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

[BulletProof]

This is an example of why the US has the worst medical system in the white world. The government has created monopoly pricing in medicine, and that's the way shithead Republicans like it.

 

[Skull Pilot]

This is an example of why the US has the worst medical system in the white world. The government has created monopoly pricing in medicine, and that's the way shithead Republicans like it.

It goes far beyond partisanship.

Get out of your little 2 dimensional box and think a little

 

[Greenbeard]

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?

If I'm following you correctly, you're arguing for a world in which people do know prices but aren't exposed to them personally. So you may be shopping for a procedure and see:

[TABLE="class: brtb_item_table"][TBODY][TR][TD][/TD]
[TD]Provider A[/TD]
[TD]Provider B[/TD]
[TD]Provider C[/TD][/TR]
[TR][TD]Procedure Price[/TD]
[TD]$250[/TD]
[TD]$750[/TD]
[TD]$1,500[/TD][/TR]
[TR][TD]Cost to you[/TD]
[TD]$0[/TD]
[TD]$0[/TD]
[TD]$0[/TD][/TR][/TBODY][/TABLE]

You're arguing people will tend to choose Provider A in this scenario. I see no reason to believe that. In this situation, cost is completely take off the table as a consideration in selecting among the three providers. That leaves other considerations, like convenience, quality ratings (if available), recommendations or word of mouth, reputation, etc.

Suggesting people will choose Provider A because they think it'll result in premium relief down the line requires people to make an assumption--a leap of faith--about the behavior of everyone else in their insurance pool (if they make the causal link at all). That doesn't strike me as very plausible.

 

[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?

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.

Consumer psychology doesn't work that way. And it doesn't make sense. From a personal finance standpoint, if you're in one of these group insurance pools, you have every incentive to maximize your "take". You can moralize to group members all day long, explaining to them how choosing the less expensive alternatives will save their insurance company money, and how the insurance companies will directly reduce premiums as a result (and no, the insurance companies wouldn't dare take the savings as windfall profit. They just wouldn't). But when their kid is laying on the table, they're going to pick the best treatment available and not give one rat's ass about saving a buck for the insurance company.

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.

The reason prices aren't transparent is because no one cares, because they aren't paying their own bills.

 

[Skull Pilot]

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?

If I'm following you correctly, you're arguing for a world in which people do know prices but aren't exposed to them personally. So you may be shopping for a procedure and see:

[TABLE="class: brtb_item_table"][TBODY][TR][TD]Provider A[/TD][TD]Provider B[/TD][TD]Provider C[/TD][/TR]
[TR][TD]Procedure Price[/TD][TD]$250[/TD][TD]$750[/TD][TD]$1,500[/TD][/TR]
[TR][TD]Cost to you[/TD][TD]$0[/TD][TD]$0[/TD][TD]$0[/TD][/TR][/TBODY][/TABLE]
You're arguing people will tend to choose Provider A in this scenario. I see no reason to believe that. In this situation, cost is completely take off the table as a consideration in selecting among the three providers. That leaves other considerations, like convenience, quality ratings (if available), recommendations or word of mouth, reputation, etc.

Suggesting people will choose Provider A because they think it'll result in premium relief down the line requires people to make an assumption--a leap of faith--about the behavior of everyone else in their insurance pool (if they make the causal link at all). That doesn't strike me as very plausible.

I think market pressure works and it can work with medical costs.

If we use your example then insurance companies might start taking those facilities that charge the highest prices off their coverage or charge higher out of network deductibles.

If the consumer had to provide estimates for health care as they do for auto insurance claims, the insurance company would also make sure they paid the lowest cost possible

 

[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.

Consumer psychology doesn't work that way. And it doesn't make sense. From a personal finance standpoint, if you're in one of these group insurance pools, you have every incentive to maximize your "take". You can moralize to group members all day long, explaining to them how choosing the less expensive alternatives will save their insurance company money, and how the insurance companies will directly reduce premiums as a result (and no, the insurance companies wouldn't dare take the savings as windfall profit. They just wouldn't). But when their kid is laying on the table, they're going to pick the best treatment available and not give one rat's ass about saving a buck for the insurance company.

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.

