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

[Fern]

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?

Health care spending in the United States is concentrated. An analysis of the 1996 Medical Expenditure Panel Survey found that the 1% of the population with the highest spending accounted for 27% of aggregate health care spending. The highest-spending 5% of the population accounted for more than half of all spending

http://en.wikipedia.org/wiki/Health_care_in_the_United_States

The fact that 5% of people account for 50% of our HC costs is something I find very significant and has been bothering me for a whle, yet I don't hear much about it in the HC debate. I think it begs two different questions which I'll combine into this one thread because they're based on this single bit of data.

Question #1: Why is it necessaritly a problem?

Unfortunately I can't find it ATM, but I have see data suggesting this is largely due to the elderly, those above 65 and particularly concentrated in those above 80 yrs.

If we're spending a disproportionate amount of HC money, more than Europe etc driving up our high national costs, on extending the lives of the elderely, is that necessarily a problem? Let's put aside the concern about escalating Medicare costs for the moment. Do Americans wanna visit this issue and find ways to reduce these costs even if it a means a shorter life span for Grandma & Grandpa?

Personally I doubt that the great costs from extending life via means of expensive new technology, proceedures and boat-loads of drugs is always worth it. Does the 'quality of life' in those last years justify the cost? Are we prolonging suffering because we Americans, infatuated with youth, are too immature and have an irrational fear of death. Can we not accept that it is inevitable?

I don't see this in the debates/discussions of HC. But if we want to continue by all means or costs possible extending the lives of our elderly I think we must accept a higher HC costs than other nations. And if we want to do that, what's wrong with it? Don't we have that freedom? But we need to recognize it for what it is.

What do you think?

---------------------------

Making a Difference:
• In 2002, the 5 percent of people with the greatest health care expenses in the U.S. population spent 49 percent of the overall health care dollar…Page 2
• The lower 50 percent of spenders accounted for 3 percent of the total national health care dollar…Page 2
• The proportion of spenders who remained among the top 1% of spenders for two years in a row doubled between 1996-97 and 2002-03 …Page 5
• The five most expensive health conditions are heart disease, cancer, trauma, mental disorders, and pulmonary disorders…Page 6

http://www.ahrq.gov/research/ria19/expendria.pdf

Question #2.

If we know that our HC costs are so highly concentrated to so few areas, why are changing the whole syatem for whole population? The lower 50% of the population avccounts for 3% of HC spending? Why the hell are bothering to mess around with their HC?

Why don't we (Congress) focus on either (1) the small population incurring the majority of costs or (2) the 5 conditions most expensive conditions?

Wouldn't it make more sense in terms of cost-cutting (and other reasons) to focus our attention strictly to these? If we wanna go single payor or public option why not limit it marrowly to the 5 conditions? Can the government not subsidize research into these 5 areas to increase efficiency and cut costs?

I think if Congress carved-out reform for these narrow purposes, where the real bang-for-the-buck appears to be, people would be far more accepting of government 'intrusion' into this portion of HC.

What do you think?

Fern

 

[Patranus]

And you wonder why people say Medicare is a disaster/doesn't work.

 

[Xellos2099]

I want to add something about the cost, Fern. CRA claim that tort reform will not lower cost, Howard Dean's action prove otherwise.

http://www.youtube.com/watch?v=HaMj-WUC-aE

Please don;t give me blahblah fox new crap, he said it himself.

 

[Ozoned]

And you wonder why people say Medicare is a disaster/doesn't work.

Medicare is the socialized portion of our health care system. It is the part that is broken. Obama says as much.

 

[mizzou]

forced excercise is the cheapest alternative to fixing this system.

If you look healthy, you can opt out. But if you are fat, you get chained to a treadmill with a alligator in toe

 

[soccerballtux]

We also have the highest investment/research and consistently bring the most cures to market. We drive the market forward.
Causal relationship.

 

[HumblePie]

We also have the highest investment/research and consistently bring the most cures to market. We drive the market forward.
Causal relationship.

Uhh since when? 1960?

Well we spend a lot on research, but as far as introducing ground breaking cures and technology I'll have to disagree.


