Why does healthcare cost so much?

[Alan Stallion]

First of all, our infant mortality rate is one of the worst, if not the worst, of all developed countries.

Let's look at two countries, the United States and Japan. Japan has the highest life expectancy of any country in the world. They also spend less on healthcare than most industrialized countries. In fact, they only spend about 1/3 of what we spend in the US. So what are some of the contributing factors?

Murder Rate: US rate is five times that of Japan.
Smoking Rate: Japans is double that of the US. (This is the one area the US has done very well at from a healthcare POV)
Obesity: US rate of Obesity is ten times higher than Japan. Over 30% in the US versus 3% in Japan.
Infant Mortality: The US Infant Mortality Rate is more than double that of Japan.

Keep in mind a key difference between the United States and Japan is that Japan is a very homogeneous nation, whereas the U.S. is a large immigrant nation (legal or illegal), so we acquire people who are from nations where life expectancy isn't as high and may carry over diseases or habits that lead to diseases (such as smoking). Plus, if they come here illegally, they may be less likely to make health care visits for fear of deportation, so health will decrease and disease will spread due to neglect of care.

On top of that, doctors and hospitals have to take out insurance on themselves for protection from lawsuits. They'll often administer unneeded tests just to cover themselves, but even that won't secure themselves from being sued. The costs of this liability of course get passed onto the general public. While there surely are legitimate lawsuits, many I believe are fraudulant. We need tort reform to help reduce the costs from lawsuit lotteries.

 

[Katzndogz]

Making sure the rich die is one of the perks! I see.

Although that means you too. You just don't see it.

Yep- all the idiots who hate the rich are going to be SOL when the rich die off.

At the rate they are going they might not die off, but be killed off instead. Their appathy towards their fellow man is quiet astounding to behold, but not unexpected. Some of the rich understand and accept their responsibility of privilage, and some don't. Those that don't jepordize those that do. Revolutionaries tend not to draw distinctions. The French didn't, and neither did the Cubans. The Bolsheviks didn't fare to well either. Just saying....

So what happened with all those revolutions?

The revolutionaries were all killed by their fellow revolutionaries. And, all the revolutions failed to deliver. All of them created more misery for the ones they were supposed to help.

Just sayin'. Just how surprised do you think Robespierre was when he was marched to the guilliontine by his fellow Jacobins?

As far as revolutions go, maybe the Chinese got it right. Mao started with the peasants instead of ending with the peasants.

 

[Political Junky]

My biggest problem with gov't health care is our gov't. I'm not concerned about how the british did it or the french did it. They won't be running our system.

Before we allow the gov't to take over our healthcare, can someone tell me one thing our federal government does well and efficiently? Ok, besides the military (we can bomb folks VERY well).

The Veteran's Administration health care is the best, and it's totally a socialist program. Doctors, nurses, everyone and everything paid by the government.

 

[WinterBorn]

My biggest problem with gov't health care is our gov't. I'm not concerned about how the british did it or the french did it. They won't be running our system.

Before we allow the gov't to take over our healthcare, can someone tell me one thing our federal government does well and efficiently? Ok, besides the military (we can bomb folks VERY well).

The Veteran's Administration health care is the best, and it's totally a socialist program. Doctors, nurses, everyone and everything paid by the government.

I stand corrected, and you are right about the quality of care. At least now. High quality care at a VA facility is a relatively recent development. And their overwhelming majority of their client base is healthy, physically fit young people.

 

[Alan Stallion]

The Veteran's Administration health care is the best, and it's totally a socialist program. Doctors, nurses, everyone and everything paid by the government.

It should be the best. The entire taxpayer base pays for a small percentage of the population for their service to the nation. Forcing the entire population under the same system would be unsustainable as well as anti-choice.

 

[Brutus]

Why does it cost so much, and why do those costs continue to go up? It really is very simple.

yes it is simple to a conservative: because liberals made competition illegal!

Imagine what computers would cost if liberals made competition illegal in that industry too. It is simple but nevertheless a liberal will lack the IQ to understand it.

 

[uscitizen]

Why does healthcare cost so much?
Because of insurance of one type or another.
If everyone had to pay from their own pocket it would be much cheaper.

 

[Brutus]

Why does healthcare cost so much?
Because of insurance of one type or another.
If everyone had to pay from their own pocket it would be much cheaper.

sorry wrong!! I pay $345 a year for auto insurance. Insurance is not necessarily expensive especially when it gives the companys'
the leverage to bargain with providers. Over a liberals head?

 

[Brutus]

The Veteran's Administration health care is the best, and it's totally a socialist program. Doctors, nurses, everyone and everything paid by the government.

of course thats absurd! How can it be the best if its socialist with no competition. Socialism means low quality, stupid, and/or inefficient. Over a liberals head?

