Bitter Pill: Why Medical Bills Are Killing Us

[Fraggle145]

This is a long one (I havent been able to read the whole thing yet), but I cant believe it hasnt shown up here yet.

http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/

Thoughts?

[yermom]

why do you hate capitalism?

[Fraggle145]

cuz I'm a dirty lib.

[StoopTroup]

I saw a story the other day that said these little paper cups that the Nurse or Nurses Aid brings you a couple of Tylenol or Advil which you probably already have in your Wife or GFs purse but Hospital Policy doesn't allow you to take....are charged to many folks bill and run as high as $12.00 just for the cost of the cup. I'm betting those things aren't much more than $12.00 to by from the guy who sells them to the Hospital for a Case and maybe even a whole Pallet of Cases of them.

http://www.phoenixmed2u.com/sc_images/products/448_image.jpg

[FaninAma]

When you read that article you will understand why primary care physicians and preventative health care are treated like 3rd class citizens in the realm of specialized hospital based acute care medicine. That's where the money is. Primary care is viewed as a necessary evil by the money changers who's sole purpose is to direct patients to the big profit centers.

[Pricetag]

yMf5dvUlYko

[KantoSooner]

So, Fanin, assuming that most of what is in that article is true, is there a way to 'fix' our healthcare 'system' short of going to a single payer/nationalized model? If so, what is it?
disclosure notice: I've asked this question of doctors, administrators and insurance people over the past five years and haven't gotten much of an answer from anyone involved in the current system.

[FaninAma]

Emphasis on preventative care. De-emphasis on heroic, costly end of life measures. As the government takes over more of the financing of medical care the customers are not going to be happy with the barriers to access that will be put inplace. There is only one way to contain costs.....restriction of access which is taking place even as we speak. There are already more and more restrictions being placed on expensive tests and procedures either by lowering reimbursement or raising the bar on the clinical requirements for recieving a specific test or procedure.

I also think the harrassment of physicians and care takers with threats of financial penalties for "abuse" of the system will cause more physicians to stop taking Medicare which will have the effect of also limiting access. I think the consequence was intended by the government. What is abuse of the system? Anything a government auditor says it is.

[rock on sooner]

Am I correct in assuming that most here think the Chargemaster system
is acceptable? Does anyone think that that sort of price gouging is "free
market capitalism"? Does anyone think that telling a very sick individual
that it is necessary to have $84000 up front to work to save that person's
life is okay? Does anyone think the declaring that it is a non profit entity and files
a profit statement of $700000000 plus is okay? Does anyone think that
charging $18 for a test strip that costs .55 cents or a generic version of
Tylenol $1.50 that cost 14.9 cents is okay?

Rather than continuing to list all the egregious charges, I'll ask one more question..
does anyone think this part of the medical complex should have any oversight
or any sort of cap on charges?

[yermom]

am i correct in assuming that you are a socialist?

why don't they just find a cheaper place to save their life?

they should shop around and let the market decide.

[badger]

I read the entire thing and the sob stories are about what you all might have seen in the movie "John Q," where a family is faced with someone needing emergency medical care, thinking they have insurance to cover it, but are instead met with the necessity of paying in advance before the life-saving treatment can happen.

I think I bemoaned selfishness in another Obamafest thread earlier today, which is what we have going on here --- nobody will do what's in everyone's best interest because that conficts with what's in self interest.

Why don't the hospitals charge fees that are just slightly above cost? Because fancy new hospital wings and big CEO salaries have to come from somewhere.

Why doesn't AARP and other liberal medical groups endorse plans that would save costs and benefit members? Because lobby lobby lobby lobby...ing.

Why don't elected officials, either Democrats or Republicans, support Medicare and hospitals seeking out the best medicines at the lowest costs? Because Big Pharma likes big profits.

Why don't people have better insurance that would pay all costs and be able to negotiate with hospitals better, or at least have higher limits to care? Because premiums are already rising and wages are stagnant as-is, so it's just not affordable, so we're all thinking about what's easiest for us in the present, not what will help in the future.

Centuries ago, many of today's treatable illnesses would have killed us instead. Maybe that's what the morbid intention is by pricing people out of the healthcare market?

[rock on sooner]

am i correct in assuming that you are a socialist?

why don't they just find a cheaper place to save their life?

they should shop around and let the market decide.

That's the rub of it all...the Chargemaster is THE list that all the
non profits use. My point is that I'm all for making a profit, as a
former small business owner. I set my prices based on the market,
not on blind siding unsuspecting, needy customers with 450% mark ups.
I think it borders on the criminal to charge $18 for something that costs
.55 cents, just and only because they can. If you are accepting of that
principal, I won't even try to label you, as you have me. In a lot of those
cases, there is no other place that can do what needs to be done, so pure
greed is the rule.

[KantoSooner]

I am a dyed in the wool capitalist. Enterprises should charge what they like for their products. If they charge too much, their customers will move to another supplier.

This works fine in a free market environment.

The problem with healthcare is that we do not have a free market, haven't for over 100 years. We have a highly regulated, controlled market. And part of that control is exercised by the competitors themselves. So, I don't feel that some degree of control over pricing is out of place; and really, the government is the logical entity to exercise that control.

[RUSH LIMBAUGH is my clone!]

...why don't they just find a cheaper place to save their life?

they should shop around and let the market decide.Wow! Yeow!!!

[SoonerBBall]

I am a dyed in the wool capitalist. Enterprises should charge what they like for their products. If they charge too much, their customers will move to another supplier.

This works fine in a free market environment.

The problem with healthcare is that we do not have a free market, haven't for over 100 years. We have a highly regulated, controlled market. And part of that control is exercised by the competitors themselves. So, I don't feel that some degree of control over pricing is out of place; and really, the government is the logical entity to exercise that control.

