Thoughts on Healthcare

Just thinking about the whole health care debate...and I wonder, why is there no discussion about limiting what hospitals, doctors, and pharmaceutical companies can charge for products and services? Is that SO unamerican? I doesn't make sense to me that cost continue to rise but advances, especially in terms of major diseases, have not increased accordingly.

Instead of advocating coverage for all Americans, which for the record I am opposed to, why not focus on what can be charged? Does it really matter that we cover everyone if Physicians are still able to charge hundreds of dollars for one visit or Big Pharm continues to charges thousands of dollars for treatment that MIGHT work? Case in point, I sprained my ankle and sought coverage out of network. The hospital bill alone was $400 plus dollars. $400 plus dollars to see a nurse for about 20 minutes and physician for 5 minutes. THAT is a rip off especially when you consider that the physician is billing me separately so his time shouldn't be included in the determination of whether that $400 charge is reasonable. Or a friend who was required to get a drug test in order to obtain a prescription (BS IMHO) and who was charged $300 for lab work. $300 to run a drug test?

Maybe I don't understand the costs but I also don't believe Democracy is synomous with Capitalism. Some things are NOT better left to the market and health care in my humble opinion is one of those. Doctors, pharmaceutical companies, and hospitals have a monopoly on this vital service and are able to charge whatever they feel and are permitted to maxamize profits.

I'm sorry, but when you look at what is the best for society as a whole, allowing health care to be completely controlled by the market makes zero sense.

 

You think it's bad now? Just watch what happens if the government gets control of your health care. Talk about a monopoly? I agree with your post in part. I think hospital and doctor charges should be the same nationwide. Why should it cost more to get your broken arm fixed in LA or NYC then it does in a small area like Rockford, Illinois? I mean, a broken arm is a broken arm no matter where it is in the country. Treatment and cost should be the same.

 

Thanks for the response. I also ask, why does it rise each yr? Why should it cost more in 2010 to fix a broken arm than in 2009? I understand an increase between 2010 and 1990.....but one year and costs increase? Like I said, I believe very strongly that the notion of profit and health care should be completely divorced. I don't want government running it, only limiting what a MD or Pharm Co. can charge for the drug or service, and NOT just to Medicare or Medicaid recipients..but to everyone

 

I have a question too...

Is there anyway of letting each state plan and execute their own model? Does it serve any purpose at all elevating this to a national level? If I have totally misunderstood this, please forgive me.

But a health care plan for 300 million people of the diversity within USA - is there something "extra" in it if it gets "federated"?

 

Before healthcare, which actually performs at a more than successful level in the US, how about we begin limiting the costs for education, which has not produced a successful product in years!

Tuition at private colleges and universities has increased anywhere from 5% to 13% every year since 1980. "
The Cost of a College Education

And for primary and secondary school:
"Based on statistics from the US Department of Education, the average cost of educating a student in elementary and secondary schools has risen from $6,200 in 1991 to $11,000 in 2005 an increase of 85%. "
US Education Market | Entourage Systems Inc.


When you consider the above, doesn't it put you in mind that the administration-media complex is manipulating the way you think, and what you think about?

Not epiphanized yet?

Then look at the following list, all of which are proven ways to reduce the costs of healthcare, and consider why none are in the Obamunist-Care plan:

1. Scrap all city, state, federal mandates for healthcare insurance policies. When a statute says policies must “cover mammograms of everyone 35 and over,’ how is this fair for a construction company with all male employees? What about ‘Podiatry,’ or ‘sexual reorientation surgery/? Allow insurance companies to write policies covering exactly what the consumer asks for:
Take two very different states: Wisconsin and New York. In Wisconsin, a family can buy a health-insurance plan for as little as $3,000 a year. The price for a basic family plan in the Empire State: $12,000. The stark difference has nothing to do with each state’s health sector as a share of its economy (14.8 percent in Wisconsin as of 2004, the most recent year for which data are available, and 13.9 percent in New York). Rather, the difference has to do with how each state’s insurance pools are regulated. In New York State, politicians have tried to run the health-insurance system from Albany, forcing insurers to deliver complex Cadillac plans to every subscriber for political reasons, driving up costs. Wisconsin’s insurers are far freer to sell plans at prices consumers want.
The gulf in insurance-premium prices among American states is a sign that too much government intervention—not too little—is what’s distorting prices from one market to the next. The key to reducing health-care costs for patients, then, is to promote competition, not to dictate insurance requirements from on high. Unfortunately, a government-run insurance plan is the core of ObamaCare.
Bigger Is Healthier by David Gratzer, City Journal 22 July 2009
a. NJ has some 68-69 mandates including in vitro fertilization, which adds some 2-2.5% to the cost of the policy

2. Tort reform:
The number of U.S. malpractice payments in 2008 was the lowest since creation of the federal National Practitioner Data Bank, which has tracked payments since 1990. And the average payment — about $326,000 — was the smallest in a decade.

