Forty-two percent of US doctors believe that their patients are getting too much medical care, according to a survey published Monday which suggests fears of malpractice suits may be to blame.
A total of 28 percent said they felt they were treating their patients too aggressively, while 45 percent said one of every 10 patients they saw daily had issues that could have been dealt with by phone, by email or by a nurse....
Not sure what the above means in terms of practicality.
I have a bit of a different take AOW-- The study was led by Brenda Sirovich and colleagues from the VA Outcomes Group in Vermont and the Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire.
SO the VA and a "Policy Group" think we are getting too much healthcare. I guess they would. Each cat Scan machine and MRI machine cost about $1 million and is out of date in about 5 years. then we have the cost of running it. We have the most amazing drugs now of which it costs about $1 Billion to develop each one. We are blessed to live in this time of access to amazing equipment that is used to keep our hearts ticking when in a hospital. We should be thankful we have all of this. Yes it cost money and that is why healthcare cost so much, I would rather spend our money on improving our quality and quantiy of life then sending Billions to those who hate us. I am alive today because of this very expensive drugs and tchnology.
Bunkerville, I am alive today because of this very expensive drugs and tchnology.
I don't doubt you.
However, we can't deny the rise in health-insurance premiums. Mr. AOW pays nearly $700 month -- for what amounts to catastrophic coverage.
I have more than one friend whose monthly pay loses 50%-75% to his employee portion of the health-insurance premiums. In contrast, my cousin who works for the county pays $64 a month; we taxpayers are picking up the rest, of course.
I come from a social security and health-care heavy nation, which we have had for a long time and we suffer for it. A great part of that is because of socialism and that somehow the State must pay for it (and of course control it) without thinking of how to raise such funds to do so AS WELL As the implications that result.
From what I see, the problem with health-care in general within the United States is down to two aspects. Insurance and legality.
Insurance - like over here on the Contenent (Europe), the power and the input by Insurance changes everything and no more so than in the US. The fear of not being insured, or the necessity of being insured, drives up costs and when the Insurance providers can they will milk the fees to levels that are simply extortion. I remember the days during my youth here on the Island and in Spain there were school and town carnivals and more public events - all dried up now because towns, schools and community groups cannot afford the horrible insurance cost to run the event.
The simple truth is that because of insurance, clinics, doctors, pharmacies and pharmacy suppliers pay such high fees that it drives up costs. The US has amongst the highest net cost of medical treatment in the word.
Legality - the US has suffered a three decades long "sue you" pandemic that is self-perpetuating. We in the global legal business feel a mix of constant dismay and some even jelousy of our American cousins simply because they have it made there. This self-created need to have a lawyer involved in everything or attach legal fees to everything also drives up prices.
Combined with Insurance it is a toxic mix that makes for a huge impact in costs such as in health care. You are required to have insurance, the fear of malpractice suits etc, etc, etc puts on what I am told is a 40 per cent hike on basic health care costs that you pay but most do not. We cannot afford health care as a nation because the government insists they must pay it, you cannot afford health care because you pay it and your being ripped-off as well!
Obama, like in economics, does not provide solutions but talk a lot instead, but I have to say your problem is not his creation at all, it actually falls on Nixon's watch and because Insurance and your legal world had too much power and money for any of the subsequent Presidents to do anything (or want to) about it.
..."while 45 percent said one of every 10 patients they saw daily had issues that could have been dealt with by phone, by email or by a nurse...."
Yet, when I, without insurance, KNOW I have something as simple as a URI and need a few days worth of antibiotic, the doctor will not call in a prescription unless I pay for an office visit first; a waste of time for us both but CYA for him!
I've always said the health care costs are way higher than they need to be.
I once suggested a cap on health care, medical personnel salaries, drug prices, and all subsidiaries in the health care industry, but then, I realized that is socialistic.
I do believe, though, that the health care industry (all facets) should voluntarily regulate prices themselves. It isn't just waste that drives the costs up. It's also greed.
For example, why should a simple exam (Blood pressure, temperature, weight and height, etc) cost over $100.00? Most of the time, during a routine examination like this, the doctor isn't even involved.
Get rid of the frivolous suits brought against health care providers and watch cost come down. As Brooke said CYA and she is correct and who wouldn't. Doctors pay out the A** for malpractice insurance to cover folks who would ask for a prescription to be called in and then turn and sue the Dr and the pharmacy because it caused a rash or made them sicker. I've seen it happen! I recently asked a doctor friend of mine why he ordered so many test for my wife. He said, if I don't order them I might miss something or could be accused of missing something and I would rather err on the side of over caution and if I don't order them I can be sued for millions of dollars. CYA, damn right and for good reason. He's a great doctor and I see him in a position of damned if I do and damned if I don't.
Scary numbers, AOW. To Adrienne's list we could add FDA, Inability for insurance companies to sell across state lines, AMA, Patent law Protection for too many years, etc. If I had to point to the biggest blame I would point at lawyers.
I don't mind paying for a product or a service in healthcare. If charges were reasonable -- instead of, say, $100 charged to my wife for a cloth sling recently -- then I believe paying for care and visits should be charged.
I think what most people want is coverage for CATASTROPHIC care that can bankrupt a person or a family when a massive trauma occurs or a horrible disease descends.
