The true cost of healthcare

[J A Eyers]

Unable to get to our NHS (socialised medicine!) doctor near to home, Gwyinivere went to the private doctor who comes to our place of work once a week to get a new asthma prescription urgently. Because he's not NHS he can't write prescriptions that are covered by the NHS, so she had to pay the bill herself. It cost £50 for 2 months' supply. I was shocked.

She wasn't. In the US when she stopped being covered by her parents' insurance the bill for exactly the same drug was $250.

If the drug companies are turning a profit on £50 in the UK, how much profit do you think they're turning by charging more than three times as much in the US?

No wonder you spend a bigger percentage of GDP on healthcare than every country that has socialised medicine. Even if you aren't coughing it up (or your employer isn't subtracting it from your salary and claiming you're getting health insurance as an 'employee benefit') then the government is taking money from the taxpayers (to pay for Medicare/Medicaid) and giving it to these price-fixing cartels that make tens (if not hundreds) of billions in profit every year.

Not only do we have socialised medicine in the UK but we have anti-price-fixing legislation and anti-monopoly laws that basically tell the drug companies if they're unwilling to sell the drugs to the NHS at little over cost value then the drugs won't get clearance from the British equivalent of the FDA and the drugs companies won't be allowed to sell them privately within the UK either.

So, does anybody have an even halfway intelligent defence of the American healthcare industry, given how patently inferior I've demonstrated it to be?

[StrangeWill]

None of this is new, it's getting the majority of Americans to pay attention to the numbers and not the political rhetoric that is difficult.


The only thing I've seen people actually defending (unbeknownst to them), seems to be this whole idea of "well, I wont buy insurance and I don't want to pay through the government, and I'll just gamble on not getting hit by a bus". Of course I point out that is just abusing the system, being as our taxes/insurance rates get to pick up the tab for that when they inevitably file for bankruptcy, then they get all defensive and act like I'm attacking them (because barely anyone here can have a civil discussion about something so politically driven). Seriously, so far the majority of my peers discussions start off with "well I haven't been to the doctor in [x] years so...." as if you can determine that you'll go to your deathbed never seeing a doctor on stupid-ass logic like that.

Mainly, as with most of American politics, it isn't about fiscal conservatism as a country, it's about a world centered around each individual voter in their own loopy mind.

Even if you aren't coughing it up (or your employer isn't subtracting it from your salary and claiming you're getting health insurance as an 'employee benefit')

Most people that brag about affordable insurance love to not mention how much their employer is subsidizing. Again, it's mostly ignorance and belief in the system.

Oh and I pay about $380/mo + max my HSA (employer contributes, so it's about another $300/mo out of pocket) for my family. If you're not maxing your HSA, you're fucking retarded (you'll see why below).


For those that aren't familiar with HSAs. Health Savings Account, basically a tax-free hole I throw money into because I have like a $3k deductible on my health insurance for each person in my family, and I believe a $10k max out of pocket for all of us as a pool (or something like that). I put all that money towards insurance, and still had a few grand worth of bills from my daughter being born and a visit to a high-risk doctor before she was born.

Not only do we have socialised medicine in the UK but we have anti-price-fixing legislation and anti-monopoly laws that basically tell the drug companies if they're unwilling to sell the drugs to the NHS at little over cost value then the drugs won't get clearance from the British equivalent of the FDA and the drugs companies won't be allowed to sell them privately within the UK either.

We have people complaining about regulatory capture now, and they'll start to blindly use that as a defense, I commonly point out that you get that as a result of screaming "anti-business" any time you put someone in power that tried to clamp down on questionable practices for the past 40 years. You don't get to shit on the system and then point out how bad it has become from your misuse of it.

Also, it is somehow accompanied by this stupid fucking idea that the problems that regulatory capture create are resolved by removing regulations.


I live in a country full of crazy people.

