Super-sized Nation = Supersized health-care costs...

[Tilikum Turbo]

Some interesting tidbits about us here why we shouldn't be shocked or surprised by our escalating health care costs:

Countries spending the most on health care

1. United States(2012)

> Health expenditure per capita(per person): $8,745
> Expenditure as a pct. of GDP: 16.9% (the highest)
> Pct. obese: 28.6% (the highest)
> Life expectancy: 78.7 years (8th lowest)

Another kick in the pants... friend of mine who works for the DOT was telling me another major factor in our crumbling infrastructure of roads and bridges is so many people now driving trucks/suvs, which of course then costs us higher taxes.

At the rate of Type I & II diabetes and obesity, my grand-kids most likely when they graduate from university, the cost of GDP in health care cost will be an astounding 22-25%

[sc_rufctr]

Not good news but having too much food is way better than not enough.

The problem is the diseases caused by obesity are very difficult to treat effectively.
Because so much of that treatment depends on the individuals actions more than anything else.

We all know diet and exercise can have a huge effect on our health.

What we need is a complete rethink of how we view and treat food.

EDIT::: Just after I posted this reply I got a pop up Pepsi ad!

[onewhippedpuppy]

One big piece that article is missing - how do comparable service costs compare per nation? For instance, what is the difference in cost of an appendectomy in the USA vs Turkey? I know several doctors and PAs, the cost of their malpractice insurance alone is staggering and drives up the cost of everything they do. Much how identical prescription drugs can be sourced for exponentially less in Canada or Mexico, I suspect identical health car services in the USA are substantially more expensive.

[john70t]

Definitely a PARF subject, but our current transportation efficiency % numbers are astoundingly bad.
It's like lighting off beef farts at the back of a train.

A few hundred years from now, engineers will just shake their heads.

[dennis in se pa]

Health care costs are high and rising in the US because of GREED. The same meds and procedures are much cheaper elsewhere. Viagra in the US = $15-$20. In India it's $1. It's criminal.

[sc_rufctr]

Originally Posted by onewhippedpuppy

One big piece that article is missing - how do comparable service costs compare per nation? For instance, what is the difference in cost of an appendectomy in the USA vs Turkey? I know several doctors and PAs, the cost of their malpractice insurance alone is staggering and drives up the cost of everything they do. Much how identical prescription drugs can be sourced for exponentially less in Canada or Mexico, I suspect identical health car services in the USA are substantially more expensive.

A doctor told me his insurance cost him about $1,400 a year. This was around 1988 (in Aus).
To put that into perspective at the same time it cost about $280 a year for a rating one driver to fully insure a car.

I wont even guess what they are now.

The US insurance costs would have to be on a completely different level.

[onewhippedpuppy]

Originally Posted by dennis in se pa

Health care costs are high and rising in the US because of GREED. The same meds and procedures are much cheaper elsewhere. Viagra in the US = $15-$20. In India it's $1. It's criminal.

I'd love to hear one of our doctors' perspective. Per my doctor neighbor friend (fellow car guy), malpractice insurance is the single highest cost for a doctor or clinic. He's a member of a multi-doctor family practice, mainly because he can't afford to have his own practice.

[Jim Richards]

Super Size Me (2004) - IMDb

[Shaun @ Tru6]

Malpractice insurance shouldn't be so high. Every major state, by population, enacted tort reform many years ago. Probably 90% of the country lives in a tort reform state.

So we should ask insurance companies if they want to make less money, would they be OK with that.

[fintstone]

I think the greed that several have mentioned is not so much on the part of doctors or insurance agencies as implied...but rather, the lawyers and the citizens that constantly sue the doctors and pharmaceutical companies. It seems like there is a commercial for some type ambulance chaser every 10 minutes on TV to sue for some medical-related reason.

No one spends big bucks on advertising if they do not make that much and more as a result.

[Shaun @ Tru6]

Get involved.

Tort reform

Originally Posted by fintstone

I think the greed that several have mentioned is not so much on the part of doctors or insurance agencies as implied...but rather, the lawyers and the citizens that constantly sue the doctors and pharmaceutical companies. It seems like there is a commercial for some type ambulance chaser every 10 minutes on TV to sue for some medical-related reason.

No one spends big bucks on advertising if they do not make that much and more as a result.

