Why does health care in the USA cost so much?

Discussion in 'Health Care' started by mihapiha, Jan 8, 2016.

  1. mihapiha

    mihapiha Active Member

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    Why does health care in the USA cost so much?



    The WHO (World Health Organization) ranks systems based on quality for the patients. Unfortunately the ranking is from the year 2000 and much has changed since, but it is the only ranking I can go by. The ranking lists the United States as #37 on the list, although Americans invest most into their health care system.

    In order to understand where the money goes I want to compare the United State’s spending with countries in the industrialized world, which the USA should be competing with. For example, San Marino, Andorra, Malta and Singapore are all in the top 10, but because of the size of their population or even country, coverage is significantly easier compared to the US. It would in my opinion be unfair to compare the US’s system and expenses to these countries.

    France (ranked #1), Italy (ranked #2), Spain (ranked #7) and Japan (ranked #10) I feel are the more interesting and fair comparisons. All of their systems are ranked highly, and it can be assumed that in the last 15 years little has changed in terms of ranking for these four countries. Probably all of them still are at least in the top 15.

    First lets look at cost. Total health expenditure is the sum of public and private health expenditure. It covers the provision of health services (preventive and curative), family planning activities, nutrition activities, and emergency aid designated for health but does not include provision of water and sanitation.

    ________________________________________

    France:

    I want to mention that in the year 2000 France spend 10.1% of the GDP to cover the health care costs to get the #1 ranking. The WHO ranked France spending the 4th most on health care per capita in the world back then.

    11.7% of the GDP was spend on health care services in 2013.
    Total GDP in 2013 was $2,806 billion
    Inhabitants = 66.03 million
    Workforce = 24.73 million

    $2,806 billion * 11.7% = $328.302 billion for health care
    $328.302 billion / 66.03 million people = $4,972 per inhabitant annually or $13.62 per inhabitant per day.
    $328.302 billion * 77% = 252.792 billion paid by the state.

    Because 77% of all expenses were paid by the sate, and with exclusively the employed working people paying, $10,222 annually would have to be paid in taxes by each of the 24.73 million people who were employed in 2013. However, in France Statutory health insurance is financed by employer and employee payroll taxes (64%); a national earmarked income tax (16%); revenue from taxes levied on tobacco and alcohol, the pharmaceutical industry, and voluntary health insurance companies (12%); state subsidies (2%); and transfers from other branches of social security (6%) (Sécurité Sociale, 2014).

    That means that practically health care insurance cost the average worker $6,542.08 of their paychecks.

    _______________________________________

    Italy:

    In the year 2000 Italy spend 7.9% of the GDP to cover the health care costs to get the #2 ranking. The WHO ranked Italy spending the 11th most on health care per capita in the world back then.

    9.1% of the GDP was spend on health care services in 2013.
    Total GDP in 2013 was $2,149 billion
    Inhabitants = 61.02 million
    Workforce = 23.09 million

    $2,149 billion * 9.1% = $195.559 billion for health care
    $195.559 billion /61.02 million people = $3,205 per inhabitant annually or $8.78 per inhabitant per day.
    $195.559 billion * 78% = 154.492 billion

    Because 78% of all expenses were paid by the sate, and with exclusively the working people paying, $6,690 annually would have to be paid in taxes by the 23.09 million people who were employed in 2013.

    ______________________________________

    Spain:

    I the year 2000 Spain spend 7.2% of the GDP to cover the health care costs to get the #7 ranking. The WHO ranked Spain spending the 29th most on health care per capita in the world back then.

    8.9% of the GDP was spend on health care services in 2013.
    Total GDP in 2013 was $1,393 billion
    Inhabitants = 47.13 million
    Workforce = 18.07 million

    $1,393 billion * 8.9 % = $123.975 billion for health care
    $123.975 billion / 47.13 million people = $2,630 per inhabitant annually or $7.21 per inhabitant per day.
    $123.975 billion * 71.2% = 88.270 billion

    Because 71.2% of all expenses were paid by the sate, and with exclusively the employed working people paying, $4,884.89 annually would have to be paid in taxes by each of the 18.07 million people who were employed in 2013.

