Thread: How to make healthcare in USA cheaper?

When I was younger all hospitals were not for profit, you had the community hospital, the Baptist hospital, the Jewish hospital etc, then they became for profit. Costs have gone through the roof since, I wished I would have saved the video a friend sent me concerning the actual cost of the most popular prescription drugs versus the profit, it was astronomical.profit percentages in the 1000s%. Of course the largest lobbyist groups in DC are the Pharmacuetical corps.

Originally Posted by nun2sharp

When I was younger all hospitals were not for profit, you had the community hospital, the Baptist hospital, the Jewish hospital etc, then they became for profit. Costs have gone through the roof since, I wished I would have saved the video a friend sent me concerning the actual cost of the most popular prescription drugs versus the profit, it was astronomical.profit percentages in the 1000s%. Of course the largest lobbyist groups in DC are the Pharmacuetical corps.

Back when we were kids they never were short of a vaccine. They made them whether there would be a profit or not if the medicines were needed. For profit threw in the root of all evil into the equation.

Originally Posted by nun2sharp

When I was younger all hospitals were not for profit, you had the community hospital, the Baptist hospital, the Jewish hospital etc, then they became for profit. Costs have gone through the roof since, I wished I would have saved the video a friend sent me concerning the actual cost of the most popular prescription drugs versus the profit, it was astronomical.profit percentages in the 1000s%. Of course the largest lobbyist groups in DC are the Pharmacuetical corps.

And don't forget that we have to subsidize the profit that the drug makers aren't allowed to make overseas where prices are govnt. controlled.

Jordan

Originally Posted by BigIan

Why dosent the U.S have a standardised health care system like we do in the UK? (the nhs)

I ask this because i`m sure i herd somthing in the news about this not so long ago. And it seemed to me most americans didn`t want this system.

Most people DO want this system. The majority of Americans want a Public Option. The problem is that conservatives will stop at nothing to prevent this because of their own corporate greed. Insurance companies lobby politicians with millions of dollars to try to stop this from happening. Sadly, it has continuously worked.

My wife's expecting our first child and yesterday I logged into my healthcare insurance account and checked out a few claims made by the provider. I never see any bills (apparently my insurance is pretty good), but basically all that stuff is inflated. I understand why Jimmy got screwed over with a $244 bill when he was the one picking up the tab: He's paying the inflated rate, but since he's a single individual, he can't pop the balloon to get to pay a normal rate.

A claim for labwork in my overview:
Expense claimed: $144
Amount paid by plan: $15
Amount paid by employee: $0

That scared me slightly, as I was wondering where that went. Open up the details:
Expense claimed: $144
In-Network discount: $129
Amount paid by plan: $15
Amount paid by employee: $0

WTF??!??!??!?!? I thought healthcare was at least a semi-ethical business practice industry....

So bringing the cost down is going to be difficult: Let's say the doctors are forced to lower their rates. What happens? Lab/doc will claim a reasonable $25 instead of the $144. Insurance thinks "ooh, good stuff! Our almost 90% discount will make us pay a whopping $3!". These rate/discount adjustments need to be done in a synchronized fashion. That brings in A LOT of regulation: bring together literally thousands and thousands of providers and insurers for sync'ing and neverending battles on what the rate should be, or we'll get more regulation on prices: Government will decide what everything costs. Prices too low? Docs will do additional testing. Because discount rates are lower, insurance companies will complain that docs claim too much and will start shovelling these costs onto the patients.

People always have their complaints ready, but it's not an easy problem to solve. One thing is sure: the current situation is not good either. From what I read (not much on thsi subject, I'll be honest), being a health insurance provider is a profitable industry to be in.

Originally Posted by riooso

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.

The don't understand how this insurance could cost that much, it's staggering !! On the other hand, if I look at the numbers above as quoted by Gugi these premiums are clearly not important in the overall scheme of things (0.5% !!). How can these two numbers be reconciled I wonder ??

Maybe the system could use some tweaking but based on the above it looks to me that tort reform would only be good for the doctors, insurance companies etc. ... without really doing anything about the huge healthcare costs. What I'm saying is, the regular citizen would probably pay as much as before, and if something happens you'd be scr***d again !!

