Why medical bills are killing us.

[Midpack]

Just noticed that Charlie Rose is interviewing the author of the TIME article. Aired last night and today in most TV markets in case anyone is interested. It's on my DVR, I'll watch it later today...

[Tyro]

Quote:

Originally Posted by Midpack Just noticed that Charlie Rose spent his full 1-hour show interviewing the author of the TIME article. Aired last night and today in most TV markets in case anyone is interested. It's on my DVR, I'll watch it later today...

He was also interviewed on The Daily Show last night.
The Daily Show with Jon Stewart - Political Comedy - Fake News | Comedy Central

I'm glad this was posted. I was about to do it myself if it hadn't been, though I think it's more than just a "Health" issue. It's having effect on all of our bottom lines, which in my mind makes it a "Money" issue as well.

I think Steven Brill will be interviewed about this article on a lot more talk venues in days/weeks to come.

Tyro

[Alan]

Quote:

Originally Posted by Texas Proud I am a bit surprised that we spend about $4K per person using public funds... heck, that is more than almost all other countries... and more than a significant number of countries TOTAL spending...

I've seen this before and it is surprising. I don't know if this public spending on healthcare includes the tax subsidies employers and employees receive on HI premiums. Even though I am very fortunate, and very pleased, to have retiree HI, there was an immediate increase in what I actually pay as the premiums no longer were taken before tax, plus I lost the FSA that I had as an employee.

[ERhoosier]

Quote:

Originally Posted by Stanley +1 This can't be that hard. Other countries provide good medical care to their population at cost that is often half of what we spend. It can and is being done.

Need to control 3 things in US health care:

1. Overutilization- More care is often NOT better care, but can lead to worse outcomes. Providers and patients need to understand this.
2. Greed- Profit margins in US health care remain rather (ahem) 'generous'
3. Liability- Medical malpractice & defensive medicine account for MUCH more costs than many want to admit. IMHO specialized medical/health care courts (like tax court, family court, etc.) would be a good start.

[Mulligan]

Quote:

Originally Posted by ERhoosier Need to control 3 things in US health care: 1. Overutilization- More care is often NOT better care, but can lead to worse outcomes. Providers and patients need to understand this. 2. Greed- Profit margins in US health care remain rather (ahem) 'generous' 3. Liability- Medical malpractice & defensive medicine account for MUCH more costs than many want to admit. IMHO specialized medical/health care courts (like tax court, family court, etc.) would be a good start.

Just last night a reform Doctor was talking about the costs of over utilization on tv. There were 3-4 examples cited, but the one I remember was MRI's for lower back pain. I had a near 3 week bedridden encounter with my lower back a few years ago when it went out on me. GF was mad at me because I wouldn't go to doctor. I told her the first thing they would do was order an MRI and I didn't want to pay for it. Plus it would have hurt to bad to go. I knew time was on my side and eventually my back would give up the fight and get tired of laying around. The decision "paid off" literally.

[Purron]

Very interesting article about healthcare in America in the latest issue of Time magazine. Always follow the money to understand an issue.

Bitter Pill: Why Medical Bills Are Killing Us | TIME.com

[Purron]

Part time poster so defer to the ongoing discussion. Mods, feel free to delete or merge into the ongoing thread.

[ERhoosier]

Overutilization, or just added cost of entertainment (i.e. inc in higher ticket prices)?

For NFL teams, Combine is all about the medical tests | ProFootballTalk

[Gatordoc50]

http://www.huffingtonpost.com/howard...comm_ref=false

Looks like a trend. Overspending with lackluster results.

[Midpack]

Quote:

Originally Posted by Gatordoc50 Howard Steven Friedman: 5 Countries With the Highest Military Expenditure Looks like a trend. Overspending with lackluster results.

With one notable difference...

[DeborahB]

The sad truth in the USA is that many people are denied health insurance (myself included) even when they can afford to pay for it (unwillingly...). I bought into my state's high-risk pool after BCBS refused to take me - and pay $941 a month for myself. It's bankruptcy insurance for me, and has a known end in sight when on June 1, I get on Medicare. Still, it is appalling. It does get me a good discount on prescriptions, but very little else. What it really does is cover me so that if something catastrophic happens, there is an upper limit to what I have to pay out of pocket - and they pay 100% after that. Three more months and counting down.

I worked in the healthcare industry for the last 12 years of my working life. There is nothing in the Time article that strikes me as inaccurate, or unusual. Not only does Medicare get a huge discount on services it pays for, all insurance companies do. Nearly 20 years ago I had a surgery bill for $21K (from the hospital, not counting doctors' fees). The hospital got about $7K for that bill from my insurer.

The whole system is crazy. My internist thinks it's crazy. All the doctors have to employ people whose entire job is arguing about payments, with insurance companies.

I hope it gets better. At least on Medicare I won't pay as much for the insurance.

