Health Care Costs and you

[SeaCat]

Okay a lot of people are talking about cutting the costs of Hospital stays. They say that visiting the hospital is too expensive, and I tend to agree. Yet how do we cut down the costs?

Why is it so expensive to visit the hospital? What is driving up the cost? What can we do to bring it back under controll?

Being in the field I have my own ideas but I'm interested in hearing your views. So lets hear it, how can we reign in the rising cost of health care?

Cat

 

[starrkers]

The expectation that a trip to the hospital will always have a happy outcome needs to be squashed.
Operations are not without risk. Sick people don't always get better.
It is usually not a doctor's fault.
Were malpractice lawsuits confined to real cases of malpractice, medicos/hospitals/et al wouldn't need to pay the outrageous amounts they currently do in malpractice insurance. That would have to decrease the costs.

 

[rgraham666]

We're having somewhat similar problems here in Ontario. Mostly due to the increasing cost of drugs and modern diagnostic equipment.

Here in Canada I'd say the best thing to do is lifestyle change. Promote better eating habits and exercise.

In the States I'd say make health care a public responsibility rather than a private one. The purpose of a private health care system is to make money. That means charging more and doing less. A public health care system's purpose is to provide health care. Different priorities would mean better, less expensive health in my opinion.

Also the same changes in lifestyle apply as well.

Another important change would be to reduce the stress in our lives. Most people I know are highly stressed. Their jobs are stressful, they have money worries, even getting to and from work is an exercise in stress. That can't be good.

 

[R. Richard]

People today live longer than people in past years. Older people have more health problems and require more health services. Many elderly people would have died of undiagnosed/misunderstood health problems in previous years. Medical science now saves them, so that they cam have still more expensive treatment.

As has been previously mentoned, the malpractice lawyers drive up cost to an almost unbelievable degree.

Modern medicine uses expensive machines to deliver health care that would have been impossible only a few years back. The new machines are expensive and so are the people who operate them.

It all adds up.

 

[ishtat]

A massive proportion of the health budget whether private or public in all the first world economies is spent in the last three or four months of peoples lives.
An obvious solution therefore is to allow the completely natural process of death to proceed with rather less pointless intervention???

Personally my preference would be for an earlier 'natural' death over one delayed by intrusive medical technology.

 

[buxxxom]

It's not just medical costs, but dental and vision costs that are mounting. Insurance premiums are terribly expensive and cost about 700 a month for my whole family, but it's too scary not to be insured when one stay in the hospital can easily top the 20K mark. Even with insurance, co-pays and deductibles are outrageous.

 

[JAMESBJOHNSON]

CAT

My last ER visit I spent $1800 for the MD to tell me he had no idea what my problem was. I diagnosed a kidney stone, and the MD agreed, but there was no kidney stone evident. Maybe I passed it while waiting 5 hours to see the doc. Anyway, my point is:

When my MD cant squeeze me in for an acute problem, I have to go to the ER, and when I go to the ER my co-pay is ten times what an office copay is. Say $100 vs $10.

I suspect people are gonna smarten up and realize they pay $8400 plus deductibles before they get any 'free' insurance care, and then theyre gonna opt-out of insurance and put the money in the bank for when they have a medical problem.

When I was a kid, and people needed inpatient care, they got with their MD and a price was agreed to for the treatment. The hospital got its money but not a dime more. There was no padding the bill with all the BS that gets added to inpatient treatment...like Patient Education (Dont shower for 72 hours) $75...or wheeling your ass to the front door.

 

[SensualCealy]

One of the major concerns that I have heard of from a Dr in the US that is a family member is the cost of malpractice insurance.

Everyone sues everyone over things that 'just' happen at times.
Drs and nurses are not GODs they are human, they only know so much and the good drs and nurses, if they dont know whats going on usually pass you on to someone that does know. They are willing to admit they DONT know.

