It finally reaches the mainstream

[blackangst1]

Originally posted by: squirrel dog
In Louisiana we have the Charity hospital system.If you do not have health ins. the state will treat you for free.I had to take my son there when he dropped out of college,as my insurer dropped him as well.The Dr.s/workers there are as good if not better tham at Oshner(my hospital/insurer) The facility although old,was very clean.The patients represented a broad section of the demographic mix that is Louisiana.This system has worked in Louisiana for many years.

I believe all states are like this. Not necessarily every hospital, but most.

(and that lock/unlocked thing on the thread was pretty cool )

 

[Athena]

Originally posted by: squirrel dog
This system has worked in Louisiana for many years.

Health care insurance premiums in Louisiana have risen by 91% in the last 9 years. In the face of declining employer insurance, premiums have risen by approximately $900/yr. An estimated 35% of Louisianans are either uninsured or covered by Medicaid.

Should this be our threshold for "working"?

 

[shira]

First of all, judging profitability by PERCENTAGE of revenues is awfully silly when you're dealing with an industry that almost certainly has the highest gross revenues of any industry. If annual health care costs in the U.S. are, what, about $2.5 trillion (and let's say that Medicare, Medicaid, and "not-covered" constitute half of that), then the health insurance industry has gross revenues on the order of $1.3 triillion. 6% profit of THAT figure is $78 billion. That sounds like well ABOVE oil-industry-level profits to me. I'm not weeping for the lack of profitability of the health insurance industry.

Second, profit is not the correct basis on which to judge the health insurance industry on cost. Total overhead is. And the widely accepted overhead figure for the health insurance industry is 20%. That's 20% of $1.3 trillion (at least). So $260 billion (at least - I've probably underestimated the gross revenue of the industry) goes to overhead. If the industry had the same overhead as Medicare - 3% - we'd be saving about $220 billion a year. Even if we allowed the industry HALF of their current profit margin, meaning 6% overhead (3% profit and 3% administrative), we'd be saving over $180 billion.

So anyone who claims that there isn't a sh!tload of money to be saved by forcing the insurance industry to become more competitive is simply ignorant, lying, or both.

Edit: Edited out my typos.

 

[blackangst1]

Originally posted by: shira
First of all, judging profitability by PERCENTAGE of revenues is awfully silly when you're dealing with an industry that almost certainly has the highest gross revenues of any industry. If annual health care costs in the U.S. are, what, about $2.5 trillion (and let's say that Medicare, Medicaid, and "not-covered" constitute half of that), then the health insurance industry has gross revenues on the order of $1.3 triillion. 6% profit of THAT figure is $78 billion. That sounds like oil-industry-level profits to me. I'm not weeping for the lack of profitability of the health insurance industry.

Second, profit is not the correct basis on which to judge the health insurance industry on cost. Total overhead is. And the widely accepted overhead figure for the health insurance industry is 20%. That's 20% of $1.3 trillion (at least). So $260 billion (at least - I've probably underestimated the gross revenue of the industry) goes to overhead. If the industry had the same overhead as Medicare - 3% - we'd be saving about $220 billion a year. Even if we allowed the industry HALF of their current profit margin, meaning 6% overhead (3% profit and 3% administrative), we'd be saving over $180 billion.

So anyone who claims that there isn't a sh!tload of money to be saved by forcing the insurance industry to become more competitive is simply ignorant, lying, or both.

Edit: Edited out my typos.

Wow. We agree on something.

 

[ElFenix]

Originally posted by: Jhhnn
I suspect that you're the one regurgitating what's been spoonfed, blackangst.

Other countries, particularly France, have better results at lower cost, expressed in terms of % of GDP and cost per person. At least the WHO seems to think so.

Google "french healthcare system" to get more stories like this-

http://baltimorechronicle.com/.../102209Ridgeway2.shtml

They have a hybrid system with govt and insurance components, but we don't hear too much about it... all we hear is a lot of misinformation and outright lies from supporters of non-reform of our own broken system...

