Why is Healthcare so expensive?

[Fingon]

Experts estimate that the nation's $2 trillion annual health-care tab is one-third to one-half higher than need be, in part because of overuse of costly treatments and unnecessary care.

 

A glaring case in point is the rise and fall of bone marrow transplants for advanced breast cancer. Early reports of dramatic shrinkage of otherwise fatal tumors, and even some apparent long-term remissions, caused an explosion in popularity of the procedure.

 

Even as insurers and some experts warned that without proper clinical trials there was no proof the new treatment worked better than the old one, dozens of hospitals started programs to cash in on the demand. An estimated $3.4 billion was spent during the 1990s giving the treatment to more than 42,000 women.

 

But in April 2000, the New England Journal of Medicine reported the results of the first major clinical trial of the procedure: Bone marrow transplantation did not improve survival at all, but it did make patients' remaining time more miserable because of its debilitating side effects.

 

Bone marrow transplantation for breast cancer is now discredited, but plenty of other expensive treatments and tests are still being overused and overpromoted for all kinds of diseases.

“About 80 percent of what we do in medicine today is not backed up by solid evidence--a clinical trial that proves it’s really superior to other therapies,” says Lee Newcomer, M.D., senior vice president for oncology at United Healthcare.

 

Many developed nations have some kind of national agency that objectively evaluates new treatments and technology and determines coverage policy, such as Britain’s National Institute for Health and Clinical Excellence. Though insurers and medical specialty societies, among others, do such evaluations in the U.S., payment and coverage decisions here are driven mainly by pressure from manufacturers, doctors, and consumers, according to a study published in the November/December 2004 issue of Health Affairs. No one wants to be “the one on the block who doesn’t know the new technique,” a physician told the researchers.

 

Some health-policy experts are advocating the creation of a national center devoted to research directly comparing different medical treatments, an idea that Consumers Union, the nonprofit publisher of Consumer Reports, strongly supports.

 

extremely informative article... I just wish politicians would listen these guys instead of trumpeting ideas (universal health care) which will only make the problem worse.

 

http://www.consumerreports.org/health/doct...ipoffs-ov_1.htm

[The Dean]

Does any modern "wealthy" industrialized, other than the US, NOT have some sort of National healthcare plan?

 

Why is it that it is only stupid, too expensive and disruptive to good health care in the USA?

[Fingon]

Does any modern "wealthy" industrialized, other than the US, NOT have some sort of National healthcare plan?

 

Why is it that it is only stupid, too expensive and disruptive to good health care in the USA?

you could always read....

 

 

but i guess that would be too hard.

[The Dean]

you could always read....

 

 

but i guess that would be too hard.

 

 

I have read, and continue to read. If you are putting all of your belief eggs in that article's basket, I suggest you widen your source material. But, nothing in that article suggests that some sort of universal coverage couldn't work here. The article is unrelated to universal care. If anything, it seems as though it might support it. You cited it yourself:

 

Many developed nations have some kind of national agency that objectively evaluates new treatments and technology and determines coverage policy, such as Britain’s National Institute for Health and Clinical Excellence. Though insurers and medical specialty societies, among others, do such evaluations in the U.S., payment and coverage decisions here are driven mainly by pressure from manufacturers, doctors, and consumers, according to a study published in the November/December 2004 issue of Health Affairs. No one wants to be “the one on the block who doesn’t know the new technique,” a physician told the researchers.

 

Some health-policy experts are advocating the creation of a national center devoted to research directly comparing different medical treatments, an idea that Consumers Union, the nonprofit publisher of Consumer Reports, strongly supports.

 

There is absolutely no reason the US citizens couldn't have basic health care available as do citizens of industrialized countries all over the world. Citing the current practices under the current system, in the USA completely misses the point. There are systematic issues ranging from drug company issues, to physician abuses to problems with insurance coverage. The fact that there are these issues should actually ENCOURAGE a change to the current system. Don't you think?

[The Big Cat]

I have read, and continue to read. If you are putting all of your belief eggs in that article's basket, I suggest you widen your source material. But, nothing in that article suggests that some sort of universal coverage couldn't work here. The article is unrelated to universal care. If anything, it seems as though it might support it. You cited it yourself:

 

 

 

There is absolutely no reason the US citizens couldn't have basic health care available as do citizens of industrialized countries all over the world. Citing the current practices under the current system, in the USA completely misses the point. There are systematic issues ranging from drug company issues, to physician abuses to problems with insurance coverage. The fact that there are these issues should actually ENCOURAGE a change to the current system. Don't you think?

 

Take a hike, Pinko.

[finknottle]

Does any modern "wealthy" industrialized, other than the US, NOT have some sort of National healthcare plan?

 

Why is it that it is only stupid, too expensive and disruptive to good health care in the USA?

