How to make healthcare in USA cheaper?

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Originally Posted by smokelaw1

I hear a lot about how tort reform needs to be a big part of the package. I am quite far removed from the side of the practice of law that would be affected, but I wonder where this fits into that pie chart. I imagine it impacts many of those areas through the cost of malpractice insurance, and hence the cost of services, etc.

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I think this is a prime example of something insignificant blown way out of proportion for political reasons.
Here's one study on the matter: http://www.insurance-reform.org/TrueRiskF.pdf

Here's the summary

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• Medical malpractice premiums, inflation-adjusted, are nearly the lowest they have been in over 30 years.
• Medical malpractice claims, inflation-adjusted, are dropping significantly, down 45 percent since 2000.
• Medical malpractice premiums are less than one-half of one percent of the country’s overall health care costs; medical malpractice claims are a mere one-fifth of one percent of health care costs. In over 30 years, premiums and claims have never been greater than 1% of our nation’s health care costs.
• Medical malpractice insurer profits are higher than the rest of the property casualty industry, which has been remarkably profitable over the last five years.
• The periodic premium spikes that doctors experience, as they did from 2002 until 2005, are not related to claims but to the economic cycle of insurers and to drops in investment income.
• Many states that have resisted enacting severe restrictions on injured patients’ legal rights experienced rate changes (i.e., premium increases or decreases for doctors) similar to those states that enacted severe restrictions on patients’ rights, i.e., there is no correlation between “tort reform” and insurance rates for doctors.

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The emphasized parts to me mean the issue is borderline irrelevant in terms of actual effect. But its high profitability can be one explanation for the overexposure it gets.

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Originally Posted by BigIan

a work college of mine is originally from america, and has just become pregnant, she said her first reaction was (oh my god how are we going to afford this.
then she remembered she lives in the uk and so its free.
apparently it costs several thousand dollars to give birth over there.

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if there are complications the sums go to tens of thousands of dollars.

WhenI had my ACL surgery, I was admitted as outpatient , spent a few hours in a room to get prepped, then a few hours before I can leave. Total stay at the hospital ~7 hours cots ~$28000, I am not sure if anywhere in the world there is a Hotel that offers an apartment that expensive per day, might be wrong though. My total bill was ~35k , for a simple knee surgery...

One thing that is hidden in very wedge of the pie is what percentage each pays out for lawsuits. My doctor who is a GP pays $150,000 a year in insurance. We need Tort reform and regulation reviews. Both parties refuse to go there because the vast majority of the people that make the laws are laywers.

Hospitals cost 5 times what any other buildings cost per square foot without all the special gear because it is overseen by a special set of government inspectors, for instance. We are being strangled by needless regulations by people that constantly need to justify their jobs. These are just two things that would make medicine cheaper for everyone and are, once again hidden in every slice of the pie.


Take Care,
Richard

seriously how do pleople afford it?

there must be a roaring trade in back street hospitals....

cut the waste - I expect this is closest to cut the cost of services in your three options given

Waste in the U.S. Healthcare System Pegged at $700 Billion in Report from Thomson Reuters - Thomson Reuters

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Here are some of the study's key findings:

• Unnecessary Care (40% of healthcare waste): Unwarranted treatment, such as the over-use of antibiotics and the use of diagnostic lab tests to protect against malpractice exposure, accounts for $250 billion to $325 billion in annual healthcare spending.
• Fraud (19% of healthcare waste): Healthcare fraud costs $125 billion to $175 billion each year, manifesting itself in everything from fraudulent Medicare claims to kickbacks for referrals for unnecessary services.
• Administrative Inefficiency (17% of healthcare waste): The large volume of redundant paperwork in the U.S healthcare system accounts for $100 billion to $150 billion in spending annually.
• Healthcare Provider Errors (12% of healthcare waste): Medical mistakes account for $75 billion to $100 billion in unnecessary spending each year.
• Preventable Conditions (6% of healthcare waste): Approximately $25 billion to $50 billion is spent annually on hospitalizations to address conditions such as uncontrolled diabetes, which are much less costly to treat when individuals receive timely access to outpatient care.
• Lack of Care Coordination (6% of healthcare waste): Inefficient communication between providers, including lack of access to medical records when specialists intervene, leads to duplication of tests and inappropriate treatments that cost $25 billion to $50 billion annually.

