Why not attack the $600 billion health care cost driver?

[dblack]

dblack, the key factor is not putting "the state" in charge of paying for medicine, it's putting one single entity in charge of it -- whoever that might be -- with an incentive for bargaining down costs. Hell, you could put me in charge of it if you want. (If I get a salary, of course. And the money to do it with.)

What happens now is that no payer has the clout to make pharmaceuticals charge here the same prices they charge for the same drugs just about everywhere else in the world. A Canadian, a Frenchman, a Japanese, an Englishman, a German -- all these people can by American-made drugs for (I'm not exaggerating here) about ten percent of what we have to pay for them here in the U.S. Why? Because the national health coverage systems in all of those countries say to our pharma companies, "You will sell the drugs for that price or you will not sell them."

Now, the interesting thing is that they DO sell them for that price, which means they must be making a profit doing so or they wouldn't do it, which means that 90+% of what they're charging for the same stuff here is pure profit -- and that's just unconscionable. There is the main reason why our medical costs are so high: a captive market, and no effective way to bargain the price down.

We know what works. We've seen it work elsewhere. The only reason we don't have it here right now -- the only reason a single-payer system rather than the Rube Goldberg ACA wasn't passed through Congress and signed by Obama in 2009 -- is because too many Congresscritters are bought and paid for by corporate interests, including the health-insurance, pharmaceutical, and health-care fields. And no, I don't just mean the ones with an R after their names.

Then by all means lets put them in charge of a health insurance monopoly! This seems like a stunningly bad idea to me, and I'm not sure how you can recognize the corrupt nature of our leadership yet advocate giving them even more power. Something doesn't add up.

To your suggestion that that consumers have no effective way to bargain and are, essentially, a captive market, I can only agree. But I suspect that you see this as some inherent 'flaw' in free market economics, rather than a byproduct of ill-conceived regulatory efforts.

It's the push toward centralization that's creating so many of our current problems. We're transferring responsibility for, and authority over ( the two are inseparable), our most personal needs from the individual to state authority. I think this will turn out to be a very bad bargain in the long run.

 

[Kooshdakhaa]

It is NOT the malpractice insurance idiot!

It is the FACT the doctors themselves SAY they order duplicate tests, MRIs, specialist opinions at the rate of $1 for every $4 spent!
Or the entire health industry is $2.5 trillion 25% of $2.5 trillion is ....
$625 BILLION a year in DEFENSIVE MEDICINE
Read closer or get your glasses FIXED!

Chill out. Stress is bad for your health. : )

I know one thing...if I've got something really bad wrong with me, I WANT my doctor to be thorough. I want to be treated like I'm the most important patient on the face of the earth.

I'm not so sure this would happen if the doctors had no fear of malpractice repercussions.

 

[Dragon]

Then by all means lets put them in charge of a health insurance monopoly!

We're not going to be able to create a single-payer system except piecemeal on the state level until we get the corporate influence out of the federal government, so that's not really a problem. First things first.

To your suggestion that that consumers have no effective way to bargain and are, essentially, a captive market, I can only agree. But I suspect that you see this as some inherent 'flaw' in free market economics, rather than a byproduct of ill-conceived regulatory efforts.

Let's just say that I recognize that a free market can only exist where both buyers and sellers can choose not to buy or sell. The labor market is not a free market because the sellers have no choice but to sell to someone; medical care is not a free market because the buyers are similarly over a barrel. Both of these markets therefore require more regulation than many others.

I'm not a believer in a free market as an ideal, to be pursued for its own sake, but I do recognize that in many parts of the economy it functions better than a command economy. I just don't believe that medicine is one of them.

 

[healthmyths]

So you are OK with the $600 billion in duplicate tests, specialists opinions, in other words inflating what insurance companies pay so they have to raise the premiums..
OR you still think even after all the proof insurance companies pay an average of 80% of premiums out in claims and have a net profit of 4% BEFORE they pay income taxes they are the bad guys here?