People, for example, with many children should pay more for medical care than I do, with no children. Simple as that. But catastrophic care can level the playing field on anyone.
Just to clarify my earlier post, private Insurance costs are what they are because it is carrying Medicare and Medicaid patient costs. Add Malpractice and the inability for Insurance companies to go across state lines, and we have what we have. Last I looked, Health insurance companies were 86th in profitability. My intention was to cooment that we not throw the Insurance companies under the bus totally, and that the article was misleading and self serving. AOW-- The Doha thing, I am not quite catching it:)))
Our Doctors pay $200,000 to $300,000 each year in malpractice costs. That is why your blood pressure visit costs $100.00. I have not had a raise in 3 years and am on mandatory time off each week. So please do not tell me how much money we all are making and that we need caps and are evil folks. sorry guys, you hit a nerve with me.
The cost of employer-sponsored health insurance surged this year, snapping a trend toward moderate growth, but experts say these increases may slow again in 2012.
Annual premiums for family coverage climbed 9 percent and surpassed $15,000 for the first time, according to a report released Tuesday by the Kaiser Family Foundation and the Health Research and Educational Trust. Premiums for single coverage rose 8 percent compared to 2010.
That compares to increases last year of 3 and 5 percent for family and single coverage, respectively. The study shows that premiums for both family and single coverage have more than doubled since 2001, while worker wages have risen 34 percent.
Why does it rise 3x as fast? Because it can when "government" is shovelling money in, much as they have done with "higher education" loans. What's to stop it? Can the government ever "run out of money" like you and I can?
Physician's have to pay phenomenal malpractice fee's to protect themselves from greedy people who are out to make a quick buck.
At some offices, nowadays, they have forms that protect themselves from lawsuits. Prescription drugs now come with warning labels and have long lists of possible side-effects.
Doctor's will make mistakes, no one is perfect. And believe me there are a few unqualified physician's who deserve to be sued, but most of the time, it's by trial and error.
Bunkerville, So please do not tell me how much money we all are making and that we need caps and are evil folks.
I am not advocating caps!
Nor am I saying that we are evil folks.
As to health insurance companies and their profits, I'm not sure how unprofitable the companies are -- after discounting CEO bonuses and the like.
Earlier, you rightly pointed out the following:
Each cat Scan machine and MRI machine cost about $1 million and is out of date in about 5 years. then we have the cost of running it.
The availability of using those services are regulated to some extent according to the health-insurance coverage one has. For example, the federal employees whom I personally know get CT scans and MRIs with greater frequency than those of us with our private policies. I should have had an MRI following my car accident of 2005, but the employer-based HMO wouldn't authorize it; a federal employee's insurance would have immediately authorized that MRI. So, the end result for me was that I suffered more damage to my back -- damage done by inappropriate PT -- because the MRI was skipped for several months. I've also heard of many unnecessary insurance-paid MRIs being done so that machines would be paid for, but I can't confirm that information.
I had the following experience when I needed post-cataract laser surgery on my eye (not Lasix) back in 1986: The hospital quoted me the price of $1200 with insurance but $395 without insurance (self pay). My father's heath insurance (transit employees' insurance) paid the $1200, but I paid the $395. Somebody pocketed the difference, IMO.
The Doha thing I mentioned is evidence of the push toward the new world order, whereby health-care costs and services are more equalized worldwide (along the lines of Agenda 21). I'll see if I can find more information on that topic.
BZ, I think what most people want is coverage for CATASTROPHIC care that can bankrupt a person or a family when a massive trauma occurs or a horrible disease descends.
The key is a policy with a maximum out of pocket. Many policies do not have that maximum, including Medicare and some HMOs. Open ended 80-20 or 90-10 coverages are recipes for medical bankruptcy for entire families!
It is getting more difficult to find catastrophic policies of the type available just five years ago.
Some commenters here have rightly pointed out that malpractice law suits and the premiums for doctors' malpractice insurance add a great deal to the cost of medical care for us the consumers. So do the costs of administrating health insurance in larger medical practices (group practices, hospitals, etc.).
D Charles, Obama, like in economics, does not provide solutions but talk a lot instead, but I have to say your problem is not his creation at all, it actually falls on Nixon's watch...
Interesting that you should mention that!
Back in the days of the Nixon administration, we heard about how HMOs were going to "save us." Didn't work out that way at all -- particularly as the population has aged.
Indeed, we cannot discount what the waves of aging Baby Boomers are doing to healthcare costs.
I personally don't know of anyone who has "cleaned up" via a medical malpractice law suit.
I recently asked a doctor friend of mine why he ordered so many test for my wife. He said, if I don't order them I might miss something or could be accused of missing something and I would rather err on the side of over caution and if I don't order them I can be sued for millions of dollars. CYA...
BZ, $100 charged to my wife for a cloth sling recently
That is cost shifting. Obviously a sling does not cost a $100, although hospitals pay an inflated cost for supplies. A majority of the costs are for the no-pays.
Someone has to pay their bill. Should it be you and your wife, or me? Hell no.
Who pays it though? The no-pay patient will not because they have no money and, if they did, no is there to force them to pay.
We have to treat them when they come to the hospital due to federal laws and lawsuits.
So with the patient not paying, and the hospital being forced to treat them, we are left with two choices
-shift the cost to paying customers
-have the hospital eat the cost
With option two they will either eventually close or provide substandard care to everyone to offset the costs.
