• This is a political forum that is non-biased/non-partisan and treats every person's position on topics equally. This debate forum is not aligned to any political party. In today's politics, many ideas are split between and even within all the political parties. Often we find ourselves agreeing on one platform but some topics break our mold. We are here to discuss them in a civil political debate. If this is your first visit to our political forums, be sure to check out the RULES. Registering for debate politics is necessary before posting. Register today to participate - it's free!

Cause of Medical Costs?

Why are Medical Costs, so high?


  • Total voters
    22
Little out of pocket is not the problem I've noticed or it wouldn't be so expensive. Maybe too little out of pocket for a millionaire?
BTW, medical insurance is part of your 'out of pocket' expenses.

Only as of late. Some very affordable insurance premiums are coupled with much higher deductibles, aka catastrophic coverage. If one must pay for an "all you can eat" option then why not consume as many, and the most expensive, items available? The PPACA exchange premiums are based on (limited to?) your ability to pay with the balance of the bill picked up by Uncle Sucker. Folks use their homeowners, renters and auto insurance policies very rarely and premiums are more based on actuarial risk, like insurance should be, not used to cover routine maintenance costs and with a 3X premium cost limit for the highest risk (relative to the lowest risk).
 
Obviously I am talking about the same level of care and the same type of system.

What country has the same level of care and system, with much lower costs?
 
What country has the same level of care and system, with much lower costs?

I t doesn't have to be the whole country.

I had Hepititus B 10 years ago.

I was in the hospital for 1 week, a private hospital. The cost was 13,000 pesos which was about $1200.00 US for the week stay and my doctor charged me around 4,000 pesos for his work to cure me.

How much would a 1 week stay plus the doctor and all the medicine for the same thing in the US?
 
Only as of late. Some very affordable insurance premiums are coupled with much higher deductibles, aka catastrophic coverage. If one must pay for an "all you can eat" option then why not consume as many, and the most expensive, items available? The PPACA exchange premiums are based on (limited to?) your ability to pay with the balance of the bill picked up by Uncle Sucker. Folks use their homeowners, renters and auto insurance policies very rarely and premiums are more based on actuarial risk, like insurance should be, not used to cover routine maintenance costs and with a 3X premium cost limit for the highest risk (relative to the lowest risk).

If medical insurance weren't a problem there wouldn't be a need for Obamacare. Even with higher deductibles the medical insurance costs have been extreme. If you have a $5000 deductible, in which case you almost don't need insurance, you still pay over $75-$150 a month.

When I was healthy in my 30's, I purchased a good PPO plan thru my employer for $12 a month in 2000 with a $500 deductible. It quickly after the next few years went up to $270 a month and $1500 deductible, which was cutting into my paycheck. The reasoning explained to us was that insurance companies weren't making enough money. ;)
 
In 2011, we were spending over 17% of our Gross Domestic Product on healthcare, dwarfing country #2 by a full 25% in dollars. And we are #1 in this percentage. Next closest is spending 9.3% of GDP. And $3,000 less per capita. Do you think we have the best healthcare in the world? I don't.

List of countries by total health expenditure (PPP) per capita - Wikipedia, the free encyclopedia

I don't think we have the best in the world but better than Canada, Britain, France, India, China, Russia, Mexico, etc.
 
In 2011, we were spending over 17% of our Gross Domestic Product on healthcare, dwarfing country #2 by a full 25% in dollars. And we are #1 in this percentage. Next closest is spending 9.3% of GDP. And $3,000 less per capita. Do you think we have the best healthcare in the world? I don't.

List of countries by total health expenditure (PPP) per capita - Wikipedia, the free encyclopedia

It would be interesting to know what perentage of that goes to malpractice insurance overhead and the tests done to "prove" that the treatment option selected was "the best". If we accept that 15% to 20% of "private" medical insurance overhead is normally added then that cost is likely higher than most other nations as well. How many other nations have 1-800-BAD-DRUG shysters?
 
In 2011, we were spending over 17% of our Gross Domestic Product on healthcare, dwarfing country #2 by a full 25% in dollars. And we are #1 in this percentage.

That doesn't tell us the whole story. What we need to keep in mind is that medical care is a superior good, which means that it is the type of good where consumers are willing to spend more as they get richer.

Luxury cars are a superior good. Luxury homes are a superior good. Canned Spam is, on the other hand, an inferior good. As people get richer, they're less and less willing to buy canned Spam.

The US is a rich country. Not all of us are rich of course, but when we look at the nation as a whole, then we're doing better than other nations.