Journalists may request a copy of the report from David Wilkins at <nobr>(734) 913-3397</nobr> or [email protected].

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And no, I didn't order the report, so I have not rigorously researched

This from Messiah Obama on July 22 '09:

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We have estimated that two-thirds of the cost of reform to bring health care security to every American can be paid for by reallocating money that is simply being wasted in federal health care programs.

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Welcome back.

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Originally Posted by hoglahoo

This from Messiah Obama on July 22 '09:

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700 billion is about 30% of the total cost - seems like a lot of room to improve.

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Originally Posted by hoglahoo

cut the waste - I expect this is closest to cut the cost of services in your three options given

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So 40% is in the first of my categories - patients should get less health care. That's why I think it's practically unsaleable to the public.
You can't just take people's right to choose from large amounts of garbage and instead throw some pearls before them, and expect them to like it.

Likewise another 23% in administrative overhead and poor coordination are necessary to avoid the fall into socialistic unified system.

Seems like the only ones left are the hard ones - fraud (19%), medical errors (12%), prevention (6%). That's in total about 10% of the health care costs and even if by some miracle they can be halved that'll be a 5% decrease in the overall cost.

If any of you have been in a hospital in the U.S and studied your bill you will easily see why things are so expensive. Every cotton ball and piece of tape they use is billed at many many times beyond the most reasonable cost. This model is passed from drug companies and hospital suppliers to all layers of middlemen and the hospital and finally to you. It's like if you went to buy a typical automobile which cost 15 grand to produce and you paid 100 grand for it. The system is set up to ensure generous profits for all involved.

30 years ago medical cost were nothing like this. What's happened. Are Doctors making more money? Are health workers in general making more money? Are hospitals suddenly paying that much more for construction and upkeep? Have government regulation changed that much? The answer to this is no. The costs have been pegged to the guys who supply the items and the middlemen and the insurance companies.

The whole health care model in this country is terminally ill.

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Originally Posted by thebigspendur

The whole health care model in this country is terminally ill.

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Agreed, I don't think the "market" works in health care or "for profit" health care. All those assumptions about behavior that drive the free market don't exist in the health care industry.

Also, about 80% of our spending goes to treat chronic disease. There has been a substantial increase in chronic disease over the last 25 years or so. The fact that we don't manage people with these conditions is a big problem:

Kenneth E. Thorpe, Lydia L. Ogden and Katya Galactionova of the Rollins School of Public Health at Emory University in Atlanta authored the report. They examined data from the 1987 National Medical Expenditure Survey and the 1997 and 2006 Medical Expenditure Panel Survey.

They suggested that increased spending on diabetes and some other conditions results from rising incidence of these diseases, not increased screening and diagnoses.

"The changing mix of medical conditions driving the rise in Medicare spending had consequential effects," they wrote. "More than half of the beneficiaries are treated for five or more chronic conditions each year. System fragmentation means that chronically ill patients receive episodic care from multiple providers who rarely coordinate the care they deliver, and chronic disease management programs are notably absent in traditional fee-for-service Medicare."



I think these patients, at a certain point should be required to participate in a disease management program. If they don't, their coverage levels should be reduced. If we're going to make an impact on cost, you have to follow the money. But then that would violate letting everyone have their cake and eat it too. Many seem to want to do whatever they want, get all the health care treatments they want from whoever they want, but they don't want to pay for it....It's frustrating.

Jordan

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Originally Posted by jnich67

Also, about 80% of our spending goes to treat chronic disease.

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Yes and when I was a young man the life expectancy was something like late 60s for men and 70s for women. Now you routinely have people living into their 80s, 90s and more then ever before 100+. That also translates to more $ along with the improved technology that made it possible.