    ______________________________________

    Japan:

    In the year 2000 Japan spend 7.6% of the GDP to cover the health care costs to get the #7 ranking. The WHO ranked Japan spending the 13th most on health care per capita in the world back then.

    10.3% of the GDP was spend on health care services in 2013.
    Total GDP in 2013 was $4,700 billion
    Inhabitants = 127.3 million
    Workforce = 63.58 million

    $4,700 billion * 10.3 % = $484.1 billion for health care
    $484.1 billion / 127.3 million people = $3,802.83 per inhabitant annually or $10,42 per inhabitant per day.
    $484.1 billion * 82.1% = 397.446 billion

    Because 82.1% of all expenses were paid by the sate, and with exclusively the employed working people paying, $6,251.12 annually would have to be paid in taxes by each of the 63.58 million people who were employed in 2013.

    ______________________________________

    United States of America:

    The USA was ranked only 37th in the world by the WHO in the year 2000, although the people paid most per capita into their system with 13.1% of the GDP being used for health care.

    17.1% of the GDP was spend on health care services in 2013!
    Total GDP in 2013 was $16,770 billion
    Inhabitants = 318.9 million
    Workforce = 148.2 million

    $16,770 billion * 17.1% = $2,867.67 billion for health care
    $2,867.67 billion / 318.9 million = $8,992.38 per inhabitant annually or $24,64 per inhabitant per day.
    $2,867.67 billion * 47.6% = $1,365.01 billion

    Because 47.6% of all expenses were paid by the sate, and with exclusively the employed working people paying, $9,210.59 annually would have to be paid in taxes by each of the 148.2 million people who were employed in 2013.

    _______________________________________

    Even if you compare the US system to the French, which is a very expensive system, it is hard to understand why the people of the US spend nearly twice per resident on health care. It was pointed out to me that the US invests most money into R&D, which is true. $120 billion annually compared Europe’s $82 billion. As you see from these numbers above, it is around 4% of what Americans invest into health care. The $38 billion R&D gap costs the workforce $265,41 more per worker annually compared to a European worker. However, the $265,41 doesn’t begin to explain why the average worker tends to pay more only in taxes for Medicate and Medicare than the average European or Japanese worker pay for full medical and dental insurance which virtually covers all people in these countries. The average American income is $50,500 and Americans spend on average $15,745 to cover the family, with workers on average paying $4,316 toward the cost of their coverage. A single or Individual employee's coverage cost $5,615, with the worker on average paying $951 out-of-pocket.

    This means if the US federal government would properly budget their Medicate and Medicare expenses and divide it among the working people evenly, nearly another $9,000 on expenses would go on top of the average $5,615 just to cover the worker.

    In my opinion there is no reason to assume that the average American is so much unhealthier than the average French, Italian, Spanish or Japanese inhabitant, and that 10 to $12 per day and inhabitant ought to cover all expenses that the average resident has. That means between 3650 and $4380 annually per resident seems normal. Even if the US for some reason was still more expensive and trump France’s $13.67 per inhabitant and day and we would assume costs of $15 per day and inhabitant, that would total to $5,475 per year. This would also mean that the average employed worker would have to pay $11,781.22 annually into the system to cover all people fully, including pharmaceuticals! However, in the United States, 32 million people still are not covered.

    Independent on how I calculate I cannot help but think that any additional expenses that the people of the US have, are a result of a privatized system, in which people finance huge profits, law offices, additional bureaucracy, marketing departments and other things which have nothing to do with health care.

    Although, it might be odd looking at a ranking from the year 2000, I would assume that the health care system 15 years ago in America wasn’t significantly worse compared to today. Therefore, can anybody explain to me how it is possible that Americans have to pay so much into their health care system, and were in the year 2000 so poorly ranked by the WHO?





    Sources:

    http://italychronicles.com/employment-in-italy/
    http://www.commonwealthfund.org/~/m.../jan/1802_mossialos_intl_profiles_2014_v7.pdf
    https://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000
    http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS
    http://www.euro.who.int/__data/assets/pdf_file/0004/128830/e94549.pdf
     
  2. Mr_Truth

    Mr_Truth Well-Known Member

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    answer:




    profit$
     
  3. democrack

    democrack Banned

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    GREED ! Over half the population doesn't work , we have illegal costing over 100 BILLION every year . We allow lobbyist to wheel and deal and set law . And there that Obamacare disaster !
     
