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Steven Brill recently took a look at the American Healthcare system, and the findings are deeply troubling. I knew the system was corrupt, but the extent of that corruption was not made aware to me until I read this article. It is quite an interesting read:
The Article, TImes Magazine
I found this article from Steven Brill's interview on the Daily Show:
Steven Brill on the Daily Show with John Stewart
Recchi’s bill and six others examined line by line for this article offer a closeup window into what happens when powerless buyers — whether they are people like Recchi or big health-insurance companies — meet sellers in what is the ultimate seller’s market.
After about three hours of tests and some brief encounters with a doctor, she was told she had indigestion and sent home. That was the good news. The bad news was the bill: $995 for the ambulance ride, $3,000 for the doctors and $17,000 for the hospital — in sum, $21,000 for a false alarm.
This would mean that Sean Recchi’s dose of Rituxan cost the Biogen Idec–Genentech partnership as little as $300 to make, test, package and ship to MD Anderson for $3,000 to $3,500, whereupon the hospital sold it to Recchi for $13,702.
I strongly reccomend everyone to read this article if you are not aware of the current health care crisis in America.
As a Capitalist, I feel like this is one area in which Capitalism has for the most part been unable to impact, and the effects are quite evident. Price gouging becomes outrageously easy when there is no competition, and is incentivized in this enviorment, Im not really sure how America would go about fixing this system, since it is inheritantly averse to capitalism due to the fact that consumers do not choose to be consumers, and are not at all educated about what they are paying for. Perhaps this is one area in which the government could actually do better? It seems that medicare actually gets much better prices than private insurance by actually basing their prices on cost rather than the "chargemaster." However hospitals still make great profits off of medicare patients.
TL; DR points
-Buyers have no knowledge of the products they are buying, one sided information leads to higher costs
-The healthcare system massively out-lobbies the "military inductrial complex"and energy companies
-Drugs and procedures cost many times what they would on the open market
-The profits are are made by upper management, the doctors and nurses are not seeing the massive profits
-This includes "not for profit" hospitals
-medicare actually pays hospitals at the cost it takes the hospital to do the procedure, those not on medicare pay rediculous mark ups, however hospitals still make a profit off of medicare patients
-60% of the personal bankruptcy filings each year are related to medical bills.
-Overall, ambulance revenues were more than $12 billion last year, or about 10% higher than Hollywood’s box-office take
-Obamacare barely scratches the surface of the real corruption
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Insurance is the problem. Hospitals and pharma companies can charge that much because most of their "customers" costs are covered by huge insurance companies. Get rid of insurance, demand falls, and so will prices.
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On February 23 2013 13:54 Millitron wrote:
Insurance is the problem. Hospitals and pharma companies can charge that much because most of their "customers" costs are covered by huge insurance companies. Get rid of insurance, demand falls, and so will prices.
Not completely. I went to the hospital in November due to a massive pain in my lower left abdomen that prevented me from doing anything, including getting up out of bed. What was it? They have no fucking idea. Bill? about 5 grand. For what? A ct scan. One ct scan is 5 grand? Insurance is only paying half of it. My brother went recently and has a 1400 dollar bill. Until they send a debt collector I'm not paying that shit. I understand they're trying to make money and a lot of other people haven't paid but that doesn't give you the right to completely rip off people.
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On February 23 2013 13:54 Millitron wrote:
Insurance is the problem. Hospitals and pharma companies can charge that much because most of their "customers" costs are covered by huge insurance companies. Get rid of insurance, demand falls, and so will prices.
Your solution is to get rid of insurance? Really?
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On February 23 2013 13:54 Millitron wrote:
Insurance is the problem. Hospitals and pharma companies can charge that much because most of their "customers" costs are covered by huge insurance companies. Get rid of insurance, demand falls, and so will prices.
Demand never falls. People dont stop being sick. Insurance companies usually get 40-50% of chargemaster prices. You will initially be charged 100% of chargemaster costs unless you get outside help.
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On February 23 2013 14:04 Dagan159 wrote:Show nested quote +On February 23 2013 13:54 Millitron wrote:
Insurance is the problem. Hospitals and pharma companies can charge that much because most of their "customers" costs are covered by huge insurance companies. Get rid of insurance, demand falls, and so will prices. Demand never falls. People dont stop being sick. Insurance companies usually get 40-50% of chargemaster prices. You will initially be charged 100% of chargemaster costs unless you get outside help.
Demand will fall. Yes people keep getting sick, but they can't actually get the care, because they can't afford it. That counts as falling demand.
Yes, it will suck like shit at first, but things will improve eventually, and once they do they will be better than they are now.
