The REAL problem with US healthcare

In one word the real problem with health care in America is COST. People are now going to other countries to get procedures at a fraction of the cost and not always third world countries either. obamacare is a tiny Bandage on a severed artery and until we address the real issue of cost our health care system is and always will be a complete mess. What in your opinion could be done to drastically reduce cost in this country? One thing we could do is stop these huge law suits that make insurance so high for docs and hospitals.

"Desperate to find an affordable solution, he reached out to a sailing buddy with friends at a medical device manufacturer, which arranged to provide his local hospital with an implant at what was described as the “list price” of $13,000, with no markup. But when the hospital’s finance office estimated that the hospital charges would run another $65,000, not including the surgeon’s fee, he knew he had to think outside the box, and outside the country. “Very leery” of going to a developing country like India or Thailand, which both draw so-called medical tourists, he ultimately chose to have his hip replaced in 2007 at a private hospital outside Brussels for $13,660. That price included not only a hip joint, made by Warsaw-based but also all doctors’ fees, operating room charges, crutches, medicine, a hospital room for five days, a week in rehab and a round-trip ticket from America.

http://www.nytimes.com/2013/08/04/health/for-medical-tourists-simple-math.html?pagewanted=all&_r=0

sawyerloggingon said:

In one word the real problem with health care in America is COST. People are now going to other countries to get procedures at a fraction of the cost and not always third world countries either.

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So you're saying that you don't like America's free market health care? Big surprise :roll:

roughdraft274 said:

So you're saying that you don't like America's free market health care? Big surprise :roll:

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Why do people insist that the free market is this perfect entity?

sookster said:

Why do people insist that the free market is this perfect entity?

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IDK, You'd have to ask them.

sawyerloggingon said:

In one word the real problem with health care in America is COST. People are now going to other countries to get procedures at a fraction of the cost and not always third world countries either. obamacare is a tiny Bandage on a severed artery and until we address the real issue of cost our health care system is and always will be a complete mess. What in your opinion could be done to drastically reduce cost in this country? One thing we could do is stop these huge law suits that make insurance so high for docs and hospitals.

"Desperate to find an affordable solution, he reached out to a sailing buddy with friends at a medical device manufacturer, which arranged to provide his local hospital with an implant at what was described as the “list price” of $13,000, with no markup. But when the hospital’s finance office estimated that the hospital charges would run another $65,000, not including the surgeon’s fee, he knew he had to think outside the box, and outside the country. “Very leery” of going to a developing country like India or Thailand, which both draw so-called medical tourists, he ultimately chose to have his hip replaced in 2007 at a private hospital outside Brussels for $13,660. That price included not only a hip joint, made by Warsaw-based but also all doctors’ fees, operating room charges, crutches, medicine, a hospital room for five days, a week in rehab and a round-trip ticket from America.

http://www.nytimes.com/2013/08/04/health/for-medical-tourists-simple-math.html?pagewanted=all&_r=0

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That would actually be an excellent start. One reason that medical bills are so high is because of the absurd malpractice insurance fees due to the ridiculous amounts awarded in lawsuits.

roughdraft274 said:

So you're saying that you don't like America's free market health care? Big surprise :roll:

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Is that your answer to the question of how to lower health care cost in this country? Big surprise.:roll:

sawyerloggingon said:

In one word the real problem with health care in America is COST. People are now going to other countries to get procedures at a fraction of the cost and not always third world countries either. obamacare is a tiny Bandage on a severed artery and until we address the real issue of cost our health care system is and always will be a complete mess. What in your opinion could be done to drastically reduce cost in this country? One thing we could do is stop these huge law suits that make insurance so high for docs and hospitals.