Blame the insurance companies and the GOP for insisting they still be a part of the Health Care Reform bill you all call "Obamcare.' It should be called 'teabaggercare.'
One suggestion was for a cap on medical personnel salaries.
This is always the answer to cutting costs in health care.
Ultimately it winds up being the nurses who get cut.
I went to school for 4 years to get my degree and become a Registered Nurse. I spend a lot of time (sometimes whole days), without pay, re-educating myself to keep up to date on care practices. I can say with all honesty, with no arrogance or hubris, that I have saved many lives in my career.
Why shouldn't I make a living doing what I am doing? I am not getting rich, trust me but this is also not charity work for me. I am a professional and I expect to get paid for my services.
Sorry AOW, this went to the heart of what I believe. I promise I will go away after this ;)
I come at this from a different view point. While I find everyone's take on this fascinating, I think the graphic is a little misleading.
I don't dispute the validity of their numbers, it is likely fairly accurate.
The problem with it is quite simple, none of the mentioned products have been improved very much since 1945.
Health care is a completely different product from what it was in 1945.
Since 1945:
-Antibiotics became widely used
-Childhood immunizations were developed
-Ultrasound, MRI, CT, PET scan all detect new diseases and help with the early detection of cancer
-Lasers were developed
-We can operate on a fetus in-utero and save a baby's life
-Microsurgery was developed to reduce pain and hasten recovery
-Transplants took leaps and bounds
-Dialysis was put into common practice
-DNA was discovered, leading to a whole new area of medicine.
I find it interesting that people will complain about paying $200 a month for health insurance but will pay the same for a family plan for cell phones or $350 a month for a car payment.
Don't get me wrong, I think we need to do a lot to cut the costs of health care and believe we could without sacrificing care but we do need to have a little perspective. We have one of the most technologically advanced health care systems in the world. We are a world leader in it. It's not cheap.
Chuck, I think your comments are spot on. My belief (and thus my own comments) point to the two issues of insurance and legality. Insurance is big business and profit making and legality is altered to support insurance - and of course the very unique American capacity to bring to court anything and everything.
The other issue that some could bring is the concept of business and profit. I understand pharmacutical companies and equipment producers turning a profit but the question is should hospitals and clinics be run as services (making enough profits and looking for sponsors) or profit making businesses like any other and thus hiking prices to increase margines?
I'm echoing D Charles' sentiments here. A litigious American society is literally eating its own flesh. Chuck is right too, the health field is not what it was in 1945. But I also can't help but think that the insurance industry and to an even larger degree, federal government, have been responsible for significant artificial inflation in health care costs.
We've been living a medical nightmare for 21 years. Mr. Longrange and I live to pay doctors, medication, hospitalizations and insurance. The only extras we have is our very old computers and basic cable tv. We've had no vacations and drive old vehicles. So Mr. Longrange works 3 jobs. We are totally against Obama care. I don't know what the answers are. I do know illegal aliens get free care and drug es.
Chuck, I haven't read all comments yet, but noticed the following from you: I promise I will go away after this ;)
Don't abandon this thread!
You are making valid points.
I posted on this topic because I believe that we are headed for a train wreck with regard to medical care.
More and more people are, of necessity, abandoning health insurance, largely because of the cost of the premiums. Unemployed individuals have made the hard choice: Do I keep my house (or pay the rent), or do I keep my health insurance? Obviously, one has to do everything to keep a roof over one's head.
So, if people continue to abandon health insurance, the circle becomes vicious: less business for the health insurance companies, resulting in higher premiums for those who carry health insurance AND more unpaid bills for providers of all types (hospitals, clinics, doctors, etc.).
In my view, ObamaCare is going to kill the health insurance industry.
The health insurance companies willingly entered into the bargain with Obama. They're going to have a reality check because when employers drop employer-based insurance, many will not be able to afford coverage.
We all hear about how ObamaCare will provide coverage for pre-existing conditions. Scam alert! Pre-existing conditions hike premiums to the moon! For example, I pay $269 a month for my catastrophic coverage policy (high deductible, no prescription coverage); Mr. AOW, because of pre-existing conditions (pre-stroke, BTW) has exactly the same kind of policy (same coverage, same company) and pays nearly $700 a month.
Oh, and for those who may not know. When one goes onto Medicare 30 months after the qualifying event AND is under age 65, one pays at least $700 a month for medigap coverage. I kid you not! At age 65, that medigap coverage drops to the normal rate. And why is that? Pre-existing conditions apply up to age 65, of course.
I find it interesting that people will complain about paying $200 a month for health insurance but will pay the same for a family plan for cell phones or $350 a month for a car payment.
But a lot of us caught in the squeeze haven't done that!
I can't remember when Mr. AOW and I paid only $200/month for our share of employer-based health insurance.
At one point, we were paying $1400 a month for COBRA coverage. The plan was great, but unaffordable with Mr. AOW unemployed full time.
Indeed, Mr. AOW lost his job in January of 2008, in large part because the employer could no longer afford have many employees on the plan. The employer kept employees who had opted out, and nearly all of them had no health insurance whatsoever. Those same uninsured employees had no property or assets either. One got terminally ill and likely cost the hospital at least $50,000 as he was hospitalized over a month -- never paid, of course.
what else COULD the high rise in medical costs be but lawyers? I've seen ERs work on people for an hour whose vital signs were virtually GONE and who'd have been vegetables had they somehow succeeded in bringing them 'to', whatever that might have been. WHY?
