Page 1 of 5 123 ... LastLast
Results 1 to 10 of 48
Thanks Tree34Thanks

Thread: Why Is Healthcare Insurance So High?

  1. #1
    SWED Missle Command Champion johnflesh's Avatar
    Joined
    Feb 2007
    Posts
    19,410
    Thanks
    9644

    From
    Colorado

    Why Is Healthcare Insurance So High?

    The reason our government has yet to come up with a proper healthcare plan is not entirely their fault. They are working with what they got. And so are we, the consumers of healthcare.
    There are a lot of discussion about universal healthcare, private insurance, costs, premiums - the primary take away from previous discussions was everyone being insured. That is no longer the issue at hand, and now it's all about demolishing one bad plan for another, (some would say) worse plan. There is one glaring fact that keeps this perpetual motion machine in play and us arguing about it all day while still paying ridiculous fees.

    Healthcare costs too much.

    Here is some verifiable facts that help outline why our healthcare costs so much money:

    1. Administrative costs - this is the number one reason our costs are so high, but only edging out others slightly. 1/4th of the cost of all care is administrative. Far higher than any other country on the planet. A good example of this is Duke University. Duke hired 1,300 administrative staff for a hospital with only 900 beds. The reason they hire so many is to not only deal with patient's records, financials, etc, but to navigate the varying landscape of insurance companies, policies. Some are hired strictly for their knowledge of certain insurance companies. This sounds wasteful, is wasteful, but its the hospital doing the best they can.

    2. Expensive treatments - The US is, on average, 3 times higher than any other developed country. An example of this is: the US has 3x as many mammograpms, 2.5x as many MRIs and 31% more Caesarean sections. This requires more technology (we'll get to tech later) in more locations. Also commonly people in the US are treated by specialists who's fees are far higher than primary care doctors - when the a lot of the same specialist treatments are done by primary care in other countries.

    3. Wages and rules - Our system is based on a process of referral decision-making so even if a healthcare provider sees an alternative to cheaper costs, they are required to follow the rules - which allocate high-reimbursements and often overutilized of specialists. In 2013, based on a report by The National Commission on Physician Payment Reform, the commission adopted 12 recommendations for changes to get control over physician pay. They are/were working with Congress to implement.

    4. Technology - this is a funny word because to many it means "costs more." But why? Why does our medical technology have to cost more than regular technology when it utilizes the very same technology? A great example was given to me by a healthcare provider: A sonography machine consists of certain tech; a computer monitor, a PC and the only outstanding technology is the ultrasound projector, which literally just sends soundwaves through a body and then converts that soundwave to an image. In 2017 that's consider low-tech. The costs of these machines range from $15,000 - well over $100K when the cost to manufacture one unit, and I'm speculating, less than $15,000. If I had to build this machine to perform as it does, we can do so with little more than $1000. The cost of these machines is presented to us as a bill on our insurance at a "fair" cost of $264 on average. And when the unit is paid off, the cost remains the same.

    We inflate the cost at R&D arbitrarily. We further inflate the costs when we go to market, arbitrarily. Then we continue to inflate the cost when we administer, arbitrarily. Because, technology... What we are essentially doing here is saying that the technology that we must have to live healthy costs more than we can afford. Quite clearly we've inflated the cost of technology simply because it's technology, and for no other reason than...

    5. Marketing - When you see the flashy branding of many healthcare providers, you are paying for that and it very much helps drive up costs. So much so the ACA has stepped in and certain hospitals will lose eligibility in ACA (they will simply be omitted in care provider lists by ACA) if facilities didn't get their branding and marketing spending under control. It alone was creating an untenable situation for ACA. A sleeper issue at the time ACA was enacted.

    6. Defensive doctors and specialists - often specialists/docs will get multiple tests even when they are certain of the diagnosis to avoid lawsuits. There are very little protections in place for lawsuit abuse and there are far too many people willing to exploit the system for a little gain. Some of these have ruined lives, let alone careers. While doctors should be protected, they are driving costs while they wait for protection.

