Unbelievably there are people in this area who so afraid of government that they are willing to destroy the delivery of healthcare to those who actually need it. These people cling to the notion that they don’t want to pay more taxes for anything that has to do with health care.
Let’s start with clearing up some misconception, health insurance does not mean health care. Health insurance is a method of financing, much like credit card, or loan. Or to put it simply, for the people who think Obama is a Communist, health insurance is a tax you pay directly to a corporation. And the corporations make sure they compensate their executives really, really well. Paying for health insurance does not mean we get health care.
Insurance is supposed to work like this, everyone pays a little into a pool that only a few will ever draw from. But that’s not the way health insurance seems to work these days. Virtually everything medically related is now paid for via insurance. It’s like paying for furniture via your homeowner’s insurance or paying for tires through your auto insurance. It didn’t start out that way, but somehow in the dusty bins of policy makers in the 1970s, that’s what happened. People stopped paying for routine medical care because suddenly their “insurance” covered it.
Here’s another misconception the cost of health care is not the same as the price of health care. If the average employer-based family health insurance plan is priced at $12,000 a year, how much is that families medical care costs? Having trouble figuring that out?
Have you ever read a medical bill? No single line item called “Obscure Medical Treatment:, instead we get a hodgepodge of administrative fees, account fees, and other things on there that have nothing to do with the actual treatment. Imagine if the same process was used to buy groceries. Your six pack of bottled water would have a stocking fee, an administrative fee, an account fee, you’d pay for the packaging separately from the water and you’d have to make an “office visit” after 90 days when you want to buy the six pack again. Then either you or the grocer would submit your “bill” for the six-pack of water, and some bean counter would think about whether you paid too much for the water, picked a brand they didn’t like, or shopped at a grocer that wasn’t in their approved list.
We put up with this byzantine payment system because most Americans get health insurance through employers and somewho think that they aren’t paying for it, the employer is. Here’s the startling factoid, guess who is really paying that average employer-based health insurance premiums of $12,000 a year? The employer? No, the employee. Because if the employer didn’t have to pay for health care insurance plans for the employee and family, then the money, which is already desginated as benefist compensation to the employee would then actually go compensate the employee and not the health insurance company recipient it currently is.
Suddenly, its $12,000 extra dollars in income that could be spent on medical care. Or if everyone is healthy, not. Suddenly, if our hypothetical family is paying for medical treatment out of their money, they might be wanting to know what that treatment costs.
There’s a whole series of medical treatments that exist outside of the realm of health insurance that have somehow managed to be cheaper and better while the routine medical care has gotten more expensive and less effective.
Cosmetic surgery, I prefer the old-skool plastic surgery, offers us deep insight into pricing by treatment instead of by procedure. No complicated tests in boob-job land. LASIK eye treatment? A per eye cost. Botox? On sale now. Want to lose weight at a spa? A per week cost, everything included. Why isn’t the rest of our medical care priced so transparently? Why can we pick and choose the $600 per eye LASIK treatment from the $1200 per eye treatment? Why have the costs of LASIK, nose jobs, and eye lifts, all gone down in price in recent years when every other aspect of routine medical care, such as my standard example, the broken arm, gone up?
While medical costs have risen by an average per-capita rate of 40%, salaries have risen by a per-capita negligible 3%. Go back to the question of who is paying for employer based medical insurance. Those 3% raises, if you’re lucky come out of the compensation pool. The hard work of employees throughout the country essentially gets transferred right to the insurance companies. And here’s the shocking part, most employees don’t end up putting in claims for medical treatment each year that come anywhere close to what is spent on their behalf in insurance. But some do. And it’s that fear of hitting a medical disaster that fuels the need of insurance against an overwhelming financial disaster. But why are so many medical treatments so expensive?
The baffling answer is that the entire pricing and compensation system of health care is based on procedures and not treatments.
Think of it this way, a broken arm being set in a cast is a treatment. The medical office visit, x-ray, mri, blood test, setting the arm, enveloping the arm in a cast, prescriptions for painkillers–those are all procedures. To you, with the broken arm, all you care about is getting your arm set and on your way. But that’s not how it works. All these procedures all require multiple specialists which means everyone has a slice of profit to wring out of your simple broken arm. No one is compensated based on how quickly your arm will mend itself. As the medical treatment gets more complicated, as the symptoms get fuzzier, the amount of procedures replicate like rabbits. Multiple Doctors, means multiple tests, and who really is in charge?
Where once if you sought medical care for a high fever and runny nose, you might have been told to “take a couple of aspirin till the fever breaks, and rest up until you feel better,” we now are confronted with diagnostic tests. These medical tests do nothing to really treat whatever it is you have, and are have become the norm in making diagnoses for the common ailments that have afflicted humans since the beginning of time. So with all the advanced medical knowledge we have attained, with all the new drugs and machines, we have produced doctors who can’t diagnose common ailments without a battery of tests where once a doctor would simply know that 9 times out of 1o, your weird symptoms were just a new manifestation of the common cold.
