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We Need to Design Health Care Reform That Puts Patients Before Profits

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Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#31

Post by AnIdiotOnTheNet »

soup10 wrote: post #24
Zelphyr wrote: post #16

I know a medical provider who works for a small family medicine practice recently purchased by a large hospital group in our area. They're being told, "You guys need to be sending more people to our hospitals." So for these organizations, patients who are sick and suffering are seen as a product. A day of reckoning is coming for these organizations because the sick and suffering are getting fed up with being treated…

Not holding my breath on that one. The current health care system is institutionalized and is going resist reform every step of the way.

I get the sense that "reckoning" in this case will be a little more "exciting" than reform.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#32

Post by kerkeslager »

helpPeople wrote: post #6

Until Americans find Physicians (and Pharmacists) as the enemy, it will never happen. They(AMA and APA) are top lobbyists that entrench themselves using monopolistic practices. Sure school can cost 500k, but with 200 to 300k+ per year salaries, they can kill that debt. (This is their common defense)

With my skillset (software engineer) I can easily pull low six figures. And I'm confident that doctors provide more value than I do. I'm pretty sure I've never saved anyone's life. So I have zero problem paying doctors 2 or 3 times my pay, which is about what you're saying they get paid.

Health insurance CEOs make, in some cases, literally hundreds of times my salary, while literally killing people for profit.

I'm going to go out on a limb and say you've misidentified the problem.

Now, certainly bringing down the cost of medical education, and allowing people with less education (i.e. nurse practitioners) to do more, would both help lower the cost of healthcare. But if we're talking about who we should consider "the enemy", it's certainly not doctors.

The entire raison d'être of capitalism is that it's supposedly meritocratic. Are you really claiming that curing illness and sometimes saving people's lives isn't meritable?

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#33

Post by aaavl2821 »

Zelphyr wrote: post #16

I know a medical provider who works for a small family medicine practice recently purchased by a large hospital group in our area. They're being told, "You guys need to be sending more people to our hospitals." So for these organizations, patients who are sick and suffering are seen as a product. A day of reckoning is coming for these organizations because the sick and suffering are getting fed up with being treated…

Large hospitals systems have been forming regional monopolies for the last few decades. First they would buy other hospitals to increase negotiating leverage with insurers, then they started buying outpatient clinics to control patient flow. They can also increase the amount they charge at outpatient clinics once the larger hospital system buys them.

Hospital spend represents 30% of US healthcare spend, and physician spend represents 20%. Physician employment by hospitals is at an all-time high. Busting local healthcare monopolies would do a ton to lower healthcare costs

Unfortunately that is difficult. The hospital lobby spends about as much as the pharma lobby. But the hospital industry has much more "soft" political power. Hospitals are one of the biggest employers in almost every county. So for a politician to fight hospitals would mean fighting their largest employers.

Hopefully more people become aware of this behavior by hospitals. You dont read much about it in the media. I'd imagine this has is because no one is incentivized to call out this behavior by hospitals

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#34

Post by rayiner »

The U.S. spends $3.5 trillion annually on healthcare. Worldwide profits for the 112 publicly traded healthcare industry companies amount to $50 billion per quarter: https://www.thefiscaltimes.com/2018/11/12/Chart-Day-Big-Phar.... Even if all those profits are allocated to the U.S., that's about 5.7% of healthcare spending. (And completely consistent with most other industries.)

Hyper-focusing on profits is misguided. Many countries with costs much lower than ours have for-profit hospitals, pharmaceutical companies, etc. Public operation of the health system would surely eliminate the profit, but why do we have reason to believe it will reduce the other $3.3 billion? We can point to European countries that have much lower costs overall, but those countries seem to provide many public services at much lower cost than we do (education, transit, etc.). Canada's government expenditures (excluding defense for both countries), is somehow slightly lower than the U.S., even though Canada offers universal healthcare.

