Why does healthcare cost so much?

[dblack]

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

Sure, there's more to it than just market dynamics, but isn't it pretty insane to just ignore them? How can we even begin to seriously analyze health care inflation without looking at that side of things?

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".

I thank Reagan for very little actually, least of all nonsense like EMTALA. That said, the free-rider effect supposedly brought on by EMTALA (and the like) has been proven, repeatedly, to have a minimal effect on the health care prices. The numbers don't add up and it simply doesn't account for the spiraling prices in health care.

The distorted market incentives, however do. When you take away a consumer's incentive to seek lower prices, especially for a service most of us need, especially when, in most cases, a third party is footing the bill - that can't not produce inflation. Ignoring this is utterly foolish.

We can address this by recognizing that we are over-insured, and remove the policies that have promoted the practice. We all need to be paying for our own health care as much as we can possible manage, and minimize the reliance on insurance schemes (whether they're private or publicly financed). Not only does this make more sense for individual consumers (most of us will pay much more in premiums than we receive in services) but it restores a strong incentive for the health care industry to provide us efficient services and low prices.

 

[geauxtohell]

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

Sure, there's more to it than just market dynamics, but isn't it pretty insane to just ignore them? How can we even begin to seriously analyze health care inflation without looking at that side of things?

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".

I thank Reagan for very little actually, least of all nonsense like EMTALA. That said, the free-rider effect supposedly brought on by EMTALA (and the like) has been proven, repeatedly, to have a minimal effect on the health care prices. The numbers don't add up and it simply doesn't account for the spiraling prices in health care.

The distorted market incentives, however do. When you take away a consumer's incentive to seek lower prices, especially for a service most of us need, especially when, in most cases, a third party is footing the bill - that can't not produce inflation. Ignoring this is utterly foolish.

We can address this by recognizing that we are over-insured, and remove the policies that have promoted the practice. We all need to be paying for our own health care as much as we can possible manage, and minimize the reliance on insurance schemes (whether they're private or publicly financed). Not only does this make more sense for individual consumers (most of us will pay much more in premiums than we receive in services) but it restores a strong incentive for the health care industry to provide us efficient services and low prices.

As long as there is no "right to refuse service", it's not a free market issue. Maybe it seems that way to you and others who pay for their insurance, but that ignores the cost of providing health care to people who have no ability to pay for that.

I don't mind it. Aside from the simple moral argument, that systems allows for the medical education of young physicians and nurses that will later go on to care for others.

Whoever, you have to look at the whole picture. If you have data that says EMTALA doesn't drive up costs, I'd be happy to see it.

 

[dblack]

As long as there is no "right to refuse service", it's not a free market issue. Maybe it seems that way to you and others who pay for their insurance, but that ignores the cost of providing health care to people who have no ability to pay for that.

I don't mind it. Aside from the simple moral argument, that systems allows for the medical education of young physicians and nurses that will later go on to care for others.

Whoever, you have to look at the whole picture. If you have data that says EMTALA doesn't drive up costs, I'd be happy to see it.

From the article:

Is Uncompensated Care a Problem?

Nationwide, the cost of unpaid care for hospitals, which includes charity care as well as money that could not be collected from patients, was around $36 billion in 2008.

Which amounts to less than three percent of health care spending. A while back I had a link to the original (non-partisan) study that produced those numbers. I'll see if I can dig it up.

I'm not saying it's not a problem, but it's relevance is vastly overstated. In any case, the free-rider issue can be resolved without chaining us to insurance companies as virtual slaves.

But would you care to address my point? How can the erosion of sane market incentives not produce inflation? Surely you've experienced it yourself - or know those who have. For those of us without insurance, healthcare is so expensive we do our best to avoid it altogether (meaning we skip necessary preventative care). When we do have insurance (of the usually, low-deductible, group variety) we simply don't care how much the actual health care costs. It's actually surprising that health care prices aren't rising even faster than they already are.

 

[uscitizen]

As long as there is no "right to refuse service", it's not a free market issue. Maybe it seems that way to you and others who pay for their insurance, but that ignores the cost of providing health care to people who have no ability to pay for that.

I don't mind it. Aside from the simple moral argument, that systems allows for the medical education of young physicians and nurses that will later go on to care for others.

Whoever, you have to look at the whole picture. If you have data that says EMTALA doesn't drive up costs, I'd be happy to see it.

From the article:

Is Uncompensated Care a Problem?

Nationwide, the cost of unpaid care for hospitals, which includes charity care as well as money that could not be collected from patients, was around $36 billion in 2008.

Which amounts to less than three percent of health care spending. A while back I had a link to the original (non-partisan) study that produced those numbers. I'll see if I can dig it up.