As far as the OPs concern, that is the case for all forms of insurance. That is the exact purpose of it. Why? It's a social net so that the relatively few that need it aren't without. Some will argue that it is not needed at all, but that is for another debate.

The problem with healthcare costs in America is that everything costs way to damn much. From simple things such as a regular checkup or blood work to more exotic procedures. It all costs way to damn much here. I have some ideas to help solve that problem, but they will never be acted upon.

Again, the relatively few using the most of the current amount of money for a social system has always been the case. Indeed, it is better that the fewer using a social system the better. That is not to say that a social system is not needed at all, but that the relative need for it be as low as possible.

 

[Thump553]

Anyone who has an elderly parent knows that healthcare costs ramp up in the later years of life. It's amazing how many tests and appointments they have to go through.

One of my big complaints though is the cost of ordinary, routine health care. When I was a kid and younger adult it wasn't totally insane to go without healthcare coverage. Things like a simple broken arm, one ER visit, etc. wouldn't bankrupt you like they do today.

I don't disagree that research in the US has been generally improving cures, but I do question why the US citizens seem to bear an unequal portion of the cost of this improvement. The simple answer is that it is easier to gouge in this market, especially when you have boondoggles like Bush's Medicare prescription plan expressly PROHIBITING the government from negotiating prices with the drug companies. Think that was done for the public good?

 

[crownjules]

I think one of the major problems is how HC in our country currently addresses the problems. It is reactive instead of proactive. Per your report, heart disease is the #1 contributor to health care costs. You know what preventable condition (in the vast majority of cases) greatly increases your chance of heart disease? Obesity. And as of the latest reports I've seen, 1 in 3 Americans are overweight. We aren't helping ourselves.

If we focused more on preventing than treating, we'd avoid lots of these strains on our current HC system and reduce costs.

 

[Dulanic]

I completely understand why a small percentage have the majority of the cost. There are many health issues that cost money. Some cost A LOT more than others. The problem is the cost for any effective treatments.

One example is cancer. 6 months of cancer treatment can easily cost $250k+. Some minor surgerys can cost $10K or so, and that is a minor surgery. I can get an animal spade for $100, but if a female wants to get her tubes tied it costs what $2K? 3K? Maybe more. I understand that there is extra costs for precautions taken etc... but minor things have HUGE expenses in our country. Fuck I mean some tylenol in the hospital costs over $50 if they give it to you while your in the hospital. Why? It makes no sense.

Then you have some conditions that are not preventable that have huge expenses. I should know, I have MS. There is no cure, there is no prevention for it. It's luck and genes. Know how much my medication costs? $2300 for a vial, 1 single vial. Oh and then we have MRIs, again what $2k or 3K to have a machine scan you? I've had one hospilitization due to my MS. Cost? $35K.

Oh and as for your question what is wrong with the US having the highest cost? Let's see #1 in cost, not even in the top 20 for quality of health care.

 

[nobodyknows]

Medicare is the socialized portion of our health care system. It is the part that is broken. Obama says as much.

It's the greedy health care system that is broken and a-holes that only care about themselves while bitching about others but offer no solutions. Glen Beck comes to mind for some reason LOL!!

I know a person on Medicaid that has a a type of spondylitis, which would be related to rhumitoid arthritis. They have some pills but medicaid won't pay for them, but they will pay for her to go to a hospital and get an IV of some expensive drug that cosys over $6000 per treatment. She has to get this treatment every 6 to 8 weeks. The pills are way cheaper but she can't afford them. Now how stupid is that?

IMO the health care industry is working the system to get as much money out of the taxpayer as possible. It seems that is the only thing the health care industry cares about and they wonder why when someone can PROVE they screwed up that they get lawsuits against them??? DUHHHH!

 

[soccerballtux]

I think one of the major problems is how HC in our country currently addresses the problems. It is reactive instead of proactive. Per your report, heart disease is the #1 contributor to health care costs. You know what preventable condition (in the vast majority of cases) greatly increases your chance of heart disease? Obesity. And as of the latest reports I've seen, 1 in 3 Americans are overweight. We aren't helping ourselves.