Now this being said, this Dr has tons of money, but tons of stress too.
I wouldnt want to be in his shoes and I personally think he deserves the huge house nice cars and frequent air tickets back home, oh did I mention he can afford to pay for his kids to go to Ivy League schools without worrying where the next payment will come from?

I think too many people abuse the use of Drs. if you haven't spent a week trying over the counter meds, or old remedies that our parents used on us that actually worked or almost killed us while trying to cure us then dont go to the frigging Drs!
Now small children are different, they cant verbalize whats wrong so they need to be seen, but by reducing the patient load there would be more time to see the drs and most likely if the reduced patient load happened the Drs would be forced to reduce some of the costs.
C

 

[ltnsfr007]

Okay a lot of people are talking about cutting the costs of Hospital stays. They say that visiting the hospital is too expensive, and I tend to agree. Yet how do we cut down the costs?

Why is it so expensive to visit the hospital? What is driving up the cost? What can we do to bring it back under controll?

Being in the field I have my own ideas but I'm interested in hearing your views. So lets hear it, how can we reign in the rising cost of health care?

Cat

Get rid of ALL the attorneys

 

[JAMESBJOHNSON]

CEALY

I came upon a report about the real culprits of healthcare increases and they are:

MDs buy expensive diagnostic machines and are clueless about how to use them. But you get billed for the phony use.

MDs dont keep up with the latest treatments. So the treatment you get tends to be whatever was hot & sexy when when your MD graduated med school...in 1968.

MDs invest in testing labs. So they order lots of tests. The tests save their ass because they dont know how to diagnose most things, anymore.

 

[Katyusha]

One of the major concerns that I have heard of from a Dr in the US that is a family member is the cost of malpractice insurance.

Everyone sues everyone over things that 'just' happen at times.
Drs and nurses are not GODs they are human, they only know so much and the good drs and nurses, if they dont know whats going on usually pass you on to someone that does know. They are willing to admit they DONT know.

Now this being said, this Dr has tons of money, but tons of stress too.
I wouldnt want to be in his shoes and I personally think he deserves the huge house nice cars and frequent air tickets back home, oh did I mention he can afford to pay for his kids to go to Ivy League schools without worrying where the next payment will come from?

I think too many people abuse the use of Drs. if you haven't spent a week trying over the counter meds, or old remedies that our parents used on us that actually worked or almost killed us while trying to cure us then dont go to the frigging Drs!
Now small children are different, they cant verbalize whats wrong so they need to be seen, but by reducing the patient load there would be more time to see the drs and most likely if the reduced patient load happened the Drs would be forced to reduce some of the costs.
C

The U.S. is a very sue-happy society...it isn't just malpractice. You have people who are 100% at-fault for a car accident suing for the cost of their medical bills. You have burglars getting injured while trying to rob a house sue their victims. You have people who get injured because of negligence on their part suing their employer, or someone who provided a service (the idiots who completely ignore all the "caution wet floor" signs and then fall, or even fall deliberately, in a store). People in this country look for reasons to sue because suing is a good, quick way to get rich these days. And suing for medical malpractice is an excellent way to get rich quick.

Some states (Mississippi) have placed caps on malpractice awards. There are doctors all over the country that are leaving their home states, or just leaving their practices, because they're paying $400 PER DAY (not per week, not per month) in malpractice insurance. And the problem isn't just the number of people who'll sue because they have a little subcutaneous bleeding left over from a blood draw, it's the ridiculous awards. People get multi-million dollar awards for malpractice that didn't really affect the quality of their life.

And for those whose lives ARE severely affected, lawsuits were never meant to make anybody rich...while you can't put a price on a life, or the quality of life, millions of dollars is not going to change what happened to you. It's not going to make your life, as it is now, any better. You'll have one less worry, sure, but you'll still have whatever problems you have now.

