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Yep, it's all those things. We pay a lot for all this extra crap thrown in. The middle men, they are all over the place like termites.
Personally I like our system it's the best in the world.
Being the best it is also the most expensive but to those that count costs there's always that little trip across the border into Mexico they can make.
People complain about the high cost of medical insurance but it really isn't that horrible when you look at what some people do with the money they earn.
I know one couple who can not wait for Obamacare to kick in so finally their health insurance will be affordable. Really amazing seeing as how they can get an excellent policy for $600/mo but at the same time they complain about the high cost of health insurance, insurance they would rather have someone else purchase for them, they both smoke going through between 3 and 4 packs a day. He smokes Marlboro and while I don't know what she smokes I feel it very safe to say they spend at least $12/day on their cigarette habit.
At least $360/month on cigarettes or well over half the cost of an excellent health insurance policy but they choose to smoke cigarettes instead. If they gave up smoking, eating ding dongs and lunching at McDonald's they could probably have enough to pay for the entire insurance policy.
Our problem with the entire country today is to many people want a free lunch.
Personally I like our system it's the best in the world.
Kind of like how a Mercedes is thought to be the best car in the world?
Quote:
Being the best it is also the most expensive but...
People complain about the high cost of medical insurance but...
Our problem with the entire country today is too many people want a free lunch.
Personally I like our system it's the best in the world.
Being the best it is also the most expensive but to those that count costs there's always that little trip across the border into Mexico they can make.
People complain about the high cost of medical insurance but it really isn't that horrible when you look at what some people do with the money they earn.
I know one couple who can not wait for Obamacare to kick in so finally their health insurance will be affordable. Really amazing seeing as how they can get an excellent policy for $600/mo but at the same time they complain about the high cost of health insurance, insurance they would rather have someone else purchase for them, they both smoke going through between 3 and 4 packs a day. He smokes Marlboro and while I don't know what she smokes I feel it very safe to say they spend at least $12/day on their cigarette habit.
At least $360/month on cigarettes or well over half the cost of an excellent health insurance policy but they choose to smoke cigarettes instead. If they gave up smoking, eating ding dongs and lunching at McDonald's they could probably have enough to pay for the entire insurance policy.
Our problem with the entire country today is to many people want a free lunch.
Well, some people feel that way. I can't begin to police them all, backed with my personal belief on how one should live their life. I think taking ones actions into account for their own health is important, personally, to those who find longevity or such the important part of their existence. Doctors can encourage this as well.
BUT: Some don't, and find personal quality to mean more to them. They like to smoke, or drink and will take those risks. Some become addicted to a bad lifestyle when they are young and then have a hard time letting those go as adults when they should. IDK, why, it's not my issue.
I wouldn't base their right for healthcare on it. I think basing that on ability to receive it would have to involve moral judgement, which I don't believe anybody to be in that position personally, as an individual. I could find a million things wrong with how you, for example, live your life if giving the chance I'm sure.
I find it most important, pertaining to this mindset actually, that we change our system to a non profit, regulated, public system. People like you can opt to buy extra coverage if you'd like.
Those who don't smoke or drink can simply enjoy a healthy life if that action brings them that. For some it doesn't because not smoking or drinking isn't a guarantee and that's the problem. We can't use that as an option for affordability because it's not a guarantee. Not to mention, if someone doesn't smoke or drink or buy cable but gets lung cancer, why would you deny them under that assumption? You've assumed people who do these things waste their chance for healthcare, but what if they don't?
The way you think is too complicated and wrapped up in individual judgement to work, IMO. I think under a non profit system we can encourage and aid for better health. But, I don't think we can tell people to stop what we think is bad or costly to buy insurance that is making a profit off their bad judgement. That's odd to me, since most companies fail morally as well.
At some point, we have to take the good and bad, go non profit and protect the general public. IMO, despite our moral judgement. We pay for their care now, one way or the other. It's not a free lunch by any stretch of your imagination.
All this aside, I want to be clear on my position. If someone like you've mentioned, smokes and buys Ding Dongs and Mikky D's then at least under a taxed NHS they would have their medical costs taken out before then bought these items. If they could still afford them after that, since costs for their medical would be cheaper, then that would be personal. We could encourage doctors on wellness by incentive but we shouldn't make that a basis for available care. IMO, it's up to an individual to live well, according to what they feel living well is.