 

Why is it that only the flag 'universal coverage' is considered, and not the wait times? Or indeed, the likliehood that a patients will actually be approved for a proceedure?

 

Wiki has an interesting piece on Canada's system: 65% of Canadians buy supplimental insurance so that they can get priority access. Here's some random tidbits on wait-times

 

Wait Times

One of the major complaints about the Canadian health care system is waiting times, whether for a specialist, major elective surgery, such as hip replacement, imaging procedures such as MRI or Cystoscopy, or specialized treatments, such as radiation for breast cancer. Studies by the Commonwealth Fund found that 57% of Canadians reported waiting 4 weeks or more to see a specialist; 24% of Canadians waited 4 hours or more in the emergency room.[24]

 

A March 2, 2004 article in the Canadian Medical Association Journal stated, "Saskatchewan is under fire for having the longest waiting time in the country for a diagnostic MRI — a whopping 22 months." [2]

 

A February 28, 2006 article in The New York Times quoted Dr. Brian Day as saying, "This is a country in which dogs can get a hip replacement in under a week and in which humans can wait two to three years."[25] In a 2007 episode of ABC News 20/20, host John Stossel cited numerous examples of Canadians who had difficulty accessing health care.[26]

 

According to the Fraser Institute, treatment time from initial referral by a GP through consultation with a specialist to final treatment, across all specialties and all procedures (emergency, non-urgent, and elective), averaged 17.7 weeks in 2005.[27][28] However, the Fraser Institute's report is greatly at odds with the Canadian government's own 2007 report.[29]

 

Since 2002, the Canadian government has invested $5.5 billion to address the wait times problem.[30] In April 2007, Canadian Prime Minister Stephen Harper announced that all ten provinces and three territories would establish patient wait times guarantees by 2010. Canadians will be guaranteed timely access to health care in at least one of the following priority areas, prioritized by each province: cancer care, hip and knee replacement, cardiac care, diagnostic imaging, cataract surgeries or primary care.

 

I've asked my friends in India about the topic. They too have universal health care, but getting treatment if you are poor is a bit like petitioning the emperor - be prepared to wait-list a few years.

 

The answer for why Heatkcare is so expensive is simple: we already have psuedo-universal healthcare: anybody can show us in an emergancy room and be treated without paying. The cost of providing that services is passed on to those that do, increasing their rates. Similarly, HMO plans provide little disincentive for abusive use - a $10 copay per visit doesn't discourage unneccessary visits.

[Boomer860]

I have read, and continue to read. If you are putting all of your belief eggs in that article's basket, I suggest you widen your source material. But, nothing in that article suggests that some sort of universal coverage couldn't work here. The article is unrelated to universal care. If anything, it seems as though it might support it. You cited it yourself:

 

 

 

There is absolutely no reason the US citizens couldn't have basic health care available as do citizens of industrialized countries all over the world. Citing the current practices under the current system, in the USA completely misses the point. There are systematic issues ranging from drug company issues, to physician abuses to problems with insurance coverage. The fact that there are these issues should actually ENCOURAGE a change to the current system. Don't you think?

Sure Tard. Don't you think the Government should run everything?

[/dev/null]

65% of Canadians buy supplimental insurance so that they can get priority access

 

So after we get Universal Healthcare, how long until we get Universal Supplimental Insurance?

[DC Tom]

Does any modern "wealthy" industrialized, other than the US, NOT have some sort of National healthcare plan?

 

Why is it that it is only stupid, too expensive and disruptive to good health care in the USA?

 

Point of fact: even the US has one. Two, actually: Medicare and Medicaid.

 

Another point of fact: no one ever talks about national health CARE in this country. They talk about national health COVERAGE - i.e., everyone having the ability to pay for health care. Two very different and oxymoronic things.

[Boomer860]

Point of fact: even the US has one. Two, actually: Medicare and Medicaid.

 

Another point of fact: no one ever talks about national health CARE in this country. They talk about national health COVERAGE - i.e., everyone having the ability to pay for health care. Two very different and oxymoronic things.

Good points.

[PastaJoe]

The answer for why Heatkcare is so expensive is simple: we already have psuedo-universal healthcare: anybody can show us in an emergancy room and be treated without paying. The cost of providing that services is passed on to those that do, increasing their rates.

 

This is true, people without preventative healthcare use the most expensive service, the emergency room, for services that would cheaper to provide from a primary physician. But since they can't afford one they go to what's available. Give them preventative healthcare with a primary physician, and emergency room costs would go down.

[VABills]

A lot of facts missing here. Seeing as my father in law is a surgeon, and with planty of our friends that are doctors or other personnel in the healthcare service this is BS. My wife too is in the industry just a different calling.

