High cost of medical care

[krAbs]

49 minutes ago, Tank said:

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.

Fun fact: Studies show that doctors get worse with experience. So, younger may be a feature here.

[Adam]

My doctor is gay. Soft hands. 

[fan_since79]

7 hours ago, Glen said:

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

My gastroenterologist is Jewish and has been a lifesaver for me with my acid reflux and its complications.

My pediatrician was also Jewish and a great doctor when we were kids.

 

[Vegas Halo Fan]

One reason is that pharmaceutical companies have been allowed to soak the American public while selling their drugs elsewhere for a fraction of the cost we pay. Their patents are also for excessive time periods compared to elsewhere, and they are far too easy to extend for new applications. There are also numerous examples of American drug companies selling drugs that they didn't even develop and making billions off the sales.

[nate]

On 7/18/2017 at 3:04 PM, mtangelsfan said:

For one thing insurance has taken away competition.  Pretty much all doctors, labs, hospitals charge the same fees for the same things.  They don't need to worry about competition.

I'm not saying that is the end all, be all but I do believe it plays a part.  

This is partially true.  Doctors negotiate with different insurance companies because if they are out of network then they are less likely to get customers.

The only place where there is no competition is in rural areas where the doctors don't have to compete.  Especially at private hospitals in rural areas, they are huge cash cows.

The ACA did nothing to curb price gouging though especially by drug companies and private hospitals.  This is why most large insurers have completely backed out of the Exchanges, aside from the fact that only sick people were signing up and the uncertainty around what will happen to cost share payments, it significantly reduces the bargaining power that insurance companies have.

It is slightly different for group or company based coverage because you have a known risk pool that you can underwrite and a known premium pool.

[krAbs]

2 hours ago, nate said:

This is partially true.  Doctors negotiate with different insurance companies because if they are out of network then they are less likely to get customers.

The only place where there is no competition is in rural areas where the doctors don't have to compete.  Especially at private hospitals in rural areas, they are huge cash cows.

The ACA did nothing to curb price gouging though especially by drug companies and private hospitals.  This is why most large insurers have completely backed out of the Exchanges, aside from the fact that only sick people were signing up and the uncertainty around what will happen to cost share payments, it significantly reduces the bargaining power that insurance companies have.

It is slightly different for group or company based coverage because you have a known risk pool that you can underwrite and a known premium pool.

Which is exactly why if you're going to keep the ACA, you need to strengthen the individual mandate. Which to me is one of the key reasons why this Rep bill is just inane.

Another possible reason for drug prices is drug advertisement. There is this whole system dedicated to developing and selling new drugs with marginal improvements, and the whole thing is largely subsidized by insurers, allowing the prices to skyrocket without the public really noticing what they are doing. BUT. This, and 90% of the other explanations here, only accounts for drug costs. That is certainly a big part of our expenses in America, but I feel like that's not all of it.

[Adam]

6 minutes ago, krAbs said:

Which is exactly why if you're going to keep the ACA, you need to strengthen the individual mandate. Which to me is one of the key reasons why this Rep bill is just inane.

Another possible reason for drug prices is drug advertisement. There is this whole system dedicated to developing and selling new drugs with marginal improvements, and the whole thing is largely subsidized by insurers, allowing the prices to skyrocket without the public really noticing what they are doing. BUT. This, and 90% of the other explanations here, only accounts for drug costs. That is certainly a big part of our expenses in America, but I feel like that's not all of it.

The individual mandate is the worst part of Obamacare

[mtangelsfan]

1 minute ago, Adam said:

The individual mandate is the worst part of Obamacare

And a complete abomination to the Constitution.

[krAbs]

13 minutes ago, Adam said:

The individual mandate is the worst part of Obamacare

Its also impossible to work ideas like pre existing condition coverage without it, sooo

[Adam]

Of course.

[Rico]

So what are the things other countries are doing to help keep costs down?

[Jason]

6 minutes ago, Rico said:

So what are the things other countries are doing to help keep costs down?

Taxing their citizens

[nate]

@krAbs not necessarily.  Since they got rid of underwriting for pre-ex and gender, it does make rating different.  It wasn't purely the individual mandate that was a problem.  The largest problem was the 3:1 rule.  It states that the highest rate charged cannot be more than 3x the lowest rate.

Meaning a 21 year old could pay $100 a month and a 64 year old could pay no more than $300 a month.  What ends up happening is the 21 year old pays more than he should because the age underwriting gap is shortened by the rule and instead just doesn't sign up for coverage because it isn't worth it for a 21 year old to pay $150 a month for insurance that he/she will likely not use.

Another problem was that the website was not designed to stop people from gaming the system and just signing up when they got sick, stopping paying for their benefits and going to a new carrier even though the law specifically prohibits that.  You are supposed to have a SEP (special enrollment period) reason such as loss of coverage (non-payment of premium does not count), adoption, birth, marriage.  The website did not enforce this, you just had to check a box and pick a reason.

They were working on shoring up the website including requiring documentation for SEPs and changing the premium rule to 5:1 but when Trump came in they shut down any improvements that were being done to ACA.

[nate]

That really isn't true.  Mostly Republicans decided that education should be for profit and they should stop funding it with tax money so the cost of education is more for the student.

[mtangelsfan]

Why shouldn't private universities make a profit?

 

[Tank]

i'm filling out financial information right now for my daughter to attend college in September. Not an enjoyable experience, but for as much as they're charging, she's getting "scholarships" for things like her GPA and for me having attended the same college back in the day. There are discounts to be had, for sure. 

[Lou]

On Wednesday, July 19, 2017 at 11:34 AM, Glen said:

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

mine died 

 

[nate]

8 hours ago, mtangelsfan said:

Why shouldn't private universities make a profit?

 

That isn't what I said.

[gotbeer]

So I just had a prescription filled.  At the bottom, it says that medication is worth $56.89.  I really don't care, because my insurance pays for it all.  But when the medication is Asprin low dose of 81 mg, ie baby asprin, at a 90 count.  And I look at Rite Aid, and over the counter baby asprin is $3.49 for a 32 count.  That just tells me this insurance thing is a scam from top to bottom.

[AngelsLakersFan]

4 hours ago, gotbeer said:

So I just had a prescription filled.  At the bottom, it says that medication is worth $56.89.  I really don't care, because my insurance pays for it all.  But when the medication is Asprin low dose of 81 mg, ie baby asprin, at a 90 count.  And I look at Rite Aid, and over the counter baby asprin is $3.49 for a 32 count.  That just tells me this insurance thing is a scam from top to bottom.

Time to blow it up and see how the ashes fall

[Rico]

On 7/24/2017 at 1:35 AM, Lou said:

mine died 

 

Must have been a terrible doctor.  

[Blarg]

On 7/24/2017 at 1:35 AM, Lou said:

mine died 

 

Are you sure he wasn't only mostly dead? 

[Lou]

28 minutes ago, Rico said:

Must have been a terrible doctor.  

He had to be at least 116-yrs old.

 

[Lou]

On July 23, 2017 at 8:14 PM, nate said:

That really isn't true.  Mostly Republicans decided that education should be for profit and they should stop funding it with tax money so the cost of education is more for the student.

I'm good with this 

Edited July 26, 2017 by Lou

[Lhalo]

The cost of education is more now because of government backed student loans. The universities know they can rake it in with those puppies.