I've lived in France and Germany and had fairly minor medical care there.......it's so inexpensive you want to giggle when they tell you what the bill is and that is NOT what we pay after subsidies..it's THE COST. And, in Germany, it's NOT FREE! My 40 year old stepdaughter pays about $1000 a month for her medical care!! I wish people knew that truth and would stop comparing 'mean ol' America' to "Germans don't pay for medical care" (RUBBISH)
Lawyers haven't dug in yet in Germany; common sense still prevails on this subject.
I travel a great deal for my work, preparing and attending a conference I co-Chair in Kuala Lumpur, within Europe to Brussels for at least two weeks every second month and to the US (DC and New York) at least once a year. I also have a practice in the Spanish enclave of Ceuta (off the coast of Morocco). Add to that close family that now live in Florida (Orlando) and eve more in Manchester (UK) and Madrid (Spain). The subject of Travel Insurance always is a topic, and it has to do with the medical componant in travel to the US.
Basically, though I will not give the figure for a number of reasons, the travel insurance for my travelling to the US is in fact EXACTLY the same amount for all the other trips (if you place one extra voyage a year to my brother in Orlando). That is right, three trips to the US a year (two by myself and one with my wife) in travel insurance is equal to three visits to Malaysia, five to Brussels, two to the UK, twice to Madrid and five times to Ceuta(which is rediculous considering I live in Gibraltar attached to Spain but yes I need to be covered). The main component of my policy and an entire chapter in my insurance providers' handbook is about the warning of the "excessive and potentially ruinous medical costs within the United States."
The biggest mistake any foreigner visiting the United States could be is getting ill enough to be hospitalized (or going to an "all you can eat" at "ribs house" in Orlando...... but that is another story.....eerp!)
Z, I've seen ERs work on people for an hour whose vital signs were virtually GONE and who'd have been vegetables had they somehow succeeded in bringing them 'to', whatever that might have been. WHY?
Thank you for making that point.
In 1986, my great aunt, about age 91 and who had lived in a nursing home for some 10 years (and before the days when DNRs were common), was resuscitated numerous times. And the emergency personnel didn't even know how long she had been dead! Her body was bruised and battered -- and her ribs broken. Medicare and/or Medicaid picked up the bill for these measures.
A friend of mine went through a similar horror with her father.
I don't want anyone to think I am okay with health care prices, I do think they are artificially inflated. This is largely due to drug companies, insurance companies, and lawyers. We are not getting rich in health care.
Z, I've seen ERs work on people for an hour whose vital signs were virtually GONE and who'd have been vegetables had they somehow succeeded in bringing them 'to', whatever that might have been. WHY?
This is a little complicated. My experience is that this is often a mixture of good intentions and lawsuits.
If someone comes into the ER without a clear cut "no code" status, no matter age, disease history, etc, they are automatically full code and so we do everything.
Part of this is because of lawsuits. There is a thought that we will get sued quicker for wrongful death than we will for wrongful life (saving someone who does not want to be saved). So we defer to resuscitation.
Also, there is the issue of it being our jobs to save lives. While we want a person to have their end of life decisions honored, in the absence of a clear directive we will default to saving them. We cannot, in good conscience, not save someone unless we know they do not want it.
We struggle with this often. We know we are sometimes doing very unpleasant things to people who do not have any decent quality of life left.
As to working for an hour, we won't typically do that in the ER I work in. At some point we do decide that the attempt is futile and begin thinking of what we are condemning the person to if we save them.
We welcome civil dialogue at Always on Watch. Comments that include any of the following are subject to deletion: 1. Any use of profanity or abusive language 2. Off topic comments and spam 3. Use of personal invective
Obama policies benefit "green" companies like GE pays no tax and Soldynara (get 535 million no strings attached,
ReplyDeleteObama policies benefit Insurance and Banks
and we are supposed to be Obamacare is good for us the consumer???
Only a democrat/liberal could believe such drviel
Blogginator,
ReplyDeleteAs you know, I'm not a supporter of ObamaCare.
But I did find the graphic and the animation interesting.
Are the figures accurate?
In my own experience, which may not be the norm, health-insurance costs lead to impoverishment -- unless one has a union or government job.
From this source:
ReplyDeleteForty-two percent of US doctors believe that their patients are getting too much medical care, according to a survey published Monday which suggests fears of malpractice suits may be to blame.
A total of 28 percent said they felt they were treating their patients too aggressively, while 45 percent said one of every 10 patients they saw daily had issues that could have been dealt with by phone, by email or by a nurse....
Not sure what the above means in terms of practicality.
Excellent illustration, AOW!
ReplyDeleteThe GOP should use this to argue against any government manipulation of markets, including under the guise of "jobs programs."
I have a bit of a different take AOW--
ReplyDeleteThe study was led by Brenda Sirovich and colleagues from the VA Outcomes Group in Vermont and the Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire.
