Skip to main content

No, this post is not a "must read," but I have found an article that everyone interested in the high cost of American health care must read if they are to be well-informed on this subject.

 

I refer to "Bitter Pill," an incredibly thorough, highly-detailed article in the March 4 issue of Time Magazine.  The author, Steve Brill, is a respected veteran journalist who has dug deeply into the subject of health care practices and costs.

 

Read the article and get well-informed on just why there is a health care crisis in this country that affects us all.  It is a very long article, but it has to be in order to competently cover this complicated subject:

http://healthland.time.com/201...ills-are-killing-us/

Original Post

Replies sorted oldest to newest

Originally Posted by Jobe:

I wouldn’t waste my time reading a bias article from a left wing rag. If you want to read something that will open your eyes, read the book Beating Obamacare by Betsy McCaughey Ph.D.  She is a former lieutenant governor of New York and has taught at Vassar College  and Columbia.


On February 20, Jobe, YOU posted this (emphasis added):

 

"College professors are the most insane people on the earth."

 

Today you recommend a book by a college professor..Is it your usual custom to comment the writing of insane persons for our edification?

 

The Time Magazine article by Steven Brill is a factual, well-documented rerport that has very useful information for anyone of any political viewpoint.  By categorically screening out any source that is not archly conservative--as seems to be your boorish habit--you assure yourself a biased, intellectually impoverished world view.

 

Grow up. 

Originally Posted by upsidedehead:
Originally Posted by Jobe:

I wouldn’t waste my time reading a bias article from a left wing rag. If you want to read something that will open your eyes, read the book Beating Obamacare by Betsy McCaughey Ph.D.  She is a former lieutenant governor of New York and has taught at Vassar College  and Columbia.


On February 20, Jobe, YOU posted this (emphasis added):

 

"College professors are the most insane people on the earth."

 

Today you recommend a book by a college professor..Is it your usual custom to comment the writing of insane persons for our edification?

 

The Time Magazine article by Steven Brill is a factual, well-documented rerport that has very useful information for anyone of any political viewpoint.  By categorically screening out any source that is not archly conservative--as seems to be your boorish habit--you assure yourself a biased, intellectually impoverished world view.

 

Grow up. 

=======

Upside, Jobe is a complete idiot, He has never yet had a post that had any information of any reliance in it. He and Crusader are good examples of why we have the block ability, and I would encourage you to utilize it for these two.

Possibly not reading articles like the one you posted is the reason he is so damm dumb.

Originally Posted by upsidedehead:
Originally Posted by Jobe:

I wouldn’t waste my time reading a bias article from a left wing rag. If you want to read something that will open your eyes, read the book Beating Obamacare by Betsy McCaughey Ph.D.  She is a former lieutenant governor of New York and has taught at Vassar College  and Columbia.


On February 20, Jobe, YOU posted this (emphasis added):

 

"College professors are the most insane people on the earth."

 

Today you recommend a book by a college professor..Is it your usual custom to comment the writing of insane persons for our edification?

 

The Time Magazine article by Steven Brill is a factual, well-documented rerport that has very useful information for anyone of any political viewpoint.  By categorically screening out any source that is not archly conservative--as seems to be your boorish habit--you assure yourself a biased, intellectually impoverished world view.

 

Grow up. 

_________________________________________________________________

College professors, as a group, are the most insane people on the earth. I’ll stand by that statement anytime. However, there are rare exceptions and Betsy McCaughey is one of them.

Originally Posted by seeweed:  

=======

Upside, Jobe is a complete idiot, He has never yet had a post that had any information of any reliance in it. He and Crusader are good examples of why we have the block ability, and I would encourage you to utilize it for these two.

Possibly not reading articles like the one you posted is the reason he is so damm dumb.

_______________________________________________________________

Seeweed,

 

I thought you had me blocked. You’re are a liar………… again.     

  

You want to call me names in front of my face?  No because you are a coward.

 

Anybody that would use their deceased mother to make a political statement is about as sorry as they can be.