And if that 1 out of 10 item is an indicator of angina? Why there’s more medical procedures in store, but now you are swept completely out of the realm of being able to judge whether these procedures will actually treat your condition. Does anyone know if angioplasty prevents heart attacks? Stents? By-pass surgery? Is there any evidence that years of life will be added by these procedures, that a simple change in lifestyle through diet and exercise will also achieve? The answer is no one knows. The people making those recommendations for procedures are getting compensated for those procedures, not for recommendations such as laying off the french fries and walking 3 miles every day.
The average cost of an angioplasty in a hospital is maybe $33k. I say maybe, because it’s not like you can easily figure out what the “real” cost is. It’s all a negotiation, between you, the insurance company and the hospital, with you having the least say about the cost. But if you look at the fine print, when the company denies payment, or reimburses a lesser amount than your hospital charges, guess who is on the hook? You are. Not your employer, you. Which explains why the most prevalent cause of bankruptcies in America is medical bills.
Sadly, the debate about health care, and the health care bill, will trot out arguments about political philosophies that have nothing to do with the core problem of our health care system. Our system of financing procedures instead of treatment or prevention is sucking up more money regardless of who “pays” the bill. In the end, we are currently paying outrageous amounts at the expense of higher incomes, at the expense of better health, because the health care industry corporations, be they insurance or provider, don’t want you to change their profit trough.
TG, thankx for explaining this so clearly. Most of the outcry is that people don't necessarily understand what they have and what they don't have and have never taken the time to figure it out, hence it is scary when their perception is that something may be taken away. In the end, since this will be a political decision, we probably will wind up with a watered down version if anything at all, at least in my lifetime.
What you don't seem to understand about the "battery of unnecessary tests" is that A) doctors have to rule out the dozens of illnesses that have comparable symptoms to the ones that the patient has presented with, and B) they have to cover all the bases of diagnoses so that the patient or the patien's family doesn't sue the doctor for malpractice if the patient should worsen after treatment, or even die.
How are parents feeling about President Obama taking time away from the already busy classroom time?
Will this be the new norm?
The timing certainly seems suspicious with the controversial health care debate.
We would love to hear what others' are feeling.
SecondHandRose: You seem to like to parrot out "talking points" from somewhere. People don't sue doctors over diganostic tests, they sue doctors when someone ties or is permantantly injured by some surgical procedure. Think wrong arm being amputated.
Here's some facts:
According to the Bureau of Justice Statistics, based on suits occurring in the 75 largest counties in the US,
* 90% of all medical malpractice lawsuits are brought by patients who have suffered permanent injury, or by those representing someone who has died as a result of malpractice.
* The Bureau of Justice Statistics also reported that almost half of all medical malpractice lawsuits filed in the US are brought against surgeons.
* Nearly 33% of medical malpractice lawsuits are attributed to non surgeons.
* The success rate of medical malpractice suits is only nearly a quarter of the total number filed. This is a much lower percentage of success than other tort cases, however the amount of compensation awarded in malpractice cases is significantly higher.
The Journal of the American Medical Association (JAMA) produced an article highlighting these medical malpractice lawsuit statistics, with regard to patient deaths:
* 106,000 patients die each year from the negative effects of medication
* 80,000 patients die each year due to complications from infections incurred in hospitals
* 20,000 deaths per year occur from other hospital errors
* 12,000 people die every year as a result of unnecessary surgery
* 7,000 medical malpractice deaths per year are attributed to medication errors in hospitals
What you don't seem to understand about the "battery of unnecessary tests" is that A) doctors have to rule out the dozens of illnesses that have comparable symptoms to the ones that the patient has presented with, and B) they have been forced to cover all the bases (or appear to have covered all the bases) of diagnoses so that the patient or the patient's family doesn't sue the doctor for malpractice if the patient should worsen after treatment, or even die. One of the major costs of health care in this country is due to the thousands upon thousands of malpractice suits being brought against doctors, insurance companies and health care facilities by patients and/or their families seeking compensation for every little thing.
Note that all the parents against the president's message to students are white. Covert racism, ya' think?
Unlike some people, I don't quote "talking points", I quote my own opinions.
Uh, yeah, Turffie, go back and read what I said. Which was (paraphrased):
"The tests are done *BECAUSE* patients and patients' families have sued in the past *BECAUSE* the patient has gotten worse or died *BECAUSE* they didn't have the "battery of tests" done IN THE FIRST PLACE."
*I* never claimed doctors were sued over tests.
*YOU* said that.
(cough, cough) Reading comprehension helps…….
Doctors do very well, generally, with surgeons averaging over $500,000 a year, and some twice that. Many hold a financial interest in some of the testing that we talk about as being done to protect against possible lawsuits. They also own most of the doctor's liablity insurance companies which pay only a very small percentage of claims. The number of claims is steadily decreasing over the last few years. Expensive procedures on TG's broken arm example don't do much for the broken arm, but occassionally reveal other serious undiscovered problems and lead to early treatment. Too many doctos now overbill medicare and private insurance and that will only get worse until a system is in place to keep them honest.