    7. Drugs - Medicare is no longer able to negotiate the price of drugs with drug companies and this is where some of the drugs with very high prices come from. VA and Medicaid still can negotiate and have the lowest drug prices in our entire system. Congressional Budget noted that "giving Medicare Part D beneficiaries access to discount medications would save the feds $116 billion in 10 years. And that is just an example, as drug prices overall vary based on patents and so forth.

    And that's just 7. I'm certain there is more but how long should one post be?

    I'm certain that our discussion about ACA, Universal, Private, Insurances would be a far different animal if we weren't paying more than everyone else on the entire planet for the same thing. And to me, this is a far more important issue to deal with so that when we actually get serious about a universal plan, we'll be able to afford it.

    I have a whole folder of sources but here are a few and of course, feel free to Google "Why does hea..." you won't need to type further. It should autofill "Why does healthcare in the US cost so much"

    http://www.investopedia.com/articles...pensive-us.asp
    https://www.pbs.org/newshour/economy...s-david-cutler
    http://thehill.com/blogs/pundits-blo...-united-states
    http://www.thehastingscenter.org/bri...al-technology/
    Thanks from boontito, HayJenn, labrea and 1 others

  2. #2
    Nuisance Factor Yeti 8 Jungle Swing Champion, YetiSports 4 - Albatross Overload Champion, YetiSports7 - Snowboard FreeRide Champion, Alu`s Revenge Champion boontito's Avatar
    Joined
    Jan 2008
    Posts
    88,623
    Thanks
    64497

    From
    out of nowhere!
    That's a lot to take in. But you're not blaming it all on communists, Nazis, minorities, or Trump so I'm not 100% sure you know what you're talking about.
    Thanks from johnflesh, labrea, Friday13 and 1 others

  3. #3
    SWED Missle Command Champion johnflesh's Avatar
    Joined
    Feb 2007
    Posts
    19,410
    Thanks
    9644

    From
    Colorado
    Quote Originally Posted by boontito View Post
    That's a lot to take in. But you're not blaming it all on communists, Nazis, minorities, or Trump so I'm not 100% sure you know what you're talking about.
    I might not get much traction with this thread since I don't speak the "lingo" very well.

  4. #4
    Veteran Member
    Joined
    Nov 2014
    Posts
    23,801
    Thanks
    3971

    From
    North Carolina
    Quote Originally Posted by johnflesh View Post
    The reason our government has yet to come up with a proper healthcare plan is not entirely their fault. They are working with what they got. And so are we, the consumers of healthcare.
    There are a lot of discussion about universal healthcare, private insurance, costs, premiums - the primary take away from previous discussions was everyone being insured. That is no longer the issue at hand, and now it's all about demolishing one bad plan for another, (some would say) worse plan. There is one glaring fact that keeps this perpetual motion machine in play and us arguing about it all day while still paying ridiculous fees.

    Healthcare costs too much.

    Here is some verifiable facts that help outline why our healthcare costs so much money:

    1. Administrative costs - this is the number one reason our costs are so high, but only edging out others slightly. 1/4th of the cost of all care is administrative. Far higher than any other country on the planet. A good example of this is Duke University. Duke hired 1,300 administrative staff for a hospital with only 900 beds. The reason they hire so many is to not only deal with patient's records, financials, etc, but to navigate the varying landscape of insurance companies, policies. Some are hired strictly for their knowledge of certain insurance companies. This sounds wasteful, is wasteful, but its the hospital doing the best they can.

    2. Expensive treatments - The US is, on average, 3 times higher than any other developed country. An example of this is: the US has 3x as many mammograpms, 2.5x as many MRIs and 31% more Caesarean sections. This requires more technology (we'll get to tech later) in more locations. Also commonly people in the US are treated by specialists who's fees are far higher than primary care doctors - when the a lot of the same specialist treatments are done by primary care in other countries.

