This is a link to Steven Brill's article in the current Time Magazine. Perhaps it will explain to our European cousins why we are so fucked up over here with medical care.

http://healthland.time.com/2013/02/20/bi...ling-us/2/

Quote:Every time a nurse drew blood, a “ROUTINE VENIPUNCTURE” charge of $36.00 appeared, accompanied by charges of $23 to $78 for each of a dozen or more lab analyses performed on the blood sample. In all, the charges for blood and other lab tests done on Recchi amounted to more than $15,000. Had Recchi been old enough for Medicare, MD Anderson would have been paid a few hundred dollars for all those tests. By law, Medicare’s payments approximate a hospital’s cost of providing a service, including overhead, equipment and salaries.

All of this leads to obscene profits by allegedly "non-profit" medical corporations. As always - in any crime, follow the money.

The problem is insurance that pays for every doctor visit and lab procedure. It really isn't insurance, which is supposed to be a pooling of interests to safeguard against catastrophic loss. There's no incentive for people to consider whether a particular procedure is necessary or to shop around for a better price. IMO a lot of our health care cost problems would be eliminated simply by moving everyone to a relatively high deductible plan.

It's a lot more complicated than that.

I can never understand why America has a worse health care system than almost anywhere else in the world.

But then I think "unscrupulous people can make money from this" and suddenly it all makes sense.

(March 5, 2013 at 1:57 pm)Minimalist Wrote: This is a link to Steven Brill's article in the current Time Magazine. Perhaps it will explain to our European cousins why we are so fucked up over here with medical care.

http://healthland.time.com/2013/02/20/bi...ling-us/2/

Quote:Every time a nurse drew blood, a “ROUTINE VENIPUNCTURE” charge of $36.00 appeared, accompanied by charges of $23 to $78 for each of a dozen or more lab analyses performed on the blood sample. In all, the charges for blood and other lab tests done on Recchi amounted to more than $15,000. Had Recchi been old enough for Medicare, MD Anderson would have been paid a few hundred dollars for all those tests. By law, Medicare’s payments approximate a hospital’s cost of providing a service, including overhead, equipment and salaries.

All of this leads to obscene profits by allegedly "non-profit" medical corporations. As always - in any crime, follow the money.

And thats why the UK NHS are the greatest health system

(March 5, 2013 at 2:06 pm)John V Wrote: The problem is insurance that pays for every doctor visit and lab procedure. It really isn't insurance, which is supposed to be a pooling of interests to safeguard against catastrophic loss. There's no incentive for people to consider whether a particular procedure is necessary or to shop around for a better price. IMO a lot of our health care cost problems would be eliminated simply by moving everyone to a relatively high deductible plan.

Most people are fully trusting of their doctors. Whatever the doc recommends they do, even if the specific thing being recommended is unhelpful, redundant, etc. Moving people of limited means to high deductible plans will mean they don't their basic medical needs met due to being unable to foot the out-of-pocket costs.

On a personal note, my oldest son was hospitalized when he was about a week old for 3 days due to jaundice. The pediatrician we were seeing at the time was insistent the jaundice was caused by a UTI or bladder infection and kept asking us to consent to giving him a catheter to test. We declined. I did some research and discovered jaundice in newborns is often caused by the breakdown of red blood cells. I also learned the leading cause of UTI's in newborn males was catheterization. Since my son had a massive bruise on his head (and an awful cone head from his birth), I figured this is what was causing his jaundice, not a UTI. The pediatrician did everything she could to shake our resolve, even telling us we were killing our child by not consenting to the test she wanted to do. His biliruben levels eventually got so high he needed to bake under the lights for a couple of days in the NICU. The doctors at the hospital agreed with me, that the jaundice was caused by the obvious, huge bruise on his head from his birth, and that a UTI was unlikely. When he was discharged the doctor went over everything with us. The doctor said, "His biliruben levels aren't where we'd like them to be, but we need the bed for sicker children." The total NICU bill for about 30 hours of care? Around $17,000 (roughly 3 times the cost of my prenatal, birth, and aftercare). I fully believe, if we had been able to rent a bili-blanket or lights (which we asked about repeatedly and were told was not an option, even when we offered to pay for them out of pocket instead of going through our insurance), we would have been able to resolve his jaundice at home. We were in the hospital because they had beds they wanted to fill, and a nice insurance policy to foot the bill.

tl;dr:
Doctors are human and sometimes wrong in their conclusions. Hospitals like people with insurance to offset the burden of those they have to care for who are unable to pay.

(March 5, 2013 at 2:06 pm)John V Wrote: The problem is insurance that pays for every doctor visit and lab procedure. It really isn't insurance, which is supposed to be a pooling of interests to safeguard against catastrophic loss. There's no incentive for people to consider whether a particular procedure is necessary or to shop around for a better price. IMO a lot of our health care cost problems would be eliminated simply by moving everyone to a relatively high deductible plan.

Perhaps that would help in some cases, but it's far from a panacea.

I've been on a high-deductible plan for about six years. Due to my personal situation, I know that I'll meet my deductible every year, and I'm covered 100% after that. Because of that, I have zero incentive to shop around, etc. - it's actually to my advantage to reach my deductible as quickly as possible (though I make no particular effort to do so).

Plus, as Min said, it's a lot more complicated than that.

When our first daughter was 3, she was in the lowest tenth percentile of weight for her age. The doctor said that could be an indicator of cystic fibrosis. He also said that our daughter didn't seem at all sick in behavior or appearance, and he never had a cf kid who wasn't observably sick. He said there was a test that could be done to be sure. Our insurance covered it, so we had it done. We learned later that the cost of the test was $800.

If I had high deductible insurance, based on the doctor's discussion and our monetary condition at that time, I wouldn't have had the test done.

Sometimes I wish I could punch America in the face.

Sure. We can swap anecdotes all day long, but that's kind of pointless, don't you think?

No doubt some people would become better consumers of medical care, while others would not.

Incidentally, most HDP's are backed by an HSA (health savings account) - with an HSA in your hypothetical, the choice would likely have been made without regard to your financial condition.