SO the VA and a "Policy Group" think we are getting too much healthcare. I guess they would. Each cat Scan machine and MRI machine cost about $1 million and is out of date in about 5 years. then we have the cost of running it. We have the most amazing drugs now of which it costs about $1 Billion to develop each one. We are blessed to live in this time of access to amazing equipment that is used to keep our hearts ticking when in a hospital. We should be thankful we have all of this. Yes it cost money and that is why healthcare cost so much, I would rather spend our money on improving our quality and quantiy of life then sending Billions to those who hate us. I am alive today because of this very expensive drugs and tchnology.
Bunkerville,
ReplyDeleteI am alive today because of this very expensive drugs and tchnology.
I don't doubt you.
However, we can't deny the rise in health-insurance premiums. Mr. AOW pays nearly $700 month -- for what amounts to catastrophic coverage.
I have more than one friend whose monthly pay loses 50%-75% to his employee portion of the health-insurance premiums. In contrast, my cousin who works for the county pays $64 a month; we taxpayers are picking up the rest, of course.
Bunkerville,
ReplyDeleteSuggestion for you: research the Doha Declaration. I think I've got that name correct.
I come from a social security and health-care heavy nation, which we have had for a long time and we suffer for it. A great part of that is because of socialism and that somehow the State must pay for it (and of course control it) without thinking of how to raise such funds to do so AS WELL As the implications that result.
ReplyDeleteFrom what I see, the problem with health-care in general within the United States is down to two aspects. Insurance and legality.
Insurance - like over here on the Contenent (Europe), the power and the input by Insurance changes everything and no more so than in the US. The fear of not being insured, or the necessity of being insured, drives up costs and when the Insurance providers can they will milk the fees to levels that are simply extortion. I remember the days during my youth here on the Island and in Spain there were school and town carnivals and more public events - all dried up now because towns, schools and community groups cannot afford the horrible insurance cost to run the event.
The simple truth is that because of insurance, clinics, doctors, pharmacies and pharmacy suppliers pay such high fees that it drives up costs. The US has amongst the highest net cost of medical treatment in the word.
Legality - the US has suffered a three decades long "sue you" pandemic that is self-perpetuating. We in the global legal business feel a mix of constant dismay and some even jelousy of our American cousins simply because they have it made there. This self-created need to have a lawyer involved in everything or attach legal fees to everything also drives up prices.
Combined with Insurance it is a toxic mix that makes for a huge impact in costs such as in health care. You are required to have insurance, the fear of malpractice suits etc, etc, etc puts on what I am told is a 40 per cent hike on basic health care costs that you pay but most do not. We cannot afford health care as a nation because the government insists they must pay it, you cannot afford health care because you pay it and your being ripped-off as well!
Obama, like in economics, does not provide solutions but talk a lot instead, but I have to say your problem is not his creation at all, it actually falls on Nixon's watch and because Insurance and your legal world had too much power and money for any of the subsequent Presidents to do anything (or want to) about it.
Cheers
All those "unnecessary treatment" costs ($210b) in those graphs are because of "fear" of increased malpractice insurance costs.
ReplyDeleteOnly reforming the "legal" environment can help that, and the Trial Lawyers OWN the DNC.
..."while 45 percent said one of every 10 patients they saw daily had issues that could have been dealt with by phone, by email or by a nurse...."
ReplyDeleteYet, when I, without insurance, KNOW I have something as simple as a URI and need a few days worth of antibiotic, the doctor will not call in a prescription unless I pay for an office visit first; a waste of time for us both but CYA for him!
I've always said the health care costs are way higher than they need to be.
ReplyDeleteI once suggested a cap on health care, medical personnel salaries, drug prices, and all subsidiaries in the health care industry, but then, I realized that is socialistic.
I do believe, though, that the health care industry (all facets) should voluntarily regulate prices themselves. It isn't just waste that drives the costs up. It's also greed.
For example, why should a simple exam (Blood pressure, temperature, weight and height, etc) cost over $100.00? Most of the time, during a routine examination like this, the doctor isn't even involved.
Get rid of the frivolous suits brought against health care providers and watch cost come down.
ReplyDeleteAs Brooke said CYA and she is correct and who wouldn't. Doctors pay out the A** for malpractice insurance to cover folks who would ask for a prescription to be called in and then turn and sue the Dr and the pharmacy because it caused a rash or made them sicker. I've seen it happen!
I recently asked a doctor friend of mine why he ordered so many test for my wife. He said, if I don't order them I might miss something or could be accused of missing something and I would rather err on the side of over caution and if I don't order them I can be sued for millions of dollars. CYA, damn right and for good reason. He's a great doctor and I see him in a position of damned if I do and
damned if I don't.
1. Government mandates
ReplyDelete2. Insurance tied to employer
3. Duplication of medical equipment
4. Lack of competition
5. Frivolous lawsuits
Government interference in what should be a free-market is the problem...
Scary numbers, AOW. To Adrienne's list we could add FDA, Inability for insurance companies to sell across state lines, AMA, Patent law Protection for too many years, etc. If I had to point to the biggest blame I would point at lawyers.
ReplyDeleteI don't mind paying for a product or a service in healthcare. If charges were reasonable -- instead of, say, $100 charged to my wife for a cloth sling recently -- then I believe paying for care and visits should be charged.
ReplyDeleteI think what most people want is coverage for CATASTROPHIC care that can bankrupt a person or a family when a massive trauma occurs or a horrible disease descends.
