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The insurance industry and Big Pharma have driven the costs high. It used to be in the 1960s, the doctor's office had a nurse and a doctor in a modest office. People had major medical coverage, which was reasonably priced. Now, it seems they need multiple employees just to handle insurance claims, and as we all know, it often takes 3 times to submit a claim before it is paid, if it is paid.
It used to be one could once to see the doctor, but all too often, with the same issue and a co-payment for each visit, one ends up going back a couple of times, and eventually paying for the visit out of pocket combining the costs of each visit.
We don't have socialized medicine, because the insurance industry is loaded with cash to stuff the pockets of the politicians. Kansas has moved Medicaid to private companies, and to me, this is not the way to go, but again, insurance companies have enough money to buy whoever they want to own.
Too many hands in the cookie jar that is the high cost of medical care.
To reiterate my OP point insurance has two primary baleful effects:
We don't factor costs into our decisions as consumers; and
We add tot he complexity of transactions.
We don't have "gasoline insurance" which means we price and pay as we go. We care about what we pay. I couldn't imagine that the average grandfather would opt for a complicated procedure with little benefit at the cost of his grandchildrens' higher education. The money spent now on those kinds of procedures is incredibly wasteful, and occurs because someone else is paying.
To reiterate my OP point insurance has two primary baleful effects:
We don't factor costs into our decisions as consumers; and
We add tot he complexity of transactions.
We don't have "gasoline insurance" which means we price and pay as we go. We care about what we pay. I couldn't imagine that the average grandfather would opt for a complicated procedure with little benefit at the cost of his grandchildrens' higher education. The money spent now on those kinds of procedures is incredibly wasteful, and occurs because someone else is paying.
Gasoline is a fairly predictable expense, and if SHTF, you could cut back by buying a hybrid car. OTOH, if you have a medical situation come up, you could be bankrupted quickly with no way to control costs. Drugs for some autoimmune conditions and cancer can cost upwards of $10,000 per month.
Gasoline is a fairly predictable expense, and if SHTF, you could cut back by buying a hybrid car. OTOH, if you have a medical situation come up, you could be bankrupted quickly with no way to control costs. Drugs for some autoimmune conditions and cancer can cost upwards of $10,000 per month.
You are making my point for me. They wouldn't cost upwards of $10,000 per month if the actual customers had to pay. The cost gets out of hand when a third-party payer indifferent to cost is "paying", or acting as a conduit of yet someone else's money.
I currently pay $79.00 per month to an organization that provides immediate access and unlimited visits with a PA. It’s not quite concierge medicine but close enough.
Yes, costs of a potential hospitalization are a concern, so for 2021, I signed up for what is essentially a major medical plan generously offered by my part-time employer for another $89.00 per month.
.
What are these magic carpets, and how do I get one? Part-time employers offer this? HOW??!!? How can they do that?
I have Wellmark insurance peovided at work, it covered 100% of everything past my $2500 deductable, but actually my deductable is $1500 because every month $89 is deposited into my HSA by the insurance.
In January I had bronchitis that either really was pneumonia or turned into it, a 15 minute $3,000 CT scan and a chest xray later revealed the pneumonia.
It was also found I had tachycardia- 156 BPM heart rate, long story short I wound up in the hospital for 4 days for cardioversion to fix that and the pneumonia was treated. I was given medications, one of which costs $600/mo (Eliquis) they found I had a leaking mitral valve as the cause.
So I asked to put surgery on the table for discussion to FIX the valve permanently instead of bandaiding things with medications, and get it done while Im still working and have great insurance.
So surgery was scheduled for Oct 13 to repair or replace the valve and do a MAZE procedure to fix the Afib/tachycardia.
The next day they said the MAZE procedure didn't work and they would need to put a pacemaker in the next morning, so that was done and after 6 days in a private room I was discharged.
5-1/2 weeks after sitting at home recovering I went back to full time work Nov 18th, with 2x a week cardio rehab- treadmill, excersize etc at the hospital.
So Wellmark has been sending me paperwork/invoices showing what they were billed, netowrk discounts, what they paid, and what my amount due was (ZERO since the deductable was met in January)
They covered EVERYTHING, ordered meals in the hospital room, all meds 100% no copays, dr, labs, tests, the angiogram, rehab, and everything else.
I still dont have a total total as the most recent statement only goes to Nov something, so the rehab, a couple of labs and dr visits and cardiologist visit arent on it yet, but the totals I see so far billed by the non profit hospital was over $200,000
If I didnt have insurance I would either not be able to get this done, or I'd be facing a $200,000 medical bill right now with a "Please pay by Jan 31, 2021, we accept Visa and Mastercard"
The answer to this may depend on what part of the country you live in. If you live close to the Mexican Border, like in San Diego, you're not as dependent on Health Insurance. Anyone can go to the Int'l Red Cross Clinic in Tijuana and see a Dr. for $5, Mexican or non-Mexican, and I've been there myself. There's also an awesome Medical Tourism Hospital there, Angeles, which I went to when I ran into too many "roadblocks" with my care when I was with Aetna in Las Vegas.
