Health care cost bubble!

[nun]

Health care cost increases seem very similar to the housing bubble. Many simply cannot contemplate paying such enormous amounts for health care. I certainly don't intend to pay for lifestyle drugs in retirement.

I'm 50 and my ex-doctor just tried to put me on hyper tension meds because of what I knew to be a couple of unnaturally high in office BP measurements. I had the knowledge to avoid getting on chronic medication, but I wonder how often it happens and how it inflates costs?

retirement-health-care-costs-marketwatch: Personal Finance News from Yahoo! Finance

 

[TromboneAl]

Are you saying that you think that costs will drop some time soon?

A few years ago I read a commentary saying "Don't worry, health insurance and health care costs can't continue to rise so much faster than inflation." But so far, they have.

 

[Blackwoodt]

I'm 50 and my ex-doctor just tried to put me on hyper tension meds because of what I knew to be a couple of unnaturally high in office BP measurements. I had the knowledge to avoid getting on chronic medication, but I wonder how often it happens and how it inflates costs?

Where I work we get a discount on our health insurance if we have a physical every year, including the normal blood work. I would say that at least 50% of us have had doctors try to push some drug on us without even discussing a lifestyle change.

It happened to my husband, the doctor wanted to put him on cholesterol medication, and sent him home with a prescription. I told him to tear it up, and that we would add a few supplements to his diet, eliminate any fried fast food, and get him rechecked. Long story short, in no time his total cholesterol was under 200.

I am in total agreement with you, many doctors would just as soon push a pill at you, then to spend the time to discuss what you could do on your own to avoid taking medication.

 

[nun]

Are you saying that you think that costs will drop some time soon?

A few years ago I read a commentary saying "Don't worry, health insurance and health care costs can't continue to rise so much faster than inflation." But so far, they have.

Yes, the increases are unsustainable and something will have to give....right now it's on the level of service side, people are just buying the bare min, high deductible policy as that's all they can afford, but eventually something will have to occur on the cost side.

However, I'm also saying that we can do sensible things to keep our costs down by being informed consumers. I'm a cyclist and know that my resting BP and pulse are 115/65 ish and 59/min, not 160/85 and 70/min that I was in the office. By knowing that my doctor was wrong about my apparent hyper tension I avoided getting on chronic medication and don't have that monthly cost. I also no longer have that doctor.

 

[eytonxav]

I've been feeling these increases are unsustainable for longer than the past ten years, and this is one bubble I'd like to see bust, but I'm not holding my breath waiting for it

 

[nun]

I've been feeling these increases are unsustainable for longer than the past ten years, and this is one bubble I'd like to see bust, but I'm not holding my breath waiting for it

That's how I felt with housing. It kept going up for far longer than I expected. Anything that increases by 3, 4 or 5 times inflation every year is unsustainable

 

[GregLee]

But aren't bubbles connected with borrowing? People don't generally borrow to finance their healthcare, or even pay as they go. They prepay.

 

[nun]

But aren't bubbles connected with borrowing? People don't generally borrow to finance their healthcare, or even pay as they go. They prepay.

Not necessarily, but borrowing makes them worse.

 

[Mulligan]

Where I work we get a discount on our health insurance if we have a physical every year, including the normal blood work. I would say that at least 50% of us have had doctors try to push some drug on us without even discussing a lifestyle change.

It happened to my husband, the doctor wanted to put him on cholesterol medication, and sent him home with a prescription. I told him to tear it up, and that we would add a few supplements to his diet, eliminate any fried fast food, and get him rechecked. Long story short, in no time his total cholesterol was under 200.

I am in total agreement with you, many doctors would just as soon push a pill at you, then to spend the time to discuss what you could do on your own to avoid taking medication.

I had that happen to me. Doc had a pad out wanting to prescribe Lipitor even though all my readings were excellent. His answer was he takes it, and his levels are fine, too, but it may prevent one of those unexplainable heart attacks some men get around 50.

 

[Ed_The_Gypsy]

Health care cost increases seem very similar to the housing bubble. Many simply cannot contemplate paying such enormous amounts for health care. I certainly don't intend to pay for lifestyle drugs in retirement.

I'm 50 and my ex-doctor just tried to put me on hyper tension meds because of what I knew to be a couple of unnaturally high in office BP measurements. I had the knowledge to avoid getting on chronic medication, but I wonder how often it happens and how it inflates costs?

retirement-health-care-costs-marketwatch: Personal Finance News from Yahoo! Finance

As an investor, I am betting against you. I have VGHCX.

Remember, the market can stay irrational longer than you can stay solvent.

Not sympatico, just ruthless.

 

[nun]

As an investor, I am betting against you. I have VGHCX.

Remember, the market can stay irrational longer than you can stay solvent.

Not sympatico, just ruthless.