  4. mihapiha

    mihapiha Active Member

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    Because I wanted as much information as possible on that topic, I chose to post it on reddit as well.

    Very interesting was this video:

    [video=youtube;qSjGouBmo0M]https://www.youtube.com/watch?v=qSjGouBmo0M[/video]

    The video mentions a few reasons of excessive spending compared to other countries:

    malpractice and defensive medicine care: $55 billion
    higher wages: $75 billion
    administrative costs: $90 billion
    drugs: $100 billion
    failed negotiations: $500 billion

    If all those numbers were true, it would result in around $820 billion dollars of excessive spending. That might ideally lower the US health care costs to around $2,000 billion total and to $17.18 per inhabitant per day. That is still nearly twice compared to Italy and more than twice compared to Spain!

    Greed seems to be the most logical reason indeed. However, if you look at other countries you can see that most other countries have less than half of the population employed as well. There's a significant number of children, elderly, etc. who for one reason or another won't or can't work. 46.5% of the US population is employed compared to France's 37.5% or Japan's 49.9%. I'd say having more than half of your country employed is rare.
     
  5. Taxpayer

    Taxpayer Well-Known Member Past Donor

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    Who get's paid doesn't explain why people spend money on bureaucracy, marketing, lawyers, etc. Consumers drive the market, the why comes from understanding what need that market is trying to serve.

    We used to consult with doctors for medical advice, folks don't have that same sense of responsibility for their own health anymore. They expect the doctor to know exactly what the problem is, provide a pill or procedure to solve it, and sue him if they don't get it. Not surprisingly the industry does excessive amount of testing and provides so many solutions as pills and procedures. Diagnosis are more cautious, doctors are more heavily insured, and solutions are more product oriented.

    The doctor used to suggest folks run laps to trim that tummy, now people insist on a lap band being installed instead. They demand a side order of Lipitor with their cheeseburger, instead of changing their diet. They treat hospitals like a day spa, emergency rooms like a drive through and ambulances like taxi cabs... without regard to tremendous cost of maintaining what should be a last resort option. They choose doctors and hospitals based on 30 second TV commercials about which one has the newest, latest, most expensive diagnostic center full of equipment the patient will never need... even when they're just shopping for a flu shot or annual checkup. So hospitals need a marketing budget and are constantly spending money on staff and equipment whose only purpose is to allow them to claim a level of service no one needs.

    Making someone else responsible for delivering health, instead of buying their advice and renting their skills is more expensive. Many folks in America can afford that luxury and so many solutions were developed, the problem was we confused that with that level of luxury with baseline services provided as a right in other countries. So now American's expect that luxury as a right. Not surprisingly, the cost of medicine in this country is ridiculous.



     
  6. democrack

    democrack Banned

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    What has the government ever run that was efficient and not over budget ?
     
  7. mihapiha

    mihapiha Active Member

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    What do you mean? In general? There have been times in which they had a budget surplus, even in the US (Clinton years come to mind). However, if you think that all government programs are inefficient in the US, the postal service, fire departments, etc. must really be different from what we have here. Besides, government programs are supposed to be "non-profit" based. They are supposed to be services or things the government does without a profit motive in order to cover all citizens. I don't think there should be a profit motive for crisis situations (fire, health, security, etc.), which is just my opinion.

    How the US solves these issues and how they perform on them is also not necessarily that important. The question at hand is really to understand why the system at hand makes people in the US invest so much money into health care, and the video mentions a few reasons.
     
  8. LiveUninhibited

    LiveUninhibited Well-Known Member

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    The guy in the video is basically correct. A root cause of these things includes corruption ultimately caused by a misinterpretation of the first amendment (bribes as free speech to, e.g., disallow medicare from negotiating for lower drug prices) and a pathological fear of socialism despite the fact that healthcare is different from other sectors of the economy (inelastic demand, difficulty of being an informed consumer, emergency situations making it hard to shop around, being sick making it hard to shop around, etc.). There's also an overemphasis on intervention and less on prevention, which is likely driven by healthcare-for-profit and a symptom of our relatively disorganized healthcare "system."
     