Libs like seeweed think the POTUS can do no wrong.  You see seeweed on these forums calling for more taxes and the reason is he wants to be sure his pension from TVA is funded and funded enough for increases along the way. Seeweed had a job at TVA but he never worked a day in his life. Then, when he sees a possible property tax increase, he will protest loudly. Seeweed is a typical liberal ……………..Seeweed is what is wrong with this country………..Seeweed is a taker and not a giver. The sad part is the entire country is heading that way.

Yes jank,

I have read it.  Of course it does nothing to address the distresses put on the system by unfounded legal complaints and bloody thirsty layers whose attacks have led to a system where  it is required to practice cover-your-"posterior" medicine.  It also does nothing to address the huge loads of debt that new medical school graduates enter in to the workplace hanging over their heads.

I abhor the parasites who are miking the system dry and giving those who play by the rules a bad name. I do not support their activities at all.  I cringe every time I see a Scooter store commercial or Hoveround.....but am impressed that just by getting one of these at "no cost to me" i will wil able to enjoy the Grand Canyon and play with the grandkids, and BTW it comes with a free drink holder....

This article specifically cites cancer treatment at MD Anderson in Houston.  That is a speciality center, typically you go there on your own, with very few patients getting in unless they are extremely sick.  The person going there for therapy could get the same thing in his own community, the same meds and the same protocol.  Cancer treatments centers are there for a reason.  They provide an access to treatment that you think you cannot get anywhere else and they make you believe that what they are doing is the ONLY thing that can save you, and in some cases it might be, but that is not always the case.  They also operate on huge amount of research dollars and alot of the things they do may be experimental, meaning no matter if you have insurance or not, if it is not proven to be effective, it is not going to be paid for by the insurance.  BTW, governmental payors such as medicare and medicaid darned sure are not going to pay for this type of care, so when you finally get the single payor system that you are hoping for from the government these places will cease to exist.

I don't know many people today who go into medicine thinking that they are going to get rich doing the garden variety treatment of patients.  Most priimary care docs I know work more than 55-50 hours a week and make less than some electricians and plumbers by the time they cover their overhead.  That is after four years of college, four years of medical school and minimum of three years of residency for primary care.  Specialists require more than this.

So despite your analysis of the situation, this article from the liberal press comes no where close to explaining the problems with medicine in today's environment, and does not offer one legitiamte clue on how to fix it.

Let me add to that by trying to explain some of the misconceptions in the article.

The Tylenol for $1.96 for instance.  It was given by the nurse, dispensed from the pharmacy and shipped to the hospital.  The government keeps a rigid guidleine on the dispensing of medicines and a paperwork trail follows everything that is given to a patient during their stay. For years those records must be kept so that a trace can be made on items dispensed or put into a patient.

That $1.96 for the tylenol is based upon the cost of the medicine, the cost of the pharmacist or assistant who prepared the does and recorded, as well as the nurse who administered it.  t also goes to cover the liability of the hospital and their employees.  You see a charge for a medicine, and I see a charge for a process.  That process includes the mechanism to pay those people's salaries that provide that care.  Lots of people are involved in caring for the patient, from kitchen and food prep staff, to nurses and their aids.

Some charges are very far out of reach, no doubt, however the article also cites the lab work, and venipuncture draws.  Each of those require a lab tech to perform it, someone to draw the blood, the disposable steile equipment for drawing the blood, the instruments to seperate the blood for the tests, the reagant to run the tests and the instrumentation to run the test.  Then there are the computer systemes to record the results, distribute them to the charts, and maintain their secrecy per the HIPAA guidelines which are followed.  No also include liability for erroneous tests results, and I would say in most cases those lab charges are more than justified.

 

Teyates, I don't think you can see the forest for the trees. I had hoped you would at least admit the real problem of over pricing in the healthcare industry. What do you think of the incomes in the article? 1.8 mil is quite a bit more than a plumber makes.

 

This article was not about the average Dr's pay. This was about the industry as a whole. It is a money making business. In business there is always a "process" in the case of healthcare the profits go above and beyond what most businesses garner in profit.

