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The high cost of healthcare; We're getting too much
Topic Started: Jan 13 2009, 03:18 PM (204 Views)
Bernard
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Senior Carp
In my current poking around to better understand insurance and the high cost of health care, I stumbled upon this article. It's very interesting...

Why Does Healthcare Cost So Much

From the article;

"Indeed, perhaps the most significant reason Americans are drowning in health care debt may shock you: Americans are getting far too much unnecessary care. Of our total $2.3 trillion health care bill last year, a whopping $500 billion to $700 billion was spent on treatments, tests, and hospitalizations that did nothing to improve our health. Even worse, new evidence suggests that too much health care may actually be killing us. According to estimates by Elliott Fisher, M.D., a noted Dartmouth researcher, unnecessary care leads to the deaths of as many as 30,000 Medicare recipients annually.

"The prestigious Institute of Medicine recently published a report that estimates that only about half of what doctors do today is backed up by valid, scientific evidence. The rest? Many procedures and tests are based on medical tradition or on unproven and potentially faulty assumptions about how the body works.
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QuirtEvans
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I Owe It All To John D'Oh
Bernard
Jan 13 2009, 03:18 PM
In my current poking around to better understand insurance and the high cost of health care, I stumbled upon this article. It's very interesting...

Why Does Healthcare Cost So Much

From the article;

"Indeed, perhaps the most significant reason Americans are drowning in health care debt may shock you: Americans are getting far too much unnecessary care. Of our total $2.3 trillion health care bill last year, a whopping $500 billion to $700 billion was spent on treatments, tests, and hospitalizations that did nothing to improve our health. Even worse, new evidence suggests that too much health care may actually be killing us. According to estimates by Elliott Fisher, M.D., a noted Dartmouth researcher, unnecessary care leads to the deaths of as many as 30,000 Medicare recipients annually.

"The prestigious Institute of Medicine recently published a report that estimates that only about half of what doctors do today is backed up by valid, scientific evidence. The rest? Many procedures and tests are based on medical tradition or on unproven and potentially faulty assumptions about how the body works.
My anecdotal evidence of why the cost of health care is so high ...

These days, if you have any kind of orthopedic injury, you get an MRI. When we were young (most of us, anyway), MRI's hadn't even been invented yet.

Or angioplasty.

Or organ transplants.

Colonoscopies weren't prescribed for everyone at age 50.

And so on.

We get MORE health care now. More costs more.
It would be unwise to underestimate what large groups of ill-informed people acting together can achieve. -- John D'Oh, January 14, 2010.
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Bernard
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Senior Carp
And this I found today from the current issue of Reason magazine... Interesting...

"The JAMA (Journal of the American Medical Association) study also found that patients with public insurance, such as Medicaid and Medicare, are more likely to crowd into emergency rooms for minor complaints than are the uninsured. Only about 17 percent of E.R. visits in the United States in the last year studied were by uninsured patients, about the same as their share of the population.
"That isn't the only way people with subsidized insurance add more burdens to the system than people with no insurance at all. A 2007 study in the Annals of Emergency Medicine looked at charges and payments for 43,128 emergency department visits between 1996 and 2004. "What surprised us was that uninsured patients actually pay a higher proportion of their emergency department charges than Medicaid does," reported co-author Renee Hsia, a specialist in emergency medicine at the University of California at San Francisco. "In fact, 35 percent of charges for uninsured visits were paid in 2004, compared with 33 percent for Medicaid visits."
"So why are emergency rooms so crowded? The JAMA study blames a rising population, a falling number of emergency departments, and understaffing that prevents stabilized patients from being admitted to other parts of the hospital.
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ivorythumper
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I am so adjective that I verb nouns!
There is a movement among insurers to limit health maintenance testing due to its costs. I am sure that the bean counters have determined it is much more cost effective for you to get cancer or heart disease or other illnesses, not have it diagnosed until you are terminal, have it dealt with at the ER and a hospital for your last days, then to do do yearly health maintenance check ups at your private physician's office.
The dogma lives loudly within me.
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QuirtEvans
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I Owe It All To John D'Oh
Bernard
Jan 13 2009, 03:25 PM
And this I found today from the current issue of Reason magazine... Interesting...

