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Cause of Medical Costs?

Why are Medical Costs, so high?


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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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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 the above?

Here are my thoughts. The reason medical care is so expensive in this country is because:

  • There's insurance out there with $500 deductibles. Too low.
  • Doctors look for zebras because of malpractice concerns.
  • Hospitals won't let doctors have hospital privileges unless they feed quotas of patients to their expensive diagnostic equipment.
  • Emergency rooms have either chosen to or been forced to treat non-emergencies.
  • The AMA stands firmly opposed to nurse practitioners staffing clinics at your local Walgreen's.
  • We aggressively treat terminally-ill patients instead of giving them palliative care that would ease their suffering and improve their quality of life.
  • We refuse to allow people to end their own lives with faced with terminal illness.


I could go on, but few of them would match yours.
 
You left out two big ones: malpractice insurance overhead and the mandate to provide life saving care without pay.
 
The cause is very simple to understand. If everyone in America wanted to drive a Ferrari, then the cost of buying a car would be more than the cost of buying a typical house.

Consumer demand for top-of-the-line medical care - the latest and greatest - the most sophisticated tests and the most sophisticated equipment. That costs. The consumer doesn't pay directly, the consumer doesn't weigh costs versus benefits as they would when buying a car. The bill gets sent to the insurance company, so hey, spare no expense and give me the best.
 
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?

When Doctors write their bills, they do not know exactly what the maximum amounts are that the Companies will pay. For that reason they write outrageously high bills and the Insurance pays the maximum and sometimes the doctors request that the patients pay the remaining balance. Other Doctors just tell the patient to forget the balance, because they wrote an outrageous bill to begin wtih and received a satisfactory amount from the insurance, even though it was less than the billed amount. This always gets the doctor/HMO/clinic the maximum amount that the Insurance will pay because of the outrageous billing. The doctors/HOs/etc. don't leave anything on the table this way.
 
Here are my thoughts. The reason medical care is so expensive in this country is because:

  • There's insurance out there with $500 deductibles. Too low.
  • Doctors look for zebras because of malpractice concerns.
  • Hospitals won't let doctors have hospital privileges unless they feed quotas of patients to their expensive diagnostic equipment.
  • Emergency rooms have either chosen to or been forced to treat non-emergencies.
  • The AMA stands firmly opposed to nurse practitioners staffing clinics at your local Walgreen's.
  • We aggressively treat terminally-ill patients instead of giving them palliative care that would ease their suffering and improve their quality of life.
  • We refuse to allow people to end their own lives with faced with terminal illness.


I could go on, but few of them would match yours.

  • Too cheap of insurance? I find this almost unfathomable.
  • Malpractice needs tort reform, badly.
  • Hospitals have become too business like in their models to make more profit.
  • Emergency rooms should not be a treatment center for Flu's and boo-boo's.
  • The AMA are a bunch of over officious jerks. More clinics with Physicians Assistants or Nurse Practitioners would lower costs and make more people available to treat.
  • Palliative care vs aggressive treatment for "end of life" patients needs legal reform. It's an older tradition stuck by religious beliefs.


These are very good points that certainly, add to costs.
 
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The cause is very simple to understand. If everyone in America wanted to drive a Ferrari, then the cost of buying a car would be more than the cost of buying a typical house.

Consumer demand for top-of-the-line medical care - the latest and greatest - the most sophisticated tests and the most sophisticated equipment. That costs. The consumer doesn't pay directly, the consumer doesn't weigh costs versus benefits as they would when buying a car. The bill gets sent to the insurance company, so hey, spare no expense and give me the best.


Of all the things to sacrifice quality on, Medical Care. Really? I'll let you get the rusty needle and I'll push for the reasonably priced, sterile, plastic syringe. Everything is not always about money.


When Doctors write their bills, they do not know exactly what the maximum amounts are that the Companies will pay. For that reason they write outrageously high bills and the Insurance pays the maximum and sometimes the doctors request that the patients pay the remaining balance. Other Doctors just tell the patient to forget the balance, because they wrote an outrageous bill to begin wtih and received a satisfactory amount from the insurance, even though it was less than the billed amount. This always gets the doctor/HMO/clinic the maximum amount that the Insurance will pay because of the outrageous billing. The doctors/HOs/etc. don't leave anything on the table this way.

