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Forums - General - Explanation of U.S. healthcare costs.

ManusJustus said:
senseinobaka said:

Health Care is wrapped in it's own protected and seperated market. One that has been allowed to out run inflation. So I think the following changes will have the best results in reducing prices.

...remove the legislation that allows hospitals/clinics to not advertise prices

1)Medicine has regulations for a reason, because its a serious profession that requires government insight to make sure shitty doctors dont become doctors.  The same can be said about engineering and many other professions, you dont want an unequalified high school drop out to build a skyscraper, so the government makes regulations to protect people.

2)Hospitals do not advertise prices because consumers do not have the knowledge to make an informed decision on their medical treatment.  Average consumers see $2000 eye surgery at Jimmy's Hospital and $3000 eye surgery at St. Johns and chooses the $2000 surgery because he has no idea about other costs and benefits.  Jimmy's hospital might be the worst hospital in the state with out of date equipment and St. Johns has a new robot to assist in surgery but the consumer has no idea about that (these were just very simple examples) and cannot make an informed decision.

1)I'm not addressing. I know you understand how much education goes into becoming a doctor and that each state has liscense programs. Go back and make your point coherent.

2)You like assuming the ignorance of the masses, yet you seem to trust your life anf future to the same masses. Interesting position. Like I said information is easily available. And when I say prices should be advertised, I mean with full disclosure. So the instituiton will have to show their mortality rate, success rate, and complications rate compared to the national/regional average. That should help in making an informed decision.

 



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Copycon said:

Privatized or socialized och whatever you choose, the thing is that SOMEONE is making A LOT of money from the American healthcare system.

Kasz216: I think you have to ground your speculations in empirical fact since it does not have to be the way you describe it. Through decentralization or whatever way you choose to to rationalize an organization you can lower there costs. In Sweden, Canada and France, just to take a few examples, we have socialized healthcare. In a neoliberal discourse this is the worst way to organize ANYTHING, because everything gets very ineffective. Still, France is considered to have the best health care system in the whole world.

MrBubbles wrote: "you steal all our doctors by throwing large piles of cash at them and it causes shortages here."

Oh, so there is a brain drain in the poor US? So all the doctors want to move away from you? Are doctors starving in the US? I think they earn a lot more than they do in Sweden and many other European countries.

That... would be going through the state.  Which was my suggestion.  You can't decentralize in a country as big as America on the national governement level. 

It doesn't work, look at the education system and how screwed up and over costly it is for little to no benefit educationally.



senseinobaka said:

1)I'm not addressing. I know you understand how much education goes into becoming a doctor and that each state has liscense programs. Go back and make your point coherent.

2)You like assuming the ignorance of the masses, yet you seem to trust your life anf future to the same masses. Interesting position. Like I said information is easily available. And when I say prices should be advertised, I mean with full disclosure. So the instituiton will have to show their mortality rate, success rate, and complications rate compared to the national/regional average. That should help in making an informed decision.

Doctors require lots of education to make informed decisions, something that the general public is not capable of.  Yes, I am stating the the masses are ignorant of medical treatment.  Likewise, doctors are ignorant of building houses.  So let doctors work on your heart and construction workers work on your house. 

As I clearly laid out in point 1 and above, the general cannot make informed decisions about what type of treatment they want or where they should go, that is why they have doctors refer them to a specialist.  When you go to your general physician and he refers you to a specialist at a certain hospital, he is able to make that decision because he is a doctor. You are not a doctor, you cannot make that decision.

Kasz:

Thats an incorrect assumption.  Not only is that not true (for isntance it assumes all entities have the same owner), but country's with less population have higher maintanance costs for boards and comittees.  In the United States, 100 people a the AMA decide that a drug is okay for the use.  In Great Britian you also need 100 people to make the same decision.  The United States has more people so the costs per capita are down.

This phenomenom is referred to as economics of scale, an important economic principle. 



Your ignoring the infrastructure. The infrastructure is much more costly then the "experts" to make the decisions.

Economics of scale does not work in a Healthcare sense, since you need CONSTANT investigation, billings, making sure everything is up to date.... there is way more cost in infrastructure then anything else.



