Cause of Medical Costs?

mbig said:

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

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Universal healthcare does no good to reduce the costs if we still have the levels of lawsuits we have.

mbig said:

About the steepest cost of medicine/medicare is unnecessary tests and defensive medicine, Not lawsuits.

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I agree it is a problem, except these procedures are done because of the lawsuits. To protect from them.

mbig said:

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.

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I disagree. I have shopped around. I located a doctor when I had no insurance, explained my situation, and searched for a doctor that would take on the spot payment for services rendered. I found a doctor willing to give me great prices, because his staff only had to do appointments and not mess with insurance companies not trying to pay him.

Mycroft said:

The cause of medical costs are a combination of basic economics (supply and demand) and a healthy (pun intended) dose of government interference.

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Government interference always raises process. Look at how much secondary education costs now that it's so easy to get student loans. There is never a shortage of students. Supply and demand pricing... Gone.

Why does medical care cost so much?

Medical training is expensive and time consuming. Your physician did 4 years of professional schooling after college and did residency for 3 (minimum, some specialties spend 5+ years in residency/fellowship training) spending 100k+ in loans for tuition and working 60+ hours a week for 3+ years making around 40k per year. Their salaries are high because their training is intense with the resource being limited. Pharmacists also did 4 years of professional schooling after college and some do 2 years worth of residency to specialize. Even your NPs and PAs did 2 years of professional schooling after college. Tuition and education are very expensive with nearly all practitioners going to graduate programs that are not eligible for the aid that undergraduates get.

Malpractice insurance is high, for some specialties (like OBGYN and some surgeons) it can cost over 100k per year to insure yourself.

People can sue and win cases over the darndest things. Some physicians will over-utilize diagnostic testing in order to cover themselves in the event of a lawsuit.

People use the medical system without paying. When people go to the ER, get thousands of dollars spent on them and then don't pay that bill the system is the one that eats the costs and those costs must be covered somehow.

Technology and innovation is expensive. Medical equipment and medications can cost a very large amount of money. Some pieces of equipment can cost over one million dollars to purchase and equipment is expensive to maintain. Even hospital beds cost over $10k to purchase. I also know of some drug therapies that cost in the thousands, some over $10,000 per treatment. Research is even more expensive, drug companies spend billions of dollars into research for one drug. That money needs to be recouped somehow.

Insurance companies will audit and fight any way they can to get out of paying for things, these losses need to be accounted for. They also try to dictate payment for services and try to pay less and less while charging higher and higher premiums. They exist for profit, not for health. The government is no better, they also look to spend less but are also backed by more legal authority and regulation that can drive up costs. Medical benefit managers like government Medicare/Medicaid and private insurance are not looking to keep costs low for patients or fair reimbursement, they look to cover their own interests and retain as much money for themselves as possible and in some instances will result in driving up costs for patients and healthcare facilities.

Patients are not compliant with therapy and we have an increasing usage of care for chronic diseases like diabetes and hypertension. Public health is pretty bad, our nation has an obesity problem. We have smokers and we have other population groups like alcoholics that live lifestyles that will result in higher risk of expensive diseases and utilization of healthcare services. The healthcare system is burdened by this as well as public health, much of it is due to American lifestyle choices that do not benefit health. Patients who aren't compliant with therapies (like taking their medications) run the risk for hospital readmission or expensive exacerbation of their condition that could have been avoided or reduced had they adhered to their therapy.

These are just some reasons why healthcare costs are high, there are others and there is also not a single issue that is resulting in driving up healthcare costs.

Mycroft said:

The cause of medical costs are a combination of basic economics (supply and demand) and a healthy (pun intended) dose of government interference.

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I see that there are realistically many causes for increased costs, for which the government is one of the least. The quality of professional education, research, technology, equipment and supplies has to be high in a field dealing with the survival of our bodies. I'd say the recent increases in the past several decades mainly come from insurance companies and supplies providers.

Lord of Planar said:

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.

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I disagree. Without some sort of legal recourse against the arrogance of the medical profession, we'd be getting the wrong limbs amputated and horrible care. I personally had a back surgery, with no pain medication post op. I woke literally screaming my brains out, till they knocked me out and got the rx for the meds.

grip said:

I disagree. Without some sort of legal recourse against the arrogance of the medical profession, we'd be getting the wrong limbs amputated and horrible care. I personally had a back surgery, with no pain medication post op. I woke literally screaming my brains out, till they knocked me out and got the rx for the meds.

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I never said we need to eliminate litigation. Problem is, there are risks any time a procedure is done. It isn't always anyone's fault, but anytime something goes wrong, the chances are high to get a payoff.

grip said:

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?

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All of those factors play a part to some degree. In my opinion, the biggest contributors are:

Doctors covering their asses with expensive malpractice insurance and unnecessary tests.
Capitalist industries (healthcare industry and insurance industry) wanting to make a profit.
Lack of affordable healthcare for everyone leading to the poor making a lot of emergency room visits since they can't afford to see a doctor before things get really serious.
Health insurance insulating consumers from the costs of their healthcare.

grip said:

I see that there are realistically many causes for increased costs, for which the government is one of the least. The quality of professional education, research, technology, equipment and supplies has to be high in a field dealing with the survival of our bodies. I'd say the recent increases in the past several decades mainly come from insurance companies and supplies providers.

