Frank discussion about healthcare costs

i did not say pure for starters so what here is what;;;;;;;;;;;;;;;;;;;;;;;;;;

http://time.com/money/4462919/prescription-drug-prices-too-high/

https://dailyreckoning.com/end-greatest-health-care-rip-century/

when single payer comes to AMERICA there will be noone to blame but the health care industry.

Why is it that an MRI costs $1,080 in America and $280 in France?

 

you know this pc crap about caps is just that pc crap,you do not like caps do not read the post.

 

1. No, that's not really true, nor is it really relevant who did the great works of history. What matters is providing a better service/good at lower cost. Of course, governments through history have had taxing powers (which businesses did not), and were often led by vainglorious individuals who didn't mind taking from the poor to add to their vanity. I hardly see that as a reason to want more government.
2. We don't "GIVE away" patents. We, the U.S., have strong patent protections. Other countries don't. It's easy once you have a product to reverse engineer it, so people in many areas around the world are able to get it without having to live with American patent protections.

It's true that our patent protections add cost - but they add cost to new devices that we otherwise would not have had. There isn't really a "solution" to it, short of getting other countries to protect patents better.

 

All insurance removes these costs. No insurance pays 100% of end of life costs for as long as the family wants to keep someone alive. This isn't an issue of single payer health care, this is an issue of any health care that is provided by any type of insurance, in which I am using that term to mean any system that pool money from a group of people to pay for everyone in the pool.

The real cost is the schooling, the licensing is less of the actual cost. It is expensive to train them, but if you think about it, whose profiting from the training of doctors? Old doctors and health care providers to a lesser degree. This is an area that could use some regulation if any. I'm not sure what but if we want to no longer pay doctors a starting salary of 250 to 450k a year, cutting their educational costs must be done.

The idea that we must pay exorbitant prices for innovation is a false one in my book. Innovations aren't motivated solely by money. The best inventors and idea people rarely consider money. In fact, those folks often don't profit from their ideas. There are many examples of this. Drugs are no different, the only difference is only drug companies are doing the work. Hence, they want to profit extremely from it. If we opened up drug research and let others develop the product to a more completed state instead of simply turning it over to the drug companies, we would force competition on pricing. At least, that's one idea. There are other ideas I'm sure.

The fact that insurance companies push this one tells me this won't lead to lower prices. They want to sell across state lines because that's what large, high profit earning corporations do. A company selling in AZ sees those selling in AK and knows they can take them out or buy them out if they can get into the ring with them. All this will do is consolidate insurance companies nation wide. That will NEVER lead to lower pricing in the long run. It will have a marginal short term benefit for sure though.

 

The reason government run health care "works," and I use quotes because the definition of works is not objective from person to person, is because people can't/don't say no to health care. They can and do say no to cars all the time.

Energy is largely a regulated monopoly in this country, at least, the distribution of it to end consumers is. Why? Because it's hard to say no to it. In fact, only the homeless say no to it and even then not completely. So we let private companies largely handle utilities, but we ensure it's not free market run for obvious reasons. Health care, by and large, is very similar. Cars are not necessities. People can live without them and do, even if non dense, suburban and rural areas.

 

We give away the patents we develop, to those best equipped to develop them into products. YES WE DO.

Whether YOU judge the works, as worthy, of the takings, is beside the point. It created those works. The blueprint is applicable to GOOD works.

Those things that can be used, to TAKE from us, profits, don't need any help. That those things we NEED haven't been taken up by SAINTS, shows the need for gov to intervene. Just look at orphan diseases and drugs, if you need any proof.

Right wingers see the efficacy of space needing help, but little else.

 

Two things:

1. If you have a point you'd like to make, go ahead and make it. Use links to support your argument, not to replace it.
2. If you think the only reason healthcare costs are high in the U.S. is the health care industry, you are sorely mistaken and should look closer into the differences. The OP would be a start....
3. Why would an MRI cost more in America?
a.) French GDP/capita is 71% of that of the U.S., and it makes sense that things in countries with a higher standard of living would cost more for some basic economic reasons that I don't think need to be explained.
b.) Americans have a more varying quality of care (because more options), which weighs more heavily towards the upper end.
c.) We don't have hidden costs in that figure. Our MRI prices go up because they need to pay for other things, doctors salaries (which are higher here, for reasons already mentioned that you did not address), facilities (not government subsidized), etc. We also don't subsidize our doctor's education, which is a hidden cost of healthcare abroad that isn't shown. It's easy to have a cheaper product when you just hide all the costs elsewhere.
d.) idk about in France, but here in the U.S. MRIs are often billed in bundles. So there are many other things that go with it, like paying for the radiologist, and rather than breaking it up everything related to the MRI is often billed as one thing.