I've worked around the medical profession for 25 years and found the physicians, as a rule, to be very ignorant about business. Somehow they always manage to afford the Mercedes, BMW or Volvo.
 
Skyrocketting cost of medical care is not a uniquely American phenomenom. We here in Canada, supposedly a UHC utopia, are suffering from many of the same problems. Here in Ontario, Canada, just under 50% of every tax and revenue dollar the Province collects goes to serve an ever decreasing list of "free" healthcare services.

I don't have the answers - just wanted to share that this is a reality world-wide and getting increasingly so as first world economies find themselves with an ever increasingly aging population and fewer young people working.
 
  • Too cheap of insurance? I find this almost unfathomable.
  • Malpractice needs tort reform, badly.
  • Hospitals have become too business like in their models to make more profit.
  • Emergency rooms should not be a treatment center for Flu's and boo-boo's.
  • The AMA are a bunch of over officious jerks. More clinics with Physicians Assistants or Nurse Practitioners would lower costs and make more people available to treat.
  • Palliative care vs aggressive treatment for "end of life" patients needs legal reform. It's an older tradition stuck by religious beliefs.


These are very good points that certainly, add to costs.

Just to clarify, nowhere did I talk about "too-cheap insurance".
 
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?

Why didn't you include malpractice as one of the options?
 
  • Too cheap of insurance? I find this almost unfathomable.
  • Malpractice needs tort reform, badly.
  • Hospitals have become too business like in their models to make more profit.
  • Emergency rooms should not be a treatment center for Flu's and boo-boo's.
  • The AMA are a bunch of over officious jerks. More clinics with Physicians Assistants or Nurse Practitioners would lower costs and make more people available to treat.
  • Palliative care vs aggressive treatment for "end of life" patients needs legal reform. It's an older tradition stuck by religious beliefs.


These are very good points that certainly, add to costs.

Maggie did not say that insurance was too cheap, but that it often has little out of pocket costs. This is made even worse under PPACA in an attempt to base the cost of your insurance premiums on your ability to pay and to lower any "out of pocket" costs even more. Rest assured that if auto insurance was mandated to cover worn tire replacement, tune-ups and oil changes at no "out of pocket" costs that it would be a boom for repair shops and raise auto insurance premiums. ;)
 
Just to clarify, nowhere did I talk about "too-cheap insurance".

:rofl Well, too low of a deductible sounds like, give the insurance company more money.



Why didn't you include malpractice as one of the options?

Yeah, Maggie brought that up and a lot of other costs I missed. But many of those are added problems, not the main cause.

CanadaJohn made a good point that medical costs are universal in scope, meaning it seems to be a value based cause.
 
You left out two big ones: malpractice insurance overhead and the mandate to provide life saving care without pay.

That was the big one that was missing IMO. I have a friend who is a doctor, he's never had a problem, he's never done anything wrong, yet his medical malpractice premiums are over $100,000 per year. That's out of pocket for him. He has to charge a ton just to break even, especially with the government screwing him over with Medicare. He has a private practice so he doesn't have to provide care for free but the system is driving up costs for doctors. It's got to stop.
 
:rofl Well, too low of a deductible sounds like, give the insurance company more money.

I've found that many, if not most, people don't really understand insurance. I've always purchased my own, and since it was so expensive, I learned quite a lot about it. No, the deductible is the amount YOU pay before your insurance company begins paying.
 
Maggie did not say that insurance was too cheap, but that it often has little out of pocket costs. This is made even worse under PPACA in an attempt to base the cost of your insurance premiums on your ability to pay and to lower any "out of pocket" costs even more. Rest assured that if auto insurance was mandated to cover worn tire replacement, tune-ups and oil changes at no "out of pocket" costs that it would be a boom for repair shops and raise auto insurance premiums. ;)

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.
 
