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The True Cost of Healthcare in the US

truecostofhealthcare.org

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Re: The True Cost of Healthcare in the US

#31

Post by bdesimone »

maxerickson wrote: post #26
bdesimone wrote: post #13

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.

Not at my fingertips, because I dealt almost exclusively with physicians in California. I'm basing this on almost every out of state physician remarking on how much lower premiums are when the move to California. NY and FL seem to be some of the worst states to work in for doctors paying their own premiums.

Malpractice rates are a factor, not the only factor in physicians deciding where and if to practice. Just like reimbursement rates.

Re: The True Cost of Healthcare in the US

#32

Post by bhousel »

robinh wrote: post #8
ambiate wrote: post #4

Earlier quoted context omitted.

If necessary, I will pay the penalty. I assume the credit for health care costs and taxes charged on health care should make up for any penalties incurred by the PPACA. If I read correctly, my penalty should only be $950-1300. Inevitably, with my insurance rates, I would spend that on 2 months of health coverage for my small family. Just to break down costs: $600/mo health for wife/kid. $7200/yr. vs ~200/mo + 1000 pe…

I'm not in the USA, but 'only $950-1300'? That's more or less what I pay for a whole year of health insurance in the NL. How much does insurance cost in the USA?

Here is an example rate sheet for where I live (Northern NJ):

http://www.horizon-bcbsnj.com/SiteGen/Uploads/Public/horizon...

Re: The True Cost of Healthcare in the US

#33

Post by kefka »

myko wrote: post #23
nirvana wrote: 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.

You can thank Rush Limbaugh politik for the "government death panels" garbage.

Re: The True Cost of Healthcare in the US

#34

Post by mlguenther »

The author missed a very important reason why hospitals are charging such high fees. In 1986 Reagan passed the "Emergency Medical Treatment and Active Labor Act". Since that time, hospitals are required to treat anyone, regardless of whether or not they have insurance, as if they were a fully insured patient. My wife, who is a physician in a busy hospital, consistently sees about 40% of her patients have no health insurance and are receiving free healthcare from that hospital. This may vary based on location, but I cant imagine by much. Hospitals foot the bill in this situation, and that is why costs to the insured are much higher.

Everybody seems to think they are smarter than everyone else when it comes to healthcare reform, but in all of the "smoking gun" articles that are posted, none of them have ever touched on this fact.

Even the new healthcare plan that passed does not address this directly, it assumes that the people who do not have healthcare will use a state healthcare exchange to get their own. I am a little pessimistic about this, and am assuming that only a small percentage of those people will do this.

Re: The True Cost of Healthcare in the US

#35

Post by rogerbinns »

pstuart wrote: 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.

IMHO the best solution would be a standard health care product paid for in a standard way (but reasonably affordable/means tested). It doesn't mean that the government has to collect all the money, or that the actual care has to be provided by the government. But what it would mean is that a baseline is available to everyone. It should also include discovering and disseminating best practises, improving overall health through any practical means (ie not just pills and doctor visits), and looking at things like hospice care for end of life instead of very expensive procedures and drugs.

And on top of that the free market can provide extras using whatever economic model works for them.

Re: The True Cost of Healthcare in the US

#36

Post by rogerbinns »

mlguenther wrote: post #34

The author missed a very important reason why hospitals are charging such high fees. In 1986 Reagan passed the "Emergency Medical Treatment and Active Labor Act". Since that time, hospitals are required to treat anyone, regardless of whether or not they have insurance, as if they were a fully insured patient. My wife, who is a physician in a busy hospital, consistently sees about 40% of her patients have no health in…

Atul Gawande covered the issue in this article: http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_...

Re: The True Cost of Healthcare in the US

#37

Post by cdavid »

nirvana wrote: 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…

There is an easy way to refute your argument: what you're saying about 'socialization' also happened in most developed countries. At least in France, so-called 'social security' (which is about mandatory health insurance, and not pension as in the US) came in place just after WW 2, and without the US insanity in price inflation.

Comparing with 1900 prices is a bit of nonsense given that there was little surgery at that time as well.

Also, there are quite a few things that are inherently expensive: diabete, dialysis, cancer (things that would have got you killed in the 1900). I don't know about the US, but dialysis costs around 100-200k euros / year, diabete around 100 k euros / year in France.

I would be curious to know how much cancer + dialysis + diabete contribute to health costs. I am ready to bet it is not in the low 2 digits.

Re: The True Cost of Healthcare in the US

#38

Post by adjwilli »

Alex3917 wrote: post #16
wiremine wrote: post #11

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…

Isn't 17% roughly 20%? Or rather, isn't 17% roughly a fifth?

Re: The True Cost of Healthcare in the US

#39

Post by ctdonath »

Shivetya wrote: post #30
nirvana wrote: 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 gro…

The same could be said about home mortgages. The increased availability in loans has exploded housing costs. ...and we've seen where that went.

The problem in all of these is the promise of a must-have little more if only repayment can be extended and others can be persuaded to contribute. What were luxuries become perceived as necessities. (And yes, I've said "no" to hospital tests, mortgage offers, and tuition financial aid.)

Re: The True Cost of Healthcare in the US

#40

Post by astrodust »

rogerbinns wrote: post #35
pstuart wrote: 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.

IMHO the best solution would be a standard health care product paid for in a standard way (but reasonably affordable/means tested). It doesn't mean that the government has to collect all the money, or that the actual care has to be provided by the government. But what it would mean is that a baseline is available to everyone. It should also include discovering and disseminating best practises, improving overall healt…

It's probably better if the federal level of government sets standards and it's up to the states to implement them.

Vermont, for example, is already ahead of the curve here.

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