  9. democrack

    democrack Banned

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    Oh , I see we pad the budget and later claim we had a surplus . The government is not for profit they simply collect more and more of the taxpayers money to fund their nonsense crap . The government spends 100 BILLION a year on ILLEGALS , that's taxpayer dollar ! Our debt is 19 TRILLION and counting , the post office is BILLIONS in debt . Obamacare has cost the taxpayers BILLIONS this year alone . Medicare fraud costing over 650 BILLION .
    Here are few more gems most taxpayers are proud to see ;

    The federal government made at least $72 billion in improper payments in 2008.[1]
    Washington spends $92 billion on corporate welfare (excluding TARP) versus $71 billion on homeland security.[2]
    Washington spends $25 billion annually maintaining unused or vacant federal properties.[3]
    Government auditors spent the past five years examining all federal programs and found that 22 percent of them -- costing taxpayers a total of $123 billion annually -- fail to show any positive impact on the populations they serve.[4]
    The Congressional Budget Office published a "Budget Options" series identifying more than $100 billion in potential spending cuts.[5]
    Examples from multiple Government Accountability Office (GAO) reports of wasteful duplication include 342 economic development programs; 130 programs serving the disabled; 130 programs serving at-risk youth; 90 early childhood development programs; 75 programs funding international education, cultural, and training exchange activities; and 72 safe water programs.[6]
    Washington will spend $2.6 million training Chinese prostitutes to drink more responsibly on the job.[7]
    A GAO audit classified nearly half of all purchases on government credit cards as improper, fraudulent, or embezzled. Examples of taxpayer-funded purchases include gambling, mortgage payments, liquor, lingerie, iPods, Xboxes, jewelry, Internet dating services, and Hawaiian vacations. In one extraordinary example, the Postal Service spent $13,500 on one dinner at a Ruth's Chris Steakhouse, including "over 200 appetizers and over $3,000 of alcohol, including more than 40 bottles of wine costing more than $50 each and brand-name liquor such as Courvoisier, Belvedere and Johnny Walker Gold." The 81 guests consumed an average of $167 worth of food and drink apiece.[8]
    Federal agencies are delinquent on nearly 20 percent of employee travel charge cards, costing taxpayers hundreds of millions of dollars annually.[9]
    The Securities and Exchange Commission spent $3.9 million rearranging desks and offices at its Washington, D.C., headquarters.[10]
    The Pentagon recently spent $998,798 shipping two 19-cent washers from South Carolina to Texas and $293,451 sending an 89-cent washer from South Carolina to Florida.[11]
    Over half of all farm subsidies go to commercial farms, which report average household incomes of $200,000.[12]
    Health care fraud is estimated to cost taxpayers more than $60 billion annually.[13]
    A GAO audit found that 95 Pentagon weapons systems suffered from a combined $295 billion in cost overruns.[14]
    The refusal of many federal employees to fly coach costs taxpayers $146 million annually in flight upgrades.[15]
    Washington will spend $126 million in 2009 to enhance the Kennedy family legacy in Massachusetts. Additionally, Senator John Kerry (D-MA) diverted $20 million from the 2010 defense budget to subsidize a new Edward M. Kennedy Institute.[16]
    Federal investigators have launched more than 20 criminal fraud investigations related to the TARP financial bailout.[17]
    Despite trillion-dollar deficits, last year's 10,160 earmarks included $200,000 for a tattoo removal program in Mission Hills, California; $190,000 for the Buffalo Bill Historical Center in Cody, Wyoming; and $75,000 for the Totally Teen Zone in Albany, Georgia.[18]
    The federal government owns more than 50,000 vacant homes.[19]
    The Federal Communications Commission spent $350,000 to sponsor NASCAR driver David Gilliland.[20]
    Members of Congress have spent hundreds of thousands of taxpayer dollars supplying their offices with popcorn machines, plasma televisions, DVD equipment, ionic air fresheners, camcorders, and signature machines -- plus $24,730 leasing a Lexus, $1,434 on a digital camera, and $84,000 on personalized calendars.[21]
    More than $13 billion in Iraq aid has been classified as wasted or stolen. Another $7.8 billion cannot be accounted for.[22]