When I wrote my post in JBJ's thread yesterday I hadn't considered lifestyles, malpractice, or the amounts of money spent on keeping someone alive for the last few months of their lives, as some of the reasons for the ridiculous cost of healthcare but they figure into this too. Like I said, it's a horribly complicated problem that an awful lot of people and organizations are a cause of. The problem isn't JUST the insurance companies, it isn't JUST businesses being unwilling to provide healthcare, it isn't JUST the pharmaceutical companies, it isn't JUST anything. All sorts of things need to be addressed and her plan ONLY addresses the issues with insurance. It's not nearly comprehensive enough. And no program that the government can come up with will be comprehensive enough.

As for making healthcare a public domain instead of a private one, our government can't be trusted with that. They're too busy trying to please everyone and so they'll develop a program that has more bugs, more loopholes, more costs, and more red tape than the current system will ever have, so that all conflicting viewpoints are addressed. And they're too busy raiding various trusts for their pet projects to be trusted with the money that would be set aside to cover a plan like that. The biggest reason I'm against government healthcare is because our government cannot be trusted to administer it in a way that'll be in the best interests of the people.

 

[CharleyH]

Vote for Hilary Clinton!!!

 

[JAMESBJOHNSON]

KATYUSHA

We have a local situation that was impossible for the people involved. The cops came upon a man wandering in traffic. They pulled him off the road and called EMS. He disclosed he had some sort of medical condition, then tried to leave. The cops forcibly kept him from leaving. The guy then went into a coma, and remains there. His momma sued the city and got 3.5 MILLION from the rubes on the jury.

If the cops had let him go, and he was run over or fell and hurt himself, his momma woulda sued them for that.

 

[oggbashan]

When the UK's National Health Service was set up, people were dying because they couldn't afford to go to a doctor.

Cosmetic conditions weren't an issue - you just lived with them. It is enlightening to look at street scenes before the war. People were walking around with obvious deformities that could be easily removed but weren't affordable to the average family.

In the early years, late 1940s and early 1950s, the NHS was a godsend. People were treated for conditions they had endured for years.

Unfortunately Health Care has a bottomless demand. People used to go to the doctor if they couldn't cure themselves with home-made remedies or over the counter preparations. Now any minor ailment is taken to the doctor who is expected to cure viruses that will pass in a couple of days. Expectations are far greater than they ever were. People expect, and usually get, a better quality of life than their parents or grandparents but are not ready to wait for treatment for conditions that are not life-threatening.

Medical science has advanced but advanced treatments have high costs. Those costs have to be paid for by National Insurance or taxes and the supply of money isn't inexhaustible so some form of rationing has to be applied. Waiting lists, or postcode lotteries (getting better, faster treatment in some parts of the country than others), or straightforward refusal to treat are all becoming common despite politicians' promises.

Medical insurance is expensive even in the UK and most private hospitals are not equipped for emergency care - that is left to the NHS. The average severe injury road accident costs nearly one million pounds for the emergency services and hospital treatment. What is the cost of insurance to cover that sort of fee?

The best bet in the UK is some type of medical insurance that will provide treatment without delay if the NHS can't deliver yet the premiums are constantly rising and the exception clauses are getting more numerous. Mental illness is almost impossible to insure for if you have already had an episode because the costs might be life-long.

Nurses and doctors now receive training far beyond that given to previous generations yet once in service the basics such as hygiene and personal care are neglected. Staff costs are so high that basic cleaning, changing bedpans and feeding patients who can't feed themselves are neglected.

The problem isn't helped by predatory lawyers but the real difficulty is meeting an impossible level of demand.

Og

 

[elfin_odalisque]

When the UK's National Health Service was set up, people were dying because they couldn't afford to go to a doctor.

In the early years, late 1940s and early 1950s, the NHS was a godsend. People were treated for conditions they had endured for years.

Unfortunately Health Care has a bottomless demand. Medical science has advanced but advanced treatments have high costs. Those costs have to be paid for by National Insurance or taxes and the supply of money isn't inexhaustible so some form of rationing has to be applied. Waiting lists, or postcode lotteries (getting better, faster treatment in some parts of the country than others), or straightforward refusal to treat are all becoming common despite politicians' promises.