That may well be a good bet, but the longer the bet is good the farther it will have to fall so get out before the bubble bursts.

 

[nun]

I had that happen to me. Doc had a pad out wanting to prescribe Lipitor even though all my readings were excellent. His answer was he takes it, and his levels are fine, too, but it may prevent one of those unexplainable heart attacks some men get around 50.

Many doctors don't think much, they just do what's considered as the standard of care and today it's easier to over prescribe than to act in a holistic manner and actually treat the patient.

 

[Dimsumkid]

I had something similar happen with my doctor 2-3 years ago, I normally get good BP readings, then when I saw my doctor, the readings were always spiking. My doctor almost put me on BP meds when she finally decided to take one last reading, and much to her surprise, it came out normal and no Rx meds were given to me. Turns out it's something called "white coat syndrome" where your BP spikes in a medical setting, so the trick was to wait until the end of the doctor's visit before a BP reading was taken.

 

[GregLee]

But aren't bubbles connected with borrowing? People don't generally borrow to finance their healthcare, or even pay as they go. They prepay.

Not necessarily, but borrowing makes them worse.

I'm not convinced. A number of googled references that I've just looked at for "health care bubble" are by health care people or disgruntled patients, rather than by economists, and don't actually argue that there is a bubble. The Wikipedia discussion of bubbles, http://en.wikipedia.org/wiki/Economic_bubble, centers around borrowing, and though many examples of bubbles are given, health care is not one of them. Even if the high and rising costs are, as many say, "unsustainable", I don't think that means there will be a collapse, as when a real bubble bursts. They'll just stop rising.

 

[rescueme]

That may well be a good bet, but the longer the bet is good the farther it will have to fall so get out before the bubble bursts.

I/DW are with E.T.G. We've both held VGHCX (and at times VGHAX, until we harvest gains and have to go back to VGHCX due to being below the minimum) for 20+ years.

With a current YTD gain of +8.59% thus far (+6.55 10 year) it has been a core holding for us, even though it's a sector fund.

Its advantages to us are its diverse areas, both in content but also in geogaphial areas, holding international stocks, pharmaceuticals, services, devices, and biotechnology. It's more than just a "pill manufacturer" and another one of those funds we hold since we use their products and see a greater need in the future.

 

[nun]

I'm not convinced. A number of googled references that I've just looked at for "health care bubble" are by health care people or disgruntled patients, rather than by economists, and don't actually argue that there is a bubble. The Wikipedia discussion of bubbles, http://en.wikipedia.org/wiki/Economic_bubble, centers around borrowing, and though many examples of bubbles are given, health care is not one of them. Even if the high and rising costs are, as many say, "unsustainable", I don't think that means there will be a collapse, as when a real bubble bursts. They'll just stop rising.

The burst of the bubble may not be in price, but in the number of people covered. Of course that would mean that the insurance industry would get smaller too, but it would still be very profitable and costs would probably still increase.

 

[FUEGO]

I have been thinking health care was a bubble for 10 years now. But the costs don't seem to be leveling, going down or popping.

Just got the costs for 2012 insurance for our family from DW's employer. Another 8% increase, with some increases and decreases in coverage. My employer's coverage keeps getting crappier and more expensive in terms of premiums, deductibles, copays and coinsurance amounts.

Maybe 10 more years before this bubble bursts. Although a few upcoming events may shorten this timeline. Obamacare kicks in in another 2 years (Jan 1 2014) that will give free or heavily subsidized coverage to a huge swath of middle and working class America. And I saw the military is rethinking the provision of lifetime medical benefits (with current active and retired being grandfathered in under the current system).

My wish is that I (and others) could get medical price transparency and preferred/discounted pricing without having to use an oligarchical health insurance company. I can pay $80 out of pocket for an xray or ultrasound (what the insurance negotiated rate is), but not the $600 rack rate that the Dr charges to cover the 4 out of 5 people who ultimately don't pay all of their medical bill.

 

[Lisa99]

Just because your doc wants to prescribe something doesn't mean you have to take it.

We are our own (and only) best advocate. If you don't want to take something, tell your doctor why. If you have a rational reason and he/she continues to push you towards unwanted meds find a doctor who is better in synch with you and your needs.

 

[FinanceDude]

I'm not convinced. A number of googled references that I've just looked at for "health care bubble" are by health care people or disgruntled patients, rather than by economists, and don't actually argue that there is a bubble. The Wikipedia discussion of bubbles, http://en.wikipedia.org/wiki/Economic_bubble, centers around borrowing, and though many examples of bubbles are given, health care is not one of them. Even if the high and rising costs are, as many say, "unsustainable", I don't think that means there will be a collapse, as when a real bubble bursts. They'll just stop rising.

Tort reform would help a lot........