 

[Dont Taz Me Bro]

Health care in this country has become expensive for the same reason college tuition has gotten expensive and the housing market ran up before it came crashing down.

Government subsidization and "cadillac" health insurance policies. We've taken free market forces out of health care.

 

[alan1]

Why does it cost so much, and why do those costs continue to go up? It really is very simple. We have found a way to increase life expectancy dramatically during a time when we have done everything else wrong.

First of all, our infant mortality rate is one of the worst, if not the worst, of all developed countries. Secondly, while we have reduced the percentage of people who smoke, we actually have more smokers than ever before, because of population increases. In any city where gangs rule the streets, hospitals see cases of gunshot wounds, beatings, and stabbings, to people who have no insurance, and this isn't a once in a while thing, it's routine. And last of all, on my list, is the fact that the fat population has doubled, leading to all sorts of costly treatments. But the bottom line is, that despite all these things, life expectancy has increased by eight to nine years over the last 40 years.

With all these things considered, you would think that life expectancy would be decreasing, not increasing, but we have seen increases because medical treatment has gotten much better. We have become very effective at keeping people alive much longer. The problem is that this all comes at a cost, and someone has to pay for it.

Let's look at two countries, the United States and Japan. Japan has the highest life expectancy of any country in the world. They also spend less on healthcare than most industrialized countries. In fact, they only spend about 1/3 of what we spend in the US. So what are some of the contributing factors?

Murder Rate: US rate is five times that of Japan.
Smoking Rate: Japans is double that of the US. (This is the one area the US has done very well at from a healthcare POV)
Obesity: US rate of Obesity is ten times higher than Japan. Over 30% in the US versus 3% in Japan.
Infant Mortality: The US Infant Mortality Rate is more than double that of Japan.

These stats give us an interesting glimpse of where we are. It is interesting that the US reduction in smoking has had little effect on reducing healthcare costs. This should tell us that obesity is a much bigger problem, and it is. As the obesity rate has more than doubled over the last 40 years, spending on healthcare has also more than doubled. Is there a correlation? Of course there is, but it is a bit more complex than that. Given that however, the fact is that a very large percentage of our increase in healthcare spending has come from the simple fact that America has become way too fat.

The bottom line is that we can reduce our healthcare costs dramatically by reducing our weight. Unfortunately this is not going to be an easy task, especially with a large percentage of the populations screaming that nobody is going to tell them what they can and cannot eat. God forbid Michele Obama suggest that people eat healthier. Of course, it's not all just about diet. Honestly it is just as much about exercise, and it starts with our kids. They no longer get enough.

When I was a kid, back in the 70's, we didn't have video games, computers, cell phones, or much of anything. Television was pretty basic and everyone watched a few of their favorite shows each week. So what did we do back then? We went outside and played. We played baseball, basketball, football, smear the queer, you name it. We were outside riding our bikes, we went to the public pool during the summer and listened to Rose Royce singing Car Wash. When we came home for dinner, we smelled terrible from sweating all day long. We were active. What we did not do was sit in front of the TV playing some stupid X-Box game eating potato chips and drinking soda for eight hours per day.

So how do we change all this and get kids back into shape? Honestly, there is only one answer that I can see that is workable, because parents aren't going to do it, and we can't take away all the video games and things that keep kids from becoming active. What it means is that we need to invest more money into our schools, make the school days longer, and use the extra time on physical activities. In other words, force the kids to be active for a couple of hours per day. The simple fact is that if kids don't become fat while they are kids, they will be and are much less likely to become fat as adults. Rather than concentrating on how to help people lose all the excess weight, we need to concentrate on not letting people become fat to begin with. But I know, it's such a communist idea.

You know it and I know it, obesity in the US is far more of a problem than any other health problem.
It's just easier to to attack smokers with special taxes and try and pretend that that will fix the problem. They are an easy minority to pick on (most tobacco taxes are levied under the ruse of providing health care to others).
It's currently a common practice to charge tobacco users more for health insurance, but I don't know of any insurance companies charging a premium to obese people.

As far as the whole lifestyle for kids thing........
My kids didn't have cable TV nor gaming systems when growing up because I wouldn't pay for it. They are now healthy young adults without any weight problems or the associated health problems that fat people have.

 

[alan1]

I don't understand why the price of MRI machines have not gone down in the way that DVD players, VHS players, Flat Screen TVs, etc. have gone down, after an initially high price.

It seems as though they have been kept artificially high.

Last I looked, 80 million people aren't buying MRI machines, but they are buying DVD players, VHS players (not these anymore), Flat Screen TVs, etc. Hey, they buy cars also, I don't see the price of cars dropping.

 

[Political Junky]

The Veteran's Administration health care is the best, and it's totally a socialist program. Doctors, nurses, everyone and everything paid by the government.

of course thats absurd! How can it be the best if its socialist with no competition. Socialism means low quality, stupid, and/or inefficient. Over a liberals head?