The reason prices aren't transparent is because no one cares, because they aren't paying their own bills.

SO you don't care that the collusion between the health care industry and the insurance companies to hide actual costs of medical care are raising both our medical and insurance costs?

 

[dblack]

SO you don't care that the collusion between the health care industry and the insurance companies to hide actual costs of medical care are raising both our medical and insurance costs?

I don't think that's what's raising our medical and insurance costs. Costs are going up because the buyers are spending someone else's money.

 

[Greenbeard]

If we use your example then insurance companies might start taking those facilities that charge the highest prices off their coverage or charge higher out of network deductibles.

Well, that's different. When insurers are forced to compete aggressively in premium (e.g., in the exchanges) that is one of the ways they find to offer lower premium options. That way you're pricing network breadth for people upfront in the premium. If they want a plan with the more expensive providers in it, then they can pay for it.

But that's what I'm talking about. If you want to impact behavior, somehow the price differential between differently priced providers needs to be translated for people in a way that exposes them to the cost of their choice.

 

[BulletProof]

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?

It's trivial to provide medical tests and drugs for a tiny fraction of what Americans are paying now, but the government won't allow it. The government, and the anti-free market Republican Party, are fully on board with creating monopoly-like pricing in medical care.

An x-ray is just a camera that uses another light spectrum. Before x-rays were found to be dangerous, you could get real-time x-rays for free.

Most prescription drugs cost no more to manufacture than a bottle of aspirin.

Many blood tests can now be done by a monkey who knows absolute nothing about lab work, as long as that monkey knows how to turn on a machine, an automated analyser. If you don't have a machine, you can do most blood tests manually for very little cost, and nearly free marginal cost.

Thankfully, the Republicans want to give us Health Savings Accounts so we can save up to pay a couple hundred dollars for a monkey to turn on a machine.

 

[Skull Pilot]

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?

It's trivial to provide medical tests and drugs for a tiny fraction of what Americans are paying now, but the government won't allow it. The government, and the anti-free market Republican Party, are fully on board with creating monopoly-like pricing in medical care.

An x-ray is just a camera that uses another light spectrum. Before x-rays were found to be dangerous, you could get real-time x-rays for free.

Most prescription drugs cost no more to manufacture than a bottle of aspirin.

Many blood tests can now be done by a monkey who knows absolute nothing about lab work, as long as that monkey knows how to turn on a machine, an automated analyser. If you don't have a machine, you can do most blood tests manually for very little cost, and nearly free marginal cost.

Thankfully, the Republicans want to give us Health Savings Accounts so we can save up to pay a couple hundred dollars for a monkey to turn on a machine.

YEah and the democrats have done soooo much to lower health care costs

As I said this goes far beyond your limited 2 dimensional thinking

 

[BulletProof]

As I said this goes far beyond your limited 2 dimensional thinking

Republicans claim to be the party of the free market. They aren't. And, Democrats don't make this claim.

Democrats would give us socialized medicine. As inherently oppressive and inefficient as socialism is, it's better than our current monopoly pricing. E.g. Canada has universal coverage at half of what the US spends.

Democrats gave working people subsidized health insurance (Obamacare) which is good thing, given the government-jacked cost of medical care.

Republicans claim to be bent on repealing Obamacare (or, wrecking it by removing the mandate), but they have nothing to replace it with. They have nothing, like the free market and deregulation, to address the monopoly pricing that makes medical care affordable to the working class.

 

[Markle]

Yep, it let's people with a government-protected profession profit off of misery. Medical licensing is restricted by the government and existing doctors benefit greatly from this government-induced limit on the quantity of doctors, which allows them to charge what they charge. Big Pharma is even worse, being given exclusive rights to sell drugs for whatever they want. I bet they wouldn't be so rich if the Chinese were allowed to sell drug copies for pennies here in the US without having to adhere to patent laws. A real free market. Bet you won't see too many Big Pharma execs railing against patent laws that protect their profits.

Would you spend a Billion dollars over at least a decade to develop a new life-extending or life-saving drug if you could not obtain a patent so you could recoup your investment and make a profit?

The point I was making is the US medical system is not a free market so I don't cry any tears when the government places restrictions and requirements that make those big pharma execs unhappy.

