High cost of medical care

[mtangelsfan]

Just now, #CF8x said:

From my understanding, fees vary wildly from doc to doc. 

That would make little sense considering a small group of entities are paying them for their services and do not shop for cheaper options.

[krAbs]

4 minutes ago, AngelsLakersFan said:

Moar fair comparison

A new challenger appears.

[mtangelsfan]

I don't want to punch a turtle

[mtangelsfan]

[Thomas]

[mtangelsfan]

25 minutes ago, krAbs said:

A new challenger appears.

He actually looks like a Dr. Seuss character

[krAbs]

Welp. This thread is off the rails.

[mtangelsfan]

That's aw.  You never know.

[Adam]

Government regulation.

[Tank]

[arch stanton]

I'll give a couple of examples of identical services about 2 years apart in two very different states. When getting a work visa for Saudi Arabia you have to submit results from a physical exam that they put together. It includes some lab work that rarely gets done in US as it is the exact same exam required by a street sweeper coming out of the Bangledeshi jungles. Both times I was paying cash out of pocket with full reimbursement expected

in 2011 I was in Massachusetts when I needed to get it done. I called a local clinic that my sister, an RN, recommended. It was clean, efficient, and very busy but it got done fairly quickly. Since I wasn't enrolled in Mass Health the lab work alone cost about $2500 and the exam. performed by a nurse practitioner (the doctor verified that I was walking upright and signed the forms), ran another $800

In 2013 I was in Akron when I needed it done. I called several doctors and none would see me. They all said they weren't taking new patients. I finally walked into an urgent care facility and they said they'd do it no problem. Not as nice a facility and not as nice a neighborhood but the doctor did the exam himself and it was over in no time.The entire physical, including lab, cost about $700

So I guess if I have a point it's that I wish it was easier to find a place that could handle a simple procedure that wasn't being fed through the insurance grinder so we could concentrate coverage on the stuff that really is expensive and life threatening. When every sniffle and stitch becomes an insurance case it can't help but to spiral the costs out od control such as was the physical done in the state with mandatory insurance even before Obamacare was in force

 

[mtangelsfan]

For those pushing for single payer, malpractice is very limited in those other countries.  Pick your poison.

[Adam]

People are stupid when they choose non Asian doctors 

[krAbs]

15 hours ago, Adam said:

Government regulation.

See, this is where some of my intuition goes to. But, I kinda doubt that this is it. Health care is only expensive in America because it is compared to cheap health care in other countries. Otherwise, it would just be an unfortunate reality. But, if it really was government regulation driving up costs, you would expect to see less regulation in other countries with lower costs. I really doubt that this is the case.

A theory I've heard floated on the left is that we care too much about fixing the problem and not enough about preventing the problem. There is an old principle in civil engineering that if something costs a dollar to fix in the plans, it will cost 10 dollars to fix on the field pre construction, and 100 dollars to fix if the thing has already been built and you need to modify it. The idea being, problems get waaay more expensive if you let them fester rather than dealing with them upfront. So, a lot of other countries take a real interest in their citizens day to day health, and put a lot of money into preventative measures. They do things like taxing sugar and encouraging healthy food and biking, that sort of thing. It is entirely possible that that is a big part of why our medical costs are so overrun - we are trying to medicate our way out of a country wide lifestyle problem.

[arch stanton]

1 hour ago, Adam said:

People are stupid when they choose non Asian doctors 

In my examples above the doc at the urgent care clinic in Akron was Vietnamese. He smelled like stale cigarette smoke and coffee with too much sugar

[Adam]

I think it is very complex. And I'm not nearly smart enough to determine all of the causes. Everyone complains about these mega insurance companies, their CEOs, etc. but they're the result of lobbying, regulation, laws, mandates, etc... These companies love all that shit because it makes competition extremely difficult.

Then you got all the providers providing services to a bunch of folks who are illegal, don't have money, refused to carry insurance, etc... They're naturally going to inflate prices to paying customers to account for the losses. It is a big crony mess. 