It's not like we have to re-invent the wheel...

Notice the price differential for name brand drugs cited in the linked piece... it's not just about insurance, but about the whole non-system we use to distribute care...

Edit- typo

the french system isn't under consideration in the US congress. so arguing that the french system is better than ours is a strawman. and if we're going to argue strawmen, singapore's system kicks france's system's ass, but i don't see the dems proposing mandated HSAs.

Originally posted by: 0marTheZealot

And yet, Britons are better off than us in every measure available in health care. Germany, which doesn't have a single-payer system, is also better off in every imaginable category.

but the question is if they're better off in medical measures. like cancer survival rates.

why people insist on using health measures when discussing the effectiveness of the medical system is beyond me. there's no controlling for general healthiness or unhealthiness of lifestyle when you do that.

Originally posted by: shira
Second, profit is not the correct basis on which to judge the health insurance industry on cost. Total overhead is. And the widely accepted overhead figure for the health insurance industry is 20%. That's 20% of $1.3 trillion (at least). So $260 billion (at least - I've probably underestimated the gross revenue of the industry) goes to overhead. If the industry had the same overhead as Medicare - 3% - we'd be saving about $220 billion a year. Even if we allowed the industry HALF of their current profit margin, meaning 6% overhead (3% profit and 3% administrative), we'd be saving over $180 billion.

So anyone who claims that there isn't a sh!tload of money to be saved by forcing the insurance industry to become more competitive is simply ignorant, lying, or both.

Edit: Edited out my typos.

problem is only inefficient overhead is bad.

if they're denying claims that would end up costing a ton and not do a thing, is that bad from a cost perspective? nope.

not to mention that medicare's overhead is way over the 3% figure that gets tossed around all over the place. it's been corrected over and over again but the same people go back to tossing around the same erroneous figure over and over again.

 

[WhipperSnapper]

Originally posted by: Genx87

Originally posted by: WhipperSnapper
I'm still waiting for someone to explain why other nation's systems could not metaphysically function here if we deported the illegals or that the GDP expenditure percentages are fraudulent or misleading.

Because

1. We wont deport illegals. The very party who is pushing health reform welcomes illegals with open arms.
2. We simply wont take European level care in the States. We have been spoiled beyond belief.
3. We as a nation will continue even in a public system to hide the costs from ourselves for anything non catastrophic. The end result is higher demand.

These are good points, actually. Sad, but probably true. However, our current system isn't working and we know that the European models are much more efficient. We need to adopt their model and then deal with the above issues. It might be better to have Americans marching in the street and protesting European rationing than to have our current system where the insurance companies and lack of health coverage ration care along with the horde of other problems our current system has. The Europeans might not be thrilled with their health care system, but they are spending a smaller percentage of their GDP and none of them seem to want the American system.

 

[shira]

Originally posted by: blackangst1

Originally posted by: shira
First of all, judging profitability by PERCENTAGE of revenues is awfully silly when you're dealing with an industry that almost certainly has the highest gross revenues of any industry. If annual health care costs in the U.S. are, what, about $2.5 trillion (and let's say that Medicare, Medicaid, and "not-covered" constitute half of that), then the health insurance industry has gross revenues on the order of $1.3 triillion. 6% profit of THAT figure is $78 billion. That sounds like oil-industry-level profits to me. I'm not weeping for the lack of profitability of the health insurance industry.

Second, profit is not the correct basis on which to judge the health insurance industry on cost. Total overhead is. And the widely accepted overhead figure for the health insurance industry is 20%. That's 20% of $1.3 trillion (at least). So $260 billion (at least - I've probably underestimated the gross revenue of the industry) goes to overhead. If the industry had the same overhead as Medicare - 3% - we'd be saving about $220 billion a year. Even if we allowed the industry HALF of their current profit margin, meaning 6% overhead (3% profit and 3% administrative), we'd be saving over $180 billion.