The best bet in the UK is some type of medical insurance that will provide treatment without delay if the NHS can't deliver yet the premiums are constantly rising and the exception clauses are getting more numerous. Mental illness is almost impossible to insure for if you have already had an episode because the costs might be life-long.

Nurses and doctors now receive training far beyond that given to previous generations yet once in service the basics such as hygiene and personal care are neglected. Staff costs are so high that basic cleaning, changing bedpans and feeding patients who can't feed themselves are neglected.

The problem isn't helped by predatory lawyers but the real difficulty is meeting an impossible level of demand.

Og

The argument about rising health costs ignores the point that we have to adjust our budgets to pay more for healthcare.

In a century, the proportion of our income we spend on food has dropped from 50% to 20%. We are not prepared to move that saving to health but choose technology, leisure and other ways to spend.

The cost of staying alive and having a reasonable quality of life is rising, yet most of us won't accept we are responsible for funding it.

 

[cantdog]

Fact is, though, we are where Britain was in the 40s. My Dad refused treatment and let himself die, simply to avoid vitiating the entire family fortune for the sake of a few more months of a life whose quality was much reduced from what it had been. He was in constant pain and incapable of most things he used to enjoy, but to keep being treated was almost certain to pauperize all of us for years and years after his inevitable death.

A lot of people neglect their health care, especially visual and dental, because they can't fuckin afford it.

Insurance companies refuse to insure nearly all existing conditions too. Their idea is not to get you health care, but to make a buck, and you're an obvious bad bet. I don't see how any profit-based system is going to better that.

 

[Katyusha]

The best bet in the UK is some type of medical insurance that will provide treatment without delay if the NHS can't deliver yet the premiums are constantly rising and the exception clauses are getting more numerous. Mental illness is almost impossible to insure for if you have already had an episode because the costs might be life-long.

Here it's almost impossible to get health insurance for the same reason; they don't want to, or can't, pay for the treatment that someone with, say, schizophrenia or OCD will have to undergo for the rest of their lives. It's the same with almost any preexisting health condition. The people who need insurance the most can't get it. And the rest of us pay these premiums for care we MIGHT someday need, but when that does happen insurance won't cover all of it. In many cases, they won't even cover more than half.

 

[JAMESBJOHNSON]

I did some looking around. What I discovered is MEDICAID patients use around 50% of the medical care in America....dollar-wise, about 4X what privately insured people use.

But MEDICAID doesnt cover the costs for treating poor people. So hospitals have to make up the money elsewhere.

And MEDICAID doesnt cover the working poor who have no insurance. The states compensate the hospitals a little, but hospitals are forced to accept whoever walks in the door if they take the state money.

It appears that insurance companies take their middle-class clients to the cleaners. On average, middle-class people use a fraction of what they pay in premiums. MEDICAID recipients are the sickest and cost the most.

So, how do insurance companies get away charging middle-class people so much for so little?

Pay-offs to politicians.

And it works like this: The insurance people get with the politicians and pay them to force the insurance companies to cover problems middle class people dont get. THROW ME IN THE BRIAR-PATCH, PLEASE! It's not a lot different than paying for protection from Space Invaders.

So what does your deductible go for? You got it! MEDICAID poor people. The money aint coming out of the insurance premium.

 

[Katyusha]

The argument about rising health costs ignores the point that we have to adjust our budgets to pay more for healthcare.

In a century, the proportion of our income we spend on food has dropped from 50% to 20%. We are not prepared to move that saving to health but choose technology, leisure and other ways to spend.

The cost of staying alive and having a reasonable quality of life is rising, yet most of us won't accept we are responsible for funding it.

Yes, but the cost of healthcare has been rising at roughly 10 times the rate of inflation in the U.S. over the past fifteen years. What justifies that? And how do people save for that, AND retirement, AND other emergencies that might pop up, while still meeting their monthly living costs even if they ARE living meagerly? Do you know how much money people have to invest and save in order to be able to cover all of this? Even wise investments don't yield very much in a short period of time.

