Healthcare costs

[TexasHusker]

There was a thread this a.m. about healthcare costs being likened to the cost of an iPhone. I'm not sure what happened to the thread but I think it presents a worthwhile discussion because healthcare costs represent such a large part of our budgets.

I think the iPhone comment is hyperbole. An iPhone costs about $700 every couple of years if you keep trading them in.

Health insurance plus your deductibles and copays can run twice or three times that amount PER MONTH for many people.

Healthcare is unaffordable because of runaway medical inflation and unadulterated price gouging in both the medical and insurance industries.

Price gouging began occurring when the government inserted itself into healthcare many years ago with Medicare. Through Medicare, the government implemented price controls on providers that were actually BELOW their cost of doing business in many instances. That forced medical providers to sock it to everyone else.

And it's only getting worse.

You see the same phenomenon in college costs - governmental intrusion and tampering has led to runaway inflation, and the price of tuition has zero relationship with the actual value of the service received. That's because there is a giant third party (i.e. the government) that has created a market imbalance that is only getting worse.

Ditto for home loans and the 2008 housing crisis: Government intervention (cheap loans, loose lending regulations mandated on the lenders by Congress, etc.) led to a dramatic runaway bubble that eventually popped.


There is no magic bullet to fix healthcare cost, unless the government completely divorced itself from the equation and the industry returned to free market. Then, and only then, would healthcare hope to become affordable again. But that isn't going to happen.

The next best hope is that the government "grease the skids" in various ways to promote rabid competition among healthcare providers and insurance companies. But their lobbies are so vast and well-orchestrated, I don't know that anything can be changed. The FTC has already allowed hundreds of hospital mergers around the country that have quashed all competition. Even in the largest markets in the U.S., two or three hospital systems control the market - and prices.

There are antidote medicines we can take for all of this, but the cure is going to be painful and arduous. I suspect we will just keep kicking the can down the road.

I do see one area that free markets are addressing this on their own: There is beginning to be a cottage industry in "cash medicine." Small hospitals - often owned by physicians - are being opened and operated on a very transparent basis, but everything is in cash.

This one, for example, has a menu of services available on a deeply discounted, cash basis. The fees are all inclusive - nothing is hidden.

https://surgerycenterok.com/pricing/

That is my kind of place. I'll pay you cash, but give me a fair price. If more people start opting for this, instead of traditional healthcare finance, we might see the needle begin to move.

[rennigade]

I think the iPhone comment is hyperbole. An iPhone costs about $700 every couple of years if you keep trading them in.

Health insurance plus your deductibles and copays can run twice or three times that amount PER MONTH for many people.

You see the same phenomenon in college costs - governmental intrusion and tampering has led to runaway inflation, and the price of tuition has zero relationship with the actual value of the service received. That's because there is a giant third party (i.e. the government) that has created a market imbalance that is only getting worse.

I dont know what people pay for health insurance since we've always had insurance through employers. The comment about the iphone was certainly a stretch. If health insurance does cost thousands per month for some people then it would be really difficult to cut back on luxury items to make up the difference.

Agree with college costs...its out of control. Do I think everyone should receive a free college education...no. Do I think college prices are fair...no. People are up in arms over healthcare but everyone ignores the skyrocketing costs of a college education. Go figure. Id hate to see real numbers of how much college has gone up over the years vs average pace of inflation.

[Singuy]

Huh, interesting that you think that government intervention is the root cause of sky rocket healthcare cost when other industrialized countries with 1/2 of our healthcare cost thinks our government doesn't intervene enough.

There's no such thing as "free market" and "competition" when it comes to healthcare cost.

Oh you don't want the best of the best samsung galaxy?..well you can go right ahead and buy a cheaper alternative.

Oh you don't want the best treatment?..well the alternative is you're dead....

[TexasHusker]

Huh, interesting that you think that government intervention is the root cause of sky rocket healthcare cost when other industrialized countries with 1/2 of our healthcare cost thinks our government doesn't intervene enough.

