Health Care - So What's Wrong With US having the Highest Costs? Or Should We Narrow O

[nobodyknows]

Title is supposed to be: Health Care - So What's Wrong With US having the Highest Costs? Or Should We Narrow Our Focus in HC Reform?



What do you think?

Fern

Why don't we just farm out all our health care to other countries? If it's good for the goose then it's good for the gander.

Either that or let all the doctors/health care workers thatwant in come here illegally like we do the Hispanics.

 

[piasabird]

How come when the left wants to make a law decision they care about what Europe things, but when Europe and the UK tell us not to choose socialized medicine they are too stupid to listen?

 

[Fern]

Ok, I get the pharmaceutical advertisement, but just who in Congress is qualified to tell physicians how to practice medicine? What set of rules and regulations substitutes for professional judgment?

Yes, people are sometimes overmedicated. No one knows better than me, however having Congress doing my job is scary beyond all reason.

Maybe you mean something else, but once you let Congress get into practicing medicine that's road you really don't want to go down.

I'm thinking more of professional boards. In the 'CPA world' if we over prescribe accounyting procedures for a client we're subject to disciplinary measure.

I see the former head of the AMA saying we could cut costs by 1/3 to 1/2 by eliminating unnecessary and/or redundant procedures.

Presently I don't have much faith in the AMA, maybe they should be changed, maybe physicians should police themselves more/better. But I'll bet they say they need the lawyers off their back to do it. (Tort reform needed?)

Fern

 

[Fern]

Responding to the OP: Fern, this is where you'll run into trouble with the AMA and Big Pharma.

For example, a large percentage of health care costs go to heroic end-of-life care. Most of which is pushed by the family, as overwhelming the poor dying do not want this care (countless data supports this claim). But try to give the terminally ill more legal options to choose to avoid heroic end-of-life measures, and you'll hear cries of 'euthanaisa' and 'death panels.'

Yes, thanks. This is one issue I wnated to drive towards with this thread.

I'm not sure death panels are a bad idea when it comes to "heroic end-of-life care" for the very elderly. I know this may sound cold. I can imagine it a very difficult decision for the children/grandchildren, who are already under great emotional stress and not in ideal condition to make such a decision. Are some of these decisions made to prevent their guilt?

I've seen data claiming that's where a lot of our costs lie. Either we accept heroic eforts for the very elderly along with a higher national cost, or we get into a national discussion about resolving it. Yeah, that means "death panels".

For younger patients I think heroic efforts are likely justified under most situations.

If there's a doctor in the house I'd like to know if the AMA has guidelines on heroic efforts for the very elderly. In the accounting world, we're required to put a "Going Concern" clause in your finacials if we think you're a 'goner'; it's the kiss of death.

Edit: Who is making heoric end of life decisions for the elderly with no children etc? Do we have a problem here? Are physicians motivated either through profit or fear of lawsuits to engage in all kinds of procedures?

Fern

 

[Darwin333]

Probably the case in all countries, though. Unless you kill the old people I don't see a way around it.

He still makes a very valid point. I haven't heard much discussion about this during this entire debate and I have heard even less on what is in the current bills to address these issues.

You simply can't cut costs if you don't look at where the majority is spent. OTOH, neither party wants to piss off old people and that is exactly why we won't really fix the issue. You can do whatever the hell you want but if you don't cut costs and therefore services (at least perceived) to 95% of the expenditures then whats the gain?

 

[alexruiz]

....

2. Too many healthcare dollars are taken as profits - the healthcare industry has become a huge cash cow only rivaled by the oil industry in their ability to produce ever increasing profits. Profiting enormously from the sick and dying is not only acceptable but viewed farvorably in our society. Too many doctors more closely resemble socialites, business moguls and used car dealers than humanitarians, with most of them entering the field of medicine for the promise of wealth rather than a desire to help their fellow man.....

?

Why is the OP asking why it cost so much, yet doesn't accept this one?

....
For one thing the oil industries profit margin are quite low, lower than just about all other industries. Poor example.