 

[healthmyths]

you wrote"What we do in my department is we look at everything and consider everything!"
And of course YOU are aware then being involved with a well known health organization heard of the Medicare Provider Analysis and Review (MEDPAR) ?

And if your "well known" organization was a hospital say like Cleveland Clinic, are you aware that :
Procedure billed to Medicare outpatient # claims per claim actual cost Markup!
Computed Tomography with Contrast 12,393 $1,928 $112 1,721.4%

A 1,721% markup by the hospital..
yea you look at the numbers!

 

[Listening]

It is NOT the malpractice insurance idiot!

It is the FACT the doctors themselves SAY they order duplicate tests, MRIs, specialist opinions at the rate of $1 for every $4 spent!
Or the entire health industry is $2.5 trillion 25% of $2.5 trillion is ....
$625 BILLION a year in DEFENSIVE MEDICINE
Read closer or get your glasses FIXED!

Chill out. Stress is bad for your health. : )

I know one thing...if I've got something really bad wrong with me, I WANT my doctor to be thorough. I want to be treated like I'm the most important patient on the face of the earth.

I'm not so sure this would happen if the doctors had no fear of malpractice repercussions.

The flipside of that is that I don't want to be x-rayed, stabbed or medicated any more than is absolutely necessary to cure my illness.

Every doctor has to exercise discression in deciding what tests to run. In other words, they work off of probability. And what I have been reading is that doctors coming out of school are not being taught this. What they are being taught is to run as many tests as necessary to be absolutely sure of something (often in the negative).

Maybe we should have different classes of treatement.

In yours, you would pay more for insurance because you will likely get more tests.

 

[midcan5]

...The flipside of that is that I don't want to be x-rayed, stabbed or medicated any more than is absolutely necessary to cure my illness.

And from rep comment: "Name calling ? Why ? There are plenty of facts to address here."

Then don't. My mom (90) recently turned down all tests and additional procedures.

Facts? You mean assumptions, exaggerations, and plain BS, don't you? Are you a corporate bot too? Think for yourself and try to stop arranging the universe according to your partisan perspective. My thoughts on topic are below.

http://www.usmessageboard.com/healt...241-answers-to-all-your-questions-on-uhc.html

http://www.usmessageboard.com/healt...lthcare/181931-conservatives-and-empathy.html
_

 

[Listening]

...The flipside of that is that I don't want to be x-rayed, stabbed or medicated any more than is absolutely necessary to cure my illness.

And from rep comment: "Name calling ? Why ? There are plenty of facts to address here."

Then don't. My mom (90) recently turned down all tests and additional procedures.

Facts? You mean assumptions, exaggerations, and plain BS, don't you? Are you a corporate bot too? Think for yourself and try to stop arranging the universe according to your partisan perspective. My thoughts on topic are below.

http://www.usmessageboard.com/healt...241-answers-to-all-your-questions-on-uhc.html

http://www.usmessageboard.com/healt...lthcare/181931-conservatives-and-empathy.html
_

Thank you for proving my pont.

And how is calling someone an un-alive corporate bot not just what I described ?

Besides the name calling in your post to me ("Are you a corporate bot too ?"), the two threads you point to are nothing more than flamefests that pit conservatives against liberals.

Maybe you should try a little of your own advice and think for yourself instead of jumping to conclusions. And BTW: there were no facts that I could see in your threads. So was the reference to B.S. the threads themselves ? Please post a few facts and we can begin the conversation.

I would cheer your mother for her choices, but as is often the case, there is no context here. She might be at the end of life and simply tired of being processed through the medical machine. Or she might be super healthy and simply not interested in being overworked by the medical machine. Either way, the choice was hers.

 

[Listening]

Let's just say that I recognize that a free market can only exist where both buyers and sellers can choose not to buy or sell. The labor market is not a free market because the sellers have no choice but to sell to someone; medical care is not a free market because the buyers are similarly over a barrel. Both of these markets therefore require more regulation than many others.

I'm not a believer in a free market as an ideal, to be pursued for its own sake, but I do recognize that in many parts of the economy it functions better than a command economy. I just don't believe that medicine is one of them.