There's no such thing as "free market" and "competition" when it comes to healthcare cost.

Oh you don't want the best of the best samsung galaxy?..well you can go right ahead and buy a cheaper alternative.

Oh you don't want the best treatment?..well the alternative is you're dead....

Good points. I am a free market proponent, but honestly as of now I think the only solution is to put everyone on Medicare and call it done. Then tax everyone accordingly.

Hybrid models where the government is trying to exist with a free economy never works. The government needs to control it (i.e. the daily mail), or none of it.

Situations where the government inserts itself (college, hospitals, housing) generally run amok to the point where the government is then REQUIRED to take it over. Perhaps this is by design? I doubt it but wouldn't be surprised.

[MooseBucks]

Good points. I am a free market proponent, but honestly as of now I think the only solution is to put everyone on Medicare and call it done. Then tax everyone accordingly.

Hybrid models where the government is trying to exist with a free economy never works. The government needs to control it (i.e. the daily mail), or none of it.

Situations where the government inserts itself (college, hospitals, housing) generally run amok to the point where the government is then REQUIRED to take it over. Perhaps this is by design? I doubt it but wouldn't be surprised.

We do need to move to a government run healthcare system. There is a reason most other developed countries have it. It works and is significantly cheaper.

[msomnipotent]

The government can't even run the government. They will just screw it up because they simply do not understand the hows, whys, and how much when it comes to healthcare. Look at Planned Parenthood. Depending on who is in office, it is feast or famine for them. Our treatments will depend on the whims of whoever controls the White House, and I'm not for that.

On the other hand, I am old enough to remember free market health insurance. When I needed health insurance the most, I was denied because I had pre-existing conditions. At the time, there was only 3 carriers offering private health insurance in my state and they were expensive and highly selective. The woman from American Family actually hung up on me when I told her that I have RA. I think it is great that they will not be allowed to deny pre-existing conditions and I expect to have to pay more than a healthy person because of it.

[Fishindude77]

I like the "cash medicine" idea. You could darned near just self insure, if these services were readily available.

Another thing we are seeing in the private sector is companies hiring nurses and doctors and starting their own clinic to care for all of the day to day needs of their employees. It's just part of the employee benefit package in many cases, and cheaper for the company to handle all of the minor needs rather than their employees going to a bunch of different places for treatments.

[disneysteve]

I think opponents of a government-run healthcare system often ignore the fact that at least 1/3 of Americans already have government-run healthcare. About 16% are on Medicare and about 16% are on Medicaid. If you add in things like Tricare (military coverage) and those insured through their government jobs, the percentage is a lot higher. It's really not a huge stretch to suggest expanding those programs to cover everyone.

[TexasHusker]

I think opponents of a government-run healthcare system often ignore the fact that at least 1/3 of Americans already have government-run healthcare. About 16% are on Medicare and about 16% are on Medicaid. If you add in things like Tricare (military coverage) and those insured through their government jobs, the percentage is a lot higher. It's really not a huge stretch to suggest expanding those programs to cover everyone.

That is correct. The government has so infected the system that it is now septic, and the only cure is a complete takeover.

The horse left the barn a long time ago.

[bigdaddybus]

My brother in law was recently injured on the job (firefighter). He pulled or tore something in his shoulder.

1. He was immediately off work.
2. within the first week he saw a general physician who suggested 10 physical therapy sessions.
3. he waited 6 weeks for his first session.
4. During session 1 they asked him "Why are you here?" he said my shoulder stopped hurting after 2 weeks but I was told I had to follow this process. When can I go back to work?
5. After 2 more weeks of paperwork he was back on the job after being off work a total of 11 weeks.

If this is GOVT healthcare, what a joke. 11 weeks of paid vacation for a strain? I wonder if this is the norm?

[TexasHusker]

My brother in law was recently injured on the job (firefighter). He pulled or tore something in his shoulder.

