Bitter Pill: Why Medical Bills Are Killing Us

Discussion in 'Politics' started by ElectricFetus, Feb 22, 2013.

  1. ElectricFetus Sanity going, going, gone Valued Senior Member

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    http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/

    Steven Brill came out with an article (title above) in Time Magazine describing in horrible details the fundamental problems of US healthcare: that its ridiculously overpriced for no other reason then to provide orgasmic profits for owners of hospitals and insurance companies. Steven provided a neat metaphorical explanation of the problem in a daily show interview yesterday

    http://www.thedailyshow.com/watch/t...usive---steven-brill-extended-interview-pt--1

    Were he compares buying shoes to buying medical care: in the former you have a choice to buy the shoe and time to shop around to find the cheapest vendor, if the shoe is crap no worries. In the latter case your dying and have no choice in what you buy or time to shop around, as a results the medical industry LOOTS YOU FOR EVERY LAST PENNY BECAUSE THEY CAN! Worse the quality of our medical care is at best at par with many other developed nations yet they pay A FRACTION of what we pay!

    In the end Steven Brill and John Stewart describe Obamacare as merely trimming the problem from the edges, and thus suggesting we need to rework not simple the insurance industry but our hospitals and care providing companies.
     
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  3. Nasor Valued Senior Member

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    One issue that Brill didn't mention in his article is that it's often basically impossible for healthcare consumers to make an informed choice, since you probably can't know, for example, if the $3k test that the doctor just said he wants to run is realy necessary, or if it's just profit padding/lawsuit protection. Capitalism can't work when consumers are unable to know the value of what they are buying.
     
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  5. arauca Banned Banned

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    Please add to rework the legal system . We need a ceiling on law suits, that will reduce the insurance policy for the doctors and hospitals. Lawyers are the biggest bandits who are making the health system expensive
     
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  7. ElectricFetus Sanity going, going, gone Valued Senior Member

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    Sure is guess they are a money drain, but how much, can you cite them as in fact the "biggest money drain"?

    Here are claims otherwise:
    http://prescriptions.blogs.nytimes.com/2009/08/31/would-tort-reform-lower-health-care-costs/
    http://www.bloomberg.com/apps/news?pid=newsarchive&sid=az9qxQZNmf0o

    "annual jury awards and legal settlements involving doctors amounts to “a drop in the bucket” in a country that spends $2.3 trillion annually on health care, said Amitabh Chandra, a Harvard University economist. Chandra estimated the cost at $12 per person in the U.S., or about $3.6 billion, in a 2005 study. Insurer WellPoint Inc. said last month that liability wasn’t driving premiums."

    The cause of the problem is the free market, or rather the lack of it as it simply cannot exist in the healthcare industry. The "customer" can't choose where he wants to go for say his heart attack, he can't choose who transports him, what procedures are done on him, where he stays, and longer term care afterward, the medical industry knows this and thus they can put what ever price they want at the end of the bill! For any illness or even check up the choice is either exorbitant prices or death, they know that most people will choose to pay what ever they need to live, and are profiting off that fact gloriously.
     
  8. Nasor Valued Senior Member

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    Brill makes a pretty good case in his article for why tort reform should be part of the solution (and how the Democrats caved to special interests to prevent it). But it's certainly NOT the case that most of our cost problems are caused by torts. They are part of the problem, yes. But certain groups (Republicans) like to pretend that they're the only issue worth paying attention to, mostly to ddeflect focus from the more serious issue; like the fundamantal fact that healthcare probably cannot be an efficient free market.
     
  9. joepistole Deacon Blues Valued Senior Member

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    Oh? I must have missed it. Perhaps you can show me where Brill makes the case for healthcare tort reform? The notion that healthcare torts are a significant problem in the US healthcare system is simply a Republican created and promulgated myth to distract and protect healthcare special interests and attack tort lawyers which have been big financial sponsors of Democratic causes.

    Brill mentioned that tort caps are already in place in many states and they have been in place for many years. There are two parts of a tort settlement, actual damages and pain and suffering. As Brill noted, many states have caps in place on “pain and suffering”, caps that have been in place for decades and if anything are probably too low as they have not been raised to adjust for inflation. The largest share of a tort damage claim is the actual damage caused to the plantif. If malpractice causes the patient to incur hundreds of thousands in future healthcare costs, that damage is driven by the actual cost of healthcare. Are you suggesting that physicians who are guilty of malpractice not pay for the damage they inflict on their patients?

    In any case as Brill said, medical torts are a hair on the end of the tail of the US healthcare dog. And that is the truth of the matter.
     
