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Americans in general do not like to go to the doctor.
Maybe because they know the doctor is going to refer them for wasteful testing to be sure they're 100% healthy. If you don't have an obvious medical condition, you have a choice of two different risks. First, there is the risk that you have a hidden medical condition that might get a lot worse. Second, there is the risk that testing might falsely discover medical conditions you seem to have but don't really, and those might end up bankrupting you, when you might have been fine without them. In recent news, even a lot of cancers were false positives, causing huge cancer treatment expenses, that seemed to be successful, because the cancer was gone.
Which of the two risks is worse? That you might have hidden medical conditions that might get worse? Or that you might get false positives that might bankrupt you for no reason? Even if you end up dying from lack of adequate testing, what are the odds? What percentage of the population ends up dying from lack of testing when they wouldn't have died in the next few years anyway? A lot of people die after being bankrupted by medical expenses and not being able to take care of themselves adequately because they can no longer afford it.
And cost is not the only problem from too much testing. Another problem is lack of adequate treatment. As I mentioned before, some treatments have to be started almost immediately, or they will be less effective. It takes time to do all the testing doctors want done. If a treatment is needed immediately, there isn't time for all that testing. Doctors need to take time and money into account in everything they do. Not just their time and their money, but also the patient's, and the time wasted before urgent treatment is started, even when they're not yet 100% sure it's the right treatment. If they're 99% sure, and the treatment is twice as likely to be successful by starting it immediately instead of a week later after a bunch of test appointments, the odds say start the treatment immediately. But our system seems to impose a philosophy that the only probabilities are 100% and less than 100%. And that philosophy imposes more risk on patients and more expense on our whole system.
Maybe because they know the doctor is going to refer them for wasteful testing to be sure they're 100% healthy.
I don't think this is an actual reason. An exam begins after all with the doctor asking for your own assessment and testimony concerning how you have felt lately. If you claim that everything has been peachy keen and in-office baseline testing suggests nothing to the contrary, you'll be out of the office in no time at all.
It seems to me that the real reasons people are reluctant to make an appointment with a doctor are things like the fact that they may be busy, they may also be a bit lazy, they may lack quality insurance coverage, or they may simply be intimidated by the notion of speaking frankly -- even though confidentially -- about personal matters to a medical professional.
While I'm sure you might disagree, I would suggest that the older you become, the more important it is to establish and maintain a regime of regular medical care. People die every day from what were originally curable diseases simply because they thought they did not have the time or money to go through a simple screening procedure. It's best not to become one of those people.
Most people think that the uninsured are the biggest burden on healthcare costs. They aren't.
Insurance companies are. They low ball and low ball, force contracts for care and completely undermine the pricing. They are the WORST payors into the system. They "owe" the most, but will never pay that balance because they have set the "pricing." It's why no doctor will spend more than 2 minutes face time with a patient. Every extra minute is cutting into that doctor's salary.
Insurance companies are not the biggest burden on healthcare costs. They are primarily a payment system - the vast majority of medical payments go through them and their main way of making money is by claim processing. They are essentially adding a percentage to the claim when they pay it. That percentage is limited by state insurance commissions to a few percent. So 90% of healthcare costs is coming from the providers of health services, not from the insurance companies.
The real problem with insurance companies is that they have added to the complexity of the system by negotiating rates with providers and then forcing their insured customers to use those providers. They are stifling the ability for us to choose the best provider based on transparent pricing. Furthermore, before ACA, they would only insure the healthiest segment of the population which left the least healthy, and the ones with the highest medical costs, to government assistance programs.
ACA now forces insurance companies to accept everyone. But of course that means they are insuring unhealthy people so their rates have to go way up to cover them. This has made people angry at ACA, but really, all ACA has done is force insurance companies to do the socially responsible thing. ACA is not responsible for the high cost of healthcare - that cost is still the same as it was before ACA. It has just shifted the cost to private insurance.
Insurance companies are not the biggest burden on healthcare costs. They are primarily a payment system - the vast majority of medical payments go through them and their main way of making money is by claim processing. They are essentially adding a percentage to the claim when they pay it. That percentage is limited by state insurance commissions to a few percent. So 90% of healthcare costs is coming from the providers of health services, not from the insurance companies.