[MolBaNdA]

The only reason I have healthcare right now is because I can stay on my parent's health care and we get it through my dad's company. In October when I turn 26 I'm fucked because unless I get a well-paying job (and right now unless I want to settle for a job I really don't want I only have unpaid or very low paid internships on the table) I can't be on my parent's health insurance anymore and I won't be able to afford it. Also since I am attending school in Massachusetts if I don't have health insurance I will get a fine from the government. Sweet.

[[Alpha]InfamousAn]

Originally Posted by J A Eyers

Unable to get to our NHS (socialised medicine!) doctor near to home, Gwyinivere went to the private doctor who comes to our place of work once a week to get a new asthma prescription urgently. Because he's not NHS he can't write prescriptions that are covered by the NHS, so she had to pay the bill herself. It cost £50 for 2 months' supply. I was shocked.

She wasn't. In the US when she stopped being covered by her parents' insurance the bill for exactly the same drug was $250.

If the drug companies are turning a profit on £50 in the UK, how much profit do you think they're turning by charging more than three times as much in the US?

No wonder you spend a bigger percentage of GDP on healthcare than every country that has socialised medicine. Even if you aren't coughing it up (or your employer isn't subtracting it from your salary and claiming you're getting health insurance as an 'employee benefit') then the government is taking money from the taxpayers (to pay for Medicare/Medicaid) and giving it to these price-fixing cartels that make tens (if not hundreds) of billions in profit every year.

Not only do we have socialised medicine in the UK but we have anti-price-fixing legislation and anti-monopoly laws that basically tell the drug companies if they're unwilling to sell the drugs to the NHS at little over cost value then the drugs won't get clearance from the British equivalent of the FDA and the drugs companies won't be allowed to sell them privately within the UK either.

So, does anybody have an even halfway intelligent defence of the American healthcare industry, given how patently inferior I've demonstrated it to be?

Heya, I dropped in because a different forum I regularly read is offline at the moment and was curious. I saw this thread and wanted to respond because it is a subject that interests me.

One thing to keep in mind about un-insured prices (drugs, hospital care, everything) is that a rather unique economic condition was created due to Health Insurance. A monopoly is defined as a single large SUPPLIER, and leads to monopolistic pricing. Health insurance creates a single powerful BUYER (the other side of the economic equation) which has lead to artificially high prices.

It works like this: As a single powerful buyer, a health insurance company can dictate the price they want to pay for goods and services. If Blue Cross / Blue Shield decide a hospital is 'out of network', so many people have insurance that the remaining clients can't sustain the facility. They have no choice but to abide by the discounts the insurance companies demand, or face going under. As a consequence, they negotiate a discount % for their insurance clients. Again, because there are far more insurance buyers than non-insurance buyers, it only makes financial sense to 'normalize' the price based on the discount. They charge $250 because they only expect to be paid $50 by most of their clients. They make their 'list price' high enough such that they are actually targeting the market price after the insurance discount.

[madbomber1998]

Originally Posted by J A Eyers

Unable to get to our NHS (socialised medicine!) doctor near to home, Gwyinivere went to the private doctor who comes to our place of work once a week to get a new asthma prescription urgently. Because he's not NHS he can't write prescriptions that are covered by the NHS, so she had to pay the bill herself. It cost £50 for 2 months' supply. I was shocked.

She wasn't. In the US when she stopped being covered by her parents' insurance the bill for exactly the same drug was $250.

If the drug companies are turning a profit on £50 in the UK, how much profit do you think they're turning by charging more than three times as much in the US?

No wonder you spend a bigger percentage of GDP on healthcare than every country that has socialised medicine. Even if you aren't coughing it up (or your employer isn't subtracting it from your salary and claiming you're getting health insurance as an 'employee benefit') then the government is taking money from the taxpayers (to pay for Medicare/Medicaid) and giving it to these price-fixing cartels that make tens (if not hundreds) of billions in profit every year.