People, for example, with many children should pay more for medical care than I do, with no children. Simple as that. But catastrophic care can level the playing field on anyone.
BZ
Just to clarify my earlier post, private Insurance costs are what they are because it is carrying Medicare and Medicaid patient costs. Add Malpractice and the inability for Insurance companies to go across state lines, and we have what we have. Last I looked, Health insurance companies were 86th in profitability. My intention was to cooment that we not throw the Insurance companies under the bus totally, and that the article was misleading and self serving.
ReplyDeleteAOW-- The Doha thing, I am not quite catching it:)))
Our Doctors pay $200,000 to $300,000 each year in malpractice costs. That is why your blood pressure visit costs $100.00. I have not had a raise in 3 years and am on mandatory time off each week. So please do not tell me how much money we all are making and that we need caps and are evil folks. sorry guys, you hit a nerve with me.
ReplyDeleteFrom today's Yahoo Finance News...
ReplyDeleteThe cost of employer-sponsored health insurance surged this year, snapping a trend toward moderate growth, but experts say these increases may slow again in 2012.
Annual premiums for family coverage climbed 9 percent and surpassed $15,000 for the first time, according to a report released Tuesday by the Kaiser Family Foundation and the Health Research and Educational Trust. Premiums for single coverage rose 8 percent compared to 2010.
That compares to increases last year of 3 and 5 percent for family and single coverage, respectively. The study shows that premiums for both family and single coverage have more than doubled since 2001, while worker wages have risen 34 percent.
Why does it rise 3x as fast? Because it can when "government" is shovelling money in, much as they have done with "higher education" loans. What's to stop it? Can the government ever "run out of money" like you and I can?
Excellent illustration and spot-on!
ReplyDeletePhysician's have to pay phenomenal malpractice fee's to protect themselves from greedy people who are out to make a quick buck.
At some offices, nowadays, they have forms that protect themselves from lawsuits. Prescription drugs now come with warning labels and have long lists of possible side-effects.
Doctor's will make mistakes, no one is perfect. And believe me there are a few unqualified physician's who deserve to be sued, but most of the time, it's by trial and error.
Bunkerville,
ReplyDeleteSo please do not tell me how much money we all are making and that we need caps and are evil folks.
I am not advocating caps!
Nor am I saying that we are evil folks.
As to health insurance companies and their profits, I'm not sure how unprofitable the companies are -- after discounting CEO bonuses and the like.
Earlier, you rightly pointed out the following:
Each cat Scan machine and MRI machine cost about $1 million and is out of date in about 5 years. then we have the cost of running it.
The availability of using those services are regulated to some extent according to the health-insurance coverage one has. For example, the federal employees whom I personally know get CT scans and MRIs with greater frequency than those of us with our private policies. I should have had an MRI following my car accident of 2005, but the employer-based HMO wouldn't authorize it; a federal employee's insurance would have immediately authorized that MRI. So, the end result for me was that I suffered more damage to my back -- damage done by inappropriate PT -- because the MRI was skipped for several months. I've also heard of many unnecessary insurance-paid MRIs being done so that machines would be paid for, but I can't confirm that information.
I had the following experience when I needed post-cataract laser surgery on my eye (not Lasix) back in 1986: The hospital quoted me the price of $1200 with insurance but $395 without insurance (self pay). My father's heath insurance (transit employees' insurance) paid the $1200, but I paid the $395. Somebody pocketed the difference, IMO.
The Doha thing I mentioned is evidence of the push toward the new world order, whereby health-care costs and services are more equalized worldwide (along the lines of Agenda 21). I'll see if I can find more information on that topic.
BZ,
ReplyDeleteI think what most people want is coverage for CATASTROPHIC care that can bankrupt a person or a family when a massive trauma occurs or a horrible disease descends.
The key is a policy with a maximum out of pocket. Many policies do not have that maximum, including Medicare and some HMOs. Open ended 80-20 or 90-10 coverages are recipes for medical bankruptcy for entire families!
It is getting more difficult to find catastrophic policies of the type available just five years ago.
Some commenters here have rightly pointed out that malpractice law suits and the premiums for doctors' malpractice insurance add a great deal to the cost of medical care for us the consumers. So do the costs of administrating health insurance in larger medical practices (group practices, hospitals, etc.).
ReplyDeleteJoe Conservative,
ReplyDeleteWhy does it rise 3x as fast? Because it can when "government" is shovelling money in...
True.
D Charles,
ReplyDeleteObama, like in economics, does not provide solutions but talk a lot instead, but I have to say your problem is not his creation at all, it actually falls on Nixon's watch...
Interesting that you should mention that!
Back in the days of the Nixon administration, we heard about how HMOs were going to "save us." Didn't work out that way at all -- particularly as the population has aged.
Indeed, we cannot discount what the waves of aging Baby Boomers are doing to healthcare costs.
I personally don't know of anyone who has "cleaned up" via a medical malpractice law suit.
Leticia,
ReplyDeleteAt some offices, nowadays, they have forms that protect themselves from lawsuits.
Also, many doctors will not testify in law suits of any kind; other doctors charge $5000-$10,000 per court appearance.
Quite the merry-go-round we've got going!