I guess thats why Exxon mobile continually beats their own record for the highest quarterly profits of any company on the planet. Their margins MAY be low but a few % of a gazillion dollars still makes them the most profitable corporation in the world.

Most hospitals are non-profit. They don't make big big profits, if you've info to the contrary let us see it.

Hospital profits aren't a problem, and I didn't say they were, now utilization of space and overhead is a problem with US hospitals that costs us plenty

Health insurance companies are said to make about 3% in profit; that's hardly a big profit.

Yeah right! Aetnea and United Healthcare alone REPORTED billions in profit which is probably only a portion of what they really made. And go to Hoovers and check out executive compensation at these companies. If you just add up the compensation packages for the top 20 execs you get a little over 500mil or an average of 25mil each.

Every time somebody bring up doctors' salaries, somebody else comes along and links a report showing how little they affect our HC costs.

Sorry but "soembody says" or "are said to" doesn't mean squat. As a financial guy, I understand that you can make numbers and statistic to prove any point you want. Just skew an assumption here, overlook a variable there and presto you can produce something that will substantiate about anything.

What big profits are you talking about?

Oh, youre right there is no big money in healthcare, thats why all the doctors and insurance execs drive chevys and live in modest houses. Hell the local lasik surgeon in my area is so poor he only owns an 80ft yacht and one private island. And his house is so small you could probably only fit a tennis court and one olympic pool in his living room.?

or answer this one?

 

[Vic]

Yes, thanks. This is one issue I wnated to drive towards with this thread.

I'm not sure death panels are a bad idea when it comes to "heroic end-of-life care" for the very elderly. I know this may sound cold. I can imagine it a very difficult decision for the children/grandchildren, who are already under great emotional stress and not in ideal condition to make such a decision. Are some of these decisions made to prevent their guilt?

I've seen data claiming that's where a lot of our costs lie. Either we accept heroic eforts for the very elderly along with a higher national cost, or we get into a national discussion about resolving it. Yeah, that means "death panels".

For younger patients I think heroic efforts are likely justified under most situations.

If there's a doctor in the house I'd like to know if the AMA has guidelines on heroic efforts for the very elderly. In the accounting world, we're required to put a "Going Concern" clause in your finacials if we think you're a 'goner'; it's the kiss of death.

Edit: Who is making heoric end of life decisions for the elderly with no children etc? Do we have a problem here? Are physicians motivated either through profit or fear of lawsuits to engage in all kinds of procedures?

Fern

I don't think it's cold at all. Perfectly rational IMO. And we don't even really need 'death panels' in order to reduce costs. Naturally, something like a death panel will always exist under any system, but studies show conclusively that a high percentage of terminally-ill elderly would voluntarily reject heroic end-of-life measures if they could. This what the whole 'death panels' furor was about last year. Rep Blumenauer of Oregon proposed a mandate to educate the terminally ill on how they could legally avoid heroic measures if they don't want them. That was the so-called 'death panels' in the health care bill. And people wonder why I don't like Palin and Rush Limbaugh...

Anyway, family is motivated by being family. With elderly parents and having lost some close relatives, I have some idea of what it's like. My wife just had to make the decision to put her 90 year-old grandmother into a home. These are tough decisions, and people tend to err on the side of caution. This is why IMO it is so important for people to spell out their wishes legally beforehand.

As for doctors and the health care industry, I figured it's both profit and liability. But suppose we could cut health care costs by a third just by those who voluntarily opt out of heroic measures, that would still be a drastic blow to the entire industry. So I can't blame them, but at the same time I won't defend them either. Saving the life of someone who just going to die a few days or weeks later might be a lucrative profession, but it is not a productive one. If my tax dollars and my health insurance premiums are going to pay for it, then at the very least, I want people who don't want that kind of heroic and unnecessary treatment to be educated in how to avoid it.

Unfortunately, the biggest hurdle in accomplishing this is not the AMA, but the religious right, who have somehow come to believe that anything less than the most heroic efforts to prevent death is the same as suicide. As for myself, I think God intended us to die as He intended to live... with dignity.