1. He was immediately off work.
2. within the first week he saw a general physician who suggested 10 physical therapy sessions.
3. he waited 6 weeks for his first session.
4. During session 1 they asked him "Why are you here?" he said my shoulder stopped hurting after 2 weeks but I was told I had to follow this process. When can I go back to work?
5. After 2 more weeks of paperwork he was back on the job after being off work a total of 11 weeks.

If this is GOVT healthcare, what a joke. 11 weeks of paid vacation for a strain? I wonder if this is the norm?

That is the wonderful world of workers comp. A little different animal.

[disneysteve]

That is the wonderful world of workers comp. A little different animal.

Ain't that the truth. We stopped doing workmen's comp work a few years ago because navigating the system was insane.

It's definitely true that people miss a lot of work for no reason because of the way the system is set up. And once the lawyers get involved, it goes from insane to whatever is worse than insane.

[LivingAlmostLarge]

You can't self-insure. You'd never be able too afford care period. And health care can never be self-insure or we'd all die and no one wants to die. People always want to survive so we try experimental and extreme treatments. Look at the cost of life at the end of life. It's very expensive because no one wants to talk about death panels. So let's be real.

We can't afford to pay out of pocket for our treatments when we get sick. Yes when healthy everyone on here says sure. But then if you need anything more than routine? Well then the idea of trying to pay for your $30k broken leg? Or arm?

Not to mention the fact that Paul Ryan I thought was a smart guy totally missed the point about insurance. You need healthy people to pay for sick ones. Because one day the healthy person will be the sick one needing care.

Maybe we don't need SS or a government safety net. But health care and insurance are not the same as getting a payout.

[Singuy]

You can still have plenty of competition and a free market with a government sponsored healthcare system, the only difference between this competitive market is that you'll only have ONE BUYER, in which only clinical trials mandate the usefulness of the drug!

Lets take a look at the following statins(for high cholesterol)
Fluvastatin, pravastatin, lovastatin, rosuvastatin, simvastatin, atorvastatin, pitavastatin

All lower cholesterol with slightly different effectiveness and side-effect profile.

Question is, do we really need 7 different statin drugs on the market all running commercials full blast during your evening news, trying to convince you who didn't read the clinical trials why their product is better while raising their drug cost due to all the advertisement they put out?

You want to get the drug cost down?

"Hi, I am the government, I just want ONE drug with good effectiveness(doesn't have to be the best)/good side-effect profile/and CHEAP). I will add this ONE drug into our national formulary after thoroughly looking into every clinical trial and decide in which the company that gets our approval will make MILLIONS until some other company makes a better drug for cheaper".

Oh and if drug companies refuse this kind of model, the government will just spend $$$ and grant university to do their own drug research and have the drugs for the cost of R&D. Also the university will specialize in making NEW drugs and not some rehash nonsense these drug companies come out yearly just to remix their patents.

No more drug commercials, no more drug reps stalking MDs giving them vacations so they can prescribe their version of the same thing..and NO MORE insurance companies trying to make a buck. This is HealthCARE. I give 2 crap about something like this killing jobs. GET THE COST DOWN and SAVE LIVES.

Healthcare spending via medicare/Medicaid/obamacare/saving freeloaders accounts for almost DOUBLE our stupid expensive military spending. Cutting foreign aid, or defunding x, y, and z is just a drop in the bucket.

[Mjenn]

Our national Health care allows for private practice. They can choose to charge the national recommended amount if they want the money from the state or charge there own fee. Most opt to take the national plan but there are some fully private organizations.

As a patient I can choose whatever clinic I want to and change when I want to.

Same with drugs. I go to the pharmacy and am told 'there is a generic version of this that is cheaper' and thus that is the one I get coverage for. I can choose a more expensive one and pay out of pocket. No drug coupons or advertising are allowed, the prices are based on agreements and sometimes the fluctuation is annoying, but the drugs are cheap.

Is it perfect? No. But I always know that I wont have unexpected healthcare costs.

We have the same program for school funding and find it works well for us, but maybe not for everyone.

I think the US system is better if you are a high earner or have good job insurance, but there are way too many surprises for my comfort.