Thread: How to make healthcare in USA cheaper?

So, we've all heard that USA spends far more money on healthcare than other developed countries and by some measures gets worse results (by other measures gets better).
In any case virtually every politician, no matter of ideology seems to say the costs are too high and getting higher and this has to be addressed. Of course, then you get their favorite recipe of how to fix it, usually reduced to ideological talking points.

Now, if you think rationally it's not all that complicated. Reduced costs need to come from one, or few of the following components:
1) Reduced services (patients get less care).
2) Reduced cost of services (doctors/pharmaceuticals/equipment makers get less for what they offer).
3) Reduced overhead (insurers get less).

Of course, the tricky point is to ensure that 'less is more', i.e. improve on the inefficiencies, not remove the good stuff.

So, where do you think the biggest inefficiencies are?
Do you have and idea how large they are (no point chasing 0.001% inefficiency if there's a 5% one)?
And more importantly, is your opinion based on relatively rigorous research (got a reference?), or is it due to politics/ideology/common sense?

I found some 2008 expenditure data

Source: http://www.cms.hhs.gov/NationalHealt...itures2008.pdf

Originally Posted by Hydaral

I found some 2008 expenditure data

Source: http://www.cms.hhs.gov/NationalHealt...itures2008.pdf

I'm intrigued by the "other spending". The admin cost seems reasonable to me as a percentage of the whole.

There is a footnote in the PDF:

Other Spending includes dentist services, other professional services, home health, durable medical products, over-the-counter medicines and sundries, public health, other personal health care, research and structures and equipment.

I've read that the largest amount of expenditure comes in the last month of life. I've also read that doctors practicing defensive medicine, i.e., ordering tests to cover themselves from the possibility of lawsuits has a big impact. I have no references, just stuff I've heard/read.

Lobbying politicians by pharmaceuticals, insurance companies and the A.M.A. is a large expenditure as is direct mail and other advertising. We love to hate insurance companies, at least I do, but they are for profit businesses. You cannot blame them for trying to minimize their risk and maximize their profits. OTOH, greed might be a consideration.

When I was a young man CEOs didn't make 400 times what their employees earned. In the 1960s my sister went to the U of Miami for 4 years and the tuition was something like $4,000. I think that is one semester now. Even 25 years ago I went for a doctor visit uninsured and it cost me $40.00. I went uninsured a couple of years ago and it cost $225.00. Now I am insured and it is out of pocket $560.00 per month. That is a lot of custom razors.

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.

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.

I keep hearing that from some of the politicians, usually on the right, but then I read about stuff like the surgeon in Tampa, FL who amputated the wrong limb on a diabetic and other such travesties. An incompetent doctor nearly killed my ex-wife in the early '80s. I inquired of a lawyer about suing the Dr. but was told that the case wasn't strong enough. I wasn't looking to sue out of greed but wanting retribution. It has to be pretty egregious to get to court IME.

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

Its not the best system in the world, but every one gets treatment, is is a very nominal amount out of your wages each month (a few pounds rather than the 100`s of dollars you guys pay) and you always have the option of going for private treatment if you want to pay for it.

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. And i found some of the reasoning behind it strange. The word comunist was banded around some what, and people seemed to think that people would be dieing in corridors and slumped on the pavement out side.

Originally Posted by BigIan

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

Its not the best system in the world, but every one gets treatment, is is a very nominal amount out of your wages each month (a few pounds rather than the 100`s of dollars you guys pay) and you always have the option of going for private treatment if you want to pay for it.

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. And i found some of the reasoning behind it strange. The word comunist was banded around some what, and people seemed to think that people would be dieing in corridors and slumped on the pavement out side.

It would be a joke if it wasn't so tragic. One of my best friends is 62 with no insurance and not in the best of health. He becomes enraged at the thought of NHC and starts the communist rant if anyone (me) is for it. The insurance companies, the American Medical Association, and the pharmaceutical companies spend billions in lobbying and advertising to keep the public perception of gov. health care negative. Vested interests. There is also the "rugged individualist, pull yourself up by your own bootstraps" perception peculiur to our culture here in the USA. A remenant of the frontier days that we all grow up seeing in the movies.

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.