So anyone who claims that there isn't a sh!tload of money to be saved by forcing the insurance industry to become more competitive is simply ignorant, lying, or both.

Edit: Edited out my typos.

Wow. We agree on something.

When you make intelligent posts, we almost always agree.

 

[TheSkinsFan]

Originally posted by: Athena

Originally posted by: squirrel dog
This system has worked in Louisiana for many years.

Health care insurance premiums in Louisiana have risen by 91% in the last 9 years. In the face of declining employer insurance, premiums have risen by approximately $900/yr. An estimated 35% of Louisianans are either uninsured or covered by Medicaid.

Should this be our threshold for "working"?

I think he was saying that those 35% already receive free healthcare at the state-sponsored facilities. I would assume that the money for those facilities, and their care, is being provided by the state of Louisiana itself. If that's the case, then maybe it is, in fact, "working" there.

 

[Athena]

Originally posted by: shira
So anyone who claims that there isn't a sh!tload of money to be saved by forcing the insurance industry to become more competitive is simply ignorant, lying, or both.

There is definitely a lot of money to be saved by changing our financing model and it would certainly be better if the 20%+ now being spent in insurance overhead were going to actual care.

Increased competition among insurers though -- whether with the addition of some sort of ill-defined public option or with more crummy policies sold across state lines -- is unlikely to have that result. Healthcare is not a commodity that responds to competition in the ways people expect and when it comes to actual health costs, insurers don't hold the winning cards. The experience of BC of California with Sutter Health in 2001 should be required study for all those who maintain that insurance companies can somehow wring better charges out of providers. Guess who the press painted as the bad guy when BC resisted Sutter's demands for 30% increases? Insurers with smaller market shares agreed to the increases without protest and BC eventually had to fold. Insurance in San Francisco, where Sutter is dominant, is still more expensive today than in nearby areas.

BTW, Sutter was an equal opportunity gouger -- a class action suit charging that the organization systematically over-charged uninsured patients was recently settled in favor of the patients.

As noted in the final segment in recent broadcast of This American Life (Someone Else's Money), the evidence of the marketplace is that the more fragmented the insurance market, the less able they are to control costs because they have weaker negotiating power. That's why Wellpoint in California pays from $1500 to $13,000 for the same procedure: it simply does not have the necessary market clout in the high-cost regions to make any real differences in costs.

I am 100% in favor of health care reform and I would gladly support a move to some other model that has been proven more successful elsewhere. No successful plan though, operates under the delusion that costs are controlled by competition among payers -- [/i]not one[/i].

 

[TheSkinsFan]

Originally posted by: shira
First of all, judging profitability by PERCENTAGE of revenues is awfully silly when you're dealing with an industry that almost certainly has the highest gross revenues of any industry. If annual health care costs in the U.S. are, what, about $2.5 trillion (and let's say that Medicare, Medicaid, and "not-covered" constitute half of that), then the health insurance industry has gross revenues on the order of $1.3 triillion. 6% profit of THAT figure is $78 billion. That sounds like well ABOVE oil-industry-level profits to me. I'm not weeping for the lack of profitability of the health insurance industry.

Second, profit is not the correct basis on which to judge the health insurance industry on cost. Total overhead is. And the widely accepted overhead figure for the health insurance industry is 20%. That's 20% of $1.3 trillion (at least). So $260 billion (at least - I've probably underestimated the gross revenue of the industry) goes to overhead. If the industry had the same overhead as Medicare - 3% - we'd be saving about $220 billion a year. Even if we allowed the industry HALF of their current profit margin, meaning 6% overhead (3% profit and 3% administrative), we'd be saving over $180 billion.

So anyone who claims that there isn't a sh!tload of money to be saved by forcing the insurance industry to become more competitive is simply ignorant, lying, or both.

Edit: Edited out my typos.

Actual net profits for health insurance companies, combined with their executive salaries, amounted to a whopping 0.374% of the total U.S. expenditures on healthcare in 2008. So, you're damn right that the real problem lies elsewhere in the system, and that it's much more likely to be found in the health insurance overhead expenditures.