While malpractice litigation accounts for only about 0.6 percent of U.S. health care costs, the fear of being sued causes U.S. doctors to order more tests than their Canadian counterparts. So-called defensive medicine increases health care costs by up to 9 percent, Medicare's administrator told Congress in 2005. "
Canada keeps malpractice cost in check - St. Petersburg Times

Now, compare those with these:
"Also, it’s worth noting that while these figures sound like a lot of money — and few would dispute the fact that health insurance company CEOs make healthy salaries — these numbers represent a very small fraction of total health care spending in the U.S. In 2007, national health care expenditures totaled $2.2 trillion. Health insurance profits of nearly $13 billion make up 0.6 percent of that. CEO compensation is a mere 0.005 percent of total spending."
FactCheck.org: Pushing for a Public Plan

So my conclusion is that the cost of malpractice suits is equal to the profit of the entire industry.

This may be significant of and by itself, but when we look at the costs of defensive medicine, it alone adds to the costs of healthcare by a factor 15!!!
Once we have tort reform, we should move toward coordinated care networks that take responsibility for their members' medical needs in return for fixed annual payments (called "capitation"). One approach is through vouchers; Medicare recipients would receive a fixed amount and shop for networks with the lowest cost and highest quality.

3.. Doctors currently have no ability to re-price or re-package their services that way every other professional does. Medicare dictates what it pays for and what it won’t pay for, and the final price. Because of this there are no telephone consultations paid for, and the same for e-mails, normal in every other profession.
Most doctors don’t digitize records, thus they cannot use software that allows electronic prescription, and make it easier to detect drug interactions or dosage mistakes. Again, Medicare doesn’t pay for it.

4. Another free market idea aimed at better quality is have warranties for surgery as we do for cars. 17% of Medicare patients who enter a hospital re-enter within 30 days because of a problem connected to the original surgery. The result is that a hospital makes money on its mistakes!

5. Walk-in clinics are growing around the country, where a registered nurse sits at a computer, the patient describes symptoms, the nurse types it in and follows a computerized protocol, the nurse can prescribe electronically, and the patient sees the price in advance

6. To reduce healthcare costs, increase the number of doctors. Obama care would do the opposite. Both tax incentives and support of the tuition of medical school.

7. Identify the 8-10 million who need and are unable to get healthcare, including those with pre-existing conditions,and provide debit cards as is done for food stamps:

"Food debit cards help 27 million people buy food, similar to the number who need help buying health coverage. In all fifty states, debit card technology has transformed the federal food stamp program, which used to be notorious for fraud and abuse. (Only 2 percent of card users are found to be ineligible, according to the General Accounting Office.) Cards are loaded with a specific dollar amount monthly, depending on family size and income, and allow cardholders to shop anywhere. The same strategy could be adapted to provide purchasing power to families who need help buying high-deductible health coverage. It's what all Americans used to buy (see chart 5), and it's all that's needed for families with moderate incomes, who can afford a routine doctor visit. "
Downgrading Health Care

8. Current law provides unlimited tax relief for coverage obtained through an employer but no comparable relief for those who purchase coverage outside their places of work. S. 334 would replace the current tax preference for employer-based health coverage with a new individual-based system. The bill would end the tax exclusion in the personal income tax for employer-based health insurance benefits and instead use a combination of subsidies and tax deductions for health insurance. Ideally, the current employer-based tax structure should be replaced with a fair and equitable universal tax credit. An across-the-board, fixed-dollar health care tax credit, for example, would offer every American federal tax relief for health care.(Wyden-Bennett Bill)

Wise up.

 

Good question Erik. States have long ceased to become the "labortories" of public opinion and political change that they once were. I would have no qualms with allowing states to devise their own health care models. I'm beginning to think that the only reason medical charge caps are not discussed is because of the huge influence doctor and pharm co lobbiest have in terms of political clout. NOW that's a shame and in fact, (when you consider big money directing policy as opposed to the general consensus or what's good for the general population) it's UnAmerican.

 

Here is a chance to educate yourself re:increase in healthcare costs.

By Betsy McCaughey Betsy McCaughey, Ph.D., is a patient advocate, founder of the Committee to Reduce Infection Deaths, and a former Lt. Governor of New York State.
Downgrading Health Care
The administration has warned that soaring health spending threatens the stability of American families and the economy. These doomsday scenarios are untrue. Health care spending is increasing at more moderate rates than in previous decades. Spending increased 10.5 percent in 1970, 13 percent in 1980, and consistently less than 7 percent in each of the last five years, reaching a low of 6.1 percent a year ago. Each year since 1960, food and energy together have taken up a declining share of Americans' expenditures, while housing has taken up a steady share. This has enabled Americans to spend an increasing share of their budgets on another necessity, healthcare. These four necessities together consume the same share of American spending now (55%) as they did in 1960 (53%). As further evidence, Americans are increasing the share of their spending that goes to recreation. Moderate income families can be helped to buy health coverage with vouchers, refundable tax credits, or debit cards. That's a low risk, "fix what's broken" approach.
Increases in healthcare expenditures:
2003 8.6%
2004 6.9%
2005 6.5%
2006 6.7%
2007 6.1%
Compare to 10.5% in 1970 and 13% in 1980


Oops, how rude of me: welcome to the board.

