Great Time article on the cost of healthcare in the US

Attic

Diamond Member
Jan 9, 2010
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http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/

The hidden chargemaster that screws us all - things like $77 charges for a gauze pad that costs 5 cents and all that kind of crap. Highly recommended reading.

Medicare getting screwed on drug prices, uninsured patients really getting screwed on everything, "Obamacare" not being a great fix since it didn't really address pricing...

My last visit I saw a charge for $54 for a Tylenol. The overall visit for an EKG and an hour on a bed was 9k.

Fixing that might be difficult, but first step is to acknowledge it as the biggest problem with American healthcare. Adding a bunch of new subscribers should be a benefit of fixing healthcare, not the solution itself.
 

Ryan

Lifer
Oct 31, 2000
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I am about to have a tonsillectomy and have a deviated septum fixed:

To literally open my mouth and say "ahh" so that the doctor could confirm that I indeed have big tonsils = $180. A 2 minute exam to put a scope in my nose to tell me I have a deviated septum = $293. 10 minute office visit = $160.

$633 for no more than 10 minutes of "work". I am terrified to find out how much the surgery is actually going to cost.
 

Engineer

Elite Member
Oct 9, 1999
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Went to a neurologist for a persistent headache just over a month ago. Went to TWO separate check in windows (one to check in and pay and the other to fill out the paperwork and history, etc). Spent 30 minutes or so with the doctor. The cost billed to insurance was just over $600. Insurance adjusted it down to $350 (just over $10 per minute of service).

Was completely floored at the charge.....
 

Screech

Golden Member
Oct 20, 2004
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It's a great article. It really goes to show that when we discuss healthcare issues in this country the real issues with healthcare are almost never discussed; the discussion always becomes one of "how can we cover more people" and not "why is it so expensive."

There's some real gems in there like where the hospital spokesperson tries to explain that the chargemaster makes sure everyone pays the same by not making everyone pay the same. If you have the time, seriously, read the article.
 
Dec 10, 2005
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It's a great article. It really goes to show that when we discuss healthcare issues in this country the real issues with healthcare are almost never discussed; the discussion always becomes one of "how can we cover more people" and not "why is it so expensive."

What I found even better was how Medicare, despite being hamstrung by being forced to pay obscene rates for drugs, pays what seems to be fair prices for most hospital procedures. Hospitals (especially all those 'nonprofits') gripe about how little it pays (but it covers their real costs and the little overhead), but I don't see them turning away Medicare patients.
 

mizzou

Diamond Member
Jan 2, 2008
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I want our doctors/nurses etc. to be paid extremely well, I hope that doesn't change. What I do not like is the wallets of health care industry workers growing.

Maybe turn the entire healthcare industry into a non-profit system and don't let the public be able to invest and turn a profit off of it :\
 
Dec 10, 2005
26,513
10,230
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I want our doctors/nurses etc. to be paid extremely well, I hope that doesn't change. What I do not like is the wallets of health care industry workers growing.

Maybe turn the entire healthcare industry into a non-profit system and don't let the public be able to invest and turn a profit off of it :\

The article actually mentions how many 'non-profit' hospitals make substantial amounts of money and that they actually make more money than for-profit hospitals in many cases.
 

mizzou

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Jan 2, 2008
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The article actually mentions how many 'non-profit' hospitals make substantial amounts of money and that they actually make more money than for-profit hospitals in many cases.

I feel it's damaging in the long run for companies that produce medicine, to have a centralized interest in returning profit to investors.

It just doesn't sound like a healthy relationship.

But yeah, "non profit" doesn't exactly have a good track record :D
 

unokitty

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Jan 5, 2012
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On health care, US spends over 2 and a half times the OCED average. Yet:

There are fewer physicians per person than in most other OECD countries. In 2010, for instance, the U.S. had 2.4 practicing physicians per 1,000 people -- well below below the OECD average of 3.1.

The number of hospital beds in the U.S. was 2.6 per 1,000 population in 2009, lower than the OECD average of 3.4 beds.

Life expectancy at birth increased by almost nine years between 1960 and 2010, but that's less than the increase of over 15 years in Japan and over 11 years on average in OECD countries. The average American now lives 78.7 years in 2010, more than one year below the average of 79.8 years.

--NPR

None of the above issues are addressed by Obamacare.

The situation is not good. And its not getting better.