"Desperate to find an affordable solution, he reached out to a sailing buddy with friends at a medical device manufacturer, which arranged to provide his local hospital with an implant at what was described as the “list price” of $13,000, with no markup. But when the hospital’s finance office estimated that the hospital charges would run another $65,000, not including the surgeon’s fee, he knew he had to think outside the box, and outside the country. “Very leery” of going to a developing country like India or Thailand, which both draw so-called medical tourists, he ultimately chose to have his hip replaced in 2007 at a private hospital outside Brussels for $13,660. That price included not only a hip joint, made by Warsaw-based but also all doctors’ fees, operating room charges, crutches, medicine, a hospital room for five days, a week in rehab and a round-trip ticket from America.

http://www.nytimes.com/2013/08/04/health/for-medical-tourists-simple-math.html?pagewanted=all&_r=0

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Too bad we can't talk about how those other countries managed to provide so much care for so much less.... because socialism which is still wrong even when it works better.... because reasons or something.

Wiseone said:

Too bad we can't talk about how those other countries managed to provide so much care for so much less.... because socialism which is still wrong even when it works better.... because reasons or something.

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Go ahead and talk about it. Tell us how they can do procedures on Americans for a fraction of the cost it is done here. I am looking for honest answers to an honest question.

sawyerloggingon said:

Is that your answer to the question of how to lower health care cost in this country? Big surprise.:roll:

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I never gave you an answer, just examined what you think is the problem...

sawyerloggingon said:

In one word the real problem with health care in America is COST. People are now going to other countries to get procedures at a fraction of the cost and not always third world countries either. obamacare is a tiny Bandage on a severed artery and until we address the real issue of cost our health care system is and always will be a complete mess. What in your opinion could be done to drastically reduce cost in this country? One thing we could do is stop these huge law suits that make insurance so high for docs and hospitals.

"Desperate to find an affordable solution, he reached out to a sailing buddy with friends at a medical device manufacturer, which arranged to provide his local hospital with an implant at what was described as the “list price” of $13,000, with no markup. But when the hospital’s finance office estimated that the hospital charges would run another $65,000, not including the surgeon’s fee, he knew he had to think outside the box, and outside the country. “Very leery” of going to a developing country like India or Thailand, which both draw so-called medical tourists, he ultimately chose to have his hip replaced in 2007 at a private hospital outside Brussels for $13,660. That price included not only a hip joint, made by Warsaw-based but also all doctors’ fees, operating room charges, crutches, medicine, a hospital room for five days, a week in rehab and a round-trip ticket from America.

http://www.nytimes.com/2013/08/04/health/for-medical-tourists-simple-math.html?pagewanted=all&_r=0

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Several years ago I went to a dentist in the Philippines - she had done some of her postdoctoral qualification at Harvard. She put in six crowns and replaced two fillings in my mouth, and did cleanings and minor fillings for my wife and son, all for $1000. I checked the price I would have paid stateside, and it was $16,000 just for my work alone. We were over there anyway, but the point is, for the money I saved by going to this dentist (that most people there think is very overpriced, btw), I could have flown myself and my family and stayed in a four-star hotel for a week - the work she did took two days - and we still would have had over $5K left over to spend.

roughdraft274 said:

I never gave you an answer, just examined what you think is the problem...

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And what exactly do these mega bucks law suits have to do with the free market?

roughdraft274 said:

So you're saying that you don't like America's free market health care? Big surprise :roll:

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America doesn't have a free market health care system...hasn't had one in a very long time.

Glen Contrarian said:

Several years ago I went to a dentist in the Philippines - she had done some of her postdoctoral qualification at Harvard. She put in six crowns and replaced two fillings in my mouth, and did cleanings and minor fillings for my wife and son, all for $1000. I checked the price I would have paid stateside, and it was $16,000 just for my work alone. We were over there anyway, but the point is, for the money I saved by going to this dentist (that most people there think is very overpriced, btw), I could have flown myself and my family and stayed in a four-star hotel for a week - the work she did took two days - and we still would have had over $5K left over to spend.

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Maybe that's the answer. If more and more Americans leave the country to get medical treatment at a fraction of the cost our providers may be forced to lower their rates.

sawyerloggingon said:

Go ahead and talk about it. Tell us how they can do procedures on Americans for a fraction of the cost it is done here. I am looking for honest answers to an honest question.

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Easy. Get the profit motive out of it. This is why ALL the other first-world democracies pay on average about half in taxpayer dollars what we ALREADY pay in taxpayer dollars...and most of their populations have longer life expectancies than we do.

