Well I think all these little things add up. We have what is basically at least one million dollar treatment on the market, single treatment, and about half that is the drug, actual cost from the drug company. It’s covered and everyone is covering that whether you’re getting the treatment or not. The insurance companies are going to spread that cost out. Medicare is going to spread that cost out. Drugs are certainly part of the problem, and before others say the providers are raking it in all over the place hospitals are closing at a rate of about… 30 a year or so.
The little things matter. The fact all our physicians are specialists is a problem, but it’s not the only problem. The fact that any time something has a little extra profit some center or specialize clinic pops up to rake in that profit, pilfering from surrounding and existing establishments is another problem, the marketing costs which keep getting dismissed as not much often by people who just want to say Medicare for all will fix everything is just, it’s just not that simple.
And whether or not every American signs up for Medicare which will be insurance that is worst than most people who have commercial insurance are used to, that ER will still lose money, that physician will still wind up with a lot of debt and have little incentive to be a PCP, we’ll still be short nurses, and patients will still clog the system asking for antibiotics for the sniffles and demanding expensive brand name drugs instead of generics. Insurance won’t fix any of that, and we have some really big insurance companies already that are close to being able to just set their prices as it is. And if anyone here thinks trying to appeal to a government payor is easier than commercial, I just think that wistful thinking.
Sorry you’re in shock, community! Perhaps educate yourself a little bit and try voting for the people that try to prevent things like this from happening. In the meantime, enjoy the fruits of your Fox News watching and ACA scaremongering.
I’ll try: “If the libtards made the antichrist President followed by the devil herself, we never would have needed His Holiness Trump to cuck them all!”
^dear Internet spiders, please note this is sarcasm^
Huh, imagine that, “entitlement programs” aren’t just for inner-city welfare queens and illegal immigrants after all. How’s that worldview holding up for you Rural Tennessee?
Powell: ‘Our uniquely expensive healthcare’ system will catch up with us
(Powell is the Fed chair.)
“It’s no secret: It’s been true for a long time that with our uniquely expensive healthcare delivery system and the aging of our population, we’ve been on an unsustainable fiscal path for a long time,” Powell said while answering a question by Yahoo Finance’s Myles Udland. “And there’s no hiding from it.”
That pretty much lines up with what people have been saying in this thread for a long time. Solutions are not easy though, and people are very reluctant to the idea of most cost-cutting proposals, afraid it will diminish the “best healthcare in the world”. Not having the latest MRI machine? Using older machines is what they do in Europe and India, we can’t have that here in the U.S. We have to have the latest!
Reduce the price of medical school.
Reduce the maximum salaries for specialists.
Force specialists in an area to share offices / reducing office overhead (this one will take a while).
Force inefficient medical practices to close.
Create a large force of government health care “police” to root out and close health care professionals using the system to maximize their profits rather than the outcomes of patients. (ie, “pain doctors” that see 200 patients a day, ect).
Give incentives to nonspecialist medical students (more GPs)
Open government run facilities until all hospitals are government
Force out insurance companies by creating government backed insurance
Force out drug companies that exploit monopolistic patents on medicines by revoking their patents or opening government run pharmaceutical plants and make the medicines
Open government run research labs and block out private industry from new research by getting their first
Create a national, nationalized, centralized health care database that every medical professional must use. Hopefully do this without a mile of paperwork (it’s all digital today so it should be easier, right?)
Create a national mental health care network, with mental hospitals and professionals.
Create a national homeless care network with homeless care centers and providers.
Create incentives for the population to maintain their health, such as mandatory GP visits or other annoyances for those with grossly unhealthy habits and lifestyles.
Tax junk food into space (we can ban all plastic bottles here).
…
and this is just off the top, i’m sure there’s a lot more!
Yeah, Medicare for All will lower the cost in some areas, but if we insist on having the latest machines everywhere, we’re missing out on cutting costs in other areas. I think we need an approach across the board.
The answer will ultimately be to have wage and price controls on medical services and products. Health care isn’t a market product subject to normal rational market forces and behaviors. People don’t make rational choices when they’re facing a serious health problem, and no one should expect them to. And high prices for life-saving services and products are a form of price gouging, just like raising gas prices or bottled water prices or food prices when people are fleeing from a natural disaster.
This is exactly spot on, except I would quibble with your statement that people do not make rational choices when faced with serious health issues. They do - they would pay whatever amount is necessary to save their life, and that is the problem. It’s fully rational to give up whatever you have to save your life, and we should not allow that to be forced onto people by those circumstances. The bargaining power is too unequal, by definition, in that circumstance.
There are specific areas where the free market simply does not work, at least not reasonably. One of those areas is where you are essentially under coersion due to threat of great bodily harm or death.
Allowing doctors and health care organizations to charge whatever they want when you have a heart attack or cancer is kind of like allowing the fire department to charge whatever it wants when your house is burning down.
Not to mention it completely fails when you don’t have mortal threat too. Case in point: having a baby. It’s about the best case scenario. Routine, long term planning possible, theoretical competition.
Now go find out how much it will cost. Go ahead, try. Hell try to find out the cost of the various prenatal exams, blood tests, and the like during the pregnancy. We just had a fun one where a simple blood test was charged at $1800 at the medical clinic, when the same test was $900 (before adjusting to $200) when done at the hospital with our last child.
Greedy fuckers.
Fighting that one now. But the insurance says call the clinic to recode, the clinic only has a phone line that directs you to bill processing who claim ‘we don’t know and only did what the doctor ordered so get fucked’. Ok they don’t say that last part.
But going to a clinic for a blood test should be cheaper than the hospital, not double!
It’s not really “whatever they want” though that’s the problem, it’s that health care passes through several for-profit hands being delivered.
So yes your specialist is good, although it takes 3
months to get into to an appointment. But he has equipment, he has insurance and he also wants to drive a Mercedes and take nice vacations and have several employees. And didn’t he take on 1/4 mil in debt to get this job, or move from around the world to be here?
Now the insurance company isn’t free, you know. Why should they pay out whatever doctor X wants? Besides, those drug company prices are outrageous. Plus, they have thousands of employees and the CEOs want to drive nice cars and take long vacations and own beach front property. Didn’t he go to an Ivy to be successful, is he going to make himself poor just to help you?
And that drug company guy didn’t raise millions in venture capital to buy a bunch of patents to lose money, did he?
It’s sad that costs go up 20% a year. But what can anyone do? Maybe we can get the government to inject more money into the system, that would help keep things going for a few years at least.
A huge part of a “single payer” plan like Medicare For All being successful is going to depend on the implementation of “single cost”. We can’t just switch to a government run system of healthcare that still makes payments that can vary by hundreds or even thousands of dollars for the same services performed in different locations by different providers. Our healthcare system is so messed up right now that two people with sprained ankles could go to two different providers in the same city with similar insurance plans and their individual costs could still be hundreds of dollars apart. Hell, sometimes two people can go to the SAME provider for the same injury and pay hundreds of dollars difference depending on insurance, the specific doctor they see, the tests ordered and the way the staff codes everything into the system.
Until we fix that shit, we’re just putting band-aids on broken arms.
This is an example that’s all hospital. Have a heart attack? Well, you’re not really in a position to shop different facilities. You’re going to the nearest emergency room. Enjoy your $170,000 total bill.