The problem is that nobody in Congress is talking about that, or proposing anything to address it. They're all too busy demonizing the CEOs of those companies and their supposedly excessive salaries. The latest Senate proposal does almost nothing to address the real cost issues in the system -- those that the insurance companies currently spend most of their "gross profits" paying for.

It would be great to see them become more competitive, but I'm not convinced that the high costs are found on their end of the healthcare system. In fact, they may be just as much a victim of the actual cost problems as we are.

 

[shira]

Originally posted by: TheSkinsFan

Originally posted by: shira
First of all, judging profitability by PERCENTAGE of revenues is awfully silly when you're dealing with an industry that almost certainly has the highest gross revenues of any industry. If annual health care costs in the U.S. are, what, about $2.5 trillion (and let's say that Medicare, Medicaid, and "not-covered" constitute half of that), then the health insurance industry has gross revenues on the order of $1.3 triillion. 6% profit of THAT figure is $78 billion. That sounds like well ABOVE oil-industry-level profits to me. I'm not weeping for the lack of profitability of the health insurance industry.

Second, profit is not the correct basis on which to judge the health insurance industry on cost. Total overhead is. And the widely accepted overhead figure for the health insurance industry is 20%. That's 20% of $1.3 trillion (at least). So $260 billion (at least - I've probably underestimated the gross revenue of the industry) goes to overhead. If the industry had the same overhead as Medicare - 3% - we'd be saving about $220 billion a year. Even if we allowed the industry HALF of their current profit margin, meaning 6% overhead (3% profit and 3% administrative), we'd be saving over $180 billion.

So anyone who claims that there isn't a sh!tload of money to be saved by forcing the insurance industry to become more competitive is simply ignorant, lying, or both.

Edit: Edited out my typos.

Actual net profits for health insurance companies, combined with their executive salaries, amounted to a whopping 0.374% of the total U.S. expenditures on healthcare in 2008. So, you're damn right that the real problem lies elsewhere in the system, and that it's much more likely to be found in the health insurance overhead expenditures.

The problem is that nobody in Congress is talking about that, or proposing anything to address it. They're all too busy demonizing the CEOs of those companies and their supposedly excessive salaries. The latest Senate proposal does almost nothing to address the real cost issues in the system -- those that the insurance companies currently spend most of their "gross profits" paying for.

It would be great to see them become more competitive, but I'm not convinced that the high costs are found on their end of the healthcare system. In fact, they may be just as much a victim of the actual cost problems as we are.

I think the biggest reason health care expenditures increase so rapdily is simply that more and more expensive treatments and drugs are now available than ever before for health conditions that formerly either weren't treated, or were treated much less expensively (and much less effectively). Clearly, that trend will continue.

For example, I'll bet if you plot the number of coronary bypass procedures performed over the last 40 years, you'll see a growth curve that's much steeper than the rate of inflation. Note that bypass surgery + ancillary costs (which total tens of thousands of dollars/patient) didn't replace some other expensive procedure - this was a brand new cost. So, whereas in 1960, we spent almost nothing on a person with heart disease, and the patient eventually just died, now we spend tens of thousands of dollars and the person lives to face another expensive disease.

Same with drugs: There was a time when serum LDL level hadn't been identified as a risk factor for heart disease. But once that risk factor was established and drugs were developed, we went from a state where no one was spending money on cholesterol-lowering drugs to a state where tens of millions of Americans use those drugs.

This cost driver is only going to get worse.

 

[ElFenix]

Originally posted by: shira

I think the biggest reason health care expenditures increase so rapdily is simply that more and more expensive treatments and drugs are now available than ever before for health conditions that formerly either weren't treated, or were treated much less expensively (and much less effectively). Clearly, that trend will continue.

iirc CBO pegged about 50% of the increase in medical spending in this country on increased technology

 

[Athena]

Originally posted by: shira
I think the biggest reason health care expenditures increase so rapdily is simply that more and more expensive treatments and drugs are now available than ever before for health conditions that formerly either weren't treated, or were treated much less expensively (and much less effectively). Clearly, that trend will continue.