Not only do we have socialised medicine in the UK but we have anti-price-fixing legislation and anti-monopoly laws that basically tell the drug companies if they're unwilling to sell the drugs to the NHS at little over cost value then the drugs won't get clearance from the British equivalent of the FDA and the drugs companies won't be allowed to sell them privately within the UK either.

So, does anybody have an even halfway intelligent defence of the American healthcare industry, given how patently inferior I've demonstrated it to be?

You'd be surprised how inflated the numbers are even in England. Go to a country with NO socialized drug benefits (IE, they don't give out medication for free) and you can buy medications STUPIDLY cheap. Heck, compare prescription meds vs. the same exact meds you can get over the country from a farm and ranch supplier - alot of the meds they give humans they use for various animals. You can get them over the country and they are INCREDIBLY cheap (and the exact same meds in most cases, made in the same factories on the same lines, same markings, same QC) - I'm talking 100's of times cheaper than prescription meds.

But yea, our countries medical industry is messed up. My mother rants about it all the time. (being a nurse and teaching nursing in a university and all that)

[madbomber1998]

Originally Posted by StrangeWill

None of this is new, it's getting the majority of Americans to pay attention to the numbers and not the political rhetoric that is difficult.

+1

Originally Posted by StrangeWill

The only thing I've seen people actually defending (unbeknownst to them), seems to be this whole idea of "well, I wont buy insurance and I don't want to pay through the government, and I'll just gamble on not getting hit by a bus". Of course I point out that is just abusing the system, being as our taxes/insurance rates get to pick up the tab for that when they inevitably file for bankruptcy, then they get all defensive and act like I'm attacking them (because barely anyone here can have a civil discussion about something so politically driven). Seriously, so far the majority of my peers discussions start off with "well I haven't been to the doctor in [x] years so...." as if you can determine that you'll go to your deathbed never seeing a doctor on stupid-ass logic like that.

This country was founded so that we wouldn't HAVE a government telling us what to do. Instead of spending stupid amounts of money on high cost health insurance, lets fix the medical system instead and get health care back to where it is affordable. It was in the past and it can be again. Not everyone (in fact, the vast majority of people) will ever need the next 'wonder drug' (seriously, we give out WAY too much medication here in the United States, and it DRASTICALLY drives up the cost of health care, more than anything else probably)

And just on a side note - my brother spends almost $800 a month on health insurance right now. Granted he has issues - but the vast majority of them are directly his fault. He owes - AFTER what his insurance covers - over $80k of medical bills. Not including about $400 a month of specialty doctor visits that his insurance won't cover. Even with insurance, he's screwed because of his medical bills. All of this from a week in the hospital with pneumonia (and no weird super-drugs given) and another 3 days in the hospital. Plus his other misc. medical stuff.

[madbomber1998]

Originally Posted by [Alpha]InfamousAn

Heya, I dropped in because a different forum I regularly read is offline at the moment and was curious. I saw this thread and wanted to respond because it is a subject that interests me.

One thing to keep in mind about un-insured prices (drugs, hospital care, everything) is that a rather unique economic condition was created due to Health Insurance. A monopoly is defined as a single large SUPPLIER, and leads to monopolistic pricing. Health insurance creates a single powerful BUYER (the other side of the economic equation) which has lead to artificially high prices.

It works like this: As a single powerful buyer, a health insurance company can dictate the price they want to pay for goods and services. If Blue Cross / Blue Shield decide a hospital is 'out of network', so many people have insurance that the remaining clients can't sustain the facility. They have no choice but to abide by the discounts the insurance companies demand, or face going under. As a consequence, they negotiate a discount % for their insurance clients. Again, because there are far more insurance buyers than non-insurance buyers, it only makes financial sense to 'normalize' the price based on the discount. They charge $250 because they only expect to be paid $50 by most of their clients. They make their 'list price' high enough such that they are actually targeting the market price after the insurance discount.