Last edited by PoppySead; 12-21-2012 at 12:02 PM..
Personally I like our system it's the best in the world.
Being the best it is also the most expensive but to those that count costs there's always that little trip across the border into Mexico they can make.
People complain about the high cost of medical insurance but it really isn't that horrible when you look at what some people do with the money they earn.
I know one couple who can not wait for Obamacare to kick in so finally their health insurance will be affordable. Really amazing seeing as how they can get an excellent policy for $600/mo but at the same time they complain about the high cost of health insurance, insurance they would rather have someone else purchase for them, they both smoke going through between 3 and 4 packs a day. He smokes Marlboro and while I don't know what she smokes I feel it very safe to say they spend at least $12/day on their cigarette habit.
At least $360/month on cigarettes or well over half the cost of an excellent health insurance policy but they choose to smoke cigarettes instead. If they gave up smoking, eating ding dongs and lunching at McDonald's they could probably have enough to pay for the entire insurance policy.
Our problem with the entire country today is to many people want a free lunch.
Actually we don't have the best health care system in world if you measure it. Google healthcare comparisons between the U.S. and other nations---it's chock full of reports showing how we are on the short end of the stick.
Now I would agree that we have the best research and equipment, but it's used very inefficiently. So we pay a lot more and are actually receiving a lot less.
You give an example of smoking and wanting cheaper insurance. Of course you are correct. But the logic of the right wing in this country would be---cigarettes don't kill people, people who smoke cigarettes kill people. Kinda like those guns. Well, in both cases there is a price to pay, and we're paying. If you keep on doing the same old thing, you keep on getting the same old results.
But the healthcare results of our system are near the bottom by every international calculation. Practically the only SYSTEM exception is the Veteran's Administration, run by Uncle Sam. I've quoted reports on it from the Wall Street Journal on this thread. It's more efficient and more effective than just about all of them--with outcomes and with preventive care. And it's all due to the government putting a top notch guy in charge.
Now don't believe me---just google "quality of healthcare in VA hospitals" for an eyeopener. Read several of the different articles. The VA has gone from being the absolute worst in the nation, so much so that they were nearly disbanded in the mid-nineties, to being better than just about everyone.
It can be done, and it can be done without profit.
Next time you get a hospital bill reflect that half that money goes not to lawyers but to avoid lawyers the sort of parasites Edwards was made of.
Sometime ago, after I joined CDF, I got tired of hearing half baked, inaccurate comments like this one. As a result, I actually took the trouble to look up what medical malpractice insurance and lawsuits are costing this system.
My source is the Congressional Budget Office. This is from 2004, but I guarantee you it hasn't changed substantially since than.
The more accurate figure is that 1% to 2% of your medical bills is related to malpractice. Mind you, even this amount is significant when you consider that healthcare expenditures for the nation may be $1 trillion a year. One percent of a trillion is $10 billion. My point though is that let's say you totally eliminated medical malpractice lawsuits. Let's say a doctor paid zero for malpractice insurance. You wouldn't even notice the change. Why? Because healthcare costs overall increase between 6% and 7% in this country every year.
Eliminating malpractice lawsuits would also have the effect of removing the one quality control that exists on medical practice that is from outside the medical system. Are you really comfortable having doctors and hospitals regulate themselves? I personally don't want the fox guarding the henhouse and that's pretty much what many here seem to advocate.
WardenDresden has made an argument in favor of a "worker's compensation" type system for dealing with medical malpractice lawsuits. Without trying it, its difficult to know for certain what the outcome would be. My concern is this. Many people currently choose not to bring malpractice lawsuits because they don't want to sue their doctor. For many--particularly in smaller communities--such an action is still stigmatic. There are surveys indicating only small percentage of malpractice results in lawsuits. A system that is more informal like WardenDresden proposes will likely increase the number of people making such complaints. As such, handling costs and payouts will rise. I agree you would avoid multi-million dollar awards, but you'd see more awards because more people would use the system. Therefore, total costs would not decrease.