Your infrastructure makes sense for things like roads, pipelines, wirelines, and such, but not for healthcare.  The only big distance cost would be ambulance rides, and I dont see that accouting for America's three times more expensive healthcare.



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ManusJustus said:

Your infrastructure makes sense for things like roads, pipelines, wirelines, and such, but not for healthcare.  The only big distance cost would be ambulance rides, and I dont see that accouting for America's three times more expensive healthcare.

Each healthcare claim needs to be processed by a person.... they need supervisors above them... and they need people above them to make sure the supervisors are doing their job and aren't scamming money out of the system via fake claims.  I

You need people to call and investigate claims that seem messed up.  Like making sure people dont have ongoing perscriptions for drugs 5 times what anyone would need. (pain killer drug dealers.)

You need to correlate said claims to make sure that hospitals don't have too many coincidences of treating the same thing and investigating those.

You need to have customer service representatives to handle everyone that will call.



ManusJustus said:
senseinobaka said:

1)I'm not addressing. I know you understand how much education goes into becoming a doctor and that each state has liscense programs. Go back and make your point coherent.

2)You like assuming the ignorance of the masses, yet you seem to trust your life anf future to the same masses. Interesting position. Like I said information is easily available. And when I say prices should be advertised, I mean with full disclosure. So the instituiton will have to show their mortality rate, success rate, and complications rate compared to the national/regional average. That should help in making an informed decision.

Doctors require lots of education to make informed decisions, something that the general public is not capable of. Yes, I am stating the the masses are ignorant of medical treatment. Likewise, doctors are ignorant of building houses. So let doctors work on your heart and construction workers work on your house.

As I clearly laid out in point 1 and above, the general cannot make informed decisions about what type of treatment they want or where they should go, that is why they have doctors refer them to a specialist. When you go to your general physician and he refers you to a specialist at a certain hospital, he is able to make that decision because he is a doctor. You are not a doctor, you cannot make that decision.

Kasz:

Thats an incorrect assumption. Not only is that not true (for isntance it assumes all entities have the same owner), but country's with less population have higher maintanance costs for boards and comittees. In the United States, 100 people a the AMA decide that a drug is okay for the use. In Great Britian you also need 100 people to make the same decision. The United States has more people so the costs per capita are down.

This phenomenom is referred to as economics of scale, an important economic principle.

See, this is the attitude about liberalism I hate so very much. It's your body, your life, your health and ultimately your responsibility. In what insane world would it be considered a good idea to transfer responsibility of ones life to someone else? What, they hang a MD and State liscense on the wall and suddenly my health is their responsibility? His credentials makes him the decision maker of MY life? Really? It's all a matter of cracking a book open, which is something the general public can do last time I checked. Exactly why is it that you value your life so little that you feel you have to transfer responsibility for "you" to the government or doctors or construction workers? Don't you find that a little sad? Or do you value your life but not the lives of those whom you think are pitiful and uneducated and think they should surrender their individual to the government or doctors or construction workers?

I would never trust a doctor unless I can verify what is being said thru a second opinion or personal research. Same thing with a construction worker. Houses are the single biggest investmnet most families make, you think some GC would be the final word on it's structural integrity I'd get? Hell no.

Also, anyone can self-refer to a specialist. Skin problems? Go to a dermatologist instead of a general physician.

And you misuse economies of scale. Sure supply for labor is higher and labor costs can be lower in American healthcare, but comparing a system of rationing to the American system leads to some problems. One Example would be the fact that  Hospitals can purchase the latest medical technology and also purchase as many as economically feasable. These costs are transfered to the consumer, but allow for immediate imaging and diagnosis and the highest quality. Meanwhile in a rationed system the hospital cannot make such decisions, which is why MRI imaging in Canada and the UK can take up to 12 months to get. Sure it's cheaper but the options to the consumers suck, especially if you may have cancer but cannot be treated under the government insurance until imaging confrims the diagnosis 12 months from now.

 



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senseinobaka said:

See, this is the attitude about liberalism I hate so very much. It's your body, your life, your health and ultimately your responsibility. In what insane world would it be considered a good idea to transfer responsibility of ones life to someone else?

What, they hang a MD and State liscense on the wall and suddenly my health is their responsibility?  It's all a matter of cracking a book open, which is something the general public can do last time I checked.