It may be true that there are more treatments available but it doesn't explain why costs here are so much out of line with those in other countries. Patients in France and Germany benefit from the same advances and, while it is true that costs there are also rising, they are not anywhere near close to bankrupting the citizenry there.

We have a patchwork health care policy that owes its existence to hospitals looking for sustenance and employers trying to get around wage controls. It has continued to grow focused on things that have little or nothing to do with actual care. We're not going to get effective cost control without actual reform.

 

[blackangst1]

Originally posted by: Athena

Originally posted by: shira
I think the biggest reason health care expenditures increase so rapdily is simply that more and more expensive treatments and drugs are now available than ever before for health conditions that formerly either weren't treated, or were treated much less expensively (and much less effectively). Clearly, that trend will continue.

It may be true that there are more treatments available but it doesn't explain why costs here are so much out of line with those in other countries. Patients in France and Germany benefit from the same advances and, while it is true that costs there are also rising, they are not anywhere near close to bankrupting the citizenry there.

We have a patchwork health care policy that owes its existence to hospitals looking for sustenance and employers trying to get around wage controls. It has continued to grow focused on things that have little or nothing to do with actual care. We're not going to get effective cost control without actual reform.

What kind of research and advancements come out of other countries vs USA?

 

[ElFenix]

Originally posted by: Athena

We have a patchwork health care policy that owes its existence to hospitals looking for sustenance and employers trying to get around wage controls. It has continued to grow focused on things that have little or nothing to do with actual care. We're not going to get effective cost control without actual reform.

i'd like to see actual reform proposed. unfortunately it looks like what we're getting is just a steaming pile of bullshine that will be fatally flawed and will make social security's 3rd rail look like a 9 volt battery.

again, our .gov already spends more per american (not just covered american) than the french .gov spends per frenchman. and that's to provide a whole lot less people coverage (on a % basis). when the .gov shows that it can bring costs in line with what other countries are spending on the systems it already administers, then we can go ahead and change the rest of it.

 

[StageLeft]

Originally posted by: ElFenix

Originally posted by: shira

I think the biggest reason health care expenditures increase so rapdily is simply that more and more expensive treatments and drugs are now available than ever before for health conditions that formerly either weren't treated, or were treated much less expensively (and much less effectively). Clearly, that trend will continue.

iirc CBO pegged about 50% of the increase in medical spending in this country on increased technology

Sweet, I had not heard any numbers at all but it seemed very logical to me to think that one of the key reasons healthcare is growing in cost _everywhere_, not just the US, is the increased availability of treatment due to technology. Before knee replacements, before MRIs, before echos no money was spent on them, naturally.

 

[Athena]

Originally posted by: blackangst1
What kind of research and advancements come out of other countries vs USA?

Excuse me? Do you honestly believe that the US is the source of all medical advancement? Do you think the researchers at the Louis Pasteur Institute in Paris or Swiss pharmaceutical labs are just sitting around waiting for the US to produce things?

About half the Nobel Laureates in the past decade have done their research in other parts of the world. And talk to the doctors at Walter Reed -- much of their work on prostheses has come in refining procedures developed elsewhere.

The idea that other countries are just reaping the benefits of US research is profoundly misguided.

 

[ElFenix]

Originally posted by: Athena

The idea that other countries are just reaping the benefits of US research is profoundly misguided.

that's mis-stating the argument. the argument is that the US is the only place that allows research costs to be recouped. doesn't matter where the research is done as long as it can be sold in the US at a little-regulated price.

 

[Athena]

Originally posted by: ElFenix
iirc CBO pegged about 50% of the increase in medical spending in this country on increased technology

And other studies estimate that as much of 30% of its use does not contribute to better medical outcomes.

when the .gov shows that it can bring costs in line with what other countries are spending on the systems it already administers, then we can go ahead and change the rest of it.