    3. Wages and rules - Our system is based on a process of referral decision-making so even if a healthcare provider sees an alternative to cheaper costs, they are required to follow the rules - which allocate high-reimbursements and often overutilized of specialists. In 2013, based on a report by The National Commission on Physician Payment Reform, the commission adopted 12 recommendations for changes to get control over physician pay. They are/were working with Congress to implement.

    4. Technology - this is a funny word because to many it means "costs more." But why? Why does our medical technology have to cost more than regular technology when it utilizes the very same technology? A great example was given to me by a healthcare provider: A sonography machine consists of certain tech; a computer monitor, a PC and the only outstanding technology is the ultrasound projector, which literally just sends soundwaves through a body and then converts that soundwave to an image. In 2017 that's consider low-tech. The costs of these machines range from $15,000 - well over $100K when the cost to manufacture one unit, and I'm speculating, less than $15,000. If I had to build this machine to perform as it does, we can do so with little more than $1000. The cost of these machines is presented to us as a bill on our insurance at a "fair" cost of $264 on average. And when the unit is paid off, the cost remains the same.

    We inflate the cost at R&D arbitrarily. We further inflate the costs when we go to market, arbitrarily. Then we continue to inflate the cost when we administer, arbitrarily. Because, technology... What we are essentially doing here is saying that the technology that we must have to live healthy costs more than we can afford. Quite clearly we've inflated the cost of technology simply because it's technology, and for no other reason than...

    5. Marketing - When you see the flashy branding of many healthcare providers, you are paying for that and it very much helps drive up costs. So much so the ACA has stepped in and certain hospitals will lose eligibility in ACA (they will simply be omitted in care provider lists by ACA) if facilities didn't get their branding and marketing spending under control. It alone was creating an untenable situation for ACA. A sleeper issue at the time ACA was enacted.

    6. Defensive doctors and specialists - often specialists/docs will get multiple tests even when they are certain of the diagnosis to avoid lawsuits. There are very little protections in place for lawsuit abuse and there are far too many people willing to exploit the system for a little gain. Some of these have ruined lives, let alone careers. While doctors should be protected, they are driving costs while they wait for protection.

    7. Drugs - Medicare is no longer able to negotiate the price of drugs with drug companies and this is where some of the drugs with very high prices come from. VA and Medicaid still can negotiate and have the lowest drug prices in our entire system. Congressional Budget noted that "giving Medicare Part D beneficiaries access to discount medications would save the feds $116 billion in 10 years. And that is just an example, as drug prices overall vary based on patents and so forth.

    And that's just 7. I'm certain there is more but how long should one post be?

    I'm certain that our discussion about ACA, Universal, Private, Insurances would be a far different animal if we weren't paying more than everyone else on the entire planet for the same thing. And to me, this is a far more important issue to deal with so that when we actually get serious about a universal plan, we'll be able to afford it.

    I have a whole folder of sources but here are a few and of course, feel free to Google "Why does hea..." you won't need to type further. It should autofill "Why does healthcare in the US cost so much"

    6 Reasons Healthcare Is So Expensive in the U.S. | Investopedia
    https://www.pbs.org/newshour/economy...s-david-cutler
    Why is healthcare so expensive in the United States? | TheHill
    Health Care Costs and Medical Technology - The Hastings Center
    I didn't read all of this. But I can answer the question posed by your OP.

    Insurance companies conspire with healthcare providers to jack up the prices. Healthcare is also a priceless commodity as rich Americans will pay almost anything to prolong their lives. So a for profit system in regards to healthcare is not going to be beneficial toward average and poor Americans because they are going to be priced out of the market.

  5. #5
    Nuisance Factor Yeti 8 Jungle Swing Champion, YetiSports 4 - Albatross Overload Champion, YetiSports7 - Snowboard FreeRide Champion, Alu`s Revenge Champion boontito's Avatar
    Joined
    Jan 2008
    Posts
    88,623
    Thanks
    64497

    From
    out of nowhere!
    Oh, me! Pick me! I want to be next to not read the OP but provide an answer!!
    Thanks from johnflesh, labrea, Friday13 and 1 others

  6. #6
    SWED Missle Command Champion johnflesh's Avatar
    Joined
    Feb 2007
    Posts
    19,410
    Thanks
    9644

    From
    Colorado
    Quote Originally Posted by Jeremy View Post
    I didn't read all of this. But I can answer the question posed by your OP.