Suppose I'm diagnosed with cancer in six months. Suppose that up until now, my husband and I have been working hard to put money away in investments and high-yield savings accounts, and we've been very frugal, very good about living within our means. Suppose that in our late twenties we already have $45,000 in liquid funds that we've been trying to build just for something such as this. NOW...suppose that I've had to stop working because of the cancer. No problem, I'm under my husband's insurance so we still have coverage for it. Right? Well...let's say that twelve months of cancer treatments, including the initial surgery to remove the tumor, amount to $250,000. The hospital sends the bills to insurance and they're only willing to cover $100,000. Now what? We haven't been able to put anything else away in the last twelve months because we no longer have any disposable income; it's all going to monthly living expenses. We have $45,000 that we can pay ourselves but that still leaves us with a bill of $105,000. And now we have no savings, no investments, no cushions at all. And I still can't work because I'm still recovering.

Contrary to popular belief, this type of thing happens to even the most money-smart of people. Whether people are spending money on luxuries or squirreling it away, many of them are STILL only a bad accident or prolonged illness away from bankruptcy. Why? Because you can't plan for that, and the costs to pay for it are impossible.

In the U.S., when income is adjusted for inflation, the middle class is making less now than they were thirty years ago. One of the problems is increasing tax breaks for corporations and the rich. Just after the end of WWII, corporations and the rich shouldered more than 75% of this country's tax burden. Today, corporations and the rich shoulder roughly 16% of the nation's tax burden. The poor get tax credits and exemptions; relief from their tax burdens. The middle class shoulders the rest. For the most part, whenever there are tax cuts in this country they favor the rich and big business and the poor and the middle class is left to pick up the slack.

Corporate America has been allowing average salaries in several industries to fall because of cheap labor. That's had a negative effect on salaries all across the corporate world here. And for ten years now salaries have not kept up with inflation. That's had a big hand in leading to the current problems Americans have with debt; it's not all irresponsible spending that has caused that.

You can't assume that the income that once gone to food, but now goes elsewhere, is all frittered away unnecessarily. In some ways it is, but in a lot of ways it's gone to cover other necessary costs that have risen at ridiculous rates.

 

[JAMESBJOHNSON]

KATYUSHA

But you forget that health insurance is a fairly recent job incentive. Forty years ago very few people had any insurance except people on MEDICAID and MEDICARE. Poor people didnt get medical treatment, and geezers went to the Old Folks Home if things were bad enough.

And medical care was affordable for the middle-class. My parents went to MDs and dentists all the time, and we had no insurance. Most people didnt.

 

[Stella_Omega]

The argument about rising health costs ignores the point that we have to adjust our budgets to pay more for healthcare.

In a century, the proportion of our income we spend on food has dropped from 50% to 20%. We are not prepared to move that saving to health but choose technology, leisure and other ways to spend.

Like housing, for instance?

 

[gauchecritic]

Not political, just how I feel....

Probably the largest issue with regard to medical costs (after inflated top dollar fees for drugs and non-essentials like ice chips) is the way that the individual procedures are accounted for.

A couple of weeks ago at my place of work we had the kitchen re-painted. The cost of repainting was 80 quid an hour. (260 dollars) for each painter.

The lads themselves were getting 10 quid an hour. (20 dollars) Guess where the other 70 quid an hour went? Cost of management, charge hands, secretaries, and every single person involved with paperwork.

I'm guessing it's similar in hospital situations. Those that do the actual job of care get a middling to poor scale of pay. Essential services (cleaners, cooks etc) get the poorest and those that sit on their arses making all the decisions get paid the most.

Yeah yeah pressure and stress and responsibility. Try the pressure and stress of being sent home for bed rest with an 8 inch stitched abdominal surgical wound and kids to watch and meals to cook. Try some of that responsibility and see how much you think you should be paid then.