 

These statements are mind-blowingly foolish.  If I could pinpoint what it is about conservatives like you (not all conservatives), it would have to be your inability to think and teh fantasy world you live in.

Yes, that MD and board liscenses on their wall makes your health their responsibility.  You cannot do their job, you do not have the knowledge to do so.  To think that being a doctor takes opening a book is horribly ignorant, it takes 8 years of school plus several more years of residency under the supervision of other doctors before you can become your own practicing physician.  And even then you dont know enough, you have to keep up with new medical practices and technology for the rest of your practicing life.

You do have a responsibilty for your own healthcare, but it is not prescribing yourself drugs or deciding which method of surgery you want, its following up on what the doctor advises.  Take your medicine as instructed, go to rehab when instructed, dont eat foods that the doctor tells you are bad, that is your responsibility.



Kasz216 said:

Each healthcare claim needs to be processed by a person.... they need supervisors above them... and they need people above them to make sure the supervisors are doing their job and aren't scamming money out of the system via fake claims.  I

You need people to call and investigate claims that seem messed up.  Like making sure people dont have ongoing perscriptions for drugs 5 times what anyone would need. (pain killer drug dealers.)

You need to correlate said claims to make sure that hospitals don't have too many coincidences of treating the same thing and investigating those.

You need to have customer service representatives to handle everyone that will call.

Everything you describe is taken into account by 'per capita.'  You only need 1 customer service representative for 500 customers, you only need 1 lawyer for 1000 people.  The more people you have the more of these jobs you need, which goes in line perfectly with the 'per capita' statistic I used.

Its not like for small countries you need 1 lawyer for every 1000 people and for big countries you need 1 lawyer for every 10 people.



senseinobaka said:
steven787 said:

It's not the executives or businesses' fault.  It is their job to do every thing legally possible to maximize profit. 

Some of the laws need to change. 

Some ideas, not the only things, not all necessary - all will allow the U.S. to attract and retain the best doctors in the world:

FDA approval processes need to get less political.

Drug producers should be forced to license out their drugs (let others produce it) or the process should be made public (not for producing copies but for research openness), for a reasonable fee instead of keeping a monopoly.  But extend the patent time, so they can keep making those smaller profits longer.

Make price caps illegal, all they do is set a minimum - and do not keep prices down.

Return to health insurance instead of managed care.

For high cost procedures, over let's say $200k, the type that would bankrupt almost every american, add in a government funding.  Nobody is doing these electively.  I am not for completely socialized medicine, but people should not have to choose between death and bankruptcy; food or prescriptions.

Force private practitioners to do a of specific type and amount of pro-bono work if they charge over a certain amount or do a lot of elective procedures (plastic surgery, cosmetic dermatology).

Subsidize health care - tax rebates (both Obama and McCain are pushing a type of this).

Do not allow HCP's to deny life saving procedures - but government should pay part of the most costly procedures.

Make many common Perscriptions OTC, like every other country.

 

These may or may not be right, but Americans should be talking about it, and they don't because they are afraid.

 

I'd like to offer a different view on this. I dont think the problems are the hospitals and doctors. It's also not a problem of the pharma companies. If anything it's the Insurance companies and government.

Health Care is wrapped in it's own protected and seperated market. One that has been allowed to out run inflation. So I think the following changes will have the best results in reducing prices.

1)remove the legislation that allows hospitals/clinics to not advertise prices

2)reform insurance to follow a sane model. Make it like car insurance. Cover for trauma and and expensive procedures that would bankrupt a person.

3)offer transient aide to people in circumstances that make premiums impossible to pay

4)stop employer shopping. allow a person to shop for and find insurance they need. if an employer wants to offer to pay for the insurance a person has purchased as an attracted method, then fine.

5)remove the facism. Stop passing laws that requires me, a male, to have maternal coverage.

6)allow ERs to turn away people who are not in an emergency situation.b

 

First, I wanted to point the underlined parts out.  We agree.

 

Second- the bolded parts are very good ideas.  2) is a good idea, but I already said that. 5) Isn't a federal law.  Florida has no requirements.

You have obviously given this much more thought and time than me.  Kudos.



I would cite regulation, but I know you will simply ignore it.