 

How low cost are we talking? I mean, I agree, you can't get something great for something cheap. But I would also point out our quality isn't great in this country. It's less than many single payer countries by every objective measure. And a lack of wait time for procedures or medical equipment such as MRI's isn't a sign of quality, it's a sign of waste. In order to have 0 wait time, one must have more equipment and personnel than the market truly supports, thus their costs must be higher in order to cover that down time.

 

Excellent.
Another example is exposure to very costly torts and suits that American providers have in spades but that most (all??) single payer providers don't have.

 

Do your own legwork and provide your own evidence - don't ask others to do it for you when you can't.

 

Which claim needs proof? That we give away our patents, that are largely developed at leading universities? That I thought was obvious. That space travel etc is funded, by taking, is obvious. Which part needs legwork?

 

Our quality really is great. I've seen the studies which rank America's health care system poorly - the devil is in the details. In each case when I looked at their methodology, one of the biggest factors they used (iirc, the number one factor) was equal distribution of quality care. Yes, in the U.S. those who can pay for top notch service routinely do, but that does not make the rest of our services crap, like some of those bs 'studies' suggest.

It is beyond stupid for a study to use that kind of methodology. It's the kind of thinking that says that a society where every person gets paid $20,000/yr is better off than a society where 95% get paid $25,000/yr, but the other 5% get paid $1,000,000/yr. It's moronic to suggest that the first is better, but that's how some of these studies actually approach their analysis. It's mind boggling.

 

OH I think I see - see I was talking about patents the way they are in almost all cases, privately developed and held, and foreign countries using them without bearing any of that cost. What you're talking about is government funded research being handed off to (often sold, iirc) to private American companies...

Entirely different thing and really, really not related to the problem being discussed.

 

The federal government, through the operation of government-owned research facilities, research grants to universities and procurement contracts with private industry, funds almost 50% of the national R&D effort. Because of this enormous funding, the federal government has the most United States patent rights. It is estimated that the government has title to over 30,000 patents and annually files several thousand new applications. The government also has rights to nonexclusive, irrevocable, royalty-free licenses in thousands of patents. In addition, the government has a myriad of other patent rights. Examples include march-in rights, rights to require the owner to license others, rights to require licensing of background patents, rights to approve assignments, rights to limit terms of license agreements and reversionary ownership rights.

There is, however, one very important exception. Several governmental agencies (e.g., the Department of Defense, the Department of Energy and NASA) have statutory prohibitions against private business organizations obtaining title to inventions developed with federal funds.
http://www.tms.org/pubs/journals/JOM/matters/matters-9004.html
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These being the EXCEPTIONS.

 

Right - but it's medical care. People don't like waiting months to see a doctor about their brain cancer. And you are correct, to have small wait times you'll need more equipment and personnel than really needed - but that is a difference in our system that is created by market forces. People want to get seen quickly.

Now part of the problem is, as people say endlessly, that the cost incentives are removed by insurance companies, because you often pay premiums only (deductibles are relatively small), and insurance companies want to keep clients who might switch after waiting months for cancer treatment, so they don't push as strong towards the way you are suggesting.

That's just what the people want.

 

The governnent grants them this power.
The government agrees with their restriction. Are you indicating that government really doesn't know best?

 

The government is NOW looking to end many requirements for teachers, to CHEAPEN the cost of employing them.

The balance of licensing to maintain quality, vs. letting capitalism provide, is a worthy debate.

 

UNIFORM PRICING (for all medical procedures--regardless of location) is a MUST.

The price of a knee replacement (for example) can vary by as much as $30,000+ (depending on the location).

 

The problem with that is, apples to apples. My father just had knee replaced, but he was radically bowlegged, with advanced heart problems. These are costly complications.

 

I find that those who complain about the AMA the loudest also advocate lots of government intrusion to maintain quality.
Perplexing

 

That is a valid point.

That said, in most situations (without complication/all things being equal) costs of medical procedures vary widely between regions.

 

Uniform wages for your occupation too. Society will be so fair

 

I like the title of the thread. And even more how you start this message denouncing partisan crap. I also think that a serious debate on Healthcare costs is long overdue.