"The JAMA (Journal of the American Medical Association) study also found that patients with public insurance, such as Medicaid and Medicare, are more likely to crowd into emergency rooms for minor complaints than are the uninsured. Only about 17 percent of E.R. visits in the United States in the last year studied were by uninsured patients, about the same as their share of the population.
"That isn't the only way people with subsidized insurance add more burdens to the system than people with no insurance at all. A 2007 study in the Annals of Emergency Medicine looked at charges and payments for 43,128 emergency department visits between 1996 and 2004. "What surprised us was that uninsured patients actually pay a higher proportion of their emergency department charges than Medicaid does," reported co-author Renee Hsia, a specialist in emergency medicine at the University of California at San Francisco. "In fact, 35 percent of charges for uninsured visits were paid in 2004, compared with 33 percent for Medicaid visits."
"So why are emergency rooms so crowded? The JAMA study blames a rising population, a falling number of emergency departments, and understaffing that prevents stabilized patients from being admitted to other parts of the hospital.
Our local hospital has a new urgent care unit right next to the ER. They triage patients one way or the other. The idea is that the urgent care unit can handle stuff like flu, etc., at a lower cost than the ER.

Do other hospitals do that, George?
It would be unwise to underestimate what large groups of ill-informed people acting together can achieve. -- John D'Oh, January 14, 2010.
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George K
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Finally
The idea of having an "urgent care" center next to an ER is a good one, IMO. I can imagine a scenario in which someone goes to the "urgent care" with a bellyache, expecting the flu and it turns out so be something more serious - go next door to the ER. If the centers are far apart, I can see a lot of people saying "screw it, I'm going home, if I get worse, I'll go to the ER" when it may be too late to prevent something more serious.

Unnecessary tests? Of course. You can't go to an ER with a tummy ache today and not get a CT scan. Did you fall and hit your head? Off to the scanner with you, you can have seat right behind the headache patient.

When I was a student in surgery, the maxim was that if less than 10% of the appendixes that you took out were normal, you were missing a lot of appendicitis. A 10% rate was EXPECTED for taking out "normal" appendixes. Today we hardly ever see a normal appendix taken out - because the diagnosis is not made with hands on the tummy and a blood count. It's made by a CT scanner, and a radiologist who's probably at home looking at films wired to him.

So, how many tummy aches that get a CT scan DON'T end up on the OR table?

A ton.

So, is that unnecessary testing? I don't know. The 10% number is history. We don't take out normal appendixes anymore. That's probably good.
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"Now look here, you Baltic gas passer... "
- Mik, 6/14/08


Nothing is as effective as homeopathy.

I'd rather listen to an hour of Abba than an hour of The Beatles.
- Klaus, 4/29/18
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Jolly
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Geaux Tigers!
Stop The Presses!

We have learned that when people get free care, or close to free care, they seek care more often.

Bernard, my friend, you ain't seen nuthin', yet...Prediction (Quirt Alert, copy now!): With the coming of ever higher percentages of Americans being covered by Medicare and Medicaid, the proportion of the U.S. economy related to healthcare will top 20% within 10 years.
The main obstacle to a stable and just world order is the United States.- George Soros
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OperaTenor
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Pisa-Carp
QuirtEvans
Jan 13 2009, 03:32 PM
Our local hospital has a new urgent care unit right next to the ER. They triage patients one way or the other. The idea is that the urgent care unit can handle stuff like flu, etc., at a lower cost than the ER.

Do other hospitals do that, George?
Even though I'm not George, ours does. It's an excellent system, IMO, and I've had the misfortune to use it often.



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Mikhailoh
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If you want trouble, find yourself a redhead
I've had a number of adventures into the healthcare system, including some very weird diagnostic tribulations, and I cannot say I have had much unnecessary testing. Every doctor I have dealt with has been concerned with cost versus necessity and willing to make a decision based on rationality, with the patient's health as the primary driver.

The ER/Urgent Care triage idea is a good one, as are community clinics for primary care.

Our healthcare system is in a bind. We demand better and better care, testing and treatments, and the doctor had better not do anything that can be questioned or we will sue them into purgatory.

Oh, and we want it to be cheaper too. Including more and better drugs, which are incredibly costly to bring to market. And we don't want to pay the pharmaceutical firms a reasonable profit for the enormous risk in drug development.

We just want it all, don't we?
Once in his life, every man is entitled to fall madly in love with a gorgeous redhead - Lucille Ball
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Klaus
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HOLY CARP!!!
Jolly
Jan 13 2009, 06:22 PM
Stop The Presses!