Yea. My wife had massive migraines for awhile, and the first part we were covered by her old companies insurance plan. Then when we lost the coverage, I negotiated with the doctor we were seeing and he let us pay him with cash and instead of buying prescription drugs, he would obtain alot of 'samples' he got cheap from the drug companies and threw that in as part of the deal. Also, we were able to order her migraine drugs from overseas for insanely stupid prices (with a prescription) - like 250 percocets for $40, delivered. It was far cheaper than having the insurance and paying the co-pays.

[Hannibalien]

One of my friends has diabetes. The level of health insurance he requires costs almost half his paycheck. Granted we work at a shitty retail job (Best Buy)(don't ever shop there), but he needs that... to live. Even the lowest option I can't afford.

[madbomber1998]

Insulin and such isn't expensive - if we had an affordable health care system. Yet we don't, so it's too expensive for him to live. Even with insurance it's borderline too expensive for him to live.

[StrangeWill]

Originally Posted by madbomber1998

This country was founded so that we wouldn't HAVE a government telling us what to do.

Stop rewriting history, our revolutionary war was telling nearly half of our people we're going to fight someone we didn't want to, threatening their very way of life is the British had the resources to bother with us. The country was founded so that we had a say in what our government does.... "No taxation without representation"

Originally Posted by madbomber1998

Instead of spending stupid amounts of money on high cost health insurance, lets fix the medical system instead and get health care back to where it is affordable. It was in the past and it can be again.

How do you "make" healthcare affordable? How do you "fix" the system? In your other threads, you, a staunch supporter of consumers controlling the market, showed a prime example of how even yourself make the system unworkable.

Originally Posted by madbomber1998

Not everyone (in fact, the vast majority of people) will ever need the next 'wonder drug' (seriously, we give out WAY too much medication here in the United States, and it DRASTICALLY drives up the cost of health care, more than anything else probably)

Got any evidence on this? Or is this just a personal opinion?

Originally Posted by madbomber1998

And just on a side note - my brother spends almost $800 a month on health insurance right now. Granted he has issues - but the vast majority of them are directly his fault. He owes - AFTER what his insurance covers - over $80k of medical bills. Not including about $400 a month of specialty doctor visits that his insurance won't cover. Even with insurance, he's screwed because of his medical bills. All of this from a week in the hospital with pneumonia (and no weird super-drugs given) and another 3 days in the hospital. Plus his other misc. medical stuff.

This is the majority of cases, no "super drug" shit.

[madbomber1998]

Originally Posted by StrangeWill

How do you "make" healthcare affordable? How do you "fix" the system? In your other threads, you, a staunch supporter of consumers controlling the market, showed a prime example of how even yourself make the system unworkable.

Healthcare can be really affordable. Most people don't need a ton of drugs to fix their problems. Change up the way medicine works (no more handing out drugs to bandaide everything), get rid of medicare and the government paying for prescription drugs (drastically cut down on the cost of healthcare - dangit, get the government out of it totally. They always suck at spending money.) Insurance? People got by without it. They saved money. Insurance raises the price of stuff drastically. Fix the lawsuits problem. Fix the illegal immigrants problem (raises the price of medical care via free care to illegals. alot of hospitals in Florida have / are shutting down completely or getting rid of their emergency rooms because of this problem) - all this and more. GOOD, QUALITY health care the fixes the majority of people's problems is cheap. (I'm not talking about the random extreme case - which does, but VERY RARELY happens)

These fixes and a few others would drop the cost of health care down to affordable levels, without needing insurance. Heck, some guy got a $14,419 bill (not including $5,556 they charged him just for his room) from a hospital in my state last week, he's a lawyer and is suing the hospital over it, it's in the NC Supreme Court right now. He was there for 2 days and was given no special care and 3 medications - diltiazem (high blood pressure, my dad takes it), which he was billed 24 times the cost of what it cost full price at a pharmacy; enoxaparin sodium (anti-coagulant, again, my dad takes it), which he was billed 15 times the price at the local pharmacy, and folic acid, which he was charges 11 times the cost of at the local pharmacy. Because they could charge that because of insurance of medicare and such, among other reasons. This guy's care should have been a fraction of what they charged him, even after paying for the room, the medications, the staff's salaries, etc. And this kind of thing is normal.