But if this is going to be a seriouis debate, we should start it by showing a serious basis for our arguments. Where did you get this information that a single-payer system cuts costs by removing end of life costs that are being mad in the current system? Please show the data and reference. Most importantly what it is that is now covered, and supposedly will not be covered in a single-payer system.

I find it strange that, while asking for a frank, non-partisan and serious (I assume) discussion, you though in so many statements without justifications. How is that relevant to a discussion about a single-payer system? Personally I think that subsidizing medical training is a good thing. But whether we chose to do that or not has nothing to do with a single-payer system.

Again: how does that change for the worse if we implement a single-payer system?

You can't get more "buying across state lines" than with a Federal single-payer system. That would solve the problem that you are enumerating. It is extremely questionable that the Federal government forcing states to accept the guidelines of other states would solve any problems. So please explain how forcing the state of New York to adopt whatever Arizona decides is their definition of "insurance" would solve any problem, and not pose a Constitutional breach?

If you are truly interested in a serious discussion about single-payer system, please respond. If not, don't bother.

 

I view 2,3,4 as insignificant relative to total costs.

the biggest problem is unhealthy habits of Americans, probably the most unhealthy mix of people of any developed nation. The massive problems we have with obesity related diseases is a huge issue. What can government or private sector do when the population is irresponsible with their health, nothing. A concerted effort needs to be made to make the population healthier, explain to people they have a duty to society to be more responsible with their health. If people refuse to be more responsible, fine, but many would change their habits out of duty.

The cost problem is also attributed to the incredibly complex system we have (administratively costly) and the lack of negotiation power from insurance companies and people. If you are not insured, providers f you over with ridiculously high priced services which you have no negotiating power over. If i go buy a bmw and someone tells me '60k' i have some power to negotiate, buying the car is not a necessity. If i go to a doctor, without insurance, i can get billed $10 for a tylenol and 1,000 for a doctor to come say hi to me for 2 seconds etc.. you get screwed! this is why healthcare cannot be looked at as it were some privilege, the consumer is forced to pay whatever providers charge or risk death.

Now insurance companies have some negotiating power but not as much; oftentimes, insurance companies will seek providers that offer lower costs (in network perhaps) but oftentimes if providers say 'no, i want to charge x', insurance companies say 'no problem' and guess who pays? premium payers..

healthcare providers know they have power over the consumer so tend to charge whatever they want and so the incentive is quantity, not quality. A provider is motivated to keep patients coming back into the office and seek more services, not really prevent the person from coming back. In the private ins. market, insurance companies don't fight providers as much as they should as they just pass on costs to premium payers. When it comes to government programs like medicare where there is more control of costs (government may determin price for x,y,z), providers find a loophole and try to make up for this by encouraging more and more patient visits and services - volume, not quality.

To control these costs, there should be a reward for performance/quality rather than quantity. We see this in the concepts of global care where instead of allowing providers to screw patients by charging them for different services, billing from different departments without any accountability for performance, providers are incentivized to work more efficiently and keep people out of hospitals. So let's say i go in and i get 5 different bills, outrageous prices and i'm not cured, so i keep going in... costs add up and doctors don't care if they are doing a good job. Now let's say doctors get $20k to manage all the costs related with my diagnosis and only one bill will be sent to me. Now what? doctors will work closely with each other, nurses and ensure they 1. do a good job so costs don't get over 20k (more incentive to cure me) 2. work more closely with each other to ensure costs don't over the 20k. Now they have an incentive to actually be efficient and keep me out of hospital.

what people simply don't get is that doctors have too much power over patients and if left alone, can just charge whatever the f they want and not care if we are cured or not, the more we go for treatment, the better for them. So paying for performance and quality need to be part of of the equation.

 

Among prescription drug costs, we pay far more than any other country, at least 20% more than Canada and over 60% more than New Zealand. For the same MRI’s and CT scans, we also pay more: $1,080 is the commercial average cost for an MRI in the U.S. as compared to $599 in Germany; at CT of the head costs $510 on average in the U.S. versus $272 in Germany. For a hip replacement, we again pay the most: $1,634 among public payers and $3,996 among private payers, versus $1,046 and $1,943 respectively in Australia. And physicians’ incomes are the highest: $187,000 on average among primary care doctors in the U.S. versus $93,000 in Australia; and $442,000 among orthopedic surgeons in the U.S. versus $154,000 in France.