I've found that many, if not most, people don't really understand insurance. I've always purchased my own, and since it was so expensive, I learned quite a lot about it. No, the deductible is the amount YOU pay before your insurance company begins paying.


If you're paying a higher deductible that's essentially money the insurance doesn't have to pay on the bill, meaning more money to them.

But I know what you mean and how that would lower your premium.
 
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.

You obviously don't understand deductibles and out-of-pocket costs. If it only costs me $40 to go to the emergency room, guess where I'm going with my splinter? If I HAVE to pay my deductible ($500) during a year, guess what? Anything else that seems likely I need? I'm going to get -- because the insurance company is going to pick up the tab.

"Doc!!! I've already paid my deductible. Anything else you think I need to do before the end of the year??"
 
:rofl Well, too low of a deductible sounds like, give the insurance company more money.





Yeah, Maggie brought that up and a lot of other costs I missed. But many of those are added problems, not the main cause.

CanadaJohn made a good point that medical costs are universal in scope, meaning it seems to be a value based cause.

I think malpractice is the main cause.

Why is it so much cheaper in other countries for the same level of care? The USA has lawyers and the other countries don't.

Why does it cost $20.00 for an asprin in a hospital?
 
If you're paying a higher deductible that's essentially money the insurance doesn't have to pay on the bill, meaning more money to them.

But I know what you mean and how that would lower your premium.

Jesus, Grip. A lower deductible doesn't LOWER your premium, it raises it.
 
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?

Don't leave out pharmaceutical costs, which are astronomical.
 
I think malpractice is the main cause.

Why is it so much cheaper in other countries for the same level of care? The USA has lawyers and the other countries don't.

Why does it cost $20.00 for an asprin in a hospital?


Because many other countries have socialized medicine with lower quality of care.

Jesus, Grip. A lower deductible doesn't LOWER your premium, it raises it.

LOL,,,, that's what I meant.
 
I don't have the answers - just wanted to share that this is a reality world-wide and getting increasingly so as first world economies find themselves with an ever increasingly aging population and fewer young people working.

The problem happens everywhere we see a third party payer for this guts the price discipline that consumers exercise. Here's PJ O'Rourke channeling Milton Friedman:

"1. You spend your money on yourself. You're motivated to get the thing you want most at the best price. This is the way middle-aged men haggle with Porsche dealers.

2. You spend your money on other people. You still want a bargain, but you're less interested in pleasing the recipient of your largesse. This is why children get underwear at Christmas.

3. You spend other people's money on yourself. You get what you want but price no longer matters. The second wives who ride around with the middle-aged men in the Porsches do this kind of spending at Neiman Marcus.

4. You spend other people's money on other people. And in this case, who gives a ****?"​
 
Because many other countries have socialized medicine with lower quality of care.



LOL,,,, that's what I meant.

Obviously I am talking about the same level of care and the same type of system.
 
The problem happens everywhere we see a third party payer for this guts the price discipline that consumers exercise. Here's PJ O'Rourke channeling Milton Friedman:

"1. You spend your money on yourself. You're motivated to get the thing you want most at the best price. This is the way middle-aged men haggle with Porsche dealers.

2. You spend your money on other people. You still want a bargain, but you're less interested in pleasing the recipient of your largesse. This is why children get underwear at Christmas.

3. You spend other people's money on yourself. You get what you want but price no longer matters. The second wives who ride around with the middle-aged men in the Porsches do this kind of spending at Neiman Marcus.

4. You spend other people's money on other people. And in this case, who gives a ****?"​

This is very true - the simple example is that in the US, in the run-up to get Obamacare approved, people claimed that in order to reduce healthcare costs, more people had to pay into the system because too many were getting "free" healthcare at hospitals, etc., increasing costs for everyone - here in Canada, where everyone has basic and hospital coverage, a large number of people use hospital services for scrapes and scratches, the sniffles and upset stomaches, and use doctors to prescribe Tylenol and other OTC medications.

As a result, with everyone in the system, funded through taxes, we're all paying more for services that are needed because too many people are abusing the system for services they should fund themselves.
 
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