While I disagree with your post in general, I will say that I don't know that I have ever seen a good description of an unregulated health care market.

For the "free market" to work, there would have to be much less restrictions on who can "practice" medicine. The supply of doctors seems pretty well controlled.

But they have to be a doctor.

What if I don't want to see a doctor ? Why can't I just pay for medications I want and live with the consequences.

What if my nieghbor is a great "practitioner" with no formal training ? Why can't she prescribe things for me ?

These are the kinds of questions that would come up in a discussion about a realy free market health care system.

And while I would be O.K. with this, many would not because of the risk it creates. People get duped all the time as it is. And can seniors really make good choices for themselves past a point ?

And so, if conservatives advocate a free market in health care, they advocate for something that feels like the wild west of health care.

So far, I have not seen anything that tells me what unregulate health care looks like.

I wish they would. In principle, I am all for it. People call health insurance a market failure, but I wonder how that can be when insurance is already so heavily regulated ?

 

[Listening]

dblack, the key factor is not putting "the state" in charge of paying for medicine, it's putting one single entity in charge of it -- whoever that might be -- with an incentive for bargaining down costs. Hell, you could put me in charge of it if you want. (If I get a salary, of course. And the money to do it with.)

What happens now is that no payer has the clout to make pharmaceuticals charge here the same prices they charge for the same drugs just about everywhere else in the world. A Canadian, a Frenchman, a Japanese, an Englishman, a German -- all these people can by American-made drugs for (I'm not exaggerating here) about ten percent of what we have to pay for them here in the U.S. Why? Because the national health coverage systems in all of those countries say to our pharma companies, "You will sell the drugs for that price or you will not sell them."

I wrote a summary on an article on this subject for a class....and it presented things much differently than what you have here.

Can you supply some documentation on your claims about the cost of American made drugs to others ?

I don't recall a lot of details, but one thing I do recall it saying was that the Canadian government did to keep costs down was that it pretty much insisted on older generation drugs...and not the most current.

I never really followed up on this....

 

[kiwiman127]

you wrote"What we do in my department is we look at everything and consider everything!"
And of course YOU are aware then being involved with a well known health organization heard of the Medicare Provider Analysis and Review (MEDPAR) ?

And if your "well known" organization was a hospital say like Cleveland Clinic, are you aware that :
Procedure billed to Medicare outpatient # claims per claim actual cost Markup!
Computed Tomography with Contrast 12,393 $1,928 $112 1,721.4%

A 1,721% markup by the hospital..
yea you look at the numbers!

And that's why we need health care reform! In WellPoint's paper on what is driving up the cost of health care, they point at technology and technology typically has very high profit margins
Most people realize that the cost of health care insurance reflects the actual cost of health care. I use the health care insurance industry's rise in premiums to reflect the high cost of health care in this country, it isn't an attack on the health care insurance companies. And per your previous post, I'm aware of the health care insurance companies 4% margin of profit.
Also, due to the confidentiality agreement every employee signs, I cannot even hint about who employs me on any message board or social network. But I guarantee you, people are very aware of who my employer is and not just in this country. We have a multiple divisions and our woork is used by many professionals around the world including government entities. That is about as specific as I dare to go.

 

[Listening]

And that's why we need health care reform! In WellPoint's paper on what is driving up the cost of health care, they point at technology and technology typically has very high profit margins.

And dare I suggest that it is those high margins that are the drivers for the technology advances we have seen in the past ?

Take away that incentive and what happens to technology advancements ?

Do you really believe they will still be happening ?

 

[kiwiman127]

And that's why we need health care reform! In WellPoint's paper on what is driving up the cost of health care, they point at technology and technology typically has very high profit margins.

And dare I suggest that it is those high margins that are the drivers for the technology advances we have seen in the past ?

Take away that incentive and what happens to technology advancements ?

Do you really believe they will still be happening ?