  10. Nasor Valued Senior Member

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    That would be paragraphs 2-5 of part 2; "Medical Technology's Perverse Economics" and paragraph 9 of the "changing our choices" sections.
     
  11. joepistole Deacon Blues Valued Senior Member

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    Something that can be verified?

    Please Register or Log in to view the hidden image!

     
  12. arauca Banned Banned

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    There are many tests the doctors order which are not necessary , but yet they order them for in case there is a lawsuit . I went for a stomach problem and they sent me for MRI ant that MRI was over $ 4ooo.0 were my bill for 7 hours in the clinic was over $8300.00.
     
  13. Asguard Kiss my dark side Valued Senior Member

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    to those who simply say "cap lawsuits" what's your partners life worth? what's your life worth to your partner and children?

    What if you are permanently disabled and unable to work again, what's that going to cost you for the rest of your life and you family

    The better option is UNIVERSAL HEALTH CARE. No doctor orders tests for us to just make money because they don't make money, they get paid the same by Medicare and if they DO rote Medicare they get charged and go to jail
     
  14. joepistole Deacon Blues Valued Senior Member

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    What makes you think the MRI was unnecessary? And if it was unnecessary, why do you think they ordered it to prevent a law suit? You do know that in the eyes of the law in order to be found liable, a physician or anyone else for that matter, must be proven to have not exercised due diligence. If due diligence was exercised, the physician is not liable for malpractice. Assuming the procedure was medically unnecessary, how do you know that the procedure was not ordered to increase physician or hospital income?

    http://californiawatch.org/health-and-welfare/chain-profits-admitting-er-patients-11561


    http://www.cbsnews.com/video/watch/?id=50136261n

    I will give you a personal experience. I have very good insurance. My problem is not too few medical procedures but too many unneeded procedures and not because of law suit threats. My blood needs to be tested every month for clotting time. There are two tests that can do this, one is a simple pin prick with almost instantaneous results . . . similar to a diabetic testing his/her glucose level. . . and the other is a venous stick and lab work and obviously much more expensive. I have had some doctors who choose the pin prick, but far more, especially if they are in major practice with a lot of overhead, like the venous stick test. One physician offered the finger prick test, but he requires a physician office visit every time, which is really unneeded. The test results are the same. So why is it most physicians prefer the more expensive procedure? The difference is the venous stick and lab work approach provides the physician with much more income.

    Hospital chains have been found to require unnecessary medical procedures, not for patients, not for some sort of amorphous legal protection, but to drive revenue and profit. So while lawyers provide a nice scape goat and are easy to hate, they are not the problem with our very expensive healthcare system.

    http://www.nytimes.com/2012/12/01/b...r-doctors-nationwide.html?pagewanted=all&_r=0
     
  15. kwhilborn Banned Banned

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    Medical bill? What's a medical bill?

    One thing I dislike about free health care is that people will attend a physician for absolutely no reason. Even a mild headache may bring people to the Doctors office in Canada.

    Now I feel that Doctors should charge per visit based on your earnings. Perhaps one hours wages for every visit. If you make $10/hour then you pay $10 for a visit. If you make $35/hour then you pay $35 for a visit. If you make $170/hour that's what you pay. A Bill Gates would spend Thousands of dollars on a single visit. These rates would be calculated when you get your health card renewed and obviously unemployment would negate the charge.

    This would drastically cut down on wasted visits, and free up doctors for more important issues.

    If you think 1 hours pay is too extreme then lower it to half an hours pay.

    Have Doctors be allowed to give free passes so if the person has a condition that needs follow up appointments such as Diabetes or blood tests they don't go broke.

    This is only a concept idea that would need pruning, but the amount of waste is staggering. Some people go to the Doctors just to get out of the house.

    There was a $5 fee that was proposed by politicians here years ago, but then people said it targeted the poor so it would need to be based on individual incomes.

    NOTE: This would cut down on Doctors visits by about 35% in my guesswork, and would stop a LOT of bills to healthcare (Canada) or Insurance Companies (America). It would likely hurt the entire health care industary as far as profits are concerned, but it might allow some of us to save an extra $100 week in healthcare we are sponsoring. This would curb any Doctor shortages. Technology is also curbing Doctor shortages and there could be automated Doctors for free where questioned are asked and answered by a diagnostic terminal capable of ordering bloodwork etc.
     
  16. Read-Only Valued Senior Member

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    There are some important things that are being completely overlooked in this thread - and it's so obvious to me that it makes some of the posters AND Steven Brill look downright silly! Despite the claims to the contrary, there is MUCH competition between local hospitals. And the only reason there isn't any between doctors is because there is a shortage of doctors in the U.S.