Ticker,
ReplyDeleteThank you for pointing out the following:
I recently asked a doctor friend of mine why he ordered so many test for my wife. He said, if I don't order them I might miss something or could be accused of missing something and I would rather err on the side of over caution and if I don't order them I can be sued for millions of dollars. CYA...
This also drives up the costs for all of us!
Speedy G,
ReplyDeletethe Trial Lawyers OWN the DNC...
And trial lawyers are very satisfied with ObamaCare, I think.
At Politico today:
ReplyDeleteHealth premiums now more than a new car
BZ, $100 charged to my wife for a cloth sling recently
ReplyDeleteThat is cost shifting. Obviously a sling does not cost a $100, although hospitals pay an inflated cost for supplies. A majority of the costs are for the no-pays.
Someone has to pay their bill. Should it be you and your wife, or me? Hell no.
Who pays it though? The no-pay patient will not because they have no money and, if they did, no is there to force them to pay.
We have to treat them when they come to the hospital due to federal laws and lawsuits.
So with the patient not paying, and the hospital being forced to treat them, we are left with two choices
-shift the cost to paying customers
-have the hospital eat the cost
With option two they will either eventually close or provide substandard care to everyone to offset the costs.
We pay their bill in the end one way or another.
Blame the insurance companies and the GOP for insisting they still be a part of the Health Care Reform bill you all call "Obamcare.' It should be called 'teabaggercare.'
ReplyDeleteOne suggestion was for a cap on medical personnel salaries.
ReplyDeleteThis is always the answer to cutting costs in health care.
Ultimately it winds up being the nurses who get cut.
I went to school for 4 years to get my degree and become a Registered Nurse. I spend a lot of time (sometimes whole days), without pay, re-educating myself to keep up to date on care practices. I can say with all honesty, with no arrogance or hubris, that I have saved many lives in my career.
Why shouldn't I make a living doing what I am doing? I am not getting rich, trust me but this is also not charity work for me. I am a professional and I expect to get paid for my services.
Sorry AOW, this went to the heart of what I believe. I promise I will go away after this ;)
ReplyDeleteI come at this from a different view point. While I find everyone's take on this fascinating, I think the graphic is a little misleading.
I don't dispute the validity of their numbers, it is likely fairly accurate.
The problem with it is quite simple, none of the mentioned products have been improved very much since 1945.
Health care is a completely different product from what it was in 1945.
Since 1945:
-Antibiotics became widely used
-Childhood immunizations were developed
-Ultrasound, MRI, CT, PET scan all detect new diseases and help with the early detection of cancer
-Lasers were developed
-We can operate on a fetus in-utero and save a baby's life
-Microsurgery was developed to reduce pain and hasten recovery
-Transplants took leaps and bounds
-Dialysis was put into common practice
-DNA was discovered, leading to a whole new area of medicine.
I find it interesting that people will complain about paying $200 a month for health insurance but will pay the same for a family plan for cell phones or $350 a month for a car payment.
Don't get me wrong, I think we need to do a lot to cut the costs of health care and believe we could without sacrificing care but we do need to have a little perspective. We have one of the most technologically advanced health care systems in the world. We are a world leader in it. It's not cheap.
Chuck, I think your comments are spot on. My belief (and thus my own comments) point to the two issues of insurance and legality. Insurance is big business and profit making and legality is altered to support insurance - and of course the very unique American capacity to bring to court anything and everything.
ReplyDeleteThe other issue that some could bring is the concept of business and profit. I understand pharmacutical companies and equipment producers turning a profit but the question is should hospitals and clinics be run as services (making enough profits and looking for sponsors) or profit making businesses like any other and thus hiking prices to increase margines?
Cheers
I'm echoing D Charles' sentiments here. A litigious American society is literally eating its own flesh. Chuck is right too, the health field is not what it was in 1945. But I also can't help but think that the insurance industry and to an even larger degree, federal government, have been responsible for significant artificial inflation in health care costs.
ReplyDeleteWe've been living a medical nightmare for 21 years. Mr. Longrange and I live to pay doctors, medication, hospitalizations and insurance. The only extras we have is our very old computers and basic cable tv. We've had no vacations and drive old vehicles.
ReplyDeleteSo Mr. Longrange works 3 jobs. We are totally against Obama care. I don't know what the answers are. I do know illegal aliens get free care and drug es.
Chuck,
ReplyDeleteI haven't read all comments yet, but noticed the following from you: I promise I will go away after this ;)
Don't abandon this thread!
You are making valid points.
I posted on this topic because I believe that we are headed for a train wreck with regard to medical care.
More and more people are, of necessity, abandoning health insurance, largely because of the cost of the premiums. Unemployed individuals have made the hard choice: Do I keep my house (or pay the rent), or do I keep my health insurance? Obviously, one has to do everything to keep a roof over one's head.
So, if people continue to abandon health insurance, the circle becomes vicious: less business for the health insurance companies, resulting in higher premiums for those who carry health insurance AND more unpaid bills for providers of all types (hospitals, clinics, doctors, etc.).
In my view, ObamaCare is going to kill the health insurance industry.
ReplyDeleteThe health insurance companies willingly entered into the bargain with Obama. They're going to have a reality check because when employers drop employer-based insurance, many will not be able to afford coverage.