[fintstone]

The $2M cap in VA is a good start...but still too high. Nationwide tort reform for pharma is what we really need...as the costs incurred in other states is passed on to all who buy the medication.

[widgeon13]

You would think that there would be some economy of scale. Corporations are usually trying to reduce cost through M&A as well as automation and computer technology, why not the healthcare system?

Seems like everything the government is involved in cost more, a lot more.

[Neilk]

Originally Posted by fintstone

The $2M cap in VA is a good start...but still too high. Nationwide tort reform for pharma is what we really need...as the costs incurred in other states is passed on to all who buy the medication.

Tort reform is good in theory, but what happens in a LEGITIMATE case when someone is left incapacitated and needs serious long term care? After lawyer's fees, you may be down to $1.3 million. If they happen to live over 10 years, they may end up destitute. Unfortunately, for every case l mentioned, there are probably 20 ridiculous cases that messes it up for everyone else.

Speaking of greed, how about "out of network" facilities or doctors that charge 10x the prevailing rates and get them because they are out of network? A co-worker recently went to an out of network surgical facility (her doctor was in network) and they charged the insurance $80,000 for a O/P surgery in which she was only in the facility, including surgery and recovery, 6 hours. That is insane. Also check out this article about a $117,000 surgical assistant. Link.

[fintstone]

Originally Posted by Neilk

Tort reform is good in theory, but what happens in a LEGITIMATE case when someone is left incapacitated and needs serious long term care? After lawyer's fees, you may be down to $1.3 million. If they happen to live over 10 years, they may end up destitute. Unfortunately, for every case l mentioned, there are probably 20 ridiculous cases that messes it up for everyone else.

Speaking of greed, how about "out of network" facilities or doctors that charge 10x the prevailing rates and get them because they are out of network? A co-worker recently went to an out of network surgical facility (her doctor was in network) and they charged the insurance $80,000 for a O/P surgery in which she was only in the facility, including surgery and recovery, 6 hours. That is insane. Also check out this article about a $117,000 surgical assistant. Link.

The problem with a set $2M cap is that if you beak your toe...you can sue for $2M or you can be an invalid for life and sue for $2M. As you posted, most cases are ridiculous (broken toe) which creates problems for those that are legit.

In VA, the limits are a cap for "pain and suffering, medical bills, wages, and punitive damages". A better system would significantly limit compensation for pain, suffering and punitive damages, but not medical bills and wages.

As far as the "out of network" costs...in a free market, a provider chooses what they charge for their services just like any other profession/business. One must shop for medical services like anything else. There is a reason that they are "out of network".

[Shaun @ Tru6]

Originally Posted by fintstone

As far as the "out of network" costs...in a free market, a provider chooses what they charge for their services just like any other profession/business. One must shop for medical services like anything else. There is a reason that they are "out of network".

Pricing is nearly impossible to get. You can't shop around.

[fintstone]

Originally Posted by Shaun 84 Targa

Pricing is nearly impossible to get. You can't shop around.

It seems to me that going "out of network" is "shopping around"...for higher costs.

Imagine trying to find care under Tricare (military health care)...which pays about 30% of retail to providers.

[scottmandue]

I'm starting my diet and exercise program... tomorrow.

Hard to tell if our medical care is going forward or backward in America... we have amazing tech but the bureaucracy juggernaut is daunting... as has been said it seems to be more about the Benjamin's that taking care of people.

[Neilk]

Originally Posted by fintstone

It seems to me that going "out of network" is "shopping around"...for higher costs.

In my co-worker's case, her doctor directed her to that outpatient surgical center. They told her to pay whatever amount she was comfortable paying for her co-pay, knowing that her insurance was about to get screwed with a ridiculous out of network surgical charge that the insurance would be on the hook for.

There are way too many parties that are gaming the system, from insurances denying legit procedures, doctors upcoding to get a higher reimbursements and on and on.

[wdfifteen]

Originally Posted by Shaun 84 Targa

Pricing is nearly impossible to get. You can't shop around.

Hospitals have been required to have a master list of prices for a long time, but they were not required to reveal it or stick to it. It should be getting better. There is a provision in the ACA to make not only the master list but also the prices actually charged available. So if you are in a position to shop price, it should be easier to do it in the future. It ought to be as easy as going on line and shopping for the best CD rate.