Originally Posted by StrangeWill

Got any evidence on this? Or is this just a personal opinion?

No, this is the opinion of every medical industry person I've ever spoken to. And just common sense. Most people don't need alot of care - just basic care. Even things like gunshot wounds and such don't need alot of care after the initial surgery.

Do you realize how often prescription drugs are prescribed that aren't really needed? I mean, I understand if you break your leg you need a good painkiller for a little while. Fine. That's like $10 worth of medication. If you have a really bad cut, you need an antibiotic and a pain killer. fine. That's like $15 worth of drugs. Etc. Etc. Etc. Most people don't need all the expensive drugs they prescribe - and insurance and medicare and such just drive the cost up.

Originally Posted by StrangeWill

This is the majority of cases, no "super drug" shit.

Exactly. All the expensive, un-necessary stuff people do, plus insurance and medicare and lawsuits and such drive the cost of care up. What should be simple care cost an outrageous amount of money.

[madbomber1998]

Sorry if my above was a bit incoherent, I'm kind of busy and sidetracked and such right now.

[StrangeWill]

Originally Posted by madbomber1998

Healthcare can be really affordable. Most people don't need a ton of drugs to fix their problems.

Ok, but from your point below we already established you have no evidence that this is the problem.

Originally Posted by madbomber1998

Change up the way medicine works (no more handing out drugs to bandaide everything), get rid of medicare and the government paying for prescription drugs (drastically cut down on the cost of healthcare - dangit, get the government out of it totally. They always suck at spending money.)

Except handing out those drugs is more profitable, it's a business model thing.

Originally Posted by madbomber1998

Insurance? People got by without it. They saved money.

Yeah, by not having access to health care.

Originally Posted by madbomber1998

Insurance raises the price of stuff drastically. Fix the lawsuits problem. Fix the illegal immigrants problem (raises the price of medical care via free care to illegals. alot of hospitals in Florida have / are shutting down completely or getting rid of their emergency rooms because of this problem) - all this and more. GOOD, QUALITY health care the fixes the majority of people's problems is cheap. (I'm not talking about the random extreme case - which does, but VERY RARELY happens)

Is the government supposed to tell us who we can and cannot sue now?

Also, have evidence to suggest that illegals put such a burden on our system?

Originally Posted by madbomber1998

These fixes and a few others would drop the cost of health care down to affordable levels

Evidence?

Originally Posted by madbomber1998

Heck, some guy got a $14,419 bill (not including $5,556 they charged him just for his room) from a hospital in my state last week, he's a lawyer and is suing the hospital over it, it's in the NC Supreme Court right now.

So the kind of shit you say to stop doing?

Originally Posted by madbomber1998

He was there for 2 days and was given no special care and 3 medications - diltiazem (high blood pressure, my dad takes it), which he was billed 24 times the cost of what it cost full price at a pharmacy; enoxaparin sodium (anti-coagulant, again, my dad takes it), which he was billed 15 times the price at the local pharmacy, and folic acid, which he was charges 11 times the cost of at the local pharmacy. Because they could charge that because of insurance of medicare and such, among other reasons. This guy's care should have been a fraction of what they charged him, even after paying for the room, the medications, the staff's salaries, etc. And this kind of thing is normal.

The price will be what the market will bare.

Originally Posted by madbomber1998

No, this is the opinion of every medical industry person I've ever spoken to. And just common sense. Most people don't need alot of care - just basic care. Even things like gunshot wounds and such don't need alot of care after the initial surgery.

Ok, that isn't hard evidence, it's anecdotal evidence, likely cherry picked by you (hey, my wife's doctor constantly shakes her head at our system and points out the UKs as more reasonable). It's shit like this that gets us into expensive and stupid solutions. As long as you're thinking that nurses should dictate the entire movement of our industry as a whole based on their personal opinions, you're being as misguided as the majority of Americans.

