supposedly to lower the price of the policies....?

ACA didn't "allow" high deductible plans, it sat on them. The thing is, before ACA, high deductible plans had very low premiums. From 2005 - 2008 mine cost around $150/mo, with a $4000 deductible. By comparison a plan with a $100 deductible cost $600/mo. The savings in premiums was more than enough to fund an HSA to cover the deductible.

But that ACA changed all that. The new regulations and mandates have cranked up the premiums on high deductible plans such that the math no longer makes sense - ie the savings in premiums for the high deductible plans don't make up for the difference in the deductible.

 

[Skull Pilot]

The best way to lower medical costs is to make hospitals post the prices of their services.

How would that make a difference? As long as it's the insurance company taking the hit patients won't care. It certainly won't give them any incentive to demand lower prices.

As it is now we have completely insulated medical costs from market forces

That is EXACTLY the problem with the health care market.

When the costs for medical services go down premiums will go down.

If people can shop around and get better prices on everything the insurance companies will pay less out and premiums will drop

 

[Skull Pilot]

The best way to lower medical costs is to make hospitals post the prices of their services.

How would that make a difference? As long as it's the insurance company taking the hit patients won't care. It certainly won't give them any incentive to demand lower prices.

As it is now we have completely insulated medical costs from market forces

That is EXACTLY the problem with the health care market.

Isn't that the purpose of deductibles being so high? So that the patient/consumer is made acutely aware of the costs of medical procedures that are not covered until they fulfill their deductibles? that was the whole purpose of high deductibles being allowed by our gvt in the ACA, that and supposedly to lower the price of the policies....?

I'm not talking about the policies I'm talking about the cost of actual medical services.

If you knew that a X rays at one place cost so much but at another they were half that price you could get your X rays done for less therefore the insurance company would pay less. Do this with enough services and the price of insurance will drop.

 

[Greenbeard]

I'm not talking about the policies I'm talking about the cost of actual medical services.

If you knew that a X rays at one place cost so much but at another they were half that price you could get your X rays done for less therefore the insurance company would pay less. Do this with enough services and the price of insurance will drop.

If we're talking about services priced below the person's deductible (so the person is on the hook for the full cost and will presumably have an incentive to choose the cheapest health care provider), that person's choice won't impact premiums because the insurer isn't playing for it either way.

The health care provider might try and drop prices to attract those consumers if they can, but they also might make up for it by raising prices on expensive services above the deductible, potentially raising premiums in the long run.

 

[Zander]

Great true story about Private Medical Care in Mexico

My son had an attack of appendicitis late Saturday night. I knew that the Obamacare inflated prices for surgery in the U.S. would be ridiculous and that the service would likely be impersonal, involve long waits, and be nerve-wracking. I have friends in the medical field so I inquired just for grins. The price for the latest routine appendectomy in my area was, my jaw dropped, $43,000. I read on-line that the average cost for an appendectomy in the U.S. is $33,000.
​

That is fucking crazy!! $43,000 to remove an appendix? So he went to Mexico.

I opted for the nearby private Catholic hospital in Mexico driving past a Catholic hospital in the U.S. en route. I also drove past the state run socialist hospital in Mexico which of course has deplorable service and doesn’t serve Americans anyway. Most of the private hospitals in Mexico have great service, modern equipment and procedures, and affordable prices. You can actually have extensive conversations with surgeons and the rest of the medical staff. They are very patient, respectful, and understanding. We arrived on a Sunday morning. This counted as an emergency after-hours visit. The fees listed below are higher because of the Sunday call-out for surgical personnel and the extra fee for the emergency room doctor that could have been avoided if I had come during normal business hours.

Private Medical Care in Mexico - LewRockwell LewRockwell.com​

Medical tourism was happening long before Obamacare became law of the land.

The cost of medical care in the US is astronomical compared to the rest of the world, and has been for a long time.

Interesting that you would mention Obamacare since I never mentioned it.....

Has Obamacare lowered costs or increased them? Why did it fail to "bend the cost curve" as promised?

 

[Toro]

Great true story about Private Medical Care in Mexico

My son had an attack of appendicitis late Saturday night. I knew that the Obamacare inflated prices for surgery in the U.S. would be ridiculous and that the service would likely be impersonal, involve long waits, and be nerve-wracking. I have friends in the medical field so I inquired just for grins. The price for the latest routine appendectomy in my area was, my jaw dropped, $43,000. I read on-line that the average cost for an appendectomy in the U.S. is $33,000.
​

That is fucking crazy!! $43,000 to remove an appendix? So he went to Mexico.