To give an example. About a decade ago, Canada had 151 MRI machines and the US had 10,000. We'd have to get rid of 8,600 of our 10,000 to get down to their MRI/ per capital level. The point is that Americans like having all of this expensive technology available. We're not that much richer than Canadians, but Canadians also ration the access to their MRI machines and so can contain some costs. We don't have that same degree of rationing - Americans don't want to wait 3 months for an MRI scan and so this is why we have 10,000 machines and why we pay so much for medical care.

Quicker access costs money. Medical care being a superior good means that people are willing to pay. Now being willing to pay doesn't exactly translate into being happy to pay, it just means that given a choice between paying and getting the service or not paying and not getting the service, people will pay and bitch about it.
 
Regarding specialization there is a factor that hasn't been mentioned. There is a trend in allied medical professions such as physical therapy and audiology to have states pass laws that require doctorates as the minimum level academic requirement for certification. People with existing certification have been grandfathered in, but all new grads must have doctorates. Why has this trend occurred? Direct billing to Medicaid & Medicare. Of course costs increase because patients are now paying for people with doctorates. We're also seeing these fields establishing a "need" for special support staff with bachelor's degrees, such as audiology techs. Somebody is paying for all this. Guess who?
 
In 2011, we were spending over 17% of our Gross Domestic Product on healthcare, dwarfing country #2 by a full 25% in dollars. And we are #1 in this percentage. Next closest is spending 9.3% of GDP. And $3,000 less per capita. Do you think we have the best healthcare in the world? I don't.

List of countries by total health expenditure (PPP) per capita - Wikipedia, the free encyclopedia

There's a difference between best healthcare and most access to healthcare. I'd argue that those who provide healthcare services in Canada are second to none - it's why many Canadian trained doctors, nurses, EMTs, etc. are actively recruited for higher paying positions throughout the US, particularly in the sunbelt/southern states.

That said, there's no doubt that even if you have the cash in hand, many services readily available in the US aren't available here in Canada or if they are, they aren't available in as timely a manner. Secondly, even though many medical breakthroughs initiate in Canada, many times more are discovered in the US where the financial incentive drives discovery. In addition, our government frequently funds healthcare services for patients to travel to the US for services needed quickly or that aren't available at all in Canada.

We here in Canada benefit greatly from the market driven medical services economy in the US.
 
That doesn't tell us the whole story. What we need to keep in mind is that medical care is a superior good, which means that it is the type of good where consumers are willing to spend more as they get richer.

Luxury cars are a superior good. Luxury homes are a superior good. Canned Spam is, on the other hand, an inferior good. As people get richer, they're less and less willing to buy canned Spam.

The US is a rich country. Not all of us are rich of course, but when we look at the nation as a whole, then we're doing better than other nations.

To give an example. About a decade ago, Canada had 151 MRI machines and the US had 10,000. We'd have to get rid of 8,600 of our 10,000 to get down to their MRI/ per capital level. The point is that Americans like having all of this expensive technology available. We're not that much richer than Canadians, but Canadians also ration the access to their MRI machines and so can contain some costs. We don't have that same degree of rationing - Americans don't want to wait 3 months for an MRI scan and so this is why we have 10,000 machines and why we pay so much for medical care.

Quicker access costs money. Medical care being a superior good means that people are willing to pay. Now being willing to pay doesn't exactly translate into being happy to pay, it just means that given a choice between paying and getting the service or not paying and not getting the service, people will pay and bitch about it.

Great post.
 
There's a difference between best healthcare and most access to healthcare. I'd argue that those who provide healthcare services in Canada are second to none - it's why many Canadian trained doctors, nurses, EMTs, etc. are actively recruited for higher paying positions throughout the US, particularly in the sunbelt/southern states.

That said, there's no doubt that even if you have the cash in hand, many services readily available in the US aren't available here in Canada or if they are, they aren't available in as timely a manner. Secondly, even though many medical breakthroughs initiate in Canada, many times more are discovered in the US where the financial incentive drives discovery. In addition, our government frequently funds healthcare services for patients to travel to the US for services needed quickly or that aren't available at all in Canada.

We here in Canada benefit greatly from the market driven medical services economy in the US.

Interesting, CJ. And you remind me of a good friend whose brother died of pancreatic cancer before his appointment for an MRI came up (or CAT scan, don't remember which). I made him feel better when I told him that his brother's pancreatic cancer was terminal. He hadn't known that. I don't know, though . . . maybe there's a lesson in that. His brother avoided grueling chemotherapy and was eased on his journey through hospice and a palliative care regime. Great Britain, by the way.
 