The real problem with insurance companies is that they have added to the complexity of the system by negotiating rates with providers and then forcing their insured customers to use those providers. They are stifling the ability for us to choose the best provider based on transparent pricing. Furthermore, before ACA, they would only insure the healthiest segment of the population which left the least healthy, and the ones with the highest medical costs, to government assistance programs.
ACA now forces insurance companies to accept everyone. But of course that means they are insuring unhealthy people so their rates have to go way up to cover them. This has made people angry at ACA, but really, all ACA has done is force insurance companies to do the socially responsible thing. ACA is not responsible for the high cost of healthcare - that cost is still the same as it was before ACA. It has just shifted the cost to private insurance.
Insurance companies use contracts to low ball pay for services. This is well known and is the same as WalMart .. "so you want to sell me [gadget] for two dollars? We'll buy it for one instead. Or you could go elsewhere .... but we serve everybody, so you kinda have to accept us or no one will go to your facility."
Talk to someone who does accounting in a hospital. Uninsured get paid through taxes. Those who use insurance pay copays/deductibles. Insurers .... pay out next to nothing, and hospitals incur more "debt" by the insurers contracts. Fact. You can debate private insurance vs ACA vs Medicare vs Medicare. At the bottom of the balance sheet, insurers cost hospitals more.
I would say the majority of Americans would be better off paying out of pocket 100% for all costs. Those who choose to be frequent fliers, chronically ill, etc., usually love going to the doctor and will tell you alllllllll about it.
the older you become, the more important it is to establish and maintain a regime of regular medical care. People die every day from what were originally curable diseases
On the other hand, the older you become, the more likely you were going to die soon anyway. If you lose one year at the end of your life because you neglected to make medical care a big part of your lifestyle, how much of a loss is that really?
And how many people die from diseases they acquire from hospitals? Those who avoid medical care are less likely to become victims of that.
Out of curiosity about prices, I took a prescription to Kroger and Rite Aid to ask them their prices to fill it. Rite Aid's price was between 2 and 3 times Kroger's price. Maybe they're relying on most people not caring about prices because their insurance pays whatever the pharmacy charges.
A friend moved here from NYC. Technically he is disabled because he has osteoarthritis in one knee and one shoulder. He gets his medical totally free, even his prescriptions. He has Medicare and Medicaid is his secondary and pays for his Medicare premium. Other than the arthritis, he is very healthy. His condition is stable.
He has been here a year. And in that year he has gone to the doctor more than I have in my entire life. Plus every test you can imagine, he has had it done. I think THIS is how the medical profession makes money on these people. They are sent to every doctor possible and have every test they can think of!
It is amazing to me that he is willing to go to appointment after appointment, test after test, month after month.
You can either have a national system which covers everyone equally but you may have lines for procedures.
Or
You can have what we have now which equates to well off people that can afford the 5k-12k out of pocket co-pays and deductibles getting quality care for chronic issues. While those that can't afford it only get some stabilizing emergency care and released with a referral they can't really use. At some point doctors want to get paid for their services and if you can't afford the drugs you don't get them.
It's not like we don't already waste a ton of money on emergency care that only results in people using the ER as a walk in. It isn't like health care is cheap with only those that can afford it really getting quality care.
I think people's biggest hang up with single payer are the lines. However you have to ask yourself if there are lines with single payer but not so much with what we have now, what is happening to those people? They just die.
Our current system is heavily flawed. Single payer isn't a perfect answer but it can be much better than what we have now. If only we'd stop trying to give billionaires paying 15% or less of their income in taxes more breaks and bombing third world crap holes under false pretense we might have some cash left over to give some to the middle class and below while improving our nations access to healthcare for everyone.
On the other hand, the older you become, the more likely you were going to die soon anyway. If you lose one year at the end of your life because you neglected to make medical care a big part of your lifestyle, how much of a loss is that really?
Sheesh! If your neglect of proper health care regimes causes you to die from what was originally a treatable condition, you will die NOW, not one year prior to whatever you thought your life expectancy was.
Quote:
Originally Posted by eok
And how many people die from diseases they acquire from hospitals? Those who avoid medical care are less likely to become victims of that.
Many people die in hospital. And many, many, many, many more are cured and saved there. It's all just a temporary effect of course.
When people are cured and saved, there is no way to know if they were really cured and saved by medical professionals. It might have been their own immune systems doing the miracles that the medical professionals get credit for.
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