I opted for the nearby private Catholic hospital in Mexico driving past a Catholic hospital in the U.S. en route. I also drove past the state run socialist hospital in Mexico which of course has deplorable service and doesn’t serve Americans anyway. Most of the private hospitals in Mexico have great service, modern equipment and procedures, and affordable prices. You can actually have extensive conversations with surgeons and the rest of the medical staff. They are very patient, respectful, and understanding. We arrived on a Sunday morning. This counted as an emergency after-hours visit. The fees listed below are higher because of the Sunday call-out for surgical personnel and the extra fee for the emergency room doctor that could have been avoided if I had come during normal business hours.

Private Medical Care in Mexico - LewRockwell LewRockwell.com​

Medical tourism was happening long before Obamacare became law of the land.

The cost of medical care in the US is astronomical compared to the rest of the world, and has been for a long time.

Interesting that you would mention Obamacare since I never mentioned it.....

Has Obamacare lowered costs or increased them? Why did it fail to "bend the cost curve" as promised?

The story mentioned Obamacare.

IIRC, though medical costs have risen over the past 7-8 years, they’ve grown at a slower rate than the past few decades. Whether or not that is due to Obamacare is another issue.

 

[boedicca]

Isn't that the purpose of deductibles being so high? So that the patient/consumer is made acutely aware of the costs of medical procedures that are not covered until they fulfill their deductibles? that was the whole purpose of high deductibles being allowed by our gvt in the ACA, that and supposedly to lower the price of the policies....?

ACA didn't "allow" high deductible plans, it sat on them. The thing is, before ACA, high deductible plans had very low premiums. From 2005 - 2008 mine cost around $150/mo, with a $4000 deductible. By comparison a plan with a $100 deductible cost $600/mo. The savings in premiums was more than enough to fund an HSA to cover the deductible.

But that ACA changed all that. The new regulations and mandates have cranked up the premiums on high deductible plans such that the math no longer makes sense - ie the savings in premiums for the high deductible plans don't make up for the difference in the deductible.

I've come to the conclusion that the premiums + deductibles + copay are what health care would cost if there was absolutely no insurance at all.

ACA is designed to transfer income and wealth from individuals to Big Pharma, Big Medical, and Big Government...just like most programs that are not Constitutional responsibilities.

 

[kiwiman127]

Healthcare insurance rate increases typically mirror the increases provider care, the costs of pharmaceuticals and increase costs of medical technology. In America, those costs increases are rising 3-4times the rate of inflation. It’s not happening in the rest of the world. Why? Because other countries won’t let it happen, period.
In America, absolutely nothing is being done about holding the costs down. Our government’s inaction is making matters much worse. Tort reform won’t do it and neither will selling insurance across state lines. Those two adjustments would only create a small dent in the annual rise of the cost of health care.
No country in the world as the cost of healthcare eating up their GDP like the US does.

U.S. Health Care from a Global Perspective

America has to get a clue before it’s too late.

https://www.rand.org/content/dam/rand/pubs/research_briefs/2011/RAND_RB9605.pdf

 

[Greenbeard]

No country in the world as the cost of healthcare eating up their GDP like the US does.

The flip side of that is health care remains a major source of employment growth and local economic activity. Health care is increasingly what America does.

 

[kiwiman127]

No country in the world as the cost of healthcare eating up their GDP like the US does.

The flip side of that is health care remains a major source of employment growth and local economic activity. Health care is increasingly what America does.

As noted in my last link, the continued high pace of healthcare costs, is eating away at the consumers expendable income. Considering that 80% of our capitalistic economy is driven by consumer spending, a reduction of disposable income hurts the US economy.

 

[Greenbeard]

As noted in my last link, the continued high pace of healthcare costs, is eating away at the consumers expendable income. Considering that 80% of our capitalistic economy is driven by consumer spending, a reduction of disposable income hurts the US economy.

ASPE looked at this a few years ago and it isn't clear-cut.

However, the view that rapidly rising health care spending harms the U.S. economy is not without dissenters, and some prominent economists view increases in health spending as having a neutral, or perhaps even a positive, economic effect. For example, Pauly (2003) has argued that rising health care spending naturally results in rapid growth in the health care and related sectors, and in employment and incomes for workers in those sectors. Notably, health care firms are largely U.S.-owned. A related argument is that as total per capita GDP rises, consumers may choose to spend a higher portion of their income on health care consequently improving population health and productivity.