That's an interesting idea -- do you have any proposals about how to do it? Would you be in favor of merging all government programs -- seniors, children, unemployed, working poor, etc. into a a single "government-run" system such as, say the VA and continue current funding levels? Would you support ""forcing" all the current recipients into an "all payer" system like they use in France or Germany, agaom while maintaining curent funding levels? If current public programs were reorganized to offer better coverage for those groups with lower cost escalation, would that satisfy you?

 

[Athena]

Originally posted by: ElFenix
that's mis-stating the argument. the argument is that the US is the only place that allows research costs to be recouped. doesn't matter where the research is done as long as it can be sold in the US at a little-regulated price.

That may be your argument. blackangst1's question implied that UHC was inhibiting advancement in other countries.

I don't know about other areas but in the case of pharmaceuticals, most research comes from government sponsored programs at Universities, not from private labs. Pharmaceutical companies spend more on advertising than they do on research. If we were really interested in reducing drug costs we would ban mass marketing to consumers.

 

[GuitarDaddy]

Originally posted by: BarrySotero
There are insurers not even making a profit. The politicians making the mandates (and protecting trial lawyers that fund them) that push costs up are same ones blaming the insurers.

Spoken like an insurance executive!

Pay no attention to the 30% I'm racking off the top, it's those guys over there, those greedy lawyers taking .5%, they are your problem

 

[ElFenix]

Originally posted by: Athena
And other studies estimate that as much of 30% of its use does not contribute to better medical outcomes.

and that's where evidence based medicine comes in. there is way too much done that has nil improvement in medical outcomes because either the docs rely on anecdote or the way things are done, the patient demands it after seeing it on tv, or defensive medicine.

That's an interesting idea -- do you have any proposals about how to do it? Would you be in favor of merging all government programs -- seniors, children, unemployed, working poor, etc. into a a single "government-run" system such as, say the VA and continue current funding levels? Would you support ""forcing" all the current recipients into an "all payer" system like they use in France or Germany, agaom while maintaining curent funding levels? If current public programs were reorganized to offer better coverage for those groups with lower cost escalation, would that satisfy you?

merging it all may make for lower overhead, though i'm afraid of bureaucratic inertia. i also don't think merging everything into the VA would be politically palatable. seniors wouldn't keep their doctors (as the VA is like the NHS, and medicare is more like canada).

just slowing the rate of increase wouldn't satisfy me, unless it was almost stopped.

 

[ElFenix]

Originally posted by: Athena

Originally posted by: ElFenix
that's mis-stating the argument. the argument is that the US is the only place that allows research costs to be recouped. doesn't matter where the research is done as long as it can be sold in the US at a little-regulated price.

That may be your argument. blackangst1's question implied that UHC was inhibiting advancement in other countries.

i didn't say it was my argument. i said that's the argument. he's mis-stating the argument as well. it's a very common mis-statement, but it amounts to a very easily defeated straw man (as you point out, medical research goes on all over the place).

I don't know about other areas but in the case of pharmaceuticals, most research comes from government sponsored programs at Universities, not from private labs. Pharmaceutical companies spend more on advertising than they do on research. If we were really interested in reducing drug costs we would ban mass marketing to consumers.

nearly every industry relies on research performed at public universities. is pharma any different?

advertised drugs tend to cost less per course than unadvertised drugs. economies of scale. so the question is whether these drugs are actually doing anything for people? are physicians being proper gatekeepers to people who have no problems but want the drug anyway? the answer tends to be no, physicians as a whole are not being very good gatekeepers. so, you have to ask yourself, are the benefits of advertising (that people may not know they had a condition or that their condition may be treatable), outweighed by the cost of advertising (and prescription to people who don't need it)? are some forms of advertising better at the beneficial part than others? it's a complicated question and despite having written a 60 page paper on it i don't have a good answer.

another way to reduce drug costs is to comparison shop. but practically no one does that. when was the last time you called around to walgreens, cvs, kroger, and walmart to find out which had the lowest price? i'm betting never.

