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The True Cost of Healthcare in the US

truecostofhealthcare.org

21–30 of 118 posts

Re: The True Cost of Healthcare in the US

#21
Back when he was alive, Milton Friedman did a study of the costs of health care in the US from 1900 to the 1970s. (I think the first study was in the 1970s, and it was updated in the 1990s)

What he found was that the funding mechanism of health care over that time had shifted from patients paying out of pocket to government paying hospitals and government incentivized (by making it a tax write off for employers) and regulated (by preventing efficient pools of insured with state-by-state regulations) insurance.

Consequently, not only did the availability of health care go down, but the costs went up 26fold.

Or put another way, despite massive improvements in technology, medicine and productivity over 70+ years, costs skyrocketed from what you could afford out of pocket to what would bankrupt you. To put it in 2013 dollars, if you hypothesize a $100,000 surgery, in 1970[1] it would cost you $100,000, and you'd need insurance or go bankrupt, but in 1900 it would have cost you $3,846 (an amount you could put on credit cards today.)

Command economies don't work, and the change in health care over the last century has been a centralization in control. I with Obamacare this has dramatically ramped up and now there are boards to decide who gets what care based on cost measures, rather than medical need.

Whenever someone talks about the need for socialized medicine because "otherwise people would go bankrupt", remember it is the socialization of medicine that caused costs to rise to the point where people would go bankrupt.

[1] The study was originally done in the 1970s, but I'm using 2013 dollars here so you can understand how cheap things would have been.

Re: The True Cost of Healthcare in the US

#22
post #5

That's my doctor's site! The real takeaway (to me) is that single-payer health insurance would be the way to go.

I think it's a bit more complicated than that. It's easy to look at other countries and say, hey, that works there, therefore it will work here. But not all governments are created equal. If the government in the U.S. had a better track record, maybe it would be more palatable. But as is, I don't see single payer being the solution to our problems.

It doesn't solve everything but it should help to simplify matters greatly.

What would help too is ubiquitous electronic records management, e.g., any records from a visit with one doctor should be usable by the patient at another doctor.

Add to that cheaper testing and more AI / self-help and that should take it even further.

Lastly, kill the corn lobby and get some real sense into people about how their diet and lifestyle directly impact their health. What percentage of US healthcare costs are going towards diabetes and any related illnesses? And what percentage of that is directly related to obesity and a sedentary lifestyle?

Re: The True Cost of Healthcare in the US

#23
post #21

Back when he was alive, Milton Friedman did a study of the costs of health care in the US from 1900 to the 1970s. (I think the first study was in the 1970s, and it was updated in the 1990s) What he found was that the funding mechanism of health care over that time had shifted from patients paying out of pocket to government paying hospitals and government incentivized (by making it a tax write off for employers) and…

> now there are boards to decide who gets what care based on cost measures, rather than medical need.

How is this different from insurance companies, or are those what you are referring to? I'm really confused by your statement.

Re: The True Cost of Healthcare in the US

#24
post #2

After visiting the ER with a 108F temp due to pneumonia, I can attest to the fact that ER visits are a rip off. 3 unique doctor visits to the room + 1 IV + phlegm sample + 1 $60 pill + 1 prescription = $4200 for 50 minutes of office and 120 minutes of wait. Afterwards, I explained I did not have insurance. $60 pill was wrote off instantly. $4200 turned into $1200. Govt reimbursed 3/4ths of the bill instantly to the h…

Not having health care works if you don't have a catastrophic injury, and/or you are willing to let the hospital write off services and pass the bills on the the rest of us.

This isn't really a sustainable plan for the nation.