Uno
 

Franz316

Golden Member
Sep 12, 2000
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The American healthcare industry is pretty laughable. It makes up almost 20% of the GDP too. Obamacare is pretty fail too, the only good things it does is with preexisting conditions and annual maximum. The rest does absolutely nothing to reduce costs. Actually they may go higher.

I wouldn't consider universal healthcare to be a right, but it is something that I would associate with a society that considers itself 'advanced.' I find something fundamentally wrong when people are forced to forgo medical care, with their own well being in the balance, because of the cost. The cost is high not because there is a true shortage, but because of greed.
 

HeXen

Diamond Member
Dec 13, 2009
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I saw my bill mention $17 for a syringe. Last time i asked the nurse if i could go to Walgreens and supply my own syringes and that they are getting ripped off if they have to charge me that much. I guess she didn't see my humor.
 

fuzzybabybunny

Moderator<br>Digital & Video Cameras
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Jan 2, 2006
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I was charged $80 for a fleece blanket that I didn't even get to keep.

Over $100 easily for a styrofoam neck brace.

Our healthcare sucks.
 

DucatiMonster696

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Aug 13, 2009
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I want our doctors/nurses etc. to be paid extremely well, I hope that doesn't change. What I do not like is the wallets of health care industry workers growing.

Maybe turn the entire healthcare industry into a non-profit system and don't let the public be able to invest and turn a profit off of it :\

1.) Everyone who is sick or injured receives healthcare when they visit a hospital no matter what the reason.

2.) The issue at hand has to do with the cost especially when associated with health insurance which is at the heart of the debate.

Furthermore the real issue has nothing to do with profits and everything to do with again the costs faced by the industry. No matter what sort of price cap is imposed on the providing of healthcare the economic costs inherent in the industry will make themselves felt in one form or another and the development of expensive new equipment, drugs, medical procedures, etc will steadily decline in quantity and quality if we resort to removing profit from the picture as we would not be dealing with the actual issues which cause the costs of healthcare to rise versus decline and thus lead to the symptomatic issue of high prices.
 
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Screech

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Oct 20, 2004
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as we would not be dealing with the issues which cause the costs of healthcare to rise versus decline.

Honest question: what do you think these factors are, and how might we approach them (if we intend to do so)? Because a blanket simply isn't $80, and a test strip isn't $18.
 

DucatiMonster696

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Aug 13, 2009
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Honest question: what do you think these factors are, and how might we approach them (if we intend to do so)?

Lawsuits and the fear of them which cause healthcare providers to issue out unnecessary procedures, government regulations, mandates and subsidies (especially our drug subsides to nations outside of the US who pay below cost prices for drugs developed in the US) all of which drive up costs and in many cases prevent competition in the industry from occurring, etc to name a few.
 
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nanette1985

Diamond Member
Oct 12, 2005
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Like a lot of members here I have some disgusting medical billing stories.

Interesting article. I wondered how long it would take to find it here at P&N

One problem he didn't mention is that our medical community only fixes problems in the most expensive way.

Also, there is no way to find out how much your procedure will be before you commit to it - and there's no way to find out how much of that will be covered by your insurance.
 

Screech

Golden Member
Oct 20, 2004
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Lawsuits and the fear of them which cause healthcare providers to issue out unnecessary producers, government regulations, mandates and subsidies (especially our drug subsides to nations outside of the US who pay below cost prices for drugs developed in the US) all of which drive up costs and in many cases prevent competition in the industry from occurring, etc to name a few.

I agree that tort reform is needed -- this is something the democrats have been f*cking up as the article notes. However, regarding the rest, why is it that medicare can get "cheap" but effective medicine -- (well, apart from cheap drugs because we decided that was bad) -- while the rest of us get lucky or screwed depending on insurance? If you think this is an issue of excessive mandates and regulation, if we simply remove said mandates/regulations, would this make our healthcare cheaper or close to on par with other countries?

I think that generally providers should be looking for cheaper drugs as long as copyright infringement is not taking place. Then, medicare could get reasonably priced drugs, and the competition might make the producers actually have to sell at a reasonable price (with less subsidizing other countries). However, we would have to protect reasonable patent laws rather strictly IMHO, or said producers would be boned by generics.
 