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Everything you mention in your post is part of the supply side of the supply/demand concept. That's why I listed that first. But please don't minimize the affect of government on medical costs. It adds an enormous amount to medical costs. In fact, government adds to the costs of the things you mention so not only does government have it's own effects, it affects supply and demand.

Lord of Planar said:

I never said we need to eliminate litigation. Problem is, there are risks any time a procedure is done. It isn't always anyone's fault, but anytime something goes wrong, the chances are high to get a payoff.

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The surgeon, not leaving an order for post op, pain meds after cutting bone, out of my back, is inexcusable. He also never got sued by me, because he was, one of only, two neurosurgeons in the area. The local lawyers all agreed they would not take him into a malpractice suit, because if he lost his privilege to practice, that would leave only one surgeon for all the brain surgeries and neural related cancers.

Mycroft said:

Everything you mention in your post is part of the supply side of the supply/demand concept. That's why I listed that first. But please don't minimize the affect of government on medical costs. It adds an enormous amount to medical costs. In fact, government adds to the costs of the things you mention so not only does government have it's own effects, it affects supply and demand.

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How does government drive up the cost, so much> tort reform legislation, taxes, regulations, FDA research costs, reducing payments for socialized medicine?

The reason I posted this poll, was in light of how could Obamacare be improved or even changed?

grip said:

How does government drive up the cost, so much> tort reform legislation, taxes, regulations, FDA research costs, reducing payments for socialized medicine?

The reason I posted this poll, was in light of how could Obamacare be improved or even changed?

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Improved?

Bad law. Eliminate it.

Lord of Planar said:

Improved?

Bad law. Eliminate it.

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hahaha... I'll get right on that.

grip said:

How does government drive up the cost, so much> tort reform legislation, taxes, regulations, FDA research costs, reducing payments for socialized medicine?

The reason I posted this poll, was in light of how could Obamacare be improved or even changed?

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All of the above.

The fact is, Obamacare cannot be "improved" except by tossing it in the trash. It, alone, is adding an enormous amount to health costs.

But it's not just Obamacare. Every law or regulation that pertains to anything that is health related adds a cost. That's not to say that every law or regulation is bad, though.

For example, DOT (Department of Transportation) has regulations that govern the packaging of compressed gases, among other things. These regulations control various things like the construction of compressed gas cylinders, rules about how those cylinders are transported by various means, when and how those cylinders must be tested to insure they won't fail...there's a BUNCH of regulations that pertain to just that one part of medical care and each rule adds costs. But without those regulations the chance of injury or death from the use of compressed gas cylinders would go through the roof. So, most would say these are good regulations...even if they do add to overall medical costs.

The question you should be asking is: Is Obamacare worth the increased costs that it generates?

grip said:

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?

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People are willing to spend a lot on their health and machines or medication can be made increasingly better and as costly to produce as the richest can demand.

grip said:

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?

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All of the above. Although a good portion of it has to do, I think, with the cost of malpractice insurance as well.

I used to date an orthopedic surgeon and the cost of malpractice insurance caused fees for services to sky rocket.

Also...just the experience I've had with major surgery expenses and portions billed to my blue cross and blue shield as compared to how much was "written off" by the hospital, surgeons, etc...is telling.

It's been that insurance companies inflate their costs so insurance companies wind up paying more.

Go to the emergency room sometime and tell them you have no insurance. Suddenly you get a much better cost than if they billed your insurance.

TheGirlNextDoor said:

All of the above. Although a good portion of it has to do, I think, with the cost of malpractice insurance as well.

I used to date an orthopedic surgeon and the cost of malpractice insurance caused fees for services to sky rocket.

Also...just the experience I've had with major surgery expenses and portions billed to my blue cross and blue shield as compared to how much was "written off" by the hospital, surgeons, etc...is telling.

It's been that insurance companies inflate their costs so insurance companies wind up paying more.

Go to the emergency room sometime and tell them you have no insurance. Suddenly you get a much better cost than if they billed your insurance.

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So essentially, you're saying it's rigged by a collusion between insurances, doctors offices and hospitals? I agree, along with malpractice and over charging of medical equipment, supplies and medicine, that's where the astronomical costs are coming from.

TheGirlNextDoor said:

All of the above. Although a good portion of it has to do, I think, with the cost of malpractice insurance as well.

I used to date an orthopedic surgeon and the cost of malpractice insurance caused fees for services to sky rocket.

Also...just the experience I've had with major surgery expenses and portions billed to my blue cross and blue shield as compared to how much was "written off" by the hospital, surgeons, etc...is telling.

It's been that insurance companies inflate their costs so insurance companies wind up paying more.

Go to the emergency room sometime and tell them you have no insurance. Suddenly you get a much better cost than if they billed your insurance.

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I'm not sure I understand the highlighted statement. It says that insurance companies inflate their costs so they wind up paying more. Is that really what you meant? Or did you mean to say that health care providers do the inflating?