I'm not saying it's not a problem, but it's relevance is vastly overstated. In any case, the free-rider issue can be resolved without chaining us to insurance companies as virtual slaves.

But would you care to address my point? How can the erosion of sane market incentives not produce inflation? Surely you've experienced it yourself - or know those who have. For those of us without insurance, healthcare is so expensive we do our best to avoid it altogether (meaning we skip necessary preventative care). When we do have insurance (of the usually, low-deductible, group variety) we simply don't care how much the actual health care costs. It's actually surprising that health care prices aren't rising even faster than they already are.

so mandated free treatment and malpractice payouts combined cost around 6% of the total cost?

 

[dblack]

so mandated free treatment and malpractice payouts combined cost around 6% of the total cost?

Something like that, I suppose. Though better stats would be helpful for the discussion.

My point isn't that we should ignore these factors, but I don't think they come close to accounting for the persistent, accelerating rise in health care prices. What I'm saying is that we shouldn't disregard the skewed market incentives either, and that's mostly what we're doing. Right now, doctors can virtually ignore the only people with a real motivation to seek lower prices (the uninsured), because most of their customers are on the insurance dole. We need to look at how that's occurred and how we can reverse it. When most patients are paying most of their medical bills themselves doctor's will have a powerful economic incentive to provide more efficient, lower-cost health care. That incentive is currently all but non-existent.

Unfortunately, most attempts at health care reform are pushing for the opposite of this prescription - more insurance, producing more unmotivated health care consumers.

 

[Dont Taz Me Bro]

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?

Wrong, my ass. He's exactly right. What the hell does your auto insurance have to do with anything?

There are no market forces to bring down the cost of health care because most of the time a third party is footing the bulk of the bill. Nobody cares if their monthly prescription costs $150 to fill if they are only paying a $10 co-pay. Since the insurance is picking up 90% of the tab there is no reason for the manufacture to reduce the cost of their medications. Thus, they charge a ton of money, insurance companies cover it, but after so long the insurance companies have to raise their premiums to keep up with the rising cost.

The way to bring down the cost of health care is for the consumer to be hit in the pocket more than they currently are.

 

[Brutus]

How can the erosion of sane market incentives not produce inflation? .

So true, the liberals made interstate competition illegal in health insurance so there is no incentive whatsoever to lower costs.

Its perfectly insane and perfectly liberal.

 

[Brutus]

Wrong, my ass. He's exactly right. What the hell does your auto insurance have to do with anything?

he said insurance, in general, was wasteful and expensive. I explained that my auto insurance was not wasteful and not expensive. The difference between auto insurance and health insurance is that liberals made competition illegal in health insurance but not in auto insurance.

Catching on now?

 

[rdean]

For the Health Care System, we need Universal Health Care, not the horrid for profit system of today.

For our children, we need to do whatever it takes to get them physically active. That has mental benefits as well as physcial. Just living longer is not a good goal. Living longer actively is. One cannot do that as an obese slug.

Do you trust the government to approve medical procedures and pay for them? Why woud you think that when every expert and health care official tells you differently? At least in for profit health care, you can get some. Once the government decides health care isn't worth it for you, based on the cost benefit analysis, you don't get any at all.

Pure, undiluted bull shit. The VA is considered among the best care in the world. Sure, you can find an occasional story about mold or something, but you have to look very hard. And this is an organization that spends 94 cents of every dollar on the patient. And, under Clinton, they created a data base that keeps track of the effectiveness of medicine and medical procedures.

AND they don't pay CEO payouts of over a hundred million dollars that have to be skimmed off hundreds of thousands of policies.

Republicans say I misrepresent them. They misrepresent reason. They have swallowed their own swill for so long, they believe it, without reservation.

I don't understand those who hate government so much they have lost the ability to reason.

 

[Brutus]

I don't understand those who hate government so much they have lost the ability to reason.

actually hating government was the most reasonable thing our Founders did. Why do you think we became the most successful country in human history?

See why we are positive a liberal will have a low IQ?

 

[dblack]

Wrong, my ass. He's exactly right. What the hell does your auto insurance have to do with anything?

he said insurance, in general, was wasteful and expensive. I explained that my auto insurance was not wasteful and not expensive. The difference between auto insurance and health insurance is that liberals made competition illegal in health insurance but not in auto insurance.

Catching on now?

That's not the main difference. The main difference is in how we use it. Auto insurance is for accidents. It covers you in the unlikely event of a wreck that results in significant damage to your car. In contrast, we use health insurance to finance our regular health care expenses. Used that way, it's incredibly wasteful and expensive. It would be like auto "insurance" that paid for your gasoline, oil-changes, new tires every three years, etc, etc... Which would, inevitably, be expensive and wasteful as a service.

