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Originally Posted by Escort Rider
This is a very complex area, and the reasons why health care costs so much are multiple and complex.
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That actually has very little impact on health care costs.
The reasons health care costs are enormous is because hospitals have created cartels which stifle competition and allow for collusion and price-fixing.
Also, an hospital is the least efficient means of health care delivery.
A good example took place in Cincinnati a few years back. A group of doctors wanted to open a cardio-pulmonary center. All they would do is open heart surgery.
The 2 hospital cartels and the "health insurance" companies ran lickity-split to Columbus and rammed through legislation outlawing it.
Why?
Because their published fee schedule had the cost of open-heart surgery $13,000
less than the cheapest hospital here charges.
That means everyone who has open-heart surgery in this area pays $13,000 more than they should be paying (and in some cases their paying more than $20,000 more).
The hospitals complained the cardio-pulmonary center would "siphon off" a large part of their client base, um, patient base.
How is it they can charge $13,000 less?
Do they have an $8 Million parking garage to pay off? No.
Do they have private police with multi-million payroll? No.
Do they have to pay the high cost of insuring a parking garage? No.
Do the have to subsidize a geriatric ward? No.
Do they have to subsidize a pediatric ward? No.
A psychiatric ward? No.
The special pharmacy with psychotropic drugs? No.
Weight loss clinic? No.
Orthopedics? No.
Ophthalmology? No.
Ear, Nose and Throat? No.
OB-Gyn? No.
Emergency Room? No.
Anyone figure out why it costs less yet?
If women went to birthing clinics instead of hospitals, they'd be paying $2,300 for child-birth instead of $9,000+
Big price difference.
Call around your local hospitals posing as expectant parents looking for a good hospital and ask how many beds for new borns there are, then go online to state vital statistics office and see how many children were born in your county.
A few years ago in Hamilton County the hospitals had 136 beds for newborns. Each bed is available each day so 136 x 365 equals 49,640 bed days, but there were only 892 infants born and if each infant stays three days, that 892 x 3 = 2676 bed days.
Isn't the number of beds available kind of lop-sided? Is that a good use of resources and money? Is that efficient? No.
The two corollaries of Capitalist Theory are "diversify and specialize."
Would you say hospitals are an excellent example of Capitalist Theory? No, of course not and because they aren't, you have duplication, waste and inefficiency.
People want an European health care system in name only. If you want system like Europe, then you'll have to close about 60% of the existing hospitals.
We have 19 hospitals here serving a county population of about 1 Million. I guaran-damn-tee you that you will not find a situation even remotely close to that anywhere in Europe.
For 1 Million people, 4-5 hospitals is all you need.
You want to know how Europeans manage costs? You can't get open-heart surgery in just any hospital. You might have to travel by car or train about 8 hours to get to a hospital that performs open heart surgery. Why? To prevent waste and duplication.
You want to lower health care costs 700% in just a few minutes?
1) Adopt the sports rule. You can only own one hospital per market.
2) Outlaw cartels and establish strict regulation. If an hospital administrator even
thinks about contacting an administrator at another hospital in person, by phone or by e-mail, they have stop everything and file a 378 page report with a regulatory agency. That'll put an end to collusion and price-fixing.
3) Define "hospital" as any medical facility that offers more than 4 different types of medical services, then require any facility that offers 5 or more services to obtain a special license the cost of which will be equal to 50% of their gross revenues. That'll put an end to hospitals and force them to diversify and specialize, which will lower costs tremendously.
The result will be that many facilities and clinics won't be able to compete and go under, and then number of service providers will be reduced which will further cut costs.
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Originally Posted by Escort Rider
They include insurance company greed
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The solution there is to tax "health insurance" companies out of existence or until the reduce their profit margin to less than 20%.
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Originally Posted by Escort Rider
tort law (practicing medicine to include unnecessary tests and procedures with an eye to potential lawsuits)
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That won't help. The main problem is you'll have two lawsuits where a hospital negligently amputated the wrong limb, yet in one case the plaintiff will get a jury award of $650,000 and in the other case $17 Million.
That needs to be standardized (yes, put a price on body parts) with a special modifier based on occupation. The jury then can award additional damages if there is negligence, and let the damages arithmetically multiply for repeated incidents at a hospital, for example Tampa General amputated the wrong leg of a patient twice in less than a year. No excuse. First lawsuit is $1 Million, 2nd $2 Million, 3rd is $4 Million etc.
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Originally Posted by Escort Rider
, the high cost of high-tech diagnostic tools (such as MRI's and colonoscopies)
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That is less of an issue than abuse. We had some smirking **** in our office who had sonogram every month of her pregnancy, and no it was not a problem pregnancy. There is no possible way to medically justify that, but then as I've been saying all along, the difference between Europeans and Americans is that Europeans go to the doctor to get well, while Americans go to the doctor to feel good.
"Getting well" and "feeling good" are not the same thing, and "feeling good" is going to cost an awful lot of money.
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Originally Posted by Escort Rider
, and the reluctance in some quarters to stop extreme end-of-life measures in favor of hospice care.
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That will be a serious problem with Obamacare (or any other national health care plan), unless the 14th Amendment is stricken or altered to avoid it.
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That is our own collective choices of poor health habits. About 20% of adult Americans still smoke, and while we rightly applaud the substantial reduction from 20 or 30 or 40 years ago, this still adds to the cost of health care.
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And your evidence of that is what, exactly? Before people smoked, people died of lung cancer. Yeah, I'm talking way back in the 1400s and 1500s. When you finally outlaw tobacco I'll be laughing while you try to figure why you still have the same number of people dying from lung cancer every year (if not more people).
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