Fenixgoon

Lifer
Jun 30, 2003
32,639
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I saw my bill mention $17 for a syringe. Last time i asked the nurse if i could go to Walgreens and supply my own syringes and that they are getting ripped off if they have to charge me that much. I guess she didn't see my humor.

product qualification and sterilization. There is an absolutely HUGE cost associated with ensuring products are clean due to FDA regulations. Im not saying this is bad. Its merely why your syringe is $17 - its guaranteed to be free of germs (likely went through an autoclave)
 

Screech

Golden Member
Oct 20, 2004
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product qualification and sterilization. There is an absolutely HUGE cost associated with ensuring products are clean due to FDA regulations. Im not saying this is bad. Its merely why your syringe is $17 - its guaranteed to be free of germs (likely went through an autoclave)

Even if that is true for the case of the syringe, for a test strip for a blood glucose meter, you don't autoclave that.....you take it out of the bottle and use it. It should never, ever, be $18. And that is only one example of absurd prices on that list with absolutely no justification whatsoever.
 
Dec 10, 2005
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product qualification and sterilization. There is an absolutely HUGE cost associated with ensuring products are clean due to FDA regulations. Im not saying this is bad. Its merely why your syringe is $17 - its guaranteed to be free of germs (likely went through an autoclave)

Half of those items should be covered under the hospital service charge though instead of being individually itemized. And then Medicare manages to pay far less for that, yet hospitals aren't turning those patients away - they must still be making enough to cover their costs. Medicare isn't out to rip hospitals off - just pay them what their actual costs were plus a little extra for overhead.

From the article, it seems that hospitals are using their chargelists to pressure insurance companies to pay out more and to squeeze the under-insured.

For laboratory use, where we require sterile equipment, we can get a box of sterile syringes for under $17. No reason that it should cost that much for a single one.
 

DucatiMonster696

Diamond Member
Aug 13, 2009
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I agree that tort reform is needed -- this is something the democrats have been f*cking up as the article notes. However, regarding the rest, why is it that medicare can get "cheap" but effective medicine -- (well, apart from cheap drugs because we decided that was bad) -- while the rest of us get lucky or screwed depending on insurance? If you think this is an issue of excessive mandates and regulation, if we simply remove said mandates/regulations, would this make our healthcare cheaper or close to on par with other countries?

Yes it is in part a problem of excessive mandates and regulations which are lobbied for partly by the industry itself as a stop gap to prevent lawsuits and ensure that competitors are stifled or kept out of the market hence the article's mention of the army of lobbyists which are sent to D.C., state and local governments to ensure that any regulation crafted has their hand in it.

I think that generally providers should be looking for cheaper drugs as long as copyright infringement is not taking place. Then, medicare could get reasonably priced drugs, and the competition might make the producers actually have to sell at a reasonable price (with less subsidizing other countries). However, we would have to protect reasonable patent laws rather strictly IMHO, or said producers would be boned by generics.


That is not going to occur so long as we keep subsidizing the rest of the world with cheap drugs. The cost of our pharmaceuticals is directly related to our policy to ensure that everyone overseas has access to US drugs at affordable price.
 

Darwin333

Lifer
Dec 11, 2006
19,946
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http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/

The hidden chargemaster that screws us all - things like $77 charges for a gauze pad that costs 5 cents and all that kind of crap. Highly recommended reading.

Medicare getting screwed on drug prices, uninsured patients really getting screwed on everything, "Obamacare" not being a great fix since it didn't really address pricing...

Its called "cost shifting" and is illegal in just about every other industry except for the medical industry. Why is it legal, because we passed laws stating they must treat people who can not pay without compensating them. There are many other reasons and forms of cost shifting in the medical industry but that is why prices vary so insanely and some minor crap is absurdly expensive.
 

soundforbjt

Lifer
Feb 15, 2002
17,788
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On health care, US spends over 2 and a half times the OCED average. Yet:

There are fewer physicians per person than in most other OECD countries. In 2010, for instance, the U.S. had 2.4 practicing physicians per 1,000 people -- well below below the OECD average of 3.1.

The number of hospital beds in the U.S. was 2.6 per 1,000 population in 2009, lower than the OECD average of 3.4 beds.

Life expectancy at birth increased by almost nine years between 1960 and 2010, but that's less than the increase of over 15 years in Japan and over 11 years on average in OECD countries. The average American now lives 78.7 years in 2010, more than one year below the average of 79.8 years.

--NPR

None of the above issues are addressed by Obamacare.

The situation is not good. And its not getting better.

Uno

Blame the amount of doctors where the blame belongs, the AMA.
 

Hayabusa Rider

Admin Emeritus & Elite Member
Jan 26, 2000
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Well at least someone is asking questions. One day maybe we'll have informed people handling this. Nothing like that now. Baby steps