 

Nice post politicalchic, but as for tort reform, I'm vehemently opposed. If the health care industry did a better job at policing itself and removing bad doctors, we wouldn't have such a big issue. As it stands now, a MD with charges against him or her can move among states and freely practice without facing reprecussions for some time. Most states have already enacted some form of tort reform legislation that limits what patients can recover.

I certainly agree on the limiting the cost of post secondary education

 

Can I assume that you concur with the other seven items, and if so, are furious with the Democrats for trying to pull the wool over your eyes by claiming to cut costs and/or pay for this bill, but have not included the items that I have listed?

And that you now realize that the reason that tort reform is not in a healthcare bill is that the trial lawyers are the first or second largest contributors to the Democrats?

Perhaps we can learn from the Canadians in this area:
"For neurosurgeons in Miami, the annual cost of medical malpractice insurance is astronomical — $237,000, far more than the median price of a house.
In Toronto, a neurosurgeon pays about $29,200 for coverage. It's even less in Montreal ($20,600) and Vancouver ($10,650).

In 1978, the Canadian Supreme Court limited damages for pain and suffering. Adjusted for inflation, the cap now is just over $300,000. The United States has no federal cap on damages, though a few states, including Florida, have imposed them."

In 2007, Canadian doctors were hit with 928 legal actions, a 17 percent drop from 2003. Only about 100 cases a year go to trial.
One reason: Canadian law firms, unlike U.S. firms, often require plaintiffs to pay for an initial investigation to determine whether the claim has merit. That cost discourages many people from pursuing a lawsuit. "

While malpractice litigation accounts for only about 0.6 percent of U.S. health care costs, the fear of being sued causes U.S. doctors to order more tests than their Canadian counterparts. So-called defensive medicine increases health care costs by up to 9 percent, Medicare's administrator told Congress in 2005.
Comparison of malpractice insurance rates per $1 million
Toronto Miami Tampa Bay
Orthopedic surgeon $10,485 $140,000 $72,000
Obstetrician $36,353 $191,000 $98,000
Neurosurgeon $29,233 $237,000 $121,000
Sources: Florida Orthopedic Society and Canadian Medical Protective Association. All figures in U.S. dollar amounts. U.S. figures are base amounts.
Canada keeps malpractice cost in check - St. Petersburg Times

BTW, it is un-American to tell physicians what they can charge. Not only would it be a form of slavery, but what effect do you suppose it would have on the number of potential physicians?

Longer days, lower pay, less prestige and more administrative headaches have turned doctors away in droves from family medicine, presumed to be the frontline for wellness and preventive-care programs that can help reduce health care costs.

The number of U.S. medical school students going into primary care has dropped 51.8% since 1997, according to the American Academy of Family Physicians (AAFP).
Considering it takes 10 to 11 years to educate a doctor, the drying up of the pipeline is a big concern to health-care experts. The AAFP is predicting a shortage of 40,000 family physicians in 2020, when the demand is expected to spike. The U.S. health care system has about 100,000 family physicians and will need 139,531 in 10 years. The current environment is attracting only half the number needed to meet the demand.

If Congress passes health care legislation that extends insurance coverage to a significant part of the 47 million Americans who lack insurance, the need for more doctors is going to escalate.
Doctor shortage looms as primary care loses its pull - USATODAY.com

 

Not only is it Unamerican, it's the height of economic stupidity. Price controls lead to shortages. Period.

If it doesn't make sense to you that costs continue to rise, then that just means you haven't researched the reasons behind it sufficiently.

Okay, first of all, one good reason we don't focus on what "can" be charged is because it's not the government's business to dictate to anyone what they have to labor for. That's just this side of involuntary servitude. If you want to tell a doctor personally that you're not willing to pay what he's asking for his services, fine. But to tell him that he MUST value his services at the same amount you do is oppression, pure and simple.

Second of all, how was it a "rip-off"? Did you get your ankle treated? Are you able to walk on it properly now? Perhaps you can tell us exactly what the "correct" amount for treatment of a sprained ankle is, and what the criteria are that you used to determine it.

Democracy isn't synonymous with capitalism, but they do go hand-in-hand. Both are predicated on the freedom of individuals to determine their own course in life, one politically and one economically, and if you deny one, then eventually the other is curtailed, as well.

Can you tell me why anything is not better left to the market, and why health care should be one of those things? Many things are vital to life, even more so than medical care, and yet are left to market forces. Seems to me that anything truly vital SHOULD be left up to the individual control and choices of the consumers themselves, rather than bureaucrats.

How would you know? Health care hasn't been completely, or even mostly, controlled by the market in your lifetime or mine, so what are you making this judgement by?