Anecdotal evidence suggests that rising health care costs have a negative effect on the U.S. economy. However, there are no empirically rigorous studies that have examined the causal impact of health care cost growth on aggregate economic outcomes. Studies that examine the association between per capita income or GDP and health care costs almost always find a positive relationship. This is possibly because economic growth is accompanied by a rising share of health care in GDP. While some economists believe that rising health care costs could improve health and consequently improve labor productivity, empirical evidence in favor of this view is limited.

This isn't to suggest that we don't want other sectors to be growing at least as fast as the health sector, I'm just pushing back on the notion that we can identify some natural proportion of the economy that health care ought to constitute in a rich nation in the 21 century.

If health care is where people want to put their money in a rich society, there's nothing inherently wrong with that. The problem is that we don't have a particularly good system in place whereby people are asked and thus able to effectively signal by voting with their wallets.

 

[dblack]

Isn't that the purpose of deductibles being so high? So that the patient/consumer is made acutely aware of the costs of medical procedures that are not covered until they fulfill their deductibles? that was the whole purpose of high deductibles being allowed by our gvt in the ACA, that and supposedly to lower the price of the policies....?

ACA didn't "allow" high deductible plans, it sat on them. The thing is, before ACA, high deductible plans had very low premiums. From 2005 - 2008 mine cost around $150/mo, with a $4000 deductible. By comparison a plan with a $100 deductible cost $600/mo. The savings in premiums was more than enough to fund an HSA to cover the deductible.

But that ACA changed all that. The new regulations and mandates have cranked up the premiums on high deductible plans such that the math no longer makes sense - ie the savings in premiums for the high deductible plans don't make up for the difference in the deductible.

I've come to the conclusion that the premiums + deductibles + copay are what health care would cost if there was absolutely no insurance at all.

How did you come to that conclusion? That actually, can't be the case. If it were, insurance companies could never turn a profit.

ACA is designed to transfer income and wealth from individuals to Big Pharma, Big Medical, and Big Government...just like most programs that are not Constitutional responsibilities.

Exactly!

 

[boedicca]

Isn't that the purpose of deductibles being so high? So that the patient/consumer is made acutely aware of the costs of medical procedures that are not covered until they fulfill their deductibles? that was the whole purpose of high deductibles being allowed by our gvt in the ACA, that and supposedly to lower the price of the policies....?

ACA didn't "allow" high deductible plans, it sat on them. The thing is, before ACA, high deductible plans had very low premiums. From 2005 - 2008 mine cost around $150/mo, with a $4000 deductible. By comparison a plan with a $100 deductible cost $600/mo. The savings in premiums was more than enough to fund an HSA to cover the deductible.

But that ACA changed all that. The new regulations and mandates have cranked up the premiums on high deductible plans such that the math no longer makes sense - ie the savings in premiums for the high deductible plans don't make up for the difference in the deductible.

I've come to the conclusion that the premiums + deductibles + copay are what health care would cost if there was absolutely no insurance at all.

How did you come to that conclusion? That actually, can't be the case. If it were, insurance companies could never turn a profit.

ACA is designed to transfer income and wealth from individuals to Big Pharma, Big Medical, and Big Government...just like most programs that are not Constitutional responsibilities.

Exactly!

Government subsidies.

 

[dblack]

The best way to lower medical costs is to make hospitals post the prices of their services.

How would that make a difference? As long as it's the insurance company taking the hit patients won't care. It certainly won't give them any incentive to demand lower prices.

As it is now we have completely insulated medical costs from market forces

That is EXACTLY the problem with the health care market.

When the costs for medical services go down premiums will go down.

If people can shop around and get better prices on everything the insurance companies will pay less out and premiums will drop

Yes, but if their insurance company is paying the bills, what interest do consumers have in shopping around? Why would people care about saving their insurance company money?

 

[dblack]

Isn't that the purpose of deductibles being so high? So that the patient/consumer is made acutely aware of the costs of medical procedures that are not covered until they fulfill their deductibles? that was the whole purpose of high deductibles being allowed by our gvt in the ACA, that and supposedly to lower the price of the policies....?

ACA didn't "allow" high deductible plans, it sat on them. The thing is, before ACA, high deductible plans had very low premiums. From 2005 - 2008 mine cost around $150/mo, with a $4000 deductible. By comparison a plan with a $100 deductible cost $600/mo. The savings in premiums was more than enough to fund an HSA to cover the deductible.

But that ACA changed all that. The new regulations and mandates have cranked up the premiums on high deductible plans such that the math no longer makes sense - ie the savings in premiums for the high deductible plans don't make up for the difference in the deductible.