If we focused more on preventing than treating, we'd avoid lots of these strains on our current HC system and reduce costs.

force people to eat more veggies and stop being fat? yah like the democrats will vote for that one...

 

[nobodyknows]

Oh and as for your question what is wrong with the US having the highest cost? Let's see #1 in cost, not even in the top 20 for quality of health care.

It's pretty obvious what for-profit health care really cares about, now isn't it.

 

[nobodyknows]

force people to eat more veggies and stop being fat? yah like the democrats will vote for that one...

force big mouths to shut up? yeah like republicans will vote for that one...

 

[crownjules]

force people to eat more veggies and stop being fat? yah like the democrats will vote for that one...

No one needs to vote on something like that being a law. Ultimately, we should all have the right to do whatever we want with our bodies. But those people that either neglect their bodies or purposefully cause harm to it by eating unhealthy or smoking should have to pay for the increased health costs they inflict on themselves. That is beginning to happen now and some health insurers are starting to charge higher premiums or give incentives to promote healthier life styles.

 

[StageLeft]

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

 

[MJinZ]

I think one of the major problems is how HC in our country currently addresses the problems. It is reactive instead of proactive. Per your report, heart disease is the #1 contributor to health care costs. You know what preventable condition (in the vast majority of cases) greatly increases your chance of heart disease? Obesity. And as of the latest reports I've seen, 1 in 3 Americans are overweight. We aren't helping ourselves.

If we focused more on preventing than treating, we'd avoid lots of these strains on our current HC system and reduce costs.

People want to have their cake and eat it too. Literally. :awe:

 

[theeedude]

I think we should concentrate on how much each procedure or drug costs in the US vs Europe. I don't think it's just that we provide too much care to elderly, but that even if we provided same care as Europe, we would still blow them out of the water in terms of cost. There is simply no political will to pass policies that would contain these costs, because these costs are some companies' profits, and they will use all means necessary to protect them.

 

[StageLeft]

I think we should concentrate on how much each procedure or drug costs in the US vs Europe. I don't think it's just that we provide too much care to elderly, but that even if we provided same care as Europe, we would still blow them out of the water in terms of cost. There is simply no political will to pass policies that would contain these costs, because these costs are some companies' profits, and they will use all means necessary to protect them.

Pharm lobbying FTL

 

[blackangst1]

Uhh since when? 1960?

Well we spend a lot on research, but as far as introducing ground breaking cures and technology I'll have to disagree.


As far as the OPs concern, that is the case for all forms of insurance. That is the exact purpose of it. Why? It's a social net so that the relatively few that need it aren't without. Some will argue that it is not needed at all, but that is for another debate.

The problem with healthcare costs in America is that everything costs way to damn much. From simple things such as a regular checkup or blood work to more exotic procedures. It all costs way to damn much here. I have some ideas to help solve that problem, but they will never be acted upon.

Again, the relatively few using the most of the current amount of money for a social system has always been the case. Indeed, it is better that the fewer using a social system the better. That is not to say that a social system is not needed at all, but that the relative need for it be as low as possible.

Disagree all you want, but you'll be wrong. Heres a link to wiki, and if you care to, click the footnotes: http://en.wikipedia.org/wiki/Health_care

In terms of pharmaceutical R&D spending, Europe spends a little less that the United States (€22.50bn compared to €27.05bn in 2006) and there is less growth in European R&D spending.[6][7] Pharmaceuticals and other medical devices are the leading high technology exports of Europe and the United States. [7][8] However, the United States dominates the biopharmaceutical field, accounting for the three quarters of the world’s biotechnology revenues and 80% of world R&D spending in biotechnology.


Theres also a link here with external footnote links: http://www.futurepundit.com/archives/003794.html

But the American health care system may be performing better than it seems at first glance. When it comes to medical innovation, the United States is the world leader. In the last 10 years, for instance, 12 Nobel Prizes in medicine have gone to American-born scientists working in the United States, 3 have gone to foreign-born scientists working in the United States, and just 7 have gone to researchers outside the country.