    Fraud related to Hurricane Katrina spending is estimated to top $2 billion. In addition, debit cards provided to hurricane victims were used to pay for Caribbean vacations, NFL tickets, Dom Perignon champagne, "Girls Gone Wild" videos, and at least one sex change operation.[23]
    Auditors discovered that 900,000 of the 2.5 million recipients of emergency Katrina assistance provided false names, addresses, or Social Security numbers or submitted multiple applications.[24]
    Congress recently gave Alaska Airlines $500,000 to paint a Chinook salmon on a Boeing 737.[25]
    The Transportation Department will subsidize up to $2,000 per flight for direct flights between Washington, D.C., and the small hometown of Congressman Hal Rogers (R-KY) -- but only on Monday mornings and Friday evenings, when lawmakers, staff, and lobbyists usually fly. Rogers is a member of the Appropriations Committee, which writes the Transportation Department's budget.[26]
    Washington has spent $3 billion re-sanding beaches -- even as this new sand washes back into the ocean.[27]
    A Department of Agriculture report concedes that much of the $2.5 billion in "stimulus" funding for broadband Internet will be wasted.[28]
    The Defense Department wasted $100 million on unused flight tickets and never bothered to collect refunds even though the tickets were refundable.[29]
    Washington spends $60,000 per hour shooting Air Force One photo-ops in front of national landmarks.[30]
    Over one recent 18-month period, Air Force and Navy personnel used government-funded credit cards to charge at least $102,400 on admission to entertainment events, $48,250 on gambling, $69,300 on cruises, and $73,950 on exotic dance clubs and prostitutes.[31]
    Members of Congress are set to pay themselves $90 million to increase their franked mailings for the 2010 election year.[32]
    Congress has ignored efficiency recommendations from the Department of Health and Human Services that would save $9 billion annually.[33]
    Taxpayers are funding paintings of high-ranking government officials at a cost of up to $50,000 apiece.[34]
    The state of Washington sent $1 food stamp checks to 250,000 households in order to raise state caseload figures and trigger $43 million in additional federal funds.[35]
    Suburban families are receiving large farm subsidies for the grass in their backyards -- subsidies that many of these families never requested and do not want. [36]
    Congress appropriated $20 million for "commemoration of success" celebrations related to Iraq and Afghanistan.[37]
    Homeland Security employee purchases include 63-inch plasma TVs, iPods, and $230 for a beer brewing kit.[38]
    Two drafting errors in the 2005 Deficit Reduction Act resulted in a $2 billion taxpayer cost.[39]
    North Ridgeville, Ohio, received $800,000 in "stimulus" funds for a project that its mayor described as "a long way from the top priority."[40]
    The National Institutes of Health spends $1.3 million per month to rent a lab that it cannot use.[41]
    Congress recently spent $2.4 billion on 10 new jets that the Pentagon insists it does not need and will not use.[42]
    Lawmakers diverted $13 million from Hurricane Katrina relief spending to build a museum celebrating the Army Corps of Engineers -- the agency partially responsible for the failed levees that flooded New Orleans.[43]
    Medicare officials recently mailed $50 million in erroneous refunds to 230,000 Medicare recipients.[44]
    Audits showed $34 billion worth of Department of Homeland Security contracts contained significant waste, fraud, and abuse.[45]
    Washington recently spent $1.8 million to help build a private golf course in Atlanta, Georgia.[46]
    The Advanced Technology Program spends $150 million annually subsidizing private businesses; 40 percent of this funding goes to Fortune 500 companies.[47]
    Congressional investigators were able to receive $55,000 in federal student loan funding for a fictional college they created to test the Department of Education.[48]
    The Conservation Reserve program pays farmers $2 billion annually not to farm their land.[49]
    The Commerce Department has lost 1,137 computers since 2001, many containing Americans' personal data.[50]
     
  10. kreo

    kreo Well-Known Member

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    Because people in U.S. believe in capitalism, even if that capitalism means government corruption.
     