If you have a serious illness, you don't pussyfoot around and try tons of half-measures, you take the prescribed medicine, regardless of how bad the side-effects are. Likewise, the healthcare industry is seriously flawed, and only extreme measures will suffice.
I suppose you could lessen the impact by slowly phasing out insurance instead of just dismantling it overnight, but I think it should be done.
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On top of my head, I feel that cheaper MD programs and cheaper drugs will remedy the problem.
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On February 23 2013 14:23 Sufficiency wrote:
On top of my head, I feel that cheaper MD programs and cheaper drugs will remedy the problem.
Doctors dont set the costs of the procedures, the drugs, and dont take in the massive profits.
Yes cheaper drugs would be great, but how do you make this happen?
On February 23 2013 14:23 Millitron wrote:Show nested quote +On February 23 2013 14:04 Dagan159 wrote:On February 23 2013 13:54 Millitron wrote:
Insurance is the problem. Hospitals and pharma companies can charge that much because most of their "customers" costs are covered by huge insurance companies. Get rid of insurance, demand falls, and so will prices. Demand never falls. People dont stop being sick. Insurance companies usually get 40-50% of chargemaster prices. You will initially be charged 100% of chargemaster costs unless you get outside help. Demand will fall. Yes people keep getting sick, but they can't actually get the care, because they can't afford it. That counts as falling demand. Yes, it will suck like shit at first, but things will improve eventually, and once they do they will be better than they are now. If you have a serious illness, you don't pussyfoot around and try tons of half-measures, you take the prescribed medicine, regardless of how bad the side-effects are. Likewise, the healthcare industry is seriously flawed, and only extreme measures will suffice. I suppose you could lessen the impact by slowly phasing out insurance instead of just dismantling it overnight, but I think it must be done one way or another.
Insurance is a great tool for modern society. It alleviates risk by spreading it throughout the population. However, in many cases in the healthcare industry, poeple simply dont understand what they are buying or the coverage they are getting.
The problem in this market is poeple dont choose their hospital based on their insurance, they choose their insurance based on the hospital, making it a completely one sided market in which the hospitals can charge almost anything they want, even to the :big bad" insurance companies. cutting out the middle man does nothing, your still gonna have to pay the crazy healthcare costs. You can expect every person that gets sick to go bankrupt in an effort to "teach the hospitals a lesson." Lowering their costs does not bring in more customers.
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So what's different about the US system compared to other western countries? The prices just seem ridiculous as does the notion of removing insurance -.-
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On February 23 2013 14:23 Millitron wrote:Show nested quote +On February 23 2013 14:04 Dagan159 wrote:On February 23 2013 13:54 Millitron wrote:
Insurance is the problem. Hospitals and pharma companies can charge that much because most of their "customers" costs are covered by huge insurance companies. Get rid of insurance, demand falls, and so will prices. Demand never falls. People dont stop being sick. Insurance companies usually get 40-50% of chargemaster prices. You will initially be charged 100% of chargemaster costs unless you get outside help. Demand will fall. Yes people keep getting sick, but they can't actually get the care, because they can't afford it. That counts as falling demand. Yes, it will suck like shit at first, but things will improve eventually, and once they do they will be better than they are now. If you have a serious illness, you don't pussyfoot around and try tons of half-measures, you take the prescribed medicine, regardless of how bad the side-effects are. Likewise, the healthcare industry is seriously flawed, and only extreme measures will suffice. I suppose you could lessen the impact by slowly phasing out insurance instead of just dismantling it overnight, but I think it must be done one way or another.
This is idiotic. Plain and simple. The problem isn't insurance. The problem is market failure due to asymmetric information, lack of competition, price inelasticity of demand, and other real issues.
Get rid of insurance? What an utter ignoramus.
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On February 23 2013 14:28 Scarecrow wrote:
So what's different about the US system compared to other western countries? The prices just seem ridiculous.
Well, in Canada part of everyone's taxes goes to health care so it's pretty much all paid for by the state (the taxpayer).
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On February 23 2013 13:54 Millitron wrote:
Insurance is the problem. Hospitals and pharma companies can charge that much because most of their "customers" costs are covered by huge insurance companies. Get rid of insurance, demand falls, and so will prices.
i have no idea how demand falls if you get rid of insurance... people all of a sudden stop getting sick?