Interesting, CJ. And you remind me of a good friend whose brother died of pancreatic cancer before his appointment for an MRI came up (or CAT scan, don't remember which). I made him feel better when I told him that his brother's pancreatic cancer was terminal. He hadn't known that. I don't know, though . . . maybe there's a lesson in that. His brother avoided grueling chemotherapy and was eased on his journey through hospice and a palliative care regime. Great Britain, by the way.

I agree - for me, if I ever become so sick or if I ever become less than self-sufficient, I sure hope we have laws in place that allow a doctor or other healthcare practioner to put me to sleep, forever - I want nothing less than what is available to the pets I've loved over the years.
 
If medical insurance weren't a problem there wouldn't be a need for Obamacare. Even with higher deductibles the medical insurance costs have been extreme. If you have a $5000 deductible, in which case you almost don't need insurance, you still pay over $75-$150 a month.

When I was healthy in my 30's, I purchased a good PPO plan thru my employer for $12 a month in 2000 with a $500 deductible. It quickly after the next few years went up to $270 a month and $1500 deductible, which was cutting into my paycheck. The reasoning explained to us was that insurance companies weren't making enough money. ;)

The difference in annual premiums (from your examples above) is $195 to $120/month - at that rate one could save the $3500, your stated deductible difference, in about two years in a (tax free) MSA. As the MSA balance grows one could then raise the deductible further - saving even more.
 
That said, there's no doubt that even if you have the cash in hand, many services readily available in the US aren't available here in Canada or if they are, they aren't available in as timely a manner.

Hence the Premier of Newfoundland flying to the US to have heart surgery instead of having it done by staff in a hospital in his own province. He knew that it would be terrible politics to jump the queue and get immediate heart surgery just because he was the Premier, so instead of waiting for months on a list, as the citizens of Newfoundland do, he paid for the surgery in the US and was treated immediately.

To offer service in a timely manner means that the entire medical system has to have the slack built into it to push people through with no back-ups in the pipeline. This also means that all of the capacity can't be used at 100% efficiency. To operate at less than 100% efficiency means that you're paying more for those underutilized assets.

In addition, our government frequently funds healthcare services for patients to travel to the US for services needed quickly or that aren't available at all in Canada.

British Columbia has a population of 4.4 million and the city of Spokane, WA has a population of 209,000. I have no clue how many hospitals BC has but whatever the number, every single one of those hospitals had their neonatal care units running at full capacity and a small American city had unused space in their neonatal care unit:

At least two premature Canadian babies sent to the United States when no bed was available for them at home are now stable enough to return to a British Columbia hospital. There's only one problem: There are no beds for them.

Consequently, the two infant girls will have to stay in the neonatal intensive-care unit at Deaconess Medical Center in Spokane, Wash., until a bed becomes available in B.C., said Patrice Sweeny, the hospital's assistant manager of the neonatal intensive-care unit.

"Bedline calls us every day," Ms. Sweeny said of the company, bcbedline, which locates emergency- and critical-care beds for B.C. citizens on behalf of doctors. "They have not had a bed yet. We're just waiting. But as soon as they have a bed, we'll send those babies back ... It's just a crisis up there."

Over the past six months, at least 40 patients from three provinces have found themselves smack in the middle of a medical drama. With no neonatal intensive-care beds available for the babies in Canada, provincial government officials were sent scrambling, trying to find care south of the border.

The babies' mothers, who have been sent abroad to Washington, Montana, Michigan and New York, were typically those who went into labour before 32 weeks gestation - at least two months early. Their babies require the highest level of neonatal intensive care, often needing a ventilator to assist breathing.​
 
We are the ONLY one of the 34 OECD countries without UHC and have by Far the highest costs. (and not near best outcome)

A suggested call to a Service Model like police or teachers.
Not a bad idea.
The more I watch and learn, the more I am for UHC
About the steepest cost of medicine/medicare is unnecessary tests and defensive medicine, Not lawsuits.


Social Security Is the Best-Funded Government Program: David Cay Johnston | Daily Ticker - Yahoo Finance

[.....]
In contrast to Social Security, "Medicare is a real Nightmare," says Johnston. He says healthcare payments for Medicare recipients surpass the healthcare liabilities of 33 other countries in the Organisation for Economic Co-operation and Development (OECD), ALL of whom have Universal Healthcare.

He suggests that the U.S. adopt a single-payer healthcare system but admits it's unlikely to happen in the foreseeable future.

In the meantime, he suggests the U.S. switch from what he calls a "business model" focused on profits for insurers to a Service model like education and police.
"It would require a sea change of thinking," says Johnston, but "it's possible."

Johnston also suggests a national health service for older Americans that would help drive down the cost of healthcare. Doctors would be protected from the lawsuits that often threaten private practices and the service would end "defensive medicine" -- i.e. extra, and often expensive, tests.