  11. kreo

    kreo Well-Known Member

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    The answer is very simple.
    Health Care system is a private monopoly supported by the government.

    Access to drug is limited by the government.
    Number of doctors is limited by the government.
    That combination allows health care providers jack up the prices as high as they want.
    Also there is two system of the Health Care in U.S.
    Public system for people over 65, disabled and no income people
    Private system for all other people.
    That dual system allows private companies charge government any price the want, and when government pays them those prices become de facto market prices.
     
  12. mihapiha

    mihapiha Active Member

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    If you look at the budget, of 2014 the US government took in $3,249 billion and spend $3,650.526 billion.
    Of the send money $620.562 billion (17%) were spend on defense $857.319 billion (23.5%) on social security, $450.795 billion (12.4%) on health, $519.027 billion (14.2%) on Medicare and $542.237 billion (14.8%) on income security.

    Only these programs are $2,989.94 billion and therefore cover 82% of all the money spend. If you look at health care alone it's $969.822 billion (26.57%) of the entire federal budget. Other health care is spend in the defense program also for veterans for example, which is another $66 billion.

    Let's compare that to one of the countries I listed: France! They spend €275.5 billion (14.5%) on defense and €232.059 (12.2%) on health care out of their €1,906.424 billions on spending total. I know you don't like overspending, but reducing health care costs is what would balance the budget faster than any of the things you mentioned. All of them total don't impact as much as dropping health care expenses to standards set by countries with single payer systems.

    Alternatively the US could also choose to reduce the defense spending to maybe half, which would ensure that the US military has "only" the budget surpassing the next two countries combined (China and Russia) instead of the next 8 countries combined, many budget problems would be solved too. However the people would not approve of that measure. As I understand it, most Americans believe though that health care just costs too much, and they would approve of changes in that regard. A full adaptation to a very expensive system such as the French would cost the government $10.5 per day per inhabitant, and they would be able to cover virtually all inhabitants. Now they cover veterans, elderly people, poor people, etc. which is problematic since we don't even know how many that is. Definitely less that half of the US population though, which means that the government is forced to pay over $16.6 per inhabitant who they cover per day. Looking at the numbers I see most room in the US budget in health care, since the people also approve of changes in that regard.
     
  13. JoakimFlorence

    JoakimFlorence Banned

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    Ridiculous liability and grossly excessive court judgments is one part of the problem. For many medical specialties, the malpractice insurance alone is well over $100,000 a year. It costs a lot of money to fund what is basically a lotto system for patients who suffered medical complications.
     
  14. CourtJester

    CourtJester Well-Known Member

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    And one big reason for the problem is that while the medical profession is by their own claim self policing in reality the profession does nothing to weed out the incompetant or dare I say the criminal.
     
  15. JoakimFlorence

    JoakimFlorence Banned

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    Same thing in state bar associations when a prosecutor abuses their position. There's no one else overseeing complaints made against these professionals, so they usually do not get in trouble unless they did something outrageously bad. Some of them have a long list of past complaints made against them and nothing ever gets done about it.
     
  16. beth115

    beth115 New Member Past Donor

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    Heath care providers aren't "jacking" up the prices, the federal government through their regulations and interference and lack of regulating private health care insurance companies are pushing up the prices, allowing g insurances companies to charge more and increase deductibles and co to UE to pay doctors and hospitals less and require insureds to pay more before they can even access their insurance coverage. It is due to the lack of knowledge by most people insured that leads them to believe obamacare is is a god send, u til they need to use their I insurance for surgery or inpatient c are. The health insurance system was never meant to pay all costs, after the 1990,'s wich the on set of hmo and ppo's, the reimbursements went down, the cost of providing health care went up and has continued to in crease due to further regulation. All while doctors work longer hours see more patients each day, pay higher operating costs and earn less money.

    How long can this trend last before more and more doctors are forced out of practice?
     
  17. CourtJester

    CourtJester Well-Known Member

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    You can do a very simple search and find the average income of doctors by profession. They may be earning less than in the past but compared to most professions thay are not suffering. The problem with American healthcare has nothing to do with doctor's income except perhaps with the artificial limitations on who can practice what types of healthcare.
     