They make it sound like lawsuits are killing their business, when in fact, that is not happening, and only a tiny number of malpractice suits ever result in big judgements.
OldTimer, when my OB worked every holiday and told his wife they couldnt go on vacation in March because that was when I was due, I said, ya know whatever he is bringing home good for him. When my husbands Neurologist gets paged at church during the holidays and misses meals and significant events with his family because some old lady is stroking out my first thoughts are not "gee he gets paid waaay too much. To the best of my knowledge none of these physicians are living all that large, and I am going to be sitting down with my family and friends eating turkey when they are at the hospital working. Open up the insurance market, lets see what competition will do
No argument, Docotors should do well, over a million a year may be a bit much, but they need to stop complaining and they need to stop overbilling. The good ones are worth every penny, but, unfortunately, there are some very greedy doctors who do a lot of "defensive" procedures because they make a lot of money on them, then tell us they need them to protect against possible malpractice claims. If you have ever been involved in a claim against a doctor, good luck finding another who will give you an appointment. How do you propose "opening" the insurance market ? There is already competition and the insurance companies are doing very well, making it a practice to only insure very healthy people.
The other thing that should be looked at is the cost of a medical education. Doctor's start out with a huge debt to pay off. Maybe the gov't can subsidize the costs of getting that MD, making it possible for more people to go into medicine and chanrge more realistically when they get into practice.
SeconhandRose: A repeat of talking points without any reference to facts is what you've done. You can claim you meant something else, but it's transparent to me, and hardly worthy of discussing.
jillcooks: The insurance markets being opened up is not a bad idea, but more impactful would be a deregulation of medical procedures, as in who can offer procedural services. A short example, Norwalk Hospital was denied the authorization to offer emergency angioplasty and open heart surgery in 2005 because of proximity to Greenwich and Bridgeport. They recently, as in July performed an emergency angioplasty. The fact that the State could deny a hospital what services it can provide is about as anti-competitive as you get. They process is called Certificate of Need, and more on the subject is here.
I agree that the CoN process is anti-competitive to the extreme, and I understand that there is no ability to take an appeal or obtain further review of the decision of the single person that makes the decision for the State. Quite a position of power. However, "deregulation" should also mean that a local zoning commission does not prevent one hospital from providing services merely to "protect" another hospital's perceived exclusive turf.
There are far too many restrictions, both official and practical, that limit competition under the guise of ensuring good service. The tension is between those providers that want to get into the game but are precluded from doing so, and those providers that currently CAN provide services who seek to prevent others from doing so. Norwalk Hospital took that position recently against Stamford Hospital, and Stamford Hospital took that position in the past with Norwalk Hospital's cardiac care proposal. The result — consumers lost.
SecondHandRose: I enjoy discussing issues based on facts, science and/or the law. Three attributes that make any discussion interesting or compelling to continue.
Oh, so what you're saying is that a battery of tests to rule out other diseases and illnesses with similar presenting symptoms is completely unnecessary? I didn't realize that you had a medical degree, excuse my temerity.
Furthermore, I find it hard to believe that someone with your intelligence is claiming that people in this country have never brought a malpractice suit against a doctor that they felt did not order or give a test that could have ruled out an illness or a disease that went on to sicken, injure or kill that person, their spouse, or a family member. I just don't think you could possibly be that dumb.
Perhaps physicians started ordering the tests because they were concerned about lawsuits, but then they saw they can actually make money by investing in the medical apparatus. This is less about defensive medicine (based on fact not simply opinion, the best way a dr. can insure not having a lawsuit is a good bedside manner) than about Dr.s feeling no compunction financial or otherwise to NOT order a test.
Interestingly a while ago I asked (in good faith) if the US has such a great system why do we pay 2 to 3 times more (per capita) than people living in other countries and on average have shorter lives and higher rates of infant mortality. No one ever responded to it. America is great but that doesn't mean we do everything better than everyone else and can't learn anything
The Senate is right now putting thru a bill that will require MANDATORY health care for all families without it. And people who do not get the mandatory health care will be fined up to $3800.
Obama is also going to put a tax on soda so that I can pay for your health care.
http://news.yahoo.com/s/ap/20090908/ap_on_go_pr_w...
Our present system is capable of the best health care in the world. People come from all over the world for treatment not available anywhere else. Most of them have money. People with money and/or good insurance get excellent health care . What makes the numbers look so bad is the level of health care available, or not, to poor people. Our present system is very much driven by capitalism. The folks with the money get the finest care in the world, the rest of us don't.. Our doctors are the highest paid in the world. That is a fact, and that is why people like our president, the late senator Kennedy, Hillary Clinton, and others, have fought so hard through the years to get the system reformed so poor people also get excellent health care.
Wiltonian: I do not to discuss zoning issues here, but to be fair the zoning commission did not "initiate" anything in the hospital or spy v. spy issues. In a broad abstract way, some communities think there is much confusion in the land, starting with Kelo V. New London on whether economic impact should be a criteria for a bunch of things.