Originally Posted by Hillie

My wife's expecting our first child and yesterday I logged into my healthcare insurance account and checked out a few claims made by the provider. I never see any bills (apparently my insurance is pretty good), but basically all that stuff is inflated. I understand why Jimmy got screwed over with a $244 bill when he was the one picking up the tab: He's paying the inflated rate, but since he's a single individual, he can't pop the balloon to get to pay a normal rate.

A claim for labwork in my overview:
Expense claimed: $144
Amount paid by plan: $15
Amount paid by employee: $0

That scared me slightly, as I was wondering where that went. Open up the details:
Expense claimed: $144
In-Network discount: $129
Amount paid by plan: $15
Amount paid by employee: $0

WTF??!??!??!?!? I thought healthcare was at least a semi-ethical business practice industry....

So bringing the cost down is going to be difficult: Let's say the doctors are forced to lower their rates. What happens? Lab/doc will claim a reasonable $25 instead of the $144. Insurance thinks "ooh, good stuff! Our almost 90% discount will make us pay a whopping $3!". These rate/discount adjustments need to be done in a synchronized fashion. That brings in A LOT of regulation: bring together literally thousands and thousands of providers and insurers for sync'ing and neverending battles on what the rate should be, or we'll get more regulation on prices: Government will decide what everything costs. Prices too low? Docs will do additional testing. Because discount rates are lower, insurance companies will complain that docs claim too much and will start shovelling these costs onto the patients.

People always have their complaints ready, but it's not an easy problem to solve. One thing is sure: the current situation is not good either. From what I read (not much on thsi subject, I'll be honest), being a health insurance provider is a profitable industry to be in.

This is what I have done for a living for 20 years.

The providers and insurers contract for the discounted rate you see. Normally it is a set fee or a % of the Medicare fee schedule - or some other mechanism - depending on the type of service. It's rarely a % of the billed charge. Insurance companies essentially get a wholesale price and the individual without coverage gets stuck with retail. Those billed charges really have no basis in reality and have little to do with what the service costs to provide. They were set more by tradition than anything else. So next time a provider says, "but our standard charge is xyz..." - it means nothing.

Jordan

Originally Posted by decraew

The don't understand how this insurance could cost that much, it's staggering !! On the other hand, if I look at the numbers above as quoted by Gugi these premiums are clearly not important in the overall scheme of things (0.5% !!). How can these two numbers be reconciled I wonder ??

Maybe the system could use some tweaking but based on the above it looks to me that tort reform would only be good for the doctors, insurance companies etc. ... without really doing anything about the huge healthcare costs. What I'm saying is, the regular citizen would probably pay as much as before, and if something happens you'd be scr***d again !!

That is my impression of the current healthcare proposal though I must admit I've not read much on it. Only heard about it on NPR and the Lehrer Newshour. Look at the prescription drug benefit passed during the Bush administration. They got it through by making a deal with the drug companies that our gov would pay full retail unlike Canada which negotiates the price of pharmaceuticals and pays a much lower price for the same thing.

Now this administration goes down the same road with both the pharmaceutical and the insurance companies. My voter's registration reads "no party affiliation" and I voted for Obama and change. What it seems we are getting is the same old-same old. It seems to me that the bail out was for the banks and wall st and the health care plan is a windfall for the drug and insurance companies.

Originally Posted by jnich67

This is what I have done for a living for 20 years.

The providers and insurers contract for the discounted rate you see. Normally it is a set fee or a % of the Medicare fee schedule - or some other mechanism - depending on the type of service. It's rarely a % of the billed charge. Insurance companies essentially get a wholesale price and the individual without coverage gets stuck with retail. Those billed charges really have no basis in reality and have little to do with what the service costs to provide. They were set more by tradition than anything else. So next time a provider says, "but our standard charge is xyz..." - it means nothing.

Jordan

I agree. If a provider says "This costs $$$$$$!!!" and the insurance says "We'll pay you our agreed ¢¢", I already know it's a bunch of nonsense numbers they ask.

But what can an individual do in case they're not insured? Pay the $2000 the provider claims, or the $400 they agreed upon with the insurance corps? It'll be a difficult battle.

I don't think this would solve the problem, but it is an interesting perspective...

Doctor and Patient - The Doctor’s Failure to Cut Costs - Question - NYTimes.com

Jordan