Read that last sentence again - the other nations with truly socialized care are paying about HALF in taxpayer dollars than we're already paying, and they're getting BETTER results. You see, over there, one doesn't become a doctor to become rich - one becomes a doctor because one wants to heal people and help them live longer, healthier lives. The doctors over there are not rich, but they certainly don't have to worry about paying the bills, either.

America does have a single-payer system that works for entire families whether young or old - it's called TRICARE, and it's our military health care system...and I love it. I retired twelve years ago, but I go to the doctor fairly often...and you know what? Instead of listening to the doctor say, "Well, we cover this but we won't cover that so you have to argue with your insurance company to see how they're going to pay for it", the doctors instead say, "Well, this is what you need, so this is what we're going to do."

Yes, conservatives will claim that our military health care system isn't socialized, but is a benefit of service instead. Thing is, it doesn't matter whether you want to call it a benefit, it's STILL socialized medicine in form and function. They don't have to worry about the profit motive - the docs are paid well, but they're not there to get rich - and the service they provide is for the most part very, very good.

Mycroft said:

America doesn't have a free market health care system...hasn't had one in a very long time.

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Private hospitals, private doctors, private health insurance companies, sure its as socialized as it gets

Glen Contrarian said:

Easy. Get the profit motive out of it. This is why ALL the other first-world democracies pay on average about half in taxpayer dollars what we ALREADY pay in taxpayer dollars...and most of their populations have longer life expectancies than we do.

Read that last sentence again - the other nations with truly socialized care are paying about HALF in taxpayer dollars than we're already paying, and they're getting BETTER results. You see, over there, one doesn't become a doctor to become rich - one becomes a doctor because one wants to heal people and help them live longer, healthier lives. The doctors over there are not rich, but they certainly don't have to worry about paying the bills, either.

America does have a single-payer system that works for entire families whether young or old - it's called TRICARE, and it's our military health care system...and I love it. I retired twelve years ago, but I go to the doctor fairly often...and you know what? Instead of listening to the doctor say, "Well, we cover this but we won't cover that so you have to argue with your insurance company to see how they're going to pay for it", the doctors instead say, "Well, this is what you need, so this is what we're going to do."

Yes, conservatives will claim that our military health care system isn't socialized, but is a benefit of service instead. Thing is, it doesn't matter whether you want to call it a benefit, it's STILL socialized medicine in form and function. They don't have to worry about the profit motive - the docs are paid well, but they're not there to get rich - and the service they provide is for the most part very, very good.

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I don't think lowering doctor pay is going to make the difference between a 65K knee surgery here vs a 13K surgery somewhere else. Docs make a lot of money but not THAT much, I only wish it were that simple.

sawyerloggingon said:

I don't think lowering doctor pay is going to make the difference between a 65K knee surgery here vs a 13K surgery somewhere else. Docs make a lot of money but not THAT much, I only wish it were that simple.

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It's the whole system. Provider services are too high... and I am a provider. Malpractice insurance is too high. Insurance company payouts are too low and mired in slight of hand tricks to not pay out. Cap malpractice lawsuit payouts. Regulate the hell out of the insurance industry to stop abuses. Encourage lower cost quality healthcare by providing tax breaks for providers who do so. Unless we place universal health care in place, we need to do those three things at least to bring down costs.

sawyerloggingon said:

Maybe that's the answer. If more and more Americans leave the country to get medical treatment at a fraction of the cost our providers may be forced to lower their rates.

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Problem is, when a person goes to a different country for something other than outright tourism, then one needs to have a clue about how things actually work in that country...which means that he or she needs to be with local people who are knowledgeable and whom he or she can trust. This isn't such a problem if one goes to one of the other first-world democracies, but if one goes to a third-world nation like I did, one's taking a very real chance that he or she will be brought to, shall we say, less-than-top-notch health care professionals - and they are never, ever liable for any mistakes they make. Ya rolls the dice and ya takes yer chances.