Lawyers are a popular "boogeyman" to blame for society's failings. The real reasons that medical costs are out of control have very little to do with lawsuits. They have to do with:
1. Medicine is technology driven and the latest, greatest technology is expensive.
2. People in America demand the best, whether they can afford it or not.
3. The salaries of those who work in healthcare are very high compared to the rest of the economy. I've mentioned $400,000 for some specialist physicians, high salaries for health care administrators, high salaries for health insurance executives, salaries of $80,000 to $100,000 for critical care and intensive care nurses, and generally salaries for everyone down to phlebotomists that are higher than most jobs outside the healthcare industry.
Those are the facts, folks. If you want to dispute what I say have at it. It would be nice to look at some facts though rather than listen to hyperbolic opinions such as "lawsuits are half the cost of medical bills". It just ain't so. And it keeps people from fixing the real problems.
My source is the Congressional Budget Office.
This is from 2004, but I guarantee you it hasn't changed substantially since than.
The more accurate figure is that 1% to 2% of your medical bills is related to malpractice.
One percent of a trillion is $10 billion.
The real reasons that medical costs are out of control have very little to do with lawsuits.
If you want to dispute what I say have at it.
I don't want to dispute what you have said really but I do want to flesh out the detail on what you
have not said. In particular money spent on technology and money spent on "the best".
In addition to the $10 Billion or so spent directly on malpractice policies and jury awards...
how much of the other "healthcare" money is spent on tests and treatments, not for objective diagnostic reasons, but because not doing those tests or treatments will or just might leave the professional or institution with a liability risk... iow: for reasons of avoiding other lawsuits?
Sometime ago, after I joined CDF, I got tired of hearing half baked, inaccurate comments like this one. As a result, I actually took the trouble to look up what medical malpractice insurance and lawsuits are costing this system.
My source is the Congressional Budget Office. This is from 2004, but I guarantee you it hasn't changed substantially since than.
The more accurate figure is that 1% to 2% of your medical bills is related to malpractice. Mind you, even this amount is significant when you consider that healthcare expenditures for the nation may be $1 trillion a year. One percent of a trillion is $10 billion. My point though is that let's say you totally eliminated medical malpractice lawsuits. Let's say a doctor paid zero for malpractice insurance. You wouldn't even notice the change. Why? Because healthcare costs overall increase between 6% and 7% in this country every year.
Eliminating malpractice lawsuits would also have the effect of removing the one quality control that exists on medical practice that is from outside the medical system. Are you really comfortable having doctors and hospitals regulate themselves? I personally don't want the fox guarding the henhouse and that's pretty much what many here seem to advocate.
WardenDresden has made an argument in favor of a "worker's compensation" type system for dealing with medical malpractice lawsuits. Without trying it, its difficult to know for certain what the outcome would be. My concern is this. Many people currently choose not to bring malpractice lawsuits because they don't want to sue their doctor. For many--particularly in smaller communities--such an action is still stigmatic. There are surveys indicating only small percentage of malpractice results in lawsuits. A system that is more informal like WardenDresden proposes will likely increase the number of people making such complaints. As such, handling costs and payouts will rise. I agree you would avoid multi-million dollar awards, but you'd see more awards because more people would use the system. Therefore, total costs would not decrease.
Lawyers are a popular "boogeyman" to blame for society's failings. The real reasons that medical costs are out of control have very little to do with lawsuits. They have to do with:
1. Medicine is technology driven and the latest, greatest technology is expensive.
2. People in America demand the best, whether they can afford it or not.
3. The salaries of those who work in healthcare are very high compared to the rest of the economy. I've mentioned $400,000 for some specialist physicians, high salaries for health care administrators, high salaries for health insurance executives, salaries of $80,000 to $100,000 for critical care and intensive care nurses, and generally salaries for everyone down to phlebotomists that are higher than most jobs outside the healthcare industry.
Those are the facts, folks. If you want to dispute what I say have at it. It would be nice to look at some facts though rather than listen to hyperbolic opinions such as "lawsuits are half the cost of medical bills". It just ain't so. And it keeps people from fixing the real problems.
Interesting enough, I agree, it's one of many issues that can be lowered with less mistakes and we could cut at least the need for lawsuits with safer practices. But, since we have many facets of care here, we will have to cut many things. There isn't one magic cut. I don't agree with the original statement, 1/2 is large but it will probably have to be included to some degree.