  18. beth115

    beth115 New Member Past Donor

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    But the other highly paid professions are not heavily regulated or have their fees basically fixed such as medicare and medicaid have done or seen their income fall by nearly half over the last decade. Lawyers charge often by the minute as do many accountants and plumbers and electricians can charge what they want without the government or any agency limiting their fees. In fact a plumber makes more per hour than a doctor is paid to amputate a foot and provide post-op care. While dentists can virtually charge what they want because most aren't forced to accept insurance and not regulated by federal or state government. Health care professionals are nearing the poin t of being unable to accept health insurance as payment or signing on to insurance plans patients will be required to pay upfront and submit the bill to their insurance on their own to get reimbursement if possible and deal on their own with company. Most insurance doesn't pay for cosmetic surgery and the patients now pay up front, the same will be true for all surgeons when reimbursement reaches the tipping point and regulations become to difficult and costly.
     
  19. Greenbeard

    Greenbeard Well-Known Member

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    The money isn't disappearing into some black hole between the patient and the care provider. Insurers are basically intermediaries--yes, they take their administrative cut (the amount of which is now limited by law). But the vast majority of money flowing into insurers through premiums goes back out as reimbursement to health care providers. So they can't be taking more from the consumer, paying less out to the provider community, and simultaneously meeting their statutory medical loss ratio requirements. If they're taking in more money through premiums, they're paying more money out to providers.
     
  20. Battle3

    Battle3 Well-Known Member

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    There was no surplus during the Clinton years. The total US debt is split into debt held by the public and intragovernmental debt. Clinton shifted money between the 2 so that the public debt would show a surplus - that's the source of the myth you wrote - but the total national debt increased every year Clinton was in office.

    The US is not the same as Europe (duh). The US postal service is always overbudget and inefficient. The private carriers far surpass the USPS in speed of delivery, reliability, and many times in cost. The US postal service is a joke.

    Police departments used to be run by local govts, but they have been co-opted by the federal govt thanks to the "war on terror". Abuses by cops are almost daily occurrences, trust in cops seems to be at an all time low.

    Fire departments are run by local governments, not the federal govt.

    The federal govt is supposed to operate without a profit motive! LOL, you should be a comedian, that is so funny. The feds are bought and paid for, they sell favors in order to keep power.


    But the question at hand - why US health care is so expensive - is easy: the federal govt runs it and they have for decades. Up until obamacare, the feds dictated how hospitals, doctors, pharmacies, medical research, etc was to be run. The feds controlled health care providers by setting the rules and regulations. WIth obamacare, they just stepped in and dictate. But obamacare is truly collapsing - the more govt involvement, the worse the health care system gets.
     
  21. kreo

    kreo Well-Known Member

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    Yea, It is less then 1% of health care cost. No one ever complained about extra diagnostic.
     
  22. beth115

    beth115 New Member Past Donor

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    Yes the money IS falling into a black hole as you call it. People aren't getting the insurance they pay for under Obama care/exchanges. The only mandated benefits many are getting is free birth control and newborn care. No limits on deductibles and out of pocket/copayments and no requirements to even pay inpatient or surgical care or for I
    Ultrasounds and other diagnostic tests as we were led to believe. A majority of exchange policies are virtually worthless especially when it comes to single men.
     
  23. ARDY

    ARDY Well-Known Member Past Donor

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    Many different polices are offered
    Coverage is different between them
    I had a policy for a while and was happy with it

    Now medicare
     
  24. Greenbeard

    Greenbeard Well-Known Member

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    You cannot have a situation in which most insurance policies pay out more to providers than they take in through premiums. In any given year, most people should be paying in more than they get out. This isn't a free energy machine, it's a way of financing care for people who need it beyond their ability to finance it. Which should be a minority of the population.

    The money doesn't go into a black hole, it's paid out to providers to cover the costs of the sicker folks in the insurance pool.
     
  25. Nebraskan

    Nebraskan New Member

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    The basic reason that health care costs so much in the US, compared to other wealthy countries, is that the US does not have effective price controls. This chart is specific to drugs, but you get the idea...Here's how other countries control health care prices.
    [​IMG]
     

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