 

We've had several doctor friends who have retired because their malpracice has gone up 10 fold in recent years as everyone is looking for any reason what so ever to sue a doctor and the hospitals. Doctors costs have also increased as more and more people are looking for healthcare services and less people staying in a very tough field or just retiring. Therefore employee costs at clinics have also gone up significantly trying to find qualified file folks, nurses, etc...

 

 

If healthcare is made available for more and more people, costs will continue to go up even more on an already limited resource. That means the very best doctors, nurses, diaticians, etc... will only go where the very best money is. That leaves fewer and worse healthcare people stretched overall more people. Costs will rise, service will get worse, lawsuits will go up even more , thus raising malpractice more and more and more people will retire from the field.

 

Ask an older family practice doctor his opinion, and stop listening to the politicians.

[finknottle]

This is true, people without preventative healthcare use the most expensive service, the emergency room, for services that would cheaper to provide from a primary physician. But since they can't afford one they go to what's available. Give them preventative healthcare with a primary physician, and emergency room costs would go down.

 

If health care is free then use will go up and any savings quickly disappear.

 

In principal I would support mandating the offering of a universal coverage product, and mandating the purchase of coverage (ala auto insurance). But simply offering free healthcare would be disasterous.

[The Dean]

Why is it that only the flag 'universal coverage' is considered, and not the wait times? Or indeed, the likliehood that a patients will actually be approved for a proceedure?

 

Wiki has an interesting piece on Canada's system: 65% of Canadians buy supplimental insurance so that they can get priority access. Here's some random tidbits on wait-times

 

 

Of course many who can afford it, or have employers who supply it, can and should have supplemental insurance. People on Medicare (as Tom rightly points out, is a form of universal health care...it simply isn't universal) regularly buy supplemental insurance. This isn't an argument against some sort of national coverage...it's an argument FOR it.

 

 

 

I've asked my friends in India about the topic. They too have universal health care, but getting treatment if you are poor is a bit like petitioning the emperor - be prepared to wait-list a few years.

 

The answer for why Heatkcare is so expensive is simple: we already have psuedo-universal healthcare: anybody can show us in an emergancy room and be treated without paying. The cost of providing that services is passed on to those that do, increasing their rates. Similarly, HMO plans provide little disincentive for abusive use - a $10 copay per visit doesn't discourage unneccessary visits.

 

Yes, India would be the first place I would go for an idea of how something would work in the USA. I'm sure India's horrible overpopulation has NOTHING to do with their healthcare wait time. Look at Canada, Great Britain, and other Western European countries for your examples.

 

When people go to the emergency room for healthcare, it is the most expensive, and ineffective, option available.

 

As for your co-pay example, you are once again, making the mistake of using a current abuse to argue against a new, and different, system.

[DC Tom]

Yes, India would be the first place I would go for an idea of how something would work in the USA. I'm sure India's horrible overpopulation has NOTHING to do with their healthcare wait time. Look at Canada, Great Britain, and other Western European countries for your examples.

 

Canada and Great Britain aren't great examples either. Care to wait six months for an MRI, as in Canada? Or three to get pneumonia treated in Great Britain (which happened to a friend's father...he didn't survive the British "health care" system).

 

 

Americans are going to have to realize that, if they want "universal health coverage", they are going to have to accept a lower standard of care.

[The Dean]

Point of fact: even the US has one. Two, actually: Medicare and Medicaid.

 

Another point of fact: no one ever talks about national health CARE in this country. They talk about national health COVERAGE - i.e., everyone having the ability to pay for health care. Two very different and oxymoronic things.

 

 

You are correct with regard to Medicare/Medicaid being a national health care plan. Of course, these plans are not universal. As I noted in my response to finknottle, many on Medicare choose to purchase supplemental insurance. I think that in any universal program in the USA, supplemental insurance will be a an option, as well.

 

I wouldn't say health care is NEVER talked about, but it certainly isn't the hot topic, right now. That's too bad, actually. I think the state of health care in this country needs an overhaul...or at least a good enema. finknottle's link is a story about how the system fails, and about abuses that occur under the current insurance system.

 

While the need for improved national health care is not the same as national coverage, national coverage does not mean that national care will decline. In fact, while the two aren't necessarily related, they can (perhaps) be tied together to make advances, and reforms, in both areas.

[The Dean]

Canada and Great Britain aren't great examples either. Care to wait six months for an MRI, as in Canada? Or three to get pneumonia treated in Great Britain (which happened to a friend's father...he didn't survive the British "health care" system).

 

 

Americans are going to have to realize that, if they want "universal health coverage", they are going to have to accept a lower standard of care.

 

 

Americans will deal with this the way they deal with everything. Those with money, will buy preferential treatment through super-insurance plans, or simply by paying out-of-pocket. Under some level of universal coverage many Americans will receive SOME care, instead of none. Many Americans may no longer have to travel to Mexico, or India, for operations, as they do now.