 

[John Galt III]

I have been thinking health care was a bubble for 10 years now. But the costs don't seem to be leveling, going down or popping.

My wish is that I (and others) could get medical price transparency and preferred/discounted pricing without having to use an oligarchical health insurance company. I can pay $80 out of pocket for an xray or ultrasound (what the insurance negotiated rate is), but not the $600 rack rate that the Dr charges to cover the 4 out of 5 people who ultimately don't pay all of their medical bill.

Fuego, I was able to get a blood test done, for thyroid, for cash, for just $35, 3 years ago. No insurance, just cash. I had to shop around. Most labs wanted $200 or so for the same bloodtest. I didn't ask any questions about why it was only $35, of course. But the impression I got was that they were still making a profit, at $35, just not an obscene profit to cover the non-payers.

 

[braumeister]

I had something similar happen with my doctor 2-3 years ago, I normally get good BP readings, then when I saw my doctor, the readings were always spiking. My doctor almost put me on BP meds when she finally decided to take one last reading, and much to her surprise, it came out normal and no Rx meds were given to me. Turns out it's something called "white coat syndrome" where your BP spikes in a medical setting, so the trick was to wait until the end of the doctor's visit before a BP reading was taken.

Absolutely right.
Once my doctor and I realized this, the problem went away. He takes the BP, it's always somewhat high, we both ignore it. We chat about other things for five minutes or so, he takes another reading, and it's always perfectly normal, just as it is when I take my own reading at home.

 

[FUEGO]

Fuego, I was able to get a blood test done, for thyroid, for cash, for just $35, 3 years ago. No insurance, just cash. I had to shop around. Most labs wanted $200 or so for the same bloodtest. I didn't ask any questions about why it was only $35, of course. But the impression I got was that they were still making a profit, at $35, just not an obscene profit to cover the non-payers.

That's probably the one my insurance company pays $10 for. I have seen a service that allows you to "buy" a coupon for a lab test of your choosing and then redeem it at any local lab that participates (and all the big ones did participate). Rates reasonable like what you are quoting (ie $35 for a $200 rack rate test).

I'm just flustered from a recent (failed) attempt at getting a price quote. The insurance company can't tell me what they will pay on a specific procedure (even when I have the CPT code) because they claim many variables are involved. And the provider can't tell me anything other than the rack rate for the procedure (which is probably 5-10x the actual negotiated rate the ins co will be paying, hence the providers' price data is meaningless). At the end of the day, I gave up caring because we only pay 20% of the cost with no deductible with DW's insurance, and I figured at the most the procedure would cost $20-30 additional, so given the burdens of price discovery, why bother finding out what the cost would be. This is strictly an optional procedure covered by insurance, and I think the total cost to us will be no more than $30, but I could be wrong. Just sad that I can't find out how much it would cost to see whether it is worth it to us.

 

[meierlde]

Health care cost increases seem very similar to the housing bubble. Many simply cannot contemplate paying such enormous amounts for health care. I certainly don't intend to pay for lifestyle drugs in retirement.

I'm 50 and my ex-doctor just tried to put me on hyper tension meds because of what I knew to be a couple of unnaturally high in office BP measurements. I had the knowledge to avoid getting on chronic medication, but I wonder how often it happens and how it inflates costs?

retirement-health-care-costs-marketwatch: Personal Finance News from Yahoo! Finance

A home blood pressure monitoring device costs about $60. I go to the doctor with a list of about 20-30 readings, and that helps a lot. We checked the first time and the readings of the doctors equipment and the cuff were within a couple of points of each other. BTW note that insist that if a drug were to be prescribed that the doctor start with one on the $10/3 month list at various pharmacies. (Its cheaper than the co-pay if paid thru the mail order pharmacy).

Also starting with the generic medications means there is less likleyhood of unexpected events because there has been a period of large population testing of the drug to see if unexpected events happen.

 

[Blackwoodt]

I had something similar happen with my doctor 2-3 years ago, I normally get good BP readings, then when I saw my doctor, the readings were always spiking. My doctor almost put me on BP meds when she finally decided to take one last reading, and much to her surprise, it came out normal and no Rx meds were given to me. Turns out it's something called "white coat syndrome" where your BP spikes in a medical setting, so the trick was to wait until the end of the doctor's visit before a BP reading was taken.

My blood pressure has to be taken manually, for some reason the automatic cuffs give off extremely high readings on me, when I have normal BP. From what I’ve been told, the automatic readings are often unreliable, and you should always have your blood pressure taken manually.

 

[John Galt III]

I think health insurance has become like Wall Street derivatives : overly complex, on purpose, in an attempt to cover up the flimflam. Having made that negative statement, let me add that I am happy with my current health ins policy, from work, which has low premiums, and good coverage. But if I were to get coverage on my own , I would probably have to pay huge premiums.