 

[Adam]

Just now, arch stanton said:

In my examples above the doc at the urgent care clinic in Akron was Vietnamese. He smelled like stale cigarette smoke and coffee with too much sugar

I went to Kent St. Glad I never had to see a doc in that area. Everyone smelled like Cigs

[Thomas]

 

6 minutes ago, krAbs said:

See, this is where some of my intuition goes to. But, I kinda doubt that this is it. Health care is only expensive in America because it is compared to cheap health care in other countries. Otherwise, it would just be an unfortunate reality. But, if it really was government regulation driving up costs, you would expect to see less regulation in other countries with lower costs. I really doubt that this is the case.

Right now those predisposed to say that government regulation is causing high prices would be right.
Right now those predisposed to say free market greed is causing high prices would be right.

The current system has all the down sides of each system and precious few of the upsides. The government ensures demand, squashes competition and places high entry costs for businesses. Which the large corporations love and had lobbied for. In theory I'd love for government and health care to never entangle and be true free market. I just have my doubts that is a reasonable expectation considering how much they lust for each other.

[krAbs]

Just now, Thomas said:

 

Right now those predisposed to say that government regulation is causing high prices would be right.
Right now those predisposed to say free market greed is causing high prices would be right.

The current system has all the down sides of each system and precious few of the upsides. The government ensures demand, squashes competition and places high entry costs for businesses. Which the large corporations love and had lobbied for. In theory I'd love for government and health care to never entangle and be true free market. I just have my doubts that is a reasonable expectation considering how much they lust for each other.

But isn't that kind of what we had before the ACA (assuming that you don't think medicare and medical had that much of an impact)? And the rates were actually skyrocketing faster then than they are now.

I'm personally a fan of slightly lower standards, because any industry that holds people's lives in its hand should have standards, more transparency/national rating systems (actually one of my favorite parts of the ACA), a stronger individual mandate (I...I know...y'all hate that...), and at least one public option as an auto-break on monopolies.

[krAbs]

BUT, I guess my point behind my point of originally asking the question that spawned this thread is: we are shooting solutions at a wall to fix a problem when we don't understand the driving mechanism behind the problem. We need to pour money into large scale studies until we understand the problem, and until then, we are on a fools errand.

[Thomas]

29 minutes ago, krAbs said:

But isn't that kind of what we had before the ACA (assuming that you don't think medicare and medical had that much of an impact)? And the rates were actually skyrocketing faster then than they are now.

Sure but ACA tightened the vice. If insurance lobbyist really didn't want ACA the Republicans might have actually tried to repeal it instead of the laughable farce we witnessed.

27 minutes ago, krAbs said:

BUT, I guess my point behind my point of originally asking the question that spawned this thread is: we are shooting solutions at a wall to fix a problem when we don't understand the driving mechanism behind the problem. We need to pour money into large scale studies until we understand the problem, and until then, we are on a fools errand.

Assuming complete laissez faire is off the table as an option in this country, and I think that's a safe assumption, you're looking at a government project on the scale of the New Deal or the Apollo Project. Millions of people trained on the government dime to be doctors, nurses, administrative staff and technicians. Effectively if not literal government mandated price controls on services, equipment and supplies. And that's the tip of the iceberg. I'm not sure if that'll ever be a political possibility in this country barring a single or multiple very significant events. Rebuilding from scratch would be leagues easier than having to wipe away the existing system. Right now it's a laughable thought considering what constitutes political compromise. We're um... inches away from half the political forum whipping their junk out to settle their arguments. (Which after reading some of theirs may actually represent an improvement)

[AngelsLakersFan]

25 minutes ago, Thomas said:

 We're um... inches away from half the political forum whipping their junk out to settle their arguments. (Which after reading some of theirs may actually represent an improvement)

That's only in the gun threads.

[Glen]

4 hours ago, Adam said:

People are stupid when they choose non Asian doctors 

I have a great old Jewish doctor. I dread the day when he retires.

[Adam]

Jews make for a solid second choice. Old Jews = 1A

[Tank]

my doctor is slightly younger than me. he's rough around the edges but a good guy all around. oh, and he's scandinavian/danish.