This article was about doctors and I noticed in the fine print it said it didn't include the cost of other areas such as hospitals, and clinics, pharma and so on. I think in total it would be a bit more but all in all it's only one of many areas to look at in lowering costs.
I would wonder though if we would see a direct price reduction in doctors services if it were lowered. Somehow I don't believe so given our current love of profit in the medical field. I just paid over 3000 dollars for a test and it was precautionary. I also have pretty good insurance. Seems high. I have friends that could never afford that.
I don't want to dispute what you have said really but I do want to flesh out the detail on what you
have not said. In particular money spent on technology and money spent on "the best".
In addition to the $10 Billion or so spent directly on malpractice policies and jury awards...
how much of the other "healthcare" money is spent on tests and treatments, not for objective diagnostic reasons, but because not doing those tests or treatments will or just might leave the professional or institution with a liability risk... iow: for reasons of avoiding other lawsuits?
I don't know if you read the article I provided or not. I don't want come across as a "know-it-all" or snippy. The term for what you are talking about is "defensive medicine" and the article addresses it.
If you read the article carefully (and its not a particularly short article) the essence of it is that most diagnostic tests are not given to "protect doctors" from the threat of lawsuits. The real reasons the tests are run is to make money. Actually, given the fact that an MRI (which is not really new technology at this point) costs upwards of $1,500.00 none of us should be surprised. Hospitals want to make money. Hospital boards want to cover the cost of all the new equipment and machines they purchase. So, there is a tendency to use equipment in borderline situations. The convenient explanation is that doctors have to do these tests to avoid potential malpractice lawsuits. The reality is something different.
The figure the article gives is that somewhere between 1% to 2% of all health care costs can be attributed to malpractice. The article makes it clear that this includes both malpractice insurance premiums and the cost of defensive medicine.
I want to clarify a couple of things as well. I'm not saying that some reform of malpractice shouldn't occur. I'm not saying that some lawsuits aren't frivolous. I'm not saying that this problem doesn't cause other problems besides raising medical care costs.
What I'm really saying is that medical malpractice reform will do very little to reduce healthcare costs. Let us assume that medical malpractice is responsible for 2% of all healthcare costs. Now, I haven't heard anyone who totally wants to abolish someone's right to make a claim if malpractice truly occurs and if they are injured. In this case, no contemplated reform will abolish the system. Let's assume we modify the liability system and reduce the costs by 50% or 1/2. Than malpractice is responsible for less than 1% of all healthcare costs and the net savings is about 1%.
The big issue is the amount of deception involved. Doctors and the healthcare industry would love to get rid of lawsuits or most lawsuits. Can you imagine that some of the claims you've heard from them maybe a bit exaggerated for that reason? As a people, we do ourselves no service by pretending there is some quick fix or panacea to this problem. Malpractice lawsuits have become a scapegoat for out of control medical costs for too many people.
Its going to make very little difference when it comes to the bills you and your insurance company get. Very little indeed. Worse, ending such lawsuits may take away accountability for physicians and the medical establishment.
I don't know if you read the article I provided or not. I don't want come across as a "know-it-all" or snippy. The term for what you are talking about is "defensive medicine" and the article addresses it.
If you read the article carefully...
The figure the article gives is that somewhere between 1% to 2% of all health care costs can be attributed to malpractice. The article makes it clear that this includes both malpractice insurance premiums and the cost of defensive medicine.
I didn't read the article at all and have been familiar with the term "defensive medicine" a long time.
My post was about YOU not mentioning that portion of the discussion in your otherwise clear post...
which might be construed as an attempt to shade the issue.
And to be clear... it's not that I really disagree with you (though I do have doubts about the %'s).
On the whole I tend to agree with most of your posts and appreciate the good you do with them.
I don't know if you read the article I provided or not. I don't want come across as a "know-it-all" or snippy. The term for what you are talking about is "defensive medicine" and the article addresses it.
If you read the article carefully (and its not a particularly short article) the essence of it is that most diagnostic tests are not given to "protect doctors" from the threat of lawsuits. The real reasons the tests are run is to make money. Actually, given the fact that an MRI (which is not really new technology at this point) costs upwards of $1,500.00 none of us should be surprised. Hospitals want to make money. Hospital boards want to cover the cost of all the new equipment and machines they purchase. So, there is a tendency to use equipment in borderline situations. The convenient explanation is that doctors have to do these tests to avoid potential malpractice lawsuits. The reality is something different.