Well, based on Healthmyth's numbers, someone is gouging someone. This gouging is reflected in our health care's cost. Compare our costs to developed nations and in particular countries that have health care comparable to ours, say Denmark, France, Germany;etc.
A person would be hard pressed to find an economist who doesn't agree that the cost of health care in the US is a huge factor with our sagging economy. It hurts businesses, our government and of course Main Street America. Our 70% consumer driven economy is hurt because it effects the consumer class as it is decreasing the expendable income. Our defense budget is extremely effected by the cost of health care. It cuts into the profits of businesses! That is why economist are very concerned about the runaway costs. In the last ten years health care insurance, which reflects the cost of health care went up 113%, inflation on the other hand rose around 38% in that same time period.
Something has to be done.

 

[Listening]

And that's why we need health care reform! In WellPoint's paper on what is driving up the cost of health care, they point at technology and technology typically has very high profit margins.

And dare I suggest that it is those high margins that are the drivers for the technology advances we have seen in the past ?

Take away that incentive and what happens to technology advancements ?

Do you really believe they will still be happening ?

Well, based on Healthmyth's numbers, someone is gouging someone. This gouging is reflected in our health care's cost. Compare our costs to developed nations and in particular countries that have health care comparable to ours, say Denmark, France, Germany;etc.
A person would be hard pressed to find an economist who doesn't agree that the cost of health care in the US is a huge factor with our sagging economy. It hurts businesses, our government and of course Main Street America. Our 70% consumer driven economy is hurt because it effects the consumer class as it is decreasing the expendable income. Our defense budget is extremely effected by the cost of health care. It cuts into the profits of businesses! That is why economist are very concerned about the runaway costs. In the last ten years health care insurance, which reflects the cost of health care went up 113%, inflation on the other hand rose around 38% in that same time period.
Something has to be done.

You did not answer my question.

I am not disputing the money. I am saying if you take away the profit potential, what happens ?

Do you have data on medical advances coming out of these countries ? I honestly don't know how their systems work.

 

[kiwiman127]

And dare I suggest that it is those high margins that are the drivers for the technology advances we have seen in the past ?

Take away that incentive and what happens to technology advancements ?

Do you really believe they will still be happening ?

Well, based on Healthmyth's numbers, someone is gouging someone. This gouging is reflected in our health care's cost. Compare our costs to developed nations and in particular countries that have health care comparable to ours, say Denmark, France, Germany;etc.
A person would be hard pressed to find an economist who doesn't agree that the cost of health care in the US is a huge factor with our sagging economy. It hurts businesses, our government and of course Main Street America. Our 70% consumer driven economy is hurt because it effects the consumer class as it is decreasing the expendable income. Our defense budget is extremely effected by the cost of health care. It cuts into the profits of businesses! That is why economist are very concerned about the runaway costs. In the last ten years health care insurance, which reflects the cost of health care went up 113%, inflation on the other hand rose around 38% in that same time period.
Something has to be done.

You did not answer my question.

I am not disputing the money. I am saying if you take away the profit potential, what happens ?

Do you have data on medical advances coming out of these countries ? I honestly don't know how their systems work.

Due to time constraints on my end, I didn't get the time I wanted to answer your question in a complete context.
But I did find a survey conducted by Eucomed Medical Technologies.