Now that I'm on Medicare it's extremely important to have this health insurance, and I live in a state where, if you're below $18k in SS income, the state pays your Premium. Not having Medicare, if you're too far away from Mexico, then it's a must.
Since I don't know where the health care/Medicare situation is going, I elected to move closer to the Mexican border, just in case, 65 miles away. I even have a wonderful "back-up" Dr. I can see there for just $3.50, and prescriptions only $3.
If a bigger chunk of our population was concentrated closer to the Border, it would pose a big threat to the health insurance companies in this country, they'd have some stiff competition.
If I didnt have insurance I would either not be able to get this done, or I'd be facing a $200,000 medical bill right now with a "Please pay by Jan 31, 2021, we accept Visa and Mastercard"
The point is that if insurance weren't involved the bills wouldn't be ridiculous. I don't know what it takes people to understand the impact of a third-party payer who is, short term, indifferent to the amount of the bills, and why that wouldn't drive them sky-high.
The point is that if insurance weren't involved the bills wouldn't be ridiculous. I don't know what it takes people to understand the impact of a third-party payer who is, short term, indifferent to the amount of the bills, and why that wouldn't drive them sky-high.
Doctors and surgeons dont work for $10 an hour though, and when one MRI machine costs millions of dollars, and insurance for malpractice is thru the roof, they have to get that somehow, the only way is pricing procedures that use those items.
Doctors spend years in very expensive medical school, someone has to pay that.
A pacemaker unit itself costs around $30,000, because a patient is not going to buy replacements every months, it's about once a DECADE, so the whole pacemaker business and the technology has to be supported by once a decade purchases, that means a device that maybe costs a few hundred to actually make is going to be priced $30,000
Without insurance, you'd be paying that price for one, and then according to your no insurance "formula" you might pay a few hundred to get it implanted- you'd still have to come up with $30,000 just for the device.
The 6 days I was in the hospital the room charges were $19,000, that $3166 a day.
I saw a video on youtube about a kid who had both hands and a foot cut off in an accident, the hospital had NINETEEN surgeons and specialists in the operating room to re-attach the limbs, even at a low $100 an hour for each that's $1900 an hour and it took many hours plus 6 months in the hospital and rehab.
For a better idea of what health care should cost, look at vetenarian bills. No insurance, just the free market economy at work.
The problem is you cant compare veterinary bills to human hospital bills, for one thing, vets are very limited in what they can charge, because if the pet owner either can't afford it or doesn't want to pay that amount, they have the animal killed and buy a new one.
If your KID needs a heart transplant or cancer treatment you dont have the option to just have the doctor euthanize your kid and go out and get a new one!
My old vet here charged me their general surgery rate of $100 an hour for the emergency middle of the night surgeries needed on my dogs over the years, the bill was rarely over $200, while the normal cost for that surgery averages $3,000-$8,000, around here no one is going to pay $8,000 but if it was in Beverly Hills they would and not bat an eye.
Veterinarians also dont pay for costly malpractice insurance, their liability is typically limited to the cost of a puppy
And how much imagery is necessary and that which is unnecessary?
A Doctor goes to an African village with no electricity, how's he going to hook up an X-ray or MRI machine? Crutches is what I call them! Then what?
In these cases he'll be forced to use his intuition. No other choices!
When I had a Baker's Cyst 3-4 years ago, first came the Ultrasound, then the X-ray's, then the MRI, then the call for an MRI with Contrast. But the insurance company and my deductibles are paying for it. So when Mr. Orthopedist insisted upon the MRI with Contrast I raced down to Angeles Hospital in Tijuana. I showed him the images and he laughed in my face. "For a Baker's Cyst, I rarely even call for an X-ray!" All it needed was aspiration. $300, I paid it happily.
Wonder why medical costs are so expensive in this country????
Another time I had tingling going down my arm. First the X-ray, then, the MRI, then the MRI with contrast, and then? "You need to see a Neck Specialist!" I didn't!
6 months later I moved to Tucson went to my $3.50 Dr. in Nogales, told him my problem and within a minute: "I know exactly when you need, no surgery!" A prescp for Gabapina. I thought I'd have to use it the rest of my life, and? I took one pill, and miracles of miracles, 2 years later, I've only needed to take another pill just once more. Problem solved.
When I hear them cutting back on Medicare, and being on Medicare, I'm on board with that, particularly when it comes to the unnecessary expensive excessive testing/imagery.
What I don't understand is why the staircase of imagery? Rather than Ultrasound/X-ray/MRI/MRI with contrast, why oh why oh why not just get the MRI with contrast to begin with?
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