 

[BoberFett]

Originally posted by: shira

Originally posted by: TheSkinsFan

Originally posted by: shira
First of all, judging profitability by PERCENTAGE of revenues is awfully silly when you're dealing with an industry that almost certainly has the highest gross revenues of any industry. If annual health care costs in the U.S. are, what, about $2.5 trillion (and let's say that Medicare, Medicaid, and "not-covered" constitute half of that), then the health insurance industry has gross revenues on the order of $1.3 triillion. 6% profit of THAT figure is $78 billion. That sounds like well ABOVE oil-industry-level profits to me. I'm not weeping for the lack of profitability of the health insurance industry.

Second, profit is not the correct basis on which to judge the health insurance industry on cost. Total overhead is. And the widely accepted overhead figure for the health insurance industry is 20%. That's 20% of $1.3 trillion (at least). So $260 billion (at least - I've probably underestimated the gross revenue of the industry) goes to overhead. If the industry had the same overhead as Medicare - 3% - we'd be saving about $220 billion a year. Even if we allowed the industry HALF of their current profit margin, meaning 6% overhead (3% profit and 3% administrative), we'd be saving over $180 billion.

So anyone who claims that there isn't a sh!tload of money to be saved by forcing the insurance industry to become more competitive is simply ignorant, lying, or both.

Edit: Edited out my typos.

Actual net profits for health insurance companies, combined with their executive salaries, amounted to a whopping 0.374% of the total U.S. expenditures on healthcare in 2008. So, you're damn right that the real problem lies elsewhere in the system, and that it's much more likely to be found in the health insurance overhead expenditures.

The problem is that nobody in Congress is talking about that, or proposing anything to address it. They're all too busy demonizing the CEOs of those companies and their supposedly excessive salaries. The latest Senate proposal does almost nothing to address the real cost issues in the system -- those that the insurance companies currently spend most of their "gross profits" paying for.

It would be great to see them become more competitive, but I'm not convinced that the high costs are found on their end of the healthcare system. In fact, they may be just as much a victim of the actual cost problems as we are.

I think the biggest reason health care expenditures increase so rapdily is simply that more and more expensive treatments and drugs are now available than ever before for health conditions that formerly either weren't treated, or were treated much less expensively (and much less effectively). Clearly, that trend will continue.

For example, I'll bet if you plot the number of coronary bypass procedures performed over the last 40 years, you'll see a growth curve that's much steeper than the rate of inflation. Note that bypass surgery + ancillary costs (which total tens of thousands of dollars/patient) didn't replace some other expensive procedure - this was a brand new cost. So, whereas in 1960, we spent almost nothing on a person with heart disease, and the patient eventually just died, now we spend tens of thousands of dollars and the person lives to face another expensive disease.

Same with drugs: There was a time when serum LDL level hadn't been identified as a risk factor for heart disease. But once that risk factor was established and drugs were developed, we went from a state where no one was spending money on cholesterol-lowering drugs to a state where tens of millions of Americans use those drugs.

This cost driver is only going to get worse.

I suspect you're absolutely correct. So then the question is how can government do anything to lower our costs? They can either A) fix prices which will give us a supply problem no matter what anyone believes or B) they can lower expectations. TANSTAAFL

 

[Athena]

Originally posted by: ElFenix
advertised drugs tend to cost less per course than unadvertised drugs.

Umm, no...the most heavily advertised drugs are the more expensive ones. Mass market advertising has led to patients demanding things that are usually no more effective than much cheaper alternatives.

another way to reduce drug costs is to comparison shop. but practically no one does that. when was the last time you called around to walgreens, cvs, kroger, and walmart to find out which had the lowest price? i'm betting never.

I personally don't comparison shop because I buy where my health plan sends me. Years ago, on other plans, I did shop around and discovered that it no retailer had a lock on being "the least expensive".