VA Health Care System Rated Highly in Government Report - Medicare and More


A recent report by the Congressional Budget Office (CBO) says the VA (U.S. Department of Veterans Affairs) does a much better job controlling health care costs than the private sector delivery system which is used by Medicare and all private sector insurance plans.

The CBO estimates that the VA’s health care cost per enrollee grew by only 1.7 % from 1999 to 2005, which amounts to 0.3% annually. Medicare’s costs grew 29.4 % per capita over that same period, or 4.4 % per year. In the private sector insurance market (employer and individual plans) premiums increased by more than 70% during this period.

The CBO report also says that the VA scores better than the private sector when it comes to patient/customer satisfaction. In 2005, the VA achieved a satisfaction score of 83 out of 100 for inpatient care and 80 out of 100 for outpatient care. The same survey showed private-sector providers of got 73 for inpatient care and 75 for outpatient care.
<more>

 

[Brutus]

I don't understand why the price of MRI machines have not gone down in the way that DVD players, VHS players, Flat Screen TVs, etc. have gone down, after an initially high price.

It seems as though they have been kept artificially high.

the cost has gone way way done with a variety of machines available the world over. In Japan for example the cost of an MRI is about $200Liberals have made competition illegal here. Imagine the cost of a blue ray if liberals did that in that industry too?

 

[spectrumc01]

The Veteran's Administration health care is the best, and it's totally a socialist program. Doctors, nurses, everyone and everything paid by the government.

It should be the best. The entire taxpayer base pays for a small percentage of the population for their service to the nation. Forcing the entire population under the same system would be unsustainable as well as anti-choice.

The system is not anti-choice because no one makes me go to the V.A. hopital. I go because I earned it through my service. Everyone is entitled to it also, they just have to put the time in and serve their country. I can go to any doctor I choose anywhere in the world I just have to pay for it out of my own pocket.

 

[Greenbeard]

The Veteran's Administration health care is the best, and it's totally a socialist program. Doctors, nurses, everyone and everything paid by the government.

It should be the best. The entire taxpayer base pays for a small percentage of the population for their service to the nation. Forcing the entire population under the same system would be unsustainable as well as anti-choice.

Why would it be unsustainable? The VHA's per-enrollee costs, even adjusted for the patient mix (i.e. the average level of care needed by its patients), have grown substantially more slowly than costs for folks enrolled in public or private insurance that sends them to private health care facilities. The VHA isn't just among the highest quality (and highest rated on patient satisfaction) areas of our health system, it's also among the cheapest, on a per person basis.

the cost has gone way way done with a variety of machines available the world over. In Japan for example the cost of an MRI is about $200Liberals have made competition illegal here. Imagine the cost of a blue ray if liberals did that in that industry too?

Japan sets prices biennially for all medical services in a negotiation between the government and the health sector.

FRONTLINE: So you're saying the government has the power to determine these prices, what they're going to pay. Don't the providers, hospitals, have power in pricing?

Naoki Ikegami, chair of the Department of Health Policy and Management at the Keio University School of Medicine: They can certainly negotiate, but after making the first-step decision I was saying -- prices are going to be decreased by 3 percent -- then everything must be fitted within that. So certain prices may go up, certain prices may go down, but in general, the final results should be that the overall budget should be as set by the first step, a 3 percent reduction.

FRONTLINE: Every two years, when they set the cost for things, they publish them in this big telephone-book-like manual. And everything's in there?

Ikegami: Right.

FRONTLINE: So there's one price for sutures and another price for stitches?

Ikegami:Yeah. If it's more than 10 square inches, it will be this amount; if it's less than 10 square inches, it will be this amount. So it's very finely defined. ...

FRONTLINE: Let's take an example of how these low costs work. In Denver, where I live, if you get an MRI of your neck region it's $1,200, and the doctor we visited in Japan says he gets $98 for an MRI. So how do you do that?

Ikegami: Well, in 2002 the government says that the MRIs, we are paying too much, so in order to be within the total budget, we will cut them by 35 percent.

FRONTLINE: If I'm a doctor, why don't I say, "I'm not going to do them; it's not enough money"?

Ikegami: You forgot that we have only one payment system. So if you want to do your MRIs, unless you can get private-pay patients, which is almost impossible in Japan, you go out of business. ...

FRONTLINE: ... The price of that MRI is so much cheaper in Japan. Doesn't he have to pay the same price, $5,000, for an MRI machine like the man in America?

Ikegami: Well, it depends on what kind of image density the radiologist wants. And the MRIs that are available in Japan are much less expensive than those that are typically found in the United States.

FRONTLINE: So the imaging machine is cheaper? ... To me that's another advantage of negotiating low prices: Then the supplying industry has to cut its prices, and the MRI makers met this need.