    Insurance companies conspire with healthcare providers to jack up the prices. Healthcare is also a priceless commodity as rich Americans will pay almost anything to prolong their lives. So a for profit system in regards to healthcare is not going to be beneficial toward average and poor Americans because they are going to be priced out of the market.
    That is absolutely an issue. But one nurtured by inflated healthcare costs way before it even gets to insurance.
    Thanks from carpe diem

  7. #7
    SWED Missle Command Champion johnflesh's Avatar
    Joined
    Feb 2007
    Posts
    19,410
    Thanks
    9644

    From
    Colorado
    Quote Originally Posted by boontito View Post
    Oh, me! Pick me! I want to be next to not read the OP but provide an answer!!
    There is a noticeable head-in-sand when it comes to loads of information. I made my peace. I'm hoping it educates at least.

  8. #8
    Moderator HayJenn's Avatar
    Joined
    Jul 2014
    Posts
    45,308
    Thanks
    35019

    From
    CA
    I thought this article made a lot of sense for a starter discussion..

    10 no-brainer ways to cut healthcare costs without hurting quality | TheHill

    I think the #1 thing right now that is out of control is the ever rising cost of prescriptions. Heck we have pretty insurance and the cost of just the few meds we use just keep going up and up. I can't imagine what it would be like if you had something like diabetes or cancer.

    But of course big pharma is by far the biggest lobby group in DC.
    Thanks from johnflesh

  9. #9
    Veteran Member
    Joined
    Nov 2014
    Posts
    23,801
    Thanks
    3971

    From
    North Carolina
    Quote Originally Posted by johnflesh View Post
    That is absolutely an issue. But one nurtured by inflated healthcare costs way before it even gets to insurance.
    That's true. Healthcare providers start the prices extremely high so as to give them a better place to start the negotiation with the insurance companies from. So you're right about that. They purposely inflate the prices long before it gets to Insurance.

    That's how negotiations typically work. You always ask for way more than you know you can get at the start of a negotiation. Unfortunately for those without insurance - this process really sucks as you are going to end up paying those absurd costs that really aren't even meant to be taken seriously.
    Last edited by Jeremy; 23rd October 2017 at 09:42 PM.
    Thanks from johnflesh and MeBelle

  10. #10
    SWED Missle Command Champion johnflesh's Avatar
    Joined
    Feb 2007
    Posts
    19,410
    Thanks
    9644

    From
    Colorado
    Quote Originally Posted by Jeremy View Post
    That's true. Healthcare providers start the prices extremely high so as to give them a better place to start the negotiation with the insurance companies from. So you're right about that. They purposely inflate the prices.

    That's how negotiations typically work. You always ask for way more than you know you can get at the start of a negotiation. Unfortunately for those without insurance - this process really sucks.
    It's a complicated mess of issues that domino, but you said it. It really sucks.
    Thanks from Jeremy and MeBelle

Page 1 of 5 123 ... LastLast

Similar Threads

  1. Healthcare Insurance Premiums Soar
    By HenryPorter in forum Current Events
    Replies: 22
    Last Post: 30th September 2011, 03:18 AM
  2. Replies: 1
    Last Post: 15th May 2011, 03:40 AM
  3. Reform healthcare now, take on insurance co's later
    By uncommonman in forum Political Discussion
    Replies: 15
    Last Post: 10th October 2009, 12:06 PM
  4. How to Fix Healthcare Insurance
    By Fritz in forum Political Discussion
    Replies: 17
    Last Post: 7th January 2008, 08:45 PM
  5. Healthcare Insurance Reform
    By Fritz in forum Healthcare
    Replies: 29
    Last Post: 3rd December 2007, 05:24 PM

Tags for this Thread


Facebook Twitter RSS Feed