At the lowest end you don't get what you want. At the high end you get ripped off. I'd say that private Mexican hospital is somewhere in the middle and US healthcare is a really expensive ripoff, with an emphasis on expensive and not so much emphasis on quality.

Indisputably the finest health care in the world. Period.

Based on what?

Results.

Quality of life after the diagnosis of a serious disease.

The number of new life-extending and life-saving drugs.

The number of new procedures and new technology.

You haven't actually provided any statistics. You only posted that chart, and it doesn't look like the US is doing very well compared to some of the other nations on that list. The USA has roughly 38 times the population of Switzerland, but it appears on that chart only 9 times as many times as Switzerland (and many of those spots are shared with other countries).

I was waiting for someone to rise to the bait. Thank you.

10 Surprising Facts about American Health Care
Brief Analyses | Health

No. 649
Tuesday, March 24, 2009
by Scott Atlas

Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world. Economists, government officials, insurers and academics alike are beating the drum for a far larger government rôle in health care. Much of the public assumes their arguments are sound because the calls for change are so ubiquitous and the topic so complex. However, before turning to government as the solution, some unheralded facts about America's health care system should be considered.

Fact No. 1: Americans have better survival rates than Europeans for common cancers.[1] Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

Fact No. 2: Americans have lower cancer mortality rates than Canadians.[2] Breast cancer mortality is 9 percent higher, prostate cancer is 184 percent higher and colon cancer mortality among men is about 10 percent higher than in the United States.

Fact No. 3: Americans have better access to treatment for chronic diseases than patients in other developed countries.[3] Some 56 percent of Americans who could benefit are taking statins, which reduce cholesterol and protect against heart disease. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons and 17 percent of Italians receive them.

Fact No. 4: Americans have better access to preventive cancer screening than Canadians.[4] Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate and colon cancer:

• Nine of 10 middle-aged American women (89 percent) have had a mammogram, compared to less than three-fourths of Canadians (72 percent).
• Nearly all American women (96 percent) have had a pap smear, compared to less than 90 percent of Canadians.
• More than half of American men (54 percent) have had a PSA test, compared to less than 1 in 6 Canadians (16 percent).
• Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with less than 1 in 20 Canadians (5 percent).

10 Surprising Facts about American Health Care

 

[Markle]

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

You left out the part where the care in the U.S. is superior to the rest of the world as well.

 

[Markle]

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.

So long as the insurance company covers the expense, patients don't care about the cost.

 

[Markle]

Most prescription drugs cost no more to manufacture than a bottle of aspirin.

Manufacture, sure. Develop and bring to market? Who pays for those ten years of development, testing, and approval by the FDA? Why do it if there is no profit?

 

[BulletProof]

Manufacture, sure. Develop and bring to market? Who pays for those ten years of development, testing, and approval by the FDA? Why do it if there is no profit?

Your argument doesn't apply to generics, yet prescription generics often have insane prices. What was it, $600 for two epipens recently, even though these deliver a generic drug? You're a stupid person who buys stupid excuses for the people to be robbed. But, you're on to one thing. The FDA is government and government is the problem.

 

[Markle]

E.g. Canada has universal coverage at half of what the US spends.

And months-long waiting lists for any specialty even up to a year or more. How is that quality health care?

Canadian Health Care: Patients Waiting Longer Than Ever For Treatment

• 12/30/2015

Socialist Medicine: Canadians love their hockey and have historically been happy with their government-run health care system. Hockey is thriving. The country's health care system, though, is a wreck and getting worse.

It could be said the words "Canada" and "health care" really don't go together because some Canadians never make it to the doctor.

Too many die untreated due to extended wait times to see a doctor, and those wait times have increased again this year. They are now almost twice as long as they were in 1993, the year Hillary Clinton tried to force government health care on Americans.

The Fraser Institute says that in 2015, Canadians waited an average of 18.3 weeks to see a specialist, "slightly longer than the 18.2-week wait reported in 2014" and "97% longer than in 1993, when it was just 9.3 weeks."

[...]