We all hear about how ObamaCare will provide coverage for pre-existing conditions. Scam alert! Pre-existing conditions hike premiums to the moon! For example, I pay $269 a month for my catastrophic coverage policy (high deductible, no prescription coverage); Mr. AOW, because of pre-existing conditions (pre-stroke, BTW) has exactly the same kind of policy (same coverage, same company) and pays nearly $700 a month.
Oh, and for those who may not know. When one goes onto Medicare 30 months after the qualifying event AND is under age 65, one pays at least $700 a month for medigap coverage. I kid you not! At age 65, that medigap coverage drops to the normal rate. And why is that? Pre-existing conditions apply up to age 65, of course.
Chuck makes an interesting point:
ReplyDeleteI find it interesting that people will complain about paying $200 a month for health insurance but will pay the same for a family plan for cell phones or $350 a month for a car payment.
But a lot of us caught in the squeeze haven't done that!
I can't remember when Mr. AOW and I paid only $200/month for our share of employer-based health insurance.
At one point, we were paying $1400 a month for COBRA coverage. The plan was great, but unaffordable with Mr. AOW unemployed full time.
Indeed, Mr. AOW lost his job in January of 2008, in large part because the employer could no longer afford have many employees on the plan. The employer kept employees who had opted out, and nearly all of them had no health insurance whatsoever. Those same uninsured employees had no property or assets either. One got terminally ill and likely cost the hospital at least $50,000 as he was hospitalized over a month -- never paid, of course.
what else COULD the high rise in medical costs be but lawyers?
ReplyDeleteI've seen ERs work on people for an hour whose vital signs were virtually GONE and who'd have been vegetables had they somehow succeeded in bringing them 'to', whatever that might have been. WHY?
I've lived in France and Germany and had fairly minor medical care there.......it's so inexpensive you want to giggle when they tell you what the bill is and that is NOT what we pay after subsidies..it's THE COST.
And, in Germany, it's NOT FREE! My 40 year old stepdaughter pays about $1000 a month for her medical care!! I wish people knew that truth and would stop comparing 'mean ol' America' to "Germans don't pay for medical care" (RUBBISH)
Lawyers haven't dug in yet in Germany; common sense still prevails on this subject.
I travel a great deal for my work, preparing and attending a conference I co-Chair in Kuala Lumpur, within Europe to Brussels for at least two weeks every second month and to the US (DC and New York) at least once a year. I also have a practice in the Spanish enclave of Ceuta (off the coast of Morocco). Add to that close family that now live in Florida (Orlando) and eve more in Manchester (UK) and Madrid (Spain). The subject of Travel Insurance always is a topic, and it has to do with the medical componant in travel to the US.
ReplyDeleteBasically, though I will not give the figure for a number of reasons, the travel insurance for my travelling to the US is in fact EXACTLY the same amount for all the other trips (if you place one extra voyage a year to my brother in Orlando). That is right, three trips to the US a year (two by myself and one with my wife) in travel insurance is equal to three visits to Malaysia, five to Brussels, two to the UK, twice to Madrid and five times to Ceuta(which is rediculous considering I live in Gibraltar attached to Spain but yes I need to be covered). The main component of my policy and an entire chapter in my insurance providers' handbook is about the warning of the "excessive and potentially ruinous medical costs within the United States."
The biggest mistake any foreigner visiting the United States could be is getting ill enough to be hospitalized (or going to an "all you can eat" at "ribs house" in Orlando...... but that is another story.....eerp!)
Z,
ReplyDeleteI've seen ERs work on people for an hour whose vital signs were virtually GONE and who'd have been vegetables had they somehow succeeded in bringing them 'to', whatever that might have been. WHY?
Thank you for making that point.
In 1986, my great aunt, about age 91 and who had lived in a nursing home for some 10 years (and before the days when DNRs were common), was resuscitated numerous times. And the emergency personnel didn't even know how long she had been dead! Her body was bruised and battered -- and her ribs broken. Medicare and/or Medicaid picked up the bill for these measures.
A friend of mine went through a similar horror with her father.
It ought to scare the tripe out of anyone who thinks government intervention is the way to go but it doesn't.
ReplyDeleteI don't want anyone to think I am okay with health care prices, I do think they are artificially inflated. This is largely due to drug companies, insurance companies, and lawyers. We are not getting rich in health care.
ReplyDeleteZ, I've seen ERs work on people for an hour whose vital signs were virtually GONE and who'd have been vegetables had they somehow succeeded in bringing them 'to', whatever that might have been. WHY?
ReplyDeleteThis is a little complicated. My experience is that this is often a mixture of good intentions and lawsuits.
If someone comes into the ER without a clear cut "no code" status, no matter age, disease history, etc, they are automatically full code and so we do everything.
Part of this is because of lawsuits. There is a thought that we will get sued quicker for wrongful death than we will for wrongful life (saving someone who does not want to be saved). So we defer to resuscitation.
Also, there is the issue of it being our jobs to save lives. While we want a person to have their end of life decisions honored, in the absence of a clear directive we will default to saving them. We cannot, in good conscience, not save someone unless we know they do not want it.
We struggle with this often. We know we are sometimes doing very unpleasant things to people who do not have any decent quality of life left.
As to working for an hour, we won't typically do that in the ER I work in. At some point we do decide that the attempt is futile and begin thinking of what we are condemning the person to if we save them.