Those additional tests—not the lawsuits—are what's largely driving healthcare costs higher, Johnston says."..
Health>Medicine is not like shopping a car.
It's Not competitive.
People don't shop when they're sick or deathly ill.
Medicine doesn't lend itself to competition/capitalism as well as other business.
 
Last edited:
I agree - for me, if I ever become so sick or if I ever become less than self-sufficient, I sure hope we have laws in place that allow a doctor or other healthcare practioner to put me to sleep, forever - I want nothing less than what is available to the pets I've loved over the years.

Exactly. I'd like to think I could die as easily as . . . Ted Bundy.
 
The history of health care spending in 7 graphs - The Washington Post

Notice how in the first graph, we are nice and steady with everyone else, then around 1975, we shoot up like a rocket. What changed at that time? Clearly our system was working just fine, then something changed.

For the rest of the world, their increases are due in part to our increases as we pay for almost all the new tech and drugs.
 
I am seeing a repeting issue with these polls... They seem to be missing (at least most of them) a conservative answer... kind of rigged i suppose.

If i could put another option up there, it would be "the cost of Tort insurance for Drs, and the way the TORT system is set up."
 
Hence the Premier of Newfoundland flying to the US to have heart surgery instead of having it done by staff in a hospital in his own province. He knew that it would be terrible politics to jump the queue and get immediate heart surgery just because he was the Premier, so instead of waiting for months on a list, as the citizens of Newfoundland do, he paid for the surgery in the US and was treated immediately.

To offer service in a timely manner means that the entire medical system has to have the slack built into it to push people through with no back-ups in the pipeline. This also means that all of the capacity can't be used at 100% efficiency. To operate at less than 100% efficiency means that you're paying more for those underutilized assets.



British Columbia has a population of 4.4 million and the city of Spokane, WA has a population of 209,000. I have no clue how many hospitals BC has but whatever the number, every single one of those hospitals had their neonatal care units running at full capacity and a small American city had unused space in their neonatal care unit:

At least two premature Canadian babies sent to the United States when no bed was available for them at home are now stable enough to return to a British Columbia hospital. There's only one problem: There are no beds for them.

Consequently, the two infant girls will have to stay in the neonatal intensive-care unit at Deaconess Medical Center in Spokane, Wash., until a bed becomes available in B.C., said Patrice Sweeny, the hospital's assistant manager of the neonatal intensive-care unit.

"Bedline calls us every day," Ms. Sweeny said of the company, bcbedline, which locates emergency- and critical-care beds for B.C. citizens on behalf of doctors. "They have not had a bed yet. We're just waiting. But as soon as they have a bed, we'll send those babies back ... It's just a crisis up there."

Over the past six months, at least 40 patients from three provinces have found themselves smack in the middle of a medical drama. With no neonatal intensive-care beds available for the babies in Canada, provincial government officials were sent scrambling, trying to find care south of the border.

The babies' mothers, who have been sent abroad to Washington, Montana, Michigan and New York, were typically those who went into labour before 32 weeks gestation - at least two months early. Their babies require the highest level of neonatal intensive care, often needing a ventilator to assist breathing.​

All too true - now, imagine if you were talking about a country of 330 or so million people all with equal access to all medical facilities and services, all funded through the federal and/or state governments. Not to say all people don't deserve, at some level, medical services they need to stay alive and live productive lives, but forcing everyone to have a stake in the system also incentivizes everyone to access the system causing shortages of supply.
 
Seing as
1. it is the Nature of capitalism to drive down prices to reach more customers.
2. Insurance are inherently based off of a capitalist system so see 1
3. Medicaid/ medicare could have something to do with it because of fraud and abuse, but because the system is inherently capitalist in nature the market would still drive down the price, if somewhat slower.
4. Specialization actually decreases the cost of healthcare because that person deals with that specific thing only, and can get you better quicker. working in again a capitalist system, we still have those forces of supply and demand that force the price down.


The way the tort system is set up causes lawsuits to be filed to often, and judges and juries are often not knowledgeable about medical issues. particularly when it comes to complex issues, and therefore are not at the moment truly qualified to apply the law. this leads to a devide where someone who is ignorant of medical treatments and procedure would more often than not vote on a jury against the defendant/ Dr. Basically the Us vs Them mentality.