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On February 23 2013 14:23 Millitron wrote:Show nested quote +On February 23 2013 14:04 Dagan159 wrote:On February 23 2013 13:54 Millitron wrote:
Insurance is the problem. Hospitals and pharma companies can charge that much because most of their "customers" costs are covered by huge insurance companies. Get rid of insurance, demand falls, and so will prices. Demand never falls. People dont stop being sick. Insurance companies usually get 40-50% of chargemaster prices. You will initially be charged 100% of chargemaster costs unless you get outside help. Demand will fall. Yes people keep getting sick, but they can't actually get the care, because they can't afford it. That counts as falling demand. Yes, it will suck like shit at first, but things will improve eventually, and once they do they will be better than they are now. If you have a serious illness, you don't pussyfoot around and try tons of half-measures, you take the prescribed medicine, regardless of how bad the side-effects are. Likewise, the healthcare industry is seriously flawed, and only extreme measures will suffice. I suppose you could lessen the impact by slowly phasing out insurance instead of just dismantling it overnight, but I think it must be done one way or another.
I hate this "morality play" logic. We see it all the time in politics. "If only we induce and endure suffering for a brief period, then we will enter another golden age!" Any clear path that creates suffering before creating this "better" system isn't a path at all.
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On February 23 2013 14:28 Scarecrow wrote:
So what's different about the US system compared to other western countries? The prices just seem ridiculous.
Just about every other country has health care prices controlled by the government.
And yes our prices are insane. Infographic
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The reason there isn't any competition is because of the government/lobbyists using said government.
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On February 23 2013 14:38 Ingenol wrote:
The reason there isn't any competition is because of the government/lobbyists using said government.
Not quite.
The lobbiests for health care really just want to maintain the status quo.
The reason there is no competition is due to the fact that people dont choose their hospital. When consumers cant choose the producer, capitalism fails.
On February 23 2013 14:00 Infernal_dream wrote:Show nested quote +On February 23 2013 13:54 Millitron wrote:
Insurance is the problem. Hospitals and pharma companies can charge that much because most of their "customers" costs are covered by huge insurance companies. Get rid of insurance, demand falls, and so will prices. Not completely. I went to the hospital in November due to a massive pain in my lower left abdomen that prevented me from doing anything, including getting up out of bed. What was it? They have no fucking idea. Bill? about 5 grand. For what? A ct scan. One ct scan is 5 grand? Insurance is only paying half of it. My brother went recently and has a 1400 dollar bill. Until they send a debt collector I'm not paying that shit. I understand they're trying to make money and a lot of other people haven't paid but that doesn't give you the right to completely rip off people.
A head CT scan in India is around 50 bucks. Its not only the main charges that they nail you with, check out the minor charges, and compare them to what your could pay for them on amazon, if its anything like the examples in the article, the results will make your head spin.
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Out of curiosity, how much does it cost to go to the doctors with a broken arm in the US?
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Aotearoa39261 Posts
On February 23 2013 14:23 Millitron wrote:
If you have a serious illness, you don't pussyfoot around and try tons of half-measures, you take the prescribed medicine, regardless of how bad the side-effects are. I normally stay out of these threads but you are seriously deluded if you truly believe this. If you have a serious illness and you cut insurance out of the picture then you're essentially condemning most of them to death. Many diseases have no cures and only things which treat the symptoms and hence are required to take life long meds. Once the money runs out to support that, the disease takes over and people die. The vast majority of people with serious illness take things pretty damn seriously, its quite insulting to suggest otherwise.
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On February 23 2013 14:41 Dagan159 wrote:
The reason there is no competition is due to the fact that people dont choose their hospital. When consumers cant choose the producer, capitalism fails.
Yeah, that's extremely important. I'm very libertarian and a firm believer in free markets, but healthcare just doesn't fit in with other consumer goods and services. It's much more like police and fire departments than buying new shoes, yet we treat it like the latter in America. It's crazy to think that all the gnashing of teeth over Obamacare and hatred towards insurance companies was really just a giant smokescreen covering up the real issue in healthcare. A single-payer system wasn't even on the table, and with the billions being funneled into Washington by ludicrously profitable non-profit hospitals, how are we ever going to change that?
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On February 23 2013 14:50 Plexa wrote:Show nested quote +On February 23 2013 14:23 Millitron wrote:
If you have a serious illness, you don't pussyfoot around and try tons of half-measures, you take the prescribed medicine, regardless of how bad the side-effects are. I normally stay out of these threads but you are seriously deluded if you truly believe this. If you have a serious illness and you cut insurance out of the picture then you're essentially condemning most of them to death. Many diseases have no cures and only things which treat the symptoms and hence are required to take life long meds. Once the money runs out to support that, the disease takes over and people die. The vast majority of people with serious illness take things pretty damn seriously, its quite insulting to suggest otherwise.
I didn't say they didn't take things seriously. I'm using it as an analogy. The medical industry is seriously flawed, and as such any fix is likely to be just as serious.
I believe insurance is the problem. I respect anyone else's position as well, and I don't expect people to think I believe my way is the only way. But every solution will have serious side effects, simply due to its scale. There is no perfect solution that will completely fix the situation with no difficulties.
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EPT