The figure the article gives is that somewhere between 1% to 2% of all health care costs can be attributed to malpractice. The article makes it clear that this includes both malpractice insurance premiums and the cost of defensive medicine.
I want to clarify a couple of things as well. I'm not saying that some reform of malpractice shouldn't occur. I'm not saying that some lawsuits aren't frivolous. I'm not saying that this problem doesn't cause other problems besides raising medical care costs.
What I'm really saying is that medical malpractice reform will do very little to reduce healthcare costs. Let us assume that medical malpractice is responsible for 2% of all healthcare costs. Now, I haven't heard anyone who totally wants to abolish someone's right to make a claim if malpractice truly occurs and if they are injured. In this case, no contemplated reform will abolish the system. Let's assume we modify the liability system and reduce the costs by 50% or 1/2. Than malpractice is responsible for less than 1% of all healthcare costs and the net savings is about 1%.
The big issue is the amount of deception involved. Doctors and the healthcare industry would love to get rid of lawsuits or most lawsuits. Can you imagine that some of the claims you've heard from them maybe a bit exaggerated for that reason? As a people, we do ourselves no service by pretending there is some quick fix or panacea to this problem. Malpractice lawsuits have become a scapegoat for out of control medical costs for too many people.
Its going to make very little difference when it comes to the bills you and your insurance company get. Very little indeed. Worse, ending such lawsuits may take away accountability for physicians and the medical establishment.
For individual doctors, their malpractice premiums can run $100,000 or more. That is quite a significant cost for their practice and drives up costs for doctor visits. I used to underwrite physician malpractice insurance as well as other lines of coverage. Thirty years as an underwriter, ratemaker, and compliance officer.
I remember well a case we had back in the mid-seventies. A man had gone in for a tonsilectomy in a small town medical center in Kentucky. He ended up bleeding to death on the operating table. We insured the physician. I asked our claims adjustor how he thought our case would go and he said, "Well there are a lot of extenuating circumstances--our physician even recommended the patient not to have the operation. But the plaintiff's lawyer will put their doctor experts on the stand to say our physician and his team should have done this or that. Then we'll put our experts on the stand and they'll say he did try this and he couldn't try that because of whatever. Then the plaintiff's attorney will bring in the widow dressed in black along with her three children and we'll write a check out for one million dollars." (one million considered adequate back then).
What would work better and more efficiently is remove tort liability out of the system and require doctor's to pay into the equivalent of a "worker's compensation" type of system. So that someone injured by a medical mistake or oversight could either have the situation corrected and/or receive compensatory damages for lost wages or additional health services they might require. It would work better because it would be administered by one non-profit organization instead of eight to twelve insurance companies that need premium money to pay claims, adminsitration, AND ten to fifteen percent profit on top of that. And like workers compensation there would be no "punitive damages" award which often makes up 60-75% of the total payout.
It could also provide us with much better statistical data, because the current system encourages doctors and hospitals to cover-up mistakes that are made because they don't want their premiums going up--no matter how small you believe them to be. If they simply reported mistakes we would have more accurate statistical data to help determine where doctors/nurses need additional education or training and where hospitals need to improve their patient care practices. This could IMPROVE healthcare itself.
Read how VA doctors who are paid less, but under most circumstances do not need to worry about medical malpractice because they are protected from lawsuits. And the VA system, as I've stated before on this thread, is probably the best healthcare system in the United States. Non-profit, government run, and consistently showing some of the best outcomes for healthcare.
As I've said before, don't believe me, google "quality of VA Hospitals" and read article after article of how it went from the worst in the nation to the best. All the changes that took place there need to take place everywhere else.
We do need some sort of tort reform, but what we really need is a non-profit health system. If you do a little googling on what has happened to non-profit hospitals in the country over the past 30 years, you'll find that many, many were convinced to change their charters and get bought out by HCA or Humana or another for-profit group. In the majority of cases, the for-profit group gave big severance packages to the directors and executives that departed from those systems. Then the costs at those hospitals began to dramatically rise.
Profit does not equal good healthcare. Good research, yes. Good equipment, yes. Good healthcare--just the opposite.
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Actually we dont have the best system