[Purron]

Always follow the money. From the article:

"According to the Center for Responsive Politics, the pharmaceutical and health-care-product industries, combined with organizations representing doctors, hospitals, nursing homes, health services and HMOs, have spent $5.36 billion since 1998 on lobbying in Washington. That dwarfs the $1.53 billion spent by the defense and aerospace industries and the $1.3 billion spent by oil and gas interests over the same period. That’s right: the health-care-industrial complex spends more than three times what the military-industrial complex spends in Washington."

Yes, it's a big mystery why the conversation in Washington has been steered to who pays the bills instead of why the bills are so high.

[gerrym51]

i have been reading this thread with amusement. most people have hospital stays that are paid by insurance.

the hospital bills a gigantic amount. the insurance company says the contracted price is 20 percent of total bill. and that all the hospital gets, and covered person owes no more.


the hospital bills that ridiculous price to make sure they get every cent possible.

[meierlde]

Quote:

Originally Posted by gerrym51 i have been reading this thread with amusement. most people have hospital stays that are paid by insurance. the hospital bills a gigantic amount. the insurance company says the contracted price is 20 percent of total bill. and that all the hospital gets, and covered person owes no more. the hospital bills that ridiculous price to make sure they get every cent possible.

It was interesting to get the medical bills when my mother was in the hospital (she was 81 at the time) There was a big total of itemized items, then it was zeroed out and a new price inserted because of medicare.
I have often wondered what would happen if you passed a simple law, medicare's charge level is now the price all pay. How many of what would cease. Physicians would have to sort of take it or find another profession for example.

[bondi688]

Is it true that MedicAid and MediCare low ball the the hospital and doctors' fees, and the hospitals are losing money on those patients? And that is why some doctors refused to take or limit the number of MedicAid and MediCare patients. If that is the case, that fee schedule used as the standard will bankrupt the medical care system, or drastically reduce the income of the medical personnel resulting in more people leaving the profession.

[ERhoosier]

Quote:

Originally Posted by meierlde I have often wondered what would happen if you passed a simple law, medicare's charge level is now the price all pay. How many of what would cease. Physicians would have to sort of take it or find another profession for example.

Best evidence is the system would collapse. Most providers can care for large #s of Medicare patients only because other privately insured patients pay more for care (i.e. cost shifting). Medicare often pays LESS than the actual cost of delivery of specific health care service (especially after billing overhead). In many areas it is becoming increasingly difficult to find docs accepting new Medicare patients, and Gov't threats to cut reimbursement further will only make things worse.
Tips on Finding a Medicare Doctor - Medicare.com
Doctors limit new Medicare patients - USATODAY.com

And there is already a big (& worsening) shortage of primary care docs-
Study Foresees Shortage of Primary-Care Doctors - US News and World Report

[Gatordoc50]

Quote:

Originally Posted by meierlde It was interesting to get the medical bills when my mother was in the hospital (she was 81 at the time) There was a big total of itemized items, then it was zeroed out and a new price inserted because of medicare. I have often wondered what would happen if you passed a simple law, medicare's charge level is now the price all pay. How many of what would cease. Physicians would have to sort of take it or find another profession for example.

They wouldn't have to necessarily find a totally different profession. They could become physician assistants, nurse anesthetists, RNs, etc. Or they could use their undergrad degrees in accounting, chemistry, engineering, biology, finance, etc. I wouldn't worry about the physicians. That's sort of like dumping a swimsuit model and worrying that she might not get another date.

[Katsmeow]

Quote:

Originally Posted by ERhoosier Best evidence is the system would collapse. Most providers can care for large #s of Medicare patients only because other privately insured patients pay more for care (i.e. cost shifting). Medicare often pays LESS than the actual cost of delivery of specific health care service (especially after billing overhead).

What real evidence is there that Medicare pays less than the cost of care. From what I have read (including the recent article in Time) I am skeptical that Medicare pays less than cost of providing. I am quite sure that some physicians don't feel Medicare pays enough and as a result those physicians choose not to accept Medicare (which is their right). That is not the same thing as saying they are receiving less than cost.

I'm sure that physicians and other providers would like to be paid more than Medicare pays but that doesn't mean to receiving less that the preferred amount means that provider is losing money.

[eridanus]

Quote:

Originally Posted by ERhoosier ' 3. Liability- Medical malpractice & defensive medicine account for MUCH more costs than many want to admit. IMHO specialized medical/health care courts (like tax court, family court, etc.) would be a good start.

Tort reform is a "red herring." It's miniscule ($30B out of $1T). Defensive medicine is harder to calculate.

Would Tort Reform Lower Costs? - NYTimes.com

http://www.jhsph.edu/news/news-relea...-spending.html

There are plenty of other studies that come to the same conclusion.

If you want a Real World example, look at Texas. Sure, malpractice premiums came down but the savings didn't pass through to the consumer. Providers just made more.

New study: Tort reform has not reduced health care costs in Texas | www.statesman.com

[frank]

the next thing I am looking for on my medicals bills is that medicare will pay this much but you are responsible for the balance if you wish to see the doctor.