When most cases of malpractice go before a MEDICAL review board they are thrown out... this had lead to the need for Tort insurance for doctors and in many states (i don't know if it is by the federal government) it is even required that Drs have Tort insurance. Look up the pricing it is EXTREMELY EXPENSIVE! THIS is what has increased the cost of Dr's visits to something most people cant pay out of pocket, increasing the need for insurance, which creates an artificial market for insurance, which forces the government to get involved to allow people who would normally be able to afford a Drs visit to be able to get one because they have been priced out of the market.

Our TORT system needs fixed....
 
All too true - now, imagine if you were talking about a country of 330 or so million people all with equal access to all medical facilities and services, all funded through the federal and/or state governments. Not to say all people don't deserve, at some level, medical services they need to stay alive and live productive lives, but forcing everyone to have a stake in the system also incentivizes everyone to access the system causing shortages of supply.

Canada does a pretty good job with the system that they have but what Americans don't see is the drawbacks which the Canadians endure, and for many Canadians they don't even recognize that they're enduring the drawbacks.

A nightmare scenario for the US is to adopt a Canada-type system and to couple it the American public's consumption habits and expectations of performance with regards to a medical system. Being used to timely service and expecting that from a Single Payer System is just a non-starter.

Liberals were furious when Governor Palin accurately noted that ObamaCare was going to implement Death Panels. You need that feature if you're going to contain costs. These panels exist everywhere in the world where there is a single payer system. Someone has to have the authority to say "NO, we're not going to pay for that procedure because it doesn't make financial sense with regard to the benefits of extending life for X months that it produces."

Sweet Jaysus, back in the 90s Canadians took a number of kicks into their nads as Martin and Chretien fought the budget deficits by curtailing spending on Health Care. The costs to quality of life for medical patients, and the costs of deaths which could have been prevented if attended to either in a timely manner or under a laxer "Death Panel" formula, were quite real and Canadians endured that painful era. After seeing the Obama era unfold, I have no faith in American ability to endure hardship in the area of reduced medical spending and the lifestyle hardships that this would impose. This being the case, a move to UHC and SPS is very unwise.
 
Canada does a pretty good job with the system that they have but what Americans don't see is the drawbacks which the Canadians endure, and for many Canadians they don't even recognize that they're enduring the drawbacks.

A nightmare scenario for the US is to adopt a Canada-type system and to couple it the American public's consumption habits and expectations of performance with regards to a medical system. Being used to timely service and expecting that from a Single Payer System is just a non-starter.

Liberals were furious when Governor Palin accurately noted that ObamaCare was going to implement Death Panels. You need that feature if you're going to contain costs. These panels exist everywhere in the world where there is a single payer system. Someone has to have the authority to say "NO, we're not going to pay for that procedure because it doesn't make financial sense with regard to the benefits of extending life for X months that it produces."

Sweet Jaysus, back in the 90s Canadians took a number of kicks into their nads as Martin and Chretien fought the budget deficits by curtailing spending on Health Care. The costs to quality of life for medical patients, and the costs of deaths which could have been prevented if attended to either in a timely manner or under a laxer "Death Panel" formula, were quite real and Canadians endured that painful era. After seeing the Obama era unfold, I have no faith in American ability to endure hardship in the area of reduced medical spending and the lifestyle hardships that this would impose. This being the case, a move to UHC and SPS is very unwise.

This is also very true - two examples - one - a woman, fairly young, mother of two, needed a specific medication to prolong her life an additional 6 months to a year at a cost of between $300,000 and $500,000. The government refused to fund the medication due to "value for money" considerations - two - the government recently reduced/eliminated some therapy for seniors provided in private homes and old age/seniors facilities, instead providing it in locations requiring the patient to go to the service rather than the service come to them. Unfortunately, many of the seniors don't have the mobility to get to the centralized provision locations - that's why they're getting therapy - so they will become more bedridden, more costly to serve, and suffer a reduction in health and lifestyle enjoyment.
 
What do you think, caused the Medical costs to become so astronomical?


Was it the nature of capitalism to extract as much profit from the value of a product, as possible. And of course, what amount would we not pay to be healthy? Is capitalism of this sort, taking an unfair advantage of our desire to not be physically miserable or dying?

Or is it the insurance companies that have gotten in between us and our providers, increasing the costs of service and medicines, by taking an absorbent share?

Do we factor in the Medicare, Medicaid provisions and non payers, as a source of increased prices, because of their discounted and written off income sources?

Is it the specialized facilities, medicines, equipment and cost of training the professionals of the field?

Could it be all of the above?

The cause of medical costs are a combination of basic economics (supply and demand) and a healthy (pun intended) dose of government interference.
 
Your poll doesn't include "other, please explain."

I believe regulations and lawsuits are the largest reason our costs are so high. We have standards stricter than other countries, and are a very litigious people.
 
Back
Top Bottom