I went where I did because I've got close family and many acquaintances there that I really can (and do) trust - and it helps that we do our part to stay on their good side, that we reach out and help them, too. That's why I knew I could trust them. The great majority of Americans don't have any such advantages.

CaptainCourtesy said:

It's the whole system. Provider services are too high... and I am a provider. Malpractice insurance is too high. Insurance company payouts are too low and mired in slight of hand tricks to not pay out. Cap malpractice lawsuit payouts. Regulate the hell out of the insurance industry to stop abuses. Encourage lower cost quality healthcare by providing tax breaks for providers who do so. Unless we place universal health care in place, we need to do those three things at least to bring down costs.

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I agree that it is the whole system, it has spiraled out of control. We need to scrap the whole freakin thing and start from scratch.

roughdraft274 said:

Private hospitals, private doctors, private health insurance companies, sure its as socialized as it gets

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The day I can shop for the best deal...nationwide...for an insurance policy or for a medical procedure, like I can when I want to buy a graphics card for my computer, is when we will have a free market health care system.

CaptainCourtesy said:

That would actually be an excellent start. One reason that medical bills are so high is because of the absurd malpractice insurance fees due to the ridiculous amounts awarded in lawsuits.

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This has been studied, and even with the most rigorous tort reform that has been proposed it would lower costs less than 1 % iirc. I am away from home till tomorrow so working from memory, so not positive of the exact number.

Note that this does not mean tort reform is not a good idea, and in fact some level of it would be good, but it is not a significant part of the overall problem.

sawyerloggingon said:

I agree that it is the whole system, it has spiraled out of control. We need to scrap the whole freakin thing and start from scratch.

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Yeah, I agree with that. I don't know about anyone else, but I started noticing things getting bad back in the mid-'80's with the advent of managed care and HMOs. I don't think this was the only issue, but it was coincidental.

Redress said:

This has been studied, and even with the most rigorous tort reform that has been proposed it would lower costs less than 1 % iirc. I am away from home till tomorrow so working from memory, so not positive of the exact number.

Note that this does not mean tort reform is not a good idea, and in fact some level of it would be good, but it is not a significant part of the overall problem.

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I'd like to see the potential impact of tort reform on malpractice insurance. I know that for OBGYNs for example, malpractice insurance is so high that their ability to make a living doing that job is severely compromised.

CaptainCourtesy said:

I'd like to see the potential impact of tort reform on malpractice insurance. I know that for OBGYNs for example, malpractice insurance is so high that their ability to make a living doing that job is severely compromised.

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If you remind me tomorrow I can dig around and see what I come up with.

sawyerloggingon said:

I don't think lowering doctor pay is going to make the difference between a 65K knee surgery here vs a 13K surgery somewhere else. Docs make a lot of money but not THAT much, I only wish it were that simple.

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No, it's not all that simple - but one must realize just how much profit is being made by health insurance agencies. Why is it that we had to pass a doggone law in order to keep the health insurance giants from spending less than 80% of their revenue on paying for actual health care while at the same time denying 1 out of every 7 claims???? Those were the REAL 'death panels'! Anyway, if we went to single-payer - and cracked down on Big Pharma for charging the American people FAR more than they charge other people for the SAME medications and equipment - our costs would drop significantly.

Two years ago my wife had bariatric surgery which probably would have cost us 20K (or more) outside. With the military health care system, it cost us $34 and change. That's all it cost.

But you know what? The American taxpayer actually SAVED money by paying for my wife's surgery. Why? Because she was diabetic, and she's not now. She was having high blood pressure, but she's not now. Instead of having to take 800mg of Motrin twice a day just to walk, now she takes Motrin maybe once a month. She's in better shape now than I am! And as a direct result, she's able to run a small business - an adult family home - employing several caregivers. Instead of being a longtime burden on the military health care system, she - and her employees - are making money and paying taxes every year. In other words, the American taxpayer PROFITED by paying for my wife's bariatric surgery!

When the people all have access to health care, they are as a whole healthier (which is why most first-world democracies' populations have longer life expectancies than we do)...which means they're better able to WORK and make money and pay taxes. One hand washes the other.