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.

Is the question about how to make health care cheaper, or how to make health care insurance cheaper?

If you want to make health care cheaper, how about this:

Go to med school, create your own pharmaceutical/ medical device company, and then give all of your services and products away for free!

Whoo hoo!

Originally Posted by honedright

Is the question about how to make health care cheaper, or how to make health care insurance cheaper?

If you want to make health care cheaper, how about this:

Go to med school, create your own pharmaceutical/ medical device company, and then give all of your services and products away for free!

Whoo hoo!

That would be great until a large corporation pays millions of $$ for well respected doctors to do "studies" showing that their products/services are better than yours. Then they might spend more money on advertising telling the public to tell their doctors that they need the expensive new-hightech products/services. Then nobody would want the free stuff, because it would be seen as second rate. That's what happens now with drugs and devices that work very well but don't have the profit potential anymore.

I don't think anyone is saying providers of service shouldn't be paid, but the services aren't always needed and those that are could be provided for a lot less overall if the system were made more efficient.

Jordan

Originally Posted by jnich67

That would be great until a large corporation pays millions of $$ for well respected doctors to do "studies" showing that their products/services are better than yours. Then they might spend more money on advertising telling the public to tell their doctors that they need the expensive new-hightech products/services. Then nobody would want the free stuff, because it would be seen as second rate. That's what happens now with drugs and devices that work very well but don't have the profit potential anymore.

I don't think anyone is saying providers of service shouldn't be paid, but the services aren't always needed and those that are could be provided for a lot less overall if the system were made more efficient.

Jordan

This sort of goes in hand with another thread about sheep and advertising. You either believe what you are told, or you believe what you experience for yourself.

It's all very simple. Don't get sick and if you do rely in a self help book or some witch doctor somewhere.