You mean *gasp* real capitalism? The kind that needs a strong federal government to reign in monopolistic and oligarchic markets? Absurd I say, we can only work with the extremes of full on socialist utopia or anarchic free market capitalism.

[KantoSooner]

You mean *gasp* real capitalism? The kind that needs a strong federal government to reign in monopolistic and oligarchic markets? Absurd I say, we can only work with the extremes of full on socialist utopia or anarchic free market capitalism.

I'll go with Hayek on this one. There are places where regulation is needed. I believe that healthcare and pharmaceuticals are two of them. They are not like cars or shovels or parcheesi sets. But, once you're in a regulated industry, it's nuts to believe that 'normal' market mechanisms are going to control prices, demand or supply. So, you regulate as little as you can, and you don't spend a lot of time wrapped around the axle emoting over that fact.

[yermom]

That's the rub of it all...the Chargemaster is THE list that all the
non profits use. My point is that I'm all for making a profit, as a
former small business owner. I set my prices based on the market,
not on blind siding unsuspecting, needy customers with 450% mark ups.
I think it borders on the criminal to charge $18 for something that costs
.55 cents, just and only because they can. If you are accepting of that
principal, I won't even try to label you, as you have me. In a lot of those
cases, there is no other place that can do what needs to be done, so pure
greed is the rule.

someone hasn't read many of my posts :D

[rock on sooner]

My original post in this thread was to get some response about the
criminality of these non profits. I am convinced that close oversight
and OVERHAUL of the Chargemaster pricing is needed. I'm scheduled
for my annual physical next week. My provider thinks I'm on Medicare
(I'm not) so he sent me a seven page form to fill out about my medical
history, since Medicare requires it. He'll be happy to know I'm not on
Medicare and he can bill my insurance at the higher rate.

There really has to be some regulation here. Otherwise, the poor and
uninsured will continue to bear the brunt of the greedy medical non
profits and suppliers, and the insured/taxpayers will continue to pay
through the nose to support ER insurance!...just sayin...

[8timechamps]

When you read that article you will understand why primary care physicians and preventative health care are treated like 3rd class citizens in the realm of specialized hospital based acute care medicine. That's where the money is. Primary care is viewed as a necessary evil by the money changers who's sole purpose is to direct patients to the big profit centers.

I can see that. Since insurance companies want as little utilization as possible. With that, insurance companies can set the market for things like "routine office visits" or "well child visits", which I can't imagine amounts to much.

My physician was part of a 3 doctor practice. He recently sold out to Exempla, and his reason was (his words) "We knew if we continued on our own, we would eventually run out of money. Now, I can at least have a regular pay check".

What has your experiences been? I'm assuming your in a PPO network, and if so, how does that affect your business?

[MR2-Sooner86]

anarchic free market capitalism

FTW

http://upload.wikimedia.org/wikipedia/commons/9/9a/VforVoluntary_normal.svg

[SoonerBBall]

FTW

http://upload.wikimedia.org/wikipedia/commons/9/9a/VforVoluntary_normal.svg

Except it isn't, because you end up creating vast market inefficiencies once monopolies and oligopolies come into existence. What we need is a system with as little regulation as possible, but also prevents regulators and regulatees from freely moving between the other position. It is much more difficult for regulators to be captured by the market with checks in place.

[StoopTroup]

I can see that. Since insurance companies want as little utilization as possible. With that, insurance companies can set the market for things like "routine office visits" or "well child visits", which I can't imagine amounts to much.

My physician was part of a 3 doctor practice. He recently sold out to Exempla, and his reason was (his words) "We knew if we continued on our own, we would eventually run out of money. Now, I can at least have a regular pay check".

What has your experiences been? I'm assuming your in a PPO network, and if so, how does that affect your business?

It's a good example of Doctor's being forced into making decisions they don't want to make. Financial trumps Patient Care. They get told how to take care of their patients by a Company that doesn't know the patient, has never seen the Patient and will never see the Patient.

[MR2-Sooner86]

Except it isn't, because you end up creating vast market inefficiencies once monopolies and oligopolies come into existence. What we need is a system with as little regulation as possible, but also prevents regulators and regulatees from freely moving between the other position. It is much more difficult for regulators to be captured by the market with checks in place.

Ummm if we're talking about fear of monopolies (which get where they're at with political help), you're an anarchist by default. The state has the monopoly of force.

When a private corporation burns women and children alive at Waco and gets away with it, or it puts a gun to the heads of over 50,000 men to force them to go die in Vietnam, I'll gladly listen to the evils of capitalism.

[SoonerBBall]

Ummm if we're talking about fear of monopolies (which get where they're at with political help), you're an anarchist by default. The state has the monopoly of force.

When a private corporation burns women and children alive at Waco and gets away with it, or it puts a gun to the heads of over 50,000 men to force them to go die in Vietnam, I'll gladly listen to the evils of capitalism.

Um, I'm not sure how my response got you there.

True free market capitalism lends itself to the creation of monopolies and oligopolies when there are high (or even medium) barriers to entry. That is the nature of any market with high barriers to entry and without government interference. The government should be there to encourage competition, not to grant private corporations monopoly or oligopoly power. I love capitalism, but free market capitalism makes generalized presuppositions about the state of all markets that doesn't lend itself to reality.

[Soonerjeepman]

someone hasn't read many of my posts :D

no doubt...I thought you were drunk there for a minute~

[Fraggle145]

someone hasn't read many of my posts :D


http://www.youtube.com/watch?feature=player_embedded&v=pGgnSfMydlw