The public rhetoric frustrates me as someone who favors universal healthcare. Demonizing corporations and rich people is red meat for partisans, but it’s not a solution. How do we pay for this system? How do we cut costs? Making healthcare into a public service in the US risks turning into the same thing we have with education, transit, and infrastructure. We spend tons of money, often more than European countries, and get very little in return. And the only solutions folks offer are to dismantle the public system (on the right), or to demand even more funding (on the left).

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#35

Post by creaghpatr »

aaavl2821 wrote: post #33
Zelphyr wrote: post #16

I know a medical provider who works for a small family medicine practice recently purchased by a large hospital group in our area. They're being told, "You guys need to be sending more people to our hospitals." So for these organizations, patients who are sick and suffering are seen as a product. A day of reckoning is coming for these organizations because the sick and suffering are getting fed up with being treated…

Large hospitals systems have been forming regional monopolies for the last few decades. First they would buy other hospitals to increase negotiating leverage with insurers, then they started buying outpatient clinics to control patient flow. They can also increase the amount they charge at outpatient clinics once the larger hospital system buys them. Hospital spend represents 30% of US healthcare spend, and physician…

Healthcare stocks comprise a not insignificant part of many Americans' 401k portfolios, the downstream economic effects of dismantling healthcare would extend way beyond the hospital/pharma industry.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#36

Post by abrichr »

rayiner wrote: post #34

The U.S. spends $3.5 trillion annually on healthcare. Worldwide profits for the 112 publicly traded healthcare industry companies amount to $50 billion per quarter: https://www.thefiscaltimes.com/2018/11/12/Chart-Day-Big-Phar... . Even if all those profits are allocated to the U.S., that's about 5.7% of healthcare spending. (And completely consistent with most other industries.) Hyper-focusing on profits is misguided…

In 2017 (from https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...):

 Hospital Care (33 percent share)

 Physician and Clinical Services (20 percent share)

 Retail Prescription Drugs (10 percent share)

 Other Health, Residential, and Personal Care Services (5 percent share)

 Nursing Care Facilities and Continuing Care Retirement Communities (5 percent share)

 Dental Services (4 percent share)

 Home Health Care (3 percent share)

 Other Professional Services (3 percent share)

 Other Non-durable Medical Products (2 percent share)

 Durable Medical Equipment (2 percent share)

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#37

Post by aaavl2821 »

4ntonius8lock wrote: post #23

I'm really not sure why this isn't mentioned: USA should commission a study of health care systems in other countries. Include costs, challenges, issues of bringing it to scale in US, etc. Then we can implement something based on real world experience and data. It seems that these highly complex topics are dealt at the ideological level only. Which is absurd, as details can make anything from any ideology horrible. I…

There is plenty of data on this available. It isn't perfect but it's there. The problem isn't lack of data, its lack of awareness of the data. Most people learn about the healthcare system by reading newspapers and other media, and from what I've seen coverage of healthcare in most US media is very political and seldom data-driven

Check out here to start, there are plenty of other resources: https://data.oecd.org/healthres/health-spending.htm

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#40

Post by leetcrew »

kerkeslager wrote: post #32
helpPeople wrote: post #6

Until Americans find Physicians (and Pharmacists) as the enemy, it will never happen. They(AMA and APA) are top lobbyists that entrench themselves using monopolistic practices. Sure school can cost 500k, but with 200 to 300k+ per year salaries, they can kill that debt. (This is their common defense)

With my skillset (software engineer) I can easily pull low six figures. And I'm confident that doctors provide more value than I do. I'm pretty sure I've never saved anyone's life. So I have zero problem paying doctors 2 or 3 times my pay, which is about what you're saying they get paid. Health insurance CEOs make, in some cases, literally hundreds of times my salary, while literally killing people for profit. I'm go…

not sure what kind of work you do, but if you make tools that save people time and you have many users, it could add up to many lifetimes not spent on some menial task. not quite the same, but I would argue that helping many people allocate their time towards activities they actually value is just as important as saving individual lives.
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