We have learned that when people get free care, or close to free care, they seek care more often.

Bernard, my friend, you ain't seen nuthin', yet...Prediction (Quirt Alert, copy now!): With the coming of ever higher percentages of Americans being covered by Medicare and Medicaid, the proportion of the U.S. economy related to healthcare will top 20% within 10 years.
Not true.

Denmark has a free health system, and it is actually a lot cheaper than the US system while having a similar quality.

Why? Because the doctors here have a lot more pressure not to spend so much money. And they don't need to be obedient to their patients and will say "Go home, it's nothing" or "There is nothing we can do" if they think that that is the case.

I'm not saying that this is necessarily a good thing, and I see many reasons against public health systems, but to say that public health systems are inherently more expensive is not true.
Trifonov Fleisher Klaus Sokolov Zimmerman
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Copper
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Shortstop
Klaus
Jan 14 2009, 05:10 AM

"Go home, it's nothing"

Many countries have some sensible doctors.

Regardless of the system or how they are paid.
The Confederate soldier was peculiar in that he was ever ready to fight, but never ready to submit to the routine duty and discipline of the camp or the march. The soldiers were determined to be soldiers after their own notions, and do their duty, for the love of it, as they thought best. Carlton McCarthy
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George K
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Finally
Copper
Jan 14 2009, 06:42 AM
Klaus
Jan 14 2009, 05:10 AM

"Go home, it's nothing"

Many countries have some sensible doctors.
You need sensible patients who will accept that.
A guide to GKSR: Click

"Now look here, you Baltic gas passer... "
- Mik, 6/14/08


Nothing is as effective as homeopathy.

I'd rather listen to an hour of Abba than an hour of The Beatles.
- Klaus, 4/29/18
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DivaDeb
HOLY CARP!!!
there is no shortage of docs in the US who are happy to say 'go home it's nothing'
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Klaus
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HOLY CARP!!!
Well, if the personal income of a doctor is directly related to the revenue of the place where is working, then he or she certainly has an incentive not to say "go home it's nothing" but to make expensive checks such as CT scans and the like "just to be safe" and to make the patient happy, even if the doctor believes that these checks are highly unlikely to reveal anything interesting.
Trifonov Fleisher Klaus Sokolov Zimmerman
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Axtremus
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HOLY CARP!!!
George K
Jan 14 2009, 06:44 AM
Copper
Jan 14 2009, 06:42 AM
Klaus
Jan 14 2009, 05:10 AM

"Go home, it's nothing"

Many countries have some sensible doctors.
You need sensible patients who will accept that.
So... American patients are mostly spoiled brats, and that's the reason for the high cost of health care here? :blink:

(I thought it's the insurance system... a layer of people to submit insurance claims, another layer to deny those claims, and the previous layer to reverse the denial. Just go with universal healthcare and you can scrap the insurance system and the layers of people in it.)
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DivaDeb
HOLY CARP!!!
Not anymore...the doctors here are dealing with an insurance maze you wouldn't believe. Sometimes, it would just be easier to die than go through the hassle of getting the care you've already paid for.

*edit...this is a response to Klaus, not Ax...sorry, should have quoted
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John D'Oh
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MAMIL
Compared to Canada and the UK I've been treated like a king over here when it comes to healthcare. Hospital visits are more like a vacation than an unpleasant chore. It's all very nice and everything, but it doesn't come cheap - more than once I've felt that the phrase 'over the top' was appropriate to the level of care.

I'd hate to go back to the lamentable UK system, but Canada seemed to me to find a much better balance between the needs of the patient, and keeping the cap on the spending.
What do you mean "we", have you got a mouse in your pocket?
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Kincaid
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HOLY CARP!!!
Axtremus
Jan 14 2009, 08:22 AM
I thought it's the insurance system... a layer of people to submit insurance claims, another layer to deny those claims, and the previous layer to reverse the denial. Just go with universal healthcare and you can scrap the insurance system and the layers of people in it.
Sounds like rising unemployment and even more crowded medical facilities.

I'd like to see universal health care as well, but using a Medical Savings Account coupled with Catastrophic Care Insurance. For those that can't afford it, there could be some kind of sliding scale of gov't subsidy.
Kincaid - disgusted Republican Partisan since 2006.
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