Try again, Brutus.

 

[Brutus]

Wrong, my ass. He's exactly right. What the hell does your auto insurance have to do with anything?

he said insurance, in general, was wasteful and expensive. I explained that my auto insurance was not wasteful and not expensive. The difference between auto insurance and health insurance is that liberals made competition illegal in health insurance but not in auto insurance.

Catching on now?

too stupid!! Why would auto insurance be expensive if the companys
that offered it operated in a competitive environment with tons of buying power, and had to have the lowest prices in the country in order to survive??????????? See why we say a liberal will have a low IQ?

That's not the main difference. The main difference is in how we use it. Auto insurance is for accidents. It covers you in the unlikely event of a wreck that results in significant damage to your car. In contrast, we use health insurance to finance our regular health care expenses. Used that way, it's incredibly wasteful and expensive. It would be like auto "insurance" that paid for your gasoline, oil-changes, new tires every three years, etc, etc... Which would, inevitably, be expensive and wasteful as a service.

Try again, Brutus.

too stupid!! Why would auto insurance be expensive if the companys operated in a Republican competitive environment with lots of buying power and so had to have the lowest prices in the country just to survive.

See why we say the liberal will have a low IQ?

 

[auditor0007]

For the Health Care System, we need Universal Health Care, not the horrid for profit system of today.

For our children, we need to do whatever it takes to get them physically active. That has mental benefits as well as physcial. Just living longer is not a good goal. Living longer actively is. One cannot do that as an obese slug.

Do you trust the government to approve medical procedures and pay for them? Why woud you think that when every expert and health care official tells you differently? At least in for profit health care, you can get some. Once the government decides health care isn't worth it for you, based on the cost benefit analysis, you don't get any at all.

We hear this argument all the time, but it isn't valid, plain and simple. The vast majority of people receive most of their healthcare in their retirement years, when they are on Medicare, so the government is already making the decision for most. Most Americans support and want to keep Medicare, because they realize, despite a few issues, it is a great program. If everyone was so against the government making medical decisions, then everyone would be against Medicare, don't you think? Last of all, if you are not yet on Medicare and depend on private insurance, then you are leaving the same decisions to those in a for profit enterprise. When push comes to shove, the for profit will cut costs wherever they can, and they do. There are no easy answers, but this argument is pretty much worthless in the overall discussion of our healthcare system.

 

[auditor0007]

The problems with the medical system are numerous. The first major problem that increases health care costs is the pharmasuetical companies unwillingness to provide affordable medication. They site R&D costs as the reason for the high cost, but in reality the pharmasuetical companies profits are in the billions of dollars and that is after the R&D costs. They are already immune to lawsuits, so the reason for high prescription drug costs must be they want to make as much money as they can at the expense of society as a whole.
Insurance is the next reason health care costs are so high. Hospitals know that insurance companies will pay out without question any bill under $10,000 or some such number. So when a hospital bills the insurance company it trys to get as close to the number as possible. $30.00 for two tylenol is the example of this practice.
Doctors and health care providers defrauding the system to the tune of hundreds of millions of dollars per year is yet another reason. Read the paper and stories just like this are all over the place. It isn't uninsured people defrauding the system it is the health care people defrauding the health care system.
As for rationiong health care, it is already being rationed, but it is financial rationing that is taking place. You can only get health care that you can afford. The rich are scared that those who can't afford it to begin with may be required to get care that might take away from them. The rich don't go to the walk-in clinics, they go right to specialists. The rest of us go to the walk-in, because the health care plans we have only cover one to two visits per year.
The list of reasons go on and on. Socialized medicine is the only way to go. Yes, I know that the rich from other countries come here for their care. This is because those of privilage never have to wait for anything. When I start seeing people from Europe who make 25K a year coming to the US for their medical care then I will rethink my position on this.
Our Health care system is riddled with fraud and corruption. Here in Michigan Blue cross and Blue shield are being sued for anti-trust. So to believe that it is all at the feet of the uninsured is just false and misleading, and done on purpose.

The biggest problem with pharmaceutical companies is the fact that we subsidize the cost of drugs to just about every other country in the world. They all put caps on how much the pharmy companies can charge and so they take what they can get and make us in the US pay the difference. There is a very simple solution to this. We should pass legislation stating they can only charge a certain percentage more than the average price among all other countries. If they want to charge more, then force the other countries to pay more. Quit making Americans pay for the rest of the world.

 

[auditor0007]

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.