Originally Posted by madbomber1998

And just common sense

Shut the fuck up, this is not the kind of shit you use in a discussion about how to resolve issues in any of our systems. You use evidence, you don't know throw "it's common sense" on the board, because you can say any argument is backed by "common sense". Americans fucking use this in every discussion about every position. I can just say the opposite is common sense, how do you put a rebuttal against that?

Originally Posted by madbomber1998

Do you realize how often prescription drugs are prescribed that aren't really needed? I mean, I understand if you break your leg you need a good painkiller for a little while. Fine. That's like $10 worth of medication. If you have a really bad cut, you need an antibiotic and a pain killer. fine. That's like $15 worth of drugs. Etc. Etc. Etc. Most people don't need all the expensive drugs they prescribe - and insurance and medicare and such just drive the cost up.

You do realize that prescription drugs are pretty poorly covered by insurance, and usually are paid mostly out of pocket.

Originally Posted by madbomber1998

Exactly. All the expensive, un-necessary stuff people do, plus insurance and medicare and lawsuits and such drive the cost of care up. What should be simple care cost an outrageous amount of money.

Which is funny, we have conflicting data: the reason for low wait times in the US is because of the lower demand on our system, this can't be caused by a large amount of elective surgeries.

[madbomber1998]

Originally Posted by StrangeWill

Except handing out those drugs is more profitable, it's a business model thing.

Exactly

Originally Posted by StrangeWill

Yeah, by not having access to health care.

They still had access to health care.

Originally Posted by StrangeWill

Is the government supposed to tell us who we can and cannot sue now?

No, just that stupid lawsuits are....stupid. Our country is sue-happy and people get awarded huge, stupid rewards for it. Fix our judicial system.

Originally Posted by StrangeWill

Also, have evidence to suggest that illegals put such a burden on our system?

Do I even need to go there? I even posted some about hospitals in Florida. I saw it first hand when I was in the ER waiting to get my leg fixed up years ago with the whole sword incident (which, btw, I paid for with cash, directly to the ER director and got away with less than $200 expenses on my end.) - while I was waiting in the ER, it was a first come, first serve thing. I had 3 or 4 hispanic families - each of them 'with no ID and couldn't pay' in because one of them had a cold and wanted free treatment.

Originally Posted by StrangeWill

So the kind of shit you say to stop doing?

There's a difference between lawsuits over stupid stuff - malpractice lawsuits over a surgery going bad (I'm sorry, but open heart surgery DOES have risks, you know? And seriously, if you're stupid enough to squeeze a hot cup of McDonalds coffee between yours legs, you deserve the burns. Not the huge settlement she got) and such like that - and suing because someone is totally ripping you and everyone else off.

Originally Posted by StrangeWill

The price will be what the market will bare.

The market only bares it because of insurance, medicare, etc. It's artificially inflated.

Originally Posted by StrangeWill

Ok, that isn't hard evidence, it's anecdotal evidence, likely cherry picked by you (hey, my wife's doctor constantly shakes her head at our system and points out the UKs as more reasonable). It's shit like this that gets us into expensive and stupid solutions. As long as you're thinking that nurses should dictate the entire movement of our industry as a whole based on their personal opinions, you're being as misguided as the majority of Americans.

So what DOES cause the price of health care in the US to be so high? Hmmmm?

Originally Posted by StrangeWill

Shut the fuck up, this is not the kind of shit you use in a discussion about how to resolve issues in any of our systems. You use evidence, you don't know throw "it's common sense" on the board, because you can say any argument is backed by "common sense". Americans fucking use this in every discussion about every position. I can just say the opposite is common sense, how do you put a rebuttal against that?

Ok, so we are going to leave common sense out this then.

Originally Posted by StrangeWill

You do realize that prescription drugs are pretty poorly covered by insurance, and usually are paid mostly out of pocket.

Originally Posted by StrangeWill

Which is funny, we have conflicting data: the reason for low wait times in the US is because of the lower demand on our system, this can't be caused by a large amount of elective surgeries.