In real terms, spending on American biomedical research has doubled since 1994. By 2003, spending was up to $94.3 billion (there is no comparable number for Europe), with 57 percent of that coming from private industry. The National Institutes of Health’s current annual research budget is $28 billion, All European Union governments, in contrast, spent $3.7 billion in 2000, and since that time, Europe has not narrowed the research and development gap. America spends more on research and development over all and on drugs in particular, even though the United States has a smaller population than the core European Union countries. From 1989 to 2002, four times as much money was invested in private biotechnology companies in America than in Europe.

 

[Mxylplyx]

While Americans certainly have a tendancy to overuse health resources in this country, the biggest elephant in the room that noone wants to talk about is doctor's wages, particularly specialists. Many doctors simply make too much money. The AMA has put a stranglehold on the supply of doctors. Also, doctors get paid per procedure, so they will run every test they can get away with to line their pockets. I know, I know, hard to believe that doctors in their shiny white coats like to make as much money as possible too. I dont see it changing though, because telling a mighty doctor that he's overpaid is apparently akin to flipping the bird to Jesus himself. We need to realign the system to where the government pays for a doctors education, and gives the doctor a narrow choice of specialty based on need, and then they go on salary when they are done. If they dont like it, they can get the fuck out and still make less money elsewhere.

 

[GuitarDaddy]

The OP's post clearly demonstrates a lack of understanding of the problem. I agree that the US will always have the highest total HC costs of any nation as long as we remain the most prosperous and this is as it should be, HC is the most important factor in human exsistense and so it only makes since that the most prosperous country will spend the most on healthcare.

The real problems with healthcare that are bringing us to our knees.

1. How healthcare is paid for - the bulk of the financial burden of healthcare for all citizens under our current system falls on the backs of a dwindling and stagnant working middle class(either through increased premiums and or taxes). And the ranks of the "insured" middle class is declining even more rapidly as companies and individuals become unable to afford the ever increasing burden, while the ranks of those on a "free ride" (the elderly abandoned by private ins., businesses that refuse to offer insurance, the young and healthy that don't think they need or should have to pay for insurance, etc..) continues to skyrocket

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


If we could fix those two issues there would be no crisis in healthcare. How do we do it short of a single payer european style socialized medicine?

 

[Special K]

While Americans certainly have a tendancy to overuse health resources in this country, the biggest elephant in the room that noone wants to talk about is doctor's wages, particularly specialists. Many doctors simply make too much money. The AMA has put a stranglehold on the supply of doctors. Also, doctors get paid per procedure, so they will run every test they can get away with to line their pockets. I know, I know, hard to believe that doctors in their shiny white coats like to make as much money as possible too. I dont see it changing though, because telling a mighty doctor that he's overpaid is apparently akin to flipping the bird to Jesus himself. We need to realign the system to where the government pays for a doctors education, and gives the doctor a narrow choice of specialty based on need, and then they go on salary when they are done. If they dont like it, they can get the fuck out and still make less money elsewhere.

I unfortunately don't have a specific link, but I seem to remember reading on here many times that doctor's salaries were a relatively small percentage of overall health care costs. I do agree that paying doctors per procedure instead of a salary would seem to give them the incentive to peform more potentially unnecessary procedures, however.

 

[Special K]

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

Is it really excessive profits? Aren't the margins for the healthcare industry only 4-5%?

 

[Fern]

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

I'd like to know if that is in fact the case, though. So far haven't been able to find a comparison.

I lived in Europe for about 8 yrs etc. Noticed a lot of very elderly people still living with their families or even in their own homes. E.g., my Italian father-in-law is over 90 yrs old and still lives in the old family home.

The area I now live is a popular retirement place. I see mnay older retirees living assisted care facilities (a nursing home). These places are pretty expensive. My job occasionally requires that visit these places, looks to me like we drug these elderly people into a stupor and do whatever it takes to drag their life out no matter the quality. Maybe they do that in Europe to, but I didn't see it personally and I can't find any data on it so far.

Fern