So long as there is a middle class, the rich will remain rich. If the middle class disappears, then so will the rich. By destroying the middle class, the rich are writing their own epitaph.

 

[auditor0007]

The problems with the medical system are numerous. The first major problem that increases health care costs is the pharmasuetical companies unwillingness to provide affordable medication. They site R&D costs as the reason for the high cost, but in reality the pharmasuetical companies profits are in the billions of dollars and that is after the R&D costs. They are already immune to lawsuits, so the reason for high prescription drug costs must be they want to make as much money as they can at the expense of society as a whole.

R&D might have been the reason for high drug costs in the past, but in 1990 something, congress passed a law that allowed BigPharma to advertise. Since then, the cost of drug advertising has taken over as the leading cause of drugs that cost too much.

That in turn causes another uptick in costs. The patient sees the ad that tells them that they need the latest and greatest new drug and they go to their physician asking for it. The doctor, practicing defensive medicine and also wanting to please the patient, gives in and orders the medication.

And when that medication brings on unwanted side effects, instead of discontinuing use of the drug, another drug is prescribed to offset the unwanted side effects. Next thing you know, you have a patient who didn't need that first drug to begin with who is now taking eight different drugs, all to offset side effects created by the use of one drug after another. But as long as it is "for profit", then it must be good for everyone.

 

[auditor0007]

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?

For all the liberal bashing you do, you just gave us an example of how an MRI costs so much less in Japan in a healthcare system where the government negotiates the price of every piece of equipment and every single medical procedure.

 

[Two Thumbs]

Has anyone seen the vast vast VAST amounts of regulations that are required now?

When I was a kid, the only people in doc ofc's and hospitals were docs, nurses, cleaning crew and kitchen staff.

The government regs got so vast that you now need a college degree to now how to work them. The nurses just gave up as it took all their time.

Government interfearance has fucked it up again.

 

[editec]

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....

FYI:

A little perspective is in order here as it regards the Cuban revolution.

That pig, Batista, killed over 20,000 Cuban civilians maintaining his authoritarian regime.

Fidel's post revolutionary Cuban goverment executed hundreds of Batista's cohorts, not thousands, not tens of thousands, but hundreds of former members of the criminal regime that Batista controlled. Those people were tired and executed for their part in the slaughter of Cubans civilians while BATISTA was in power. They died and they deserved to die, too, folks.

Now thousands of Cubans fled the island when Fidel took over, that is very true.

Mostly those who fled were former players in the Batista regime, wealthy land owners whose lands were nationalized, and many of the more affluent upper and middle class left, and they were allowed to leave, too.

But there was no wholesale slaughter by the Cuban communists, which is, apparently the myth that so many Americans believe about that revolution.

Incidently the post revolutionary government of the FRENCH revolution didn't kill all that many people, either.

Remember, ARTISOS like Lafayette weren't killed, they were REVERED AND HONORED by the French revolutionaries

I've read estimates that about 6,000 artisos, functionaries and other tools of the ancient regime died at the FR. revolutionaries hands.

It was the post revolutionary governments squabbling for control where the slaughters happened in France after the revolution.

 

[spectrumc01]

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....

FYI:

A little perspective is in order here as it regards the Cuban revolution.

That pig, Batista, killed over 20,000 Cuban civilians maintaining his authoritarian regime.

Fidel's post revolutionary Cuban goverment executed hundreds of Batista's cohorts, not thousands, not tens of thousands, but hundreds of former members of the criminal regime that Batista controlled. Those people were tired and executed for their part in the slaughter of Cubans civilians while BATISTA was in power. They died and they deserved to die, too, folks.

Now thousands of Cubans fled the island when Fidel took over, that is very true.

Mostly those who fled were former players in the Batista regime, wealthy land owners whose lands were nationalized, and many of the more affluent upper and middle class left, and they were allowed to leave, too.

But there was no wholesale slaughter by the Cuban communists, which is, apparently the myth that so many Americans believe about that revolution.

Incidently the post revolutionary government of the FRENCH revolution didn't kill all that many people, either.

Remember, ARTISOS like Lafayette weren't killed, they were REVERED AND HONORED by the French revolutionaries

I've read estimates that about 6,000 artisos, functionaries and other tools of the ancient regime died at the FR. revolutionaries hands.

It was the post revolutionary governments squabbling for control where the slaughters happened in France after the revolution.

The point is that when people, good or bad, have nothing left to loose and the feeling of hopelessness sets in. The attitude is, "I can sit here and die quietly or I can revolt and possibly die trying to better my lot." How does one get to that point? If we keep doing what we're doing we'll see it first hand. The point wasn't that those revolutions were good, but that there was a revolution and why it happened.