"Following the publication of the European Commission’s Medical Devices
Competitiveness and Impact on Public Health Expenditure report – hereinafter
referred to as the Pammolli Report – in September 2005, Eucomed began exploring
ways to address and expand upon the conclusions of this report.
To assess the limiters of European competitiveness and innovativeness vis-à-vis
medical technology, Eucomed conducted a survey of its membership (corporate and
association members), questioning them on various aspects of the European market
which may hinder (or help) the health and growth of the medical technology industry.
This survey was launched in July 2006 and finished at the end of September. Overall,
63 organisations completed the survey, comprising 42 Eucomed corporate members,
20 Eucomed association members, and 1 other European medical technology
industry association. Overall, 73% of those invited to participate did so, and over 70%
of participants completed the survey.
The survey was divided among three principal areas: part A gathered general
information on the respondents to provide a basis for analysis; part B gathered
economic data about the medical technology industry, with the goal of updating
Eucomed’s benchmark economic figures on the industry; part C is the core of the
survey, and was further subdivided among three areas: European market access,
external trade, and R&D and innovation.
Among the corporate members, the majority had their headquarters in the United
States 55%) , while 43% had their headquarters in Europe. Within Europe, a plurality of the
respondents have their headquarters in Germany (12%). 17% of corporate
respondents reported having being small or medium-sized enterprises (fewer than
250 employees). The largest business focus group among corporate respondents is
single-use technology, followed closely by non-active implantable technology. Among
corporate respondents, 92% reported having sales in all pre-2004 EU member states
and 80% reported having sales in the post-2004 EU member states. In terms of
manufacturing, 42% had manufacturing operations in Germany, and roughly the
same percentage had manufacturing operations in France. Among the post-2004
member states, Poland and Hungary have the highest share of companies with
manufacturing operations in their countries, each representing about 4% of
participants. 32% of participants had in-house research and development operations
in Germany, while about 30% had R&D operations in France and Switzerland.

http://ec.europa.eu/enterprise/newsroom/cf/_getdocument.cfm?doc_id=3159

I wish I had more time to read it but you are welcomed to take a look. What I gathered skim-reading it is that US innovation plays a large part on the European technological landscape. Also it's clear of strong US presences.

Answering your question: To me, the bottom line is the economics and how much expense can the US medical landscape handle. So, I strongly considered the opinions of economist and feel at this time, due to economic restraints at least in the short-term and the mentality that we should do what we can afford in today economically strapped environment. I think we as a country have to look at solutions to reign in the cost of heath care. So does that mean cutting back on R & D and put innovation on the back burner, I say yes, for the short period.

 

[Listening]

Answering your question: To me, the bottom line is the economics and how much expense can the US medical landscape handle. So, I strongly considered the opinions of economist and feel at this time, due to economic restraints at least in the short-term and the mentality that we should do what we can afford in today economically strapped environment. I think we as a country have to look at solutions to reign in the cost of heath care. So does that mean cutting back on R & D and put innovation on the back burner, I say yes, for the short period.

What is the difference between that and withholding the technology from those who can't afford it (or won't pay for it....and there are plent of them around) ?

The answer is that those of us who want access to it won't have that choice.

Truthfully, there is no difference between denying them and simply shutting down the advancements (difference to them).

There might be a difference to the rest of us.

 

[Listening]

A bump for the money the CBO says Obamacare will now cost us (not save us).

 

[Katzndogz]

Sadly, the health care fund has already been raided, for the foreseeable future. Democrats robbed their own fund to pay for entitlements today.

 

[Greenbeard]

We're not going to be able to create a single-payer system except piecemeal on the state level until we get the corporate influence out of the federal government, so that's not really a problem. First things first.

I realize you're talking about individual state-level efforts (like Vermont's successful legislation and California's twice-vetoed bill), but interestingly enough, this session Bernie Sanders has introduced federal legislation for a state-level single-payer program.

Unlike some of the other proposals (e.g. H.R. 676) which are built more on a Medicare model, Sanders' bill is built on the Medicaid model, in which each state has its own individualized program, operated by the state government, in a joint federal-state partnership. I thought that was fascinating because national single-payer advocates rarely seem to look to Medicaid for inspiration for a potential program structure.

 

[Meister]

We're not going to be able to create a single-payer system except piecemeal on the state level until we get the corporate influence out of the federal government, so that's not really a problem. First things first.

I realize you're talking about individual state-level efforts (like Vermont's successful legislation and California's twice-vetoed bill), but interestingly enough, this session Bernie Sanders has introduced federal legislation for a state-level single-payer program.

Unlike some of the other proposals (e.g. H.R. 676) which are built more on a Medicare model, Sanders' bill is built on the Medicaid model, in which each state has its own individualized program, operated by the state government, in a joint federal-state partnership. I thought that was fascinating because national single-payer advocates rarely seem to look to Medicaid for inspiration for a potential program structure.

Like any state will be able to afford it.