Canadian Health Care: Patients Waiting Longer Than Ever For Treatment | Stock News & Stock Market Analysis - IBD

Waiting Your Turn: Wait Times for Health Care in Canada, 2016 Report

 

[BulletProof]

Fact No. 1: Americans have better survival rates than Europeans for common cancers.[1] Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

No thank you for the propaganda. Overall, Australia, Finland, Japan, Sweden, and Switzerland all have lower cancer mortality rates than the US. Denmark, UK, Netherlands, and Ireland have a higher cancer mortality rate. It looks like to me, the US falls into the middle when it comes to cancer mortality. Individual cancers may differ from the overall rate.

You have more than a score of western-style countries to cherry pick you cancer examples from. But, if I had cancer, half the countries would be the same or better to have cancer in. Tellingly, of the five cancer examples you give, three of them come from the UK, which does have an overall a higher cancer mortality rate.

 

[bgrouse]

Yep, it let's people with a government-protected profession profit off of misery. Medical licensing is restricted by the government and existing doctors benefit greatly from this government-induced limit on the quantity of doctors, which allows them to charge what they charge. Big Pharma is even worse, being given exclusive rights to sell drugs for whatever they want. I bet they wouldn't be so rich if the Chinese were allowed to sell drug copies for pennies here in the US without having to adhere to patent laws. A real free market. Bet you won't see too many Big Pharma execs railing against patent laws that protect their profits.

Would you spend a Billion dollars over at least a decade to develop a new life-extending or life-saving drug if you could not obtain a patent so you could recoup your investment and make a profit?

The point I was making is the US medical system is not a free market so I don't cry any tears when the government places restrictions and requirements that make those big pharma execs unhappy.

At the lowest end you don't get what you want. At the high end you get ripped off. I'd say that private Mexican hospital is somewhere in the middle and US healthcare is a really expensive ripoff, with an emphasis on expensive and not so much emphasis on quality.

Indisputably the finest health care in the world. Period.

Based on what?

Results.

Quality of life after the diagnosis of a serious disease.

The number of new life-extending and life-saving drugs.

The number of new procedures and new technology.

You haven't actually provided any statistics. You only posted that chart, and it doesn't look like the US is doing very well compared to some of the other nations on that list. The USA has roughly 38 times the population of Switzerland, but it appears on that chart only 9 times as many times as Switzerland (and many of those spots are shared with other countries).

I was waiting for someone to rise to the bait. Thank you.

10 Surprising Facts about American Health Care
Brief Analyses | Health

No. 649
Tuesday, March 24, 2009
by Scott Atlas

Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world. Economists, government officials, insurers and academics alike are beating the drum for a far larger government rôle in health care. Much of the public assumes their arguments are sound because the calls for change are so ubiquitous and the topic so complex. However, before turning to government as the solution, some unheralded facts about America's health care system should be considered.

Fact No. 1: Americans have better survival rates than Europeans for common cancers.[1] Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

Fact No. 2: Americans have lower cancer mortality rates than Canadians.[2] Breast cancer mortality is 9 percent higher, prostate cancer is 184 percent higher and colon cancer mortality among men is about 10 percent higher than in the United States.

Fact No. 3: Americans have better access to treatment for chronic diseases than patients in other developed countries.[3] Some 56 percent of Americans who could benefit are taking statins, which reduce cholesterol and protect against heart disease. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons and 17 percent of Italians receive them.

Fact No. 4: Americans have better access to preventive cancer screening than Canadians.[4] Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate and colon cancer:

• Nine of 10 middle-aged American women (89 percent) have had a mammogram, compared to less than three-fourths of Canadians (72 percent).
• Nearly all American women (96 percent) have had a pap smear, compared to less than 90 percent of Canadians.
• More than half of American men (54 percent) have had a PSA test, compared to less than 1 in 6 Canadians (16 percent).
• Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with less than 1 in 20 Canadians (5 percent).

10 Surprising Facts about American Health Care

Those are some good cherrypicked claims, but how do they explain higher life expectancies in those countries?

List of countries by life expectancy - Wikipedia

Maybe Americans just don't live long enough to die from some of those cancers.

 

[frigidweirdo]

We need to build a wall to keep Americans out

Or to keep Americans in the US so they can be screwed over by their own.