Re: The True Cost of Healthcare in the US

#25
post #2

After visiting the ER with a 108F temp due to pneumonia, I can attest to the fact that ER visits are a rip off. 3 unique doctor visits to the room + 1 IV + phlegm sample + 1 $60 pill + 1 prescription = $4200 for 50 minutes of office and 120 minutes of wait. Afterwards, I explained I did not have insurance. $60 pill was wrote off instantly. $4200 turned into $1200. Govt reimbursed 3/4ths of the bill instantly to the h…

I'm in the same boat. My insurance premium changed this year to $950 a month. We have 3 younger kids and are all healthy. I would be paying almost $12,000k a year for the privilege of being able to pay "less" after the deductible is met. Paying around ~$120 for an office visit is so much less than premium + copay, and like you said a lot of services prices change once they know you don't have insurance.

I wish health insurance were more like car insurance (accidental coverage, not maintenance) and I think we wouldn't have the same convoluted pricing we have now.

Re: The True Cost of Healthcare in the US

#26

I haven't read the whole site yet but I jumped to the topic I know fairly well, medical malpractice. Just some additional notes to consider: * 9 out of 10 physicians would discourage their children from becoming doctors.[3] There are many reasons for this. Malpractice insurance premiums are a factor. Not the only factor. * California physicians have the lowest insurance premiums in the country. This is directly the r…

Do you happen to have more digestible numbers? Something like: "In California, malpractice insurance is ~X% of cost, in the rest of the country, it is around Y% of cost."

My understanding is that for all the attention it gets, malpractice insurance isn't that big a deal. But I haven't researched it very much.

Re: The True Cost of Healthcare in the US

#27
Do other countries have employer-funded health insurance? Why doesn't my employer pay for, say, my car insurance? This system discourages people from leaving a job to start their own business because private health insurance can be very expensive.

Re: The True Cost of Healthcare in the US

#28

Earlier quoted context omitted.

Read it this weekend: I'd love to see a response from the health care industry that wasn't hand waiving. If he's right on 50% of his facts, it is disgusting how the system works.

"If he's right on 50% of his facts, it is disgusting how the system works." There were only a handful of actual statistics in there. The one thing he is wrong about though is that healthcare isn't "roughly 20% of the GDP", rather it's about 17.9%. The furthest out cms.gov gives yearly projections is to 2021, and even then healthcare is only supposed to be 19.6% of the GDP. And I think that might even include things l…

Facts are more than just statistics. There were numerous statements about (what seems to be) gross, gross overcharging on everything from pens to surgical gowns to diagnostic equipment. There were the exorbitant salaries and let's not forget the chargemaster.

Re: The True Cost of Healthcare in the US

#29
post #2

After visiting the ER with a 108F temp due to pneumonia, I can attest to the fact that ER visits are a rip off. 3 unique doctor visits to the room + 1 IV + phlegm sample + 1 $60 pill + 1 prescription = $4200 for 50 minutes of office and 120 minutes of wait. Afterwards, I explained I did not have insurance. $60 pill was wrote off instantly. $4200 turned into $1200. Govt reimbursed 3/4ths of the bill instantly to the h…

Not having health care works if you don't have a catastrophic injury, and/or you are willing to let the hospital write off services and pass the bills on the the rest of us. This isn't really a sustainable plan for the nation.

There's a hidden truth in 'writing off'.

Insurance companies wager paying the bill too. They say "We'll pay 60% of that $8000 ER visit."

Guess who covers 25% of that leftover 40%? In a majority of cases, the government.

(Source: My aunt has worked for a hospital performing these write-offs the majority of her 45 year life.)

Re: The True Cost of Healthcare in the US

#30
post #21

Back when he was alive, Milton Friedman did a study of the costs of health care in the US from 1900 to the 1970s. (I think the first study was in the 1970s, and it was updated in the 1990s) What he found was that the funding mechanism of health care over that time had shifted from patients paying out of pocket to government paying hospitals and government incentivized (by making it a tax write off for employers) and…

The same could be said about college education. The increased availability in grants and loans has exploded education costs.

With regards to medical care, far too many types of care are required to be carried by insurance companies who then pass the costs to their customers. Hospitals do not get full reimbursement for all types of patients, specifically government covered patients, so they pass the costs along to groups who can and do pay. Those being individuals and insurance companies, the later nothing more than a collection of individuals.

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