Ikegami: Right. And MRIs have now become very big in [the] export industry.

FRONTLINE: So the health ministry set a low price, the MRI makers make cheaper machines to help the doctors meet that price, and now Japan is exporting these around the world?

Ikegami: Right. ... This is a situation where the market does work in health care. ...

 

[Alan Stallion]

The Veteran's Administration health care is the best, and it's totally a socialist program. Doctors, nurses, everyone and everything paid by the government.

It should be the best. The entire taxpayer base pays for a small percentage of the population for their service to the nation. Forcing the entire population under the same system would be unsustainable as well as anti-choice.

The system is not anti-choice because no one makes me go to the V.A. hopital. I go because I earned it through my service. Everyone is entitled to it also, they just have to put the time in and serve their country. I can go to any doctor I choose anywhere in the world I just have to pay for it out of my own pocket.

You misunderstood what I said. I wasn't talking about the veterans. The "anti-choice" part is if the ENTIRE U.S POPULATION was forced under a one-size-fits-all system that some people advocate.

 

[dblack]

Why does it cost so much, and why do those costs continue to go up? It really is very simple. ...

That's a very good question. And while I don't think it's "very" simple, it's not terribly complicated. Unfortunately your post is trying to answer a different question entirely.

All the issues you cite pertain to increased health care consumption, and ignore the price inflation that is pinching the average American. It's a fine argument to justify draconian state controls over our personal habits, but it has nothing to do with spiraling inflation in the health care industry.

Price inflation is a market problem. Prices are going up because we've minimized the market incentives that would keep them down. To put it another way, doctors and health care providers don't offer lower prices because there's not much demand for them to do so. Patients are either "covered", in which case they don't care how much it the individual services cost, or they're not - and they can't afford to play at all.

 

[geauxtohell]

There are several reasons why health care is so expensive.

Americans overall have this belief that they are owed healthcare regardless of their own input into the equation.

HMO legislation passed in the 70's took the free market aspect away from the issue by forcing insurance companies to all offer comprehensive coverage rather than catastrophic coverage which was common prior to that time.

Americans are getting fatter and less productive (lazy).

Americans have created a culture of self-obsession and denial of reality.

If we would promote preventive medicine as much as we have promoted Viagra, costs would be much lower.

The data shows that preventive medicine programs do not lower the cost of health care.

That depends on your definition of "preventative medicine". You are likely referencing the work of Dartmouth's Institute of Health Policy which is one of the leaders in this area.

Preventative Medicine as it applies to costly and un-necessary screens and tests to "look for disease" costs more money and leads to poor patient outcomes. The simple question of "why order a test if you don't have an idea of what you are going to do with the results?" should be asked. If you order a CT chest in an asymptomatic smoker to look for lung cancer and find an incidental mass in the lungs that leads to a full work up and biopsy to discover it's an old ball of fungus, you have cost the system money and subjected the patient to un-necessary suffering.

However, simple prevention such as annual physicals and lifestyle modification absolutely save money.

Both sides are guilty of this silly canard. When the USJPTF recommended against annual mammograms due to the poor outcomes, people went absolutely batshit crazy. It was likened to death panels.

Guess what? Mammograms are "preventative medicine". So either you live and die by the data or simply join the masses that selectively choose the healthcare cause du joir because it fits their political opinion.

Essay - McCain and Obama Health Plans Promote Myth of Prevention as Cost Cutter - NYTimes.com

The term “preventive medicine” no longer means what it used to: keeping people well by promoting healthy habits, like exercising, eating a balanced diet and not smoking. To their credit, both candidates ardently support that approach.

But the medical model for prevention has become less about health promotion and more about early diagnosis. Both candidates appear to have bought into it: Mr. Obama encourages annual checkups and screening, Mr. McCain early testing and screening.

 

[geauxtohell]

Why does it cost so much, and why do those costs continue to go up? It really is very simple. ...

That's a very good question. And while I don't think it's "very" simple, it's not terribly complicated. Unfortunately your post is trying to answer a different question entirely.

All the issues you cite pertain to increased health care consumption, and ignore the price inflation that is pinching the average American. It's a fine argument to justify draconian state controls over our personal habits, but it has nothing to do with spiraling inflation in the health care industry.

Price inflation is a market problem. Prices are going up because we've minimized the market incentives that would keep them down. To put it another way, doctors and health care providers don't offer lower prices because there's not much demand for them to do so. Patients are either "covered", in which case they don't care how much it the individual services cost, or they're not - and they can't afford to play at all.

This isn't simply an "open market" issue.

As long as there is a law (which I support) that everyone in this country is treated regardless of cost, you can't apply open market parameters to it.

You can thank that God of the Free Market, Ronald Reagan, for that.

"EMTALA".