I've come to the conclusion that the premiums + deductibles + copay are what health care would cost if there was absolutely no insurance at all.

How did you come to that conclusion? That actually, can't be the case. If it were, insurance companies could never turn a profit.

ACA is designed to transfer income and wealth from individuals to Big Pharma, Big Medical, and Big Government...just like most programs that are not Constitutional responsibilities.

Exactly!

Government subsidies.

Yep. It's corporatism run amok. We have industry lobbyists formulating policy whole, and handing it to Congress for implementation.

 

[Skull Pilot]

I'm not talking about the policies I'm talking about the cost of actual medical services.

If you knew that a X rays at one place cost so much but at another they were half that price you could get your X rays done for less therefore the insurance company would pay less. Do this with enough services and the price of insurance will drop.

If we're talking about services priced below the person's deductible (so the person is on the hook for the full cost and will presumably have an incentive to choose the cheapest health care provider), that person's choice won't impact premiums because the insurer isn't playing for it either way.

The health care provider might try and drop prices to attract those consumers if they can, but they also might make up for it by raising prices on expensive services above the deductible, potentially raising premiums in the long run.

There would be no need for deductibles like we have now if medical costs came down enough.

Deductibles could be and quite frankly still are optional on health insurance

 

[Skull Pilot]

Healthcare insurance rate increases typically mirror the increases provider care, the costs of pharmaceuticals and increase costs of medical technology. In America, those costs increases are rising 3-4times the rate of inflation. It’s not happening in the rest of the world. Why? Because other countries won’t let it happen, period.
In America, absolutely nothing is being done about holding the costs down. Our government’s inaction is making matters much worse. Tort reform won’t do it and neither will selling insurance across state lines. Those two adjustments would only create a small dent in the annual rise of the cost of health care.
No country in the world as the cost of healthcare eating up their GDP like the US does.

U.S. Health Care from a Global Perspective

America has to get a clue before it’s too late.

https://www.rand.org/content/dam/rand/pubs/research_briefs/2011/RAND_RB9605.pdf

Exactly my point.

People do not know what medical costs are so market forces cannot be brought to bear.

If we made all medical costs transparent including what it costs patients to pay for the armies of people hospitals and HMOs need to handle all the insurance bullshit then the public could put pressure on both the insurance industry and the health care industry.

People will have to take more of a role in their own health care but how is that not a good thing?

 

[Skull Pilot]

The best way to lower medical costs is to make hospitals post the prices of their services.

How would that make a difference? As long as it's the insurance company taking the hit patients won't care. It certainly won't give them any incentive to demand lower prices.

As it is now we have completely insulated medical costs from market forces

That is EXACTLY the problem with the health care market.

When the costs for medical services go down premiums will go down.

If people can shop around and get better prices on everything the insurance companies will pay less out and premiums will drop

Yes, but if their insurance company is paying the bills, what interest do consumers have in shopping around? Why would people care about saving their insurance company money?

If the insurance companies save money then the cost of insurance goes down. If you're heel bent on making the insurance company pay as much as possible then premiums will keep skyrocketing

IMO we shouldn't let hospitals be the middlemen between the consumer and his insurance company that's a big reason why there is such secrecy about the actual costs of health care.

 

[Greenbeard]

If the insurance companies save money then the cost of insurance goes down. If you're heel bent on making the insurance company pay as much as possible then premiums will keep skyrocketing.

While true (assuming insurers are in a market that forces them to compete aggressively on premium), there's virtually zero chance that realization will influence anyone's behavior if the cost to them at the point of service is the same regardless of whether they choose the cheapest or most expensive provider. Particularly since people tend to equate provider costs with quality.

 

[Skull Pilot]

If the insurance companies save money then the cost of insurance goes down. If you're heel bent on making the insurance company pay as much as possible then premiums will keep skyrocketing.

While true (assuming insurers are in a market that forces them to compete aggressively on premium), there's virtually zero chance that realization will influence anyone's behavior if the cost to them at the point of service is the same regardless of whether they choose the cheapest or most expensive provider. Particularly since people tend to equate provider costs with quality.

People have no idea what the costs are now so it is impossible to make any judgement on quality as related to cost so knowing the costs allows that call to be made. But really does it matter if your Xray costs 1000 or 100 dollars? My Vet has a digital Xray and I can get imaging done on my dog for a hell of a lot less than on myself. So what would happen is that we could have a businesses like X rays R us that will do volume imaging at lower costs and people will just go there for X rays. How about routine blood lab work? IS a blood panel any better because it costs 3 times more at one lab than another?