It's not the elective surgeries. Those should ALL be paid for with cash.

[StrangeWill]

Originally Posted by madbomber1998

They still had access to health care.

How far back are we going? Since BCBS existed since the 30s and employer sponsored health insurance cropped up in the late 1920s. Are you saying that the majority of people had access to healthcare in the late 1800s and early 1900s?

Originally Posted by madbomber1998

No, just that stupid lawsuits are....stupid. Our country is sue-happy and people get awarded huge, stupid rewards for it. Fix our judicial system.

So you expect people to just stop suing out of the goodness of their heart? I mean your lawyer friend is an excellent example of how this already isn't working.

Originally Posted by madbomber1998

Do I even need to go there? I even posted some about hospitals in Florida. I saw it first hand when I was in the ER waiting to get my leg fixed up years ago with the whole sword incident (which, btw, I paid for with cash, directly to the ER director and got away with less than $200 expenses on my end.) - while I was waiting in the ER, it was a first come, first serve thing. I had 3 or 4 hispanic families - each of them 'with no ID and couldn't pay' in because one of them had a cold and wanted free treatment.

Yes, because anecdotal evidence is not empirical evidence. I can come up with anecdotal evidence pushing any insane idea out there. On top of that you're trying to say that immigration is purely an American concept and problem.

Originally Posted by madbomber1998

There's a difference between lawsuits over stupid stuff - malpractice lawsuits over a surgery going bad (I'm sorry, but open heart surgery DOES have risks, you know? And seriously, if you're stupid enough to squeeze a hot cup of McDonalds coffee between yours legs, you deserve the burns. Not the huge settlement she got) and such like that - and suing because someone is totally ripping you and everyone else off.

If anything malpractice is one of the most valid reasons to sue over... if I can't sue over a doctor making a bad decision that cripples me for life, what the fuck CAN I sue over?

Originally Posted by madbomber1998

And seriously, if you're stupid enough to squeeze a hot cup of McDonalds coffee between yours legs, you deserve the burns.

And again you show your complete lack of understanding of a lawsuit...

Originally Posted by madbomber1998

The market only bares it because of insurance, medicare, etc. It's artificially inflated.

Yeah, that's what it means.

Originally Posted by madbomber1998

So what DOES cause the price of health care in the US to be so high? Hmmmm?

Administrative complexity is one common site cited over and over again in the private industry (administration costs in health insurance is high, hospital administrative costs are higher here too, Medicare has about 1/10th the administrative cost of other systems). Over-treatment of patients, again, common in a for-profit system.

Of course Medicare is fucked because legally it isn't allowed to use it's leverage to get cheaper drugs, but that is the fault of the "pro-business" shitheads you guys keep putting into office.

Originally Posted by madbomber1998

{chart}

It's not the elective surgeries. Those should ALL be paid for with cash.

Sorry, should have specified, name-brand, a lot of the prescription waste (unless doctor Madbomber now wants to say what drugs we can and cannot take). Furthermore do we kindly ask doctors to not give us prescriptions we may not need? Because your solution is: the government can't step in and tell them they can't (even though this is a silly notion to begin with).

And where is the other 2.2 TRILLION DOLLARS we spend on healthcare? Let that sink in: we barely even spend 10% of our medical costs on drugs, so stop blaming it. This entire idea you have is constructed in your mind as the one thing we can fix to solve our healthcare problem... even if we paid $0 for drugs, we'd still be paying twice as much as any other country.

Unless you're also the kind of person to blame NASA for our budget problems.


----

Anyway JA, Madbomber is pretty much a gleaming example of how the medical debate situation is in our country (and the same stance fora lot of things), that we just need to return to late 1800s we'll be fine.

[madbomber1998]

Originally Posted by StrangeWill

Anyway JA, Madbomber is pretty much a gleaming example of how the medical debate situation is in our country (and the same stance fora lot of things), that we just need to return to late 1800s we'll be fine.