 

Might there be some disadvantages? Of course...no system is perfect and change always creates new issues, as it addresses old problems. But, I can tell you this. I need an MRI, and have needed one for about 30 years and NEVER got one, even though I had insurance. So, a six month wait sounds pretty good, to me.

 

Every country, and every system has its issues. You can find examples of poor care, and horrible malpractice in every country, I'm sure. Using these examples to infer the insurance system in that country is the culprit is a little suspect. I simply have not seen evidence that having some sort of universal national health care plan will lead to a poorer level of health care in this country.

[DrFishfinder]

Americans will deal with this the way they deal with everything. Those with money, will buy preferential treatment through super-insurance plans, or simply by paying out-of-pocket. Under some level of universal coverage many Americans will receive SOME care, instead of none. Many Americans may no longer have to travel to Mexico, or India, for operations, as they do now.

 

Might there be some disadvantages? Of course...no system is perfect and change always creates new issues, as it addresses old problems. But, I can tell you this. I need an MRI, and have needed one for about 30 years and NEVER got one, even though I had insurance. So, a six month wait sounds pretty good, to me.

 

Every country, and every system has its issues. You can find examples of poor care, and horrible malpractice in every country, I'm sure. Using these examples to infer the insurance system in that country is the culprit is a little suspect. I simply have not seen evidence that having some sort of universal national health care plan will lead to a poorer level of health care in this country.

I'll chime in here, with the six words that govern just about everything:

 

It

all

comes

down

to

money.

 

Unless the healthcare insurance companies and pharmaceutical companies in particular (and a bunch of other companies in general and to a much lesser degree) are going to make an acceptable amount of profit, nothing is going to change because they will pull out all the guns, and they have a virtually inexhaustable amount of VERY big guns, to stop it.

 

If any of you, or if you have had a friend or family member get caught up in a "Red Flag" from an insurance company for medical coverage, you know precisely what I am talkiing about. I have gut wrenching firsthand experience with that. It has nothing to do with healthcare, the patient, treatment, or anything other than money. When your insurance company's outlay for medical expenses reaches a certain figure, you get "Red Flagged". At that point, the insurance company in most cases, will start to make things extremely difficult for continued coverage, even though you are legally entitled to it. Insurance companies go into "Deny" mode. They deny everything and it is then up to you to attempt to fight it. They grind you up and spit you out. They outfight you, out attorney you, out wait you and out everything you. I am saying this as someone who has been through this already, with a family member. And it was not an elderly person with only a year or two left.

 

It was my 12 year old daughter. The insurance companies started denying everything, treatment, doctors, medicines, everything, I went before their board with my own attorney. Denied. I appealed. Denied. I appealed the appeal. Denied.

 

Red flagged and done.

 

So before everyone gets all caught up in national VS private healthcare, step back for a minute and consider who is pulling the strings here. And what the consequences will be based on which direction the bullet goes after the trigger is pulled.

[The Big Cat]

I'll chime in here, with the six words that govern just about everything:

 

It

all

comes

down

to

money.

 

Unless the healthcare insurance companies and pharmaceutical companies in particular (and a bunch of other companies in general and to a much lesser degree) are going to make an acceptable amount of profit, nothing is going to change because they will pull out all the guns, and they have a virtually inexhaustable amount of VERY big guns, to stop it.

 

If any of you, or if you have had a friend or family member get caught up in a "Red Flag" from an insurance company for medical coverage, you know precisely what I am talkiing about. I have gut wrenching firsthand experience with that. It has nothing to do with healthcare, the patient, treatment, or anything other than money. When your insurance company's outlay for medical expenses reaches a certain figure, you get "Red Flagged". At that point, the insurance company in most cases, will start to make things extremely difficult for continued coverage, even though you are legally entitled to it. Insurance companies go into "Deny" mode. They deny everything and it is then up to you to attempt to fight it. They grind you up and spit you out. They outfight you, out attorney you, out wait you and out everything you. I am saying this as someone who has been through this already, with a family member. And it was not an elderly person with only a year or two left.

 

It was my 12 year old daughter. The insurance companies started denying everything, treatment, doctors, medicines, everything, I went before their board with my own attorney. Denied. I appealed. Denied. I appealed the appeal. Denied.

 

Red flagged and done.

 

So before everyone gets all caught up in national VS private healthcare, step back for a minute and consider who is pulling the strings here. And what the consequences will be based on which direction the bullet goes after the trigger is pulled.

 

Sheesh! Sounds like the country could use a Rudy Baylor right about now!

[The Dean]

Sheesh! Sounds like the country could use a Rudy Baylor right about now!

 

 

http://www.youtube.com/watch?v=ZWTzyU5MFgM