    One major problem today is that Americans in general have lost (or never bother to think about) the ability to plan ahead! Every single one of us could have an accident at any time and as we grow older we ALL face an increasing chance of needing hospitalization - those are just simple, basic facts of life. But how many of you actually bother to prepare for them???

    Wherever I live (and I used to move frequently) I've always made it a point to shop fro a hospital, and do it no differently than shopping for a car. There are websites available that will rank hospitals for you (sorry, don't have any links handy, haven't needed them for a long time) and I always talked to new friends and neighbors when I moved. It just plain common sense to plan ahead - but few seem to do it on this particular issue.

    So if you wind up getting stuck in hospital not of your choosing, guess what? It's no one's fault but your own. <shrug> (The single exception is if you are a long way from home for some reason.)
     
  17. kwhilborn Banned Banned

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    An Add-on to Read Only comment.

    My Mother swears owning a home in the city saved her life. She has been 20 years without cancer, but back when she was first diagnosed with Breast cancer it was her families doctor association with the hospital that got her into surgery and treatment very quickly. People in outlying towns would be put on a waiting list.

    City Doctors often take shifts at the local hospitals and are "connected"

    My Parents owned several homes at that time and although the country home was meant to be the retirement haven, they opted for the city in the end for that reasoning plus public transport might be easier.

    It is odd to think where you live could affect your quality of medical service.
     
  18. joepistole Deacon Blues Valued Senior Member

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    Competition between hospitals, yes I am sure there is competition between hospitals. But they don’t compete on price or quality. They compete in marketing and public relations and in lobbying government officials. Because that is where the money is and increasingly hospitals and clinics are being bought out by large healthcare chains. I live in a big metropolitan area and there are many hospitals but they are owned by only 3 different entities.

    I don’t think that is something that has been lost. It never existed, just look at how many seniors who are entirely dependent on Social Security.

    Should you need emergency services, I think you might be surprised with your lack of choice. Most areas have designated hospitals for certain kinds of problems. For example, if you are injured in a car accident, you will be taken to the designated trauma center regardless of what you may want. A couple of years ago I called EMS for my aunt, she had fallen. I requested they take her to her favorite hospital. But they informed me that was against their protocol. Trauma victims had to go to a specific hospital and coincidentally, that was the hospital she absolutely hated.
     
  19. ElectricFetus Sanity going, going, gone Valued Senior Member

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    Its also quite possible they sent you in for that tested just to get you to have the pay for it!
     
  20. Asguard Kiss my dark side Valued Senior Member

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    anyone want to put money on how long before Michael jumps in to this thread with "its all governments fault, if it wasn't for government it would be all rosy"?
     
  21. Read-Only Valued Senior Member

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    I've no idea what the prevailing conditions are in your area except from what you've said. But that's NOT the case here in the deep Southeast. While certain hospitals certainly do specialize in certain things - burn units, for example - we are completely free to use the one of our choice. Even when it's NOT their specialty.
     
  22. Asguard Kiss my dark side Valued Senior Member

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    And how do you chose when your unconscious?
     
  23. joepistole Deacon Blues Valued Senior Member

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    While going through college I used to work for the EMS system in Oakland, Ca. In the mid 80’s they implemented the trauma center model. And I think it is in place in most areas. I know it’s in place in Kansas, California and Ohio. And I am pretty sure; it’s fully implemented in every state. Patients are routed to hospitals based on condition and need, not on personal preference.

    You can go to whichever hospital you want and will except you for nonemergency care in any state. But if you need emergency care and use the Emergency Medical System, you go where there protocols tell them to go.

    “Medical control

    EMS providers work under the authority and indirect supervision of a medical director, or board-certified physician who oversees the policies and protocols of a particular EMS system or organization.[26] Both the medical director and the actions he or she undertakes are often referred to as "Medical Control".

    Equipment and procedures are necessarily limited in the pre-hospital environment, and EMS professionals are trained to follow a formal and carefully designed decision tree (more commonly referred to as a "protocol") which has been approved by Medical Control. This protocol helps ensure a consistent approach to the most common types of emergencies the EMS professional may encounter. Medical Control may take place on-line, with the EMS personnel having to contact the physician for direction delegation for all Advanced Life Support (ALS) procedures, or off-line, with EMS personnel performing some or all of their ALS procedures on the basis of protocols or 'standing orders'. The NHTSA curriculum remains the Standard of Care for EMS organizations in the US.” - Wikipedia
     

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