Ok, I get it. I'll just give in for the sake or argument - we will just ignore fixing the problems and just give everyone free healthcare. Not like we spend more money per person on healthcare than any other country, for the same treatment, by HUGE amounts....

[StrangeWill]

Originally Posted by madbomber1998

Ok, I get it. I'll just give in for the sake or argument - we will just ignore fixing the problems and just give everyone free healthcare. Not like we spend more money per person on healthcare than any other country, for the same treatment, by HUGE amounts....

Um, that's kind of the point of adopting the UK's model as opposed to "come up with it as I go" model, we point to a working model that costs less than half and say "start there", you adopt their NHS, you'll be paying less than half guaran-fucking-teed. Is anyone here suggesting we go with just forking over money to expensive health insurance companies and not putting anything like the NHS in place to help regulate costs? I'm sure not. Though you're thoroughly on track for being a standard American politician with that attitude, "let's just do it the stupidest fucking way possible so I can try to prove a point when it collapses, then I can push deregulation as our savior".

Fixing the problems involves being proactive, not believing the fucking invisible hand of the free markets still exists. I would at least take some kind of insane theory that I haven't heard over the typical American drivel of "the only solution is to liquidate the government".

[StrangeWill]

Originally Posted by [Alpha]InfamousAn

Heya, I dropped in because a different forum I regularly read is offline at the moment and was curious. I saw this thread and wanted to respond because it is a subject that interests me.

One thing to keep in mind about un-insured prices (drugs, hospital care, everything) is that a rather unique economic condition was created due to Health Insurance. A monopoly is defined as a single large SUPPLIER, and leads to monopolistic pricing. Health insurance creates a single powerful BUYER (the other side of the economic equation) which has lead to artificially high prices.

It works like this: As a single powerful buyer, a health insurance company can dictate the price they want to pay for goods and services. If Blue Cross / Blue Shield decide a hospital is 'out of network', so many people have insurance that the remaining clients can't sustain the facility. They have no choice but to abide by the discounts the insurance companies demand, or face going under. As a consequence, they negotiate a discount % for their insurance clients. Again, because there are far more insurance buyers than non-insurance buyers, it only makes financial sense to 'normalize' the price based on the discount. They charge $250 because they only expect to be paid $50 by most of their clients. They make their 'list price' high enough such that they are actually targeting the market price after the insurance discount.

How does that not apply to NHS and private health providers in the UK (nearly 10% of their market)? Is the NHS just more fair about their payouts even though they're statistically paying out half? I could see (and data suggests) the whole insurance industry does tack on decent administrative overhead at the provider level, but not that much alone.

They charge $250 because they only expect to be paid $50 by most of their clients. They make their 'list price' high enough such that they are actually targeting the market price after the insurance discount.

How does the whole compensation of underpaying insurance companies account for 16% of our GDP going towards healthcare? Shouldn't an equilibrium of actual payouts show as a fairly stable price compared to other countries if that was really the cause, as opposed to just another symptom?

They make their 'list price' high enough such that they are actually targeting the market price after the insurance discount.

Every time I've dealt with insurance, it's been "BCBS covers [x], you pay the rest [y]", it seems to greatly imply that list price has nothing to do with their discount being as they don't discount a percentage at all. Sometimes x is the entire thing, sometimes it isn't.


I do however agree that health insurance companies are a huge part of the problem, but mainly due to their lumbering inefficiencies (that make the government statistically more efficient fiscally by a factor of 10) and profit-driven service (though these two problems are also on the provider level too, with no incentive to un-fuck it). Some of their inefficiencies can maybe be combated by allowing cross-state heath insurance, but that is a state level issue, and states do have a good point in the whole idea that it will just lead to an immediate race to the bottom for where all health insurance companies should be based out of.

[Greyhaven]

Yes! We need to change the Healthcare system.

Good luck with that...it will never happen. We will continue to piece together minor patches so everyone is happy.