 

I ran a business for many years that had a "process". I paid sales personnel to sale the products. I paid to receive these products, the shipping and handling to get it to my store. I paid the warehouse employees to handle the products and load them. I paid the office help to process the paper work and billing. I paid the utilites on the building and the rent. I paid the insurance, encase someone was hurt in my business, or if someone felt they needed to sue. What I did not have was a 400% markup on my products. If I had I would not have been in business for very long. When it comes to healthcare people don't have the luxury of just not buying the "product" or in many areas shopping around for the best prices. Healthcare should not be just for those that can afford it. Its not like a simple want like a speed boat or new counter tops. There should be more regulation on what healthcare industries should be able to charge.

 

I guess we will always disagree on this subject.

BTW, the article references the administrator of MD Anderson as making the large amount of money, not the physician who is actually taking care of the patient. To his credit, it is a lrge corporation. Houston by itself is the 4th largest city in the US.  The medcial complex which makes up the Houston medicent of which MD Anderson is the largest portion, is the biggest in the world and is bigger than most US cities by itself.  It employs more people than the population of some of the big cities in the US. I would say his money is probably earned, certainly as much as the hillbilly pimp Rachel Madcow or Blowhard Bill O'Reilly.  The problem in this country is that perogatives and responsibilites are all skewed.  We don't have a problem with a ball player making $7M a year to play a sport, nor pay $150 for a ticket to see the Titans play on Sunday, or purchase a big bass boat or Harley, but we will balk when it comes to paying for health insurance or paying a deductible at the doctor's office.

Tye,

Please consider the following chart, and explain why healthcare is sooooooo much more expensive in the US than in every other country. 

 

Then, consider the following article entitled "US scores dead last again in healthcare" :

http://www.reuters.com/article...dUSTRE65M0SU20100623

Please help us to reconcile why we pay twice as much for healthcare , and it would seem , we get far less for our money .

I guess you did not read what I wrote.  The doctors in this country making that kind of money can be counted on your fingers and toes.  The typical physician in practice today makes nothing like the quoted figure...nothing.  If you look at the national average, the typical primary care physician (family practice or internal medicine (not specialized) will make less than $200K. The upcoming sequestration will take about $10B out of the Medicare doles for the physicians, so look for even more unpleasantness.

You can disagree with me all you want, but I have worked in this industry long enough to know that the current changes made by this administration are only going to make things worse. There was little to no input requested from the basic working medical field.  insurance companies continue to squeeze. The government payors continue to squeeze.  Pateints get caught in the middle, and the liberal media uses a few scam artists and manipulators to incite more class warfare and blame it on the physicians.

I truly feel for the man in the article who had to put up so much money for the transplant, but don't fool yourself into thinking the physicians who were doing that transplant got that money. Critical care, such as one gets when you undergo a procedure like this, is extremely expensive. Every industry in the US is there to make a profit. Healthcare is no different.  Without profits why would a company go into R&D for drugs? Why would there be incentive to develop a newer technology or product?  I see it everyday.  When those products fail to show any good to the patient care the insurance companies will eventually quit paying for that procedure and it will die out.  You may want the latest and greatest in robotic surgery, BUT when the data shows that this procedure, which costs five times more to do, does nothing to help the patient, nor increase safety, you should have to pay for it yourself.

Gone are the days when you can get something just because you want it done. Unless you have the money up front to pay for it, it is not going to happen. Yes...making a living is certainly an incentive to work in the medical field, but it comes with many disadvantages such as being subjected to work anytime of the year (holidays) or day or night. Taking call and being subjected to huge amounts of liability. When the income stops, and people are still required to pay huge amounts of money to go to school for up to 12-15 years, people are going to decide they can spent that 20% of their life doing something else much more enjoyable.

Originally Posted by teyates:

.  The problem in this country is that perogatives and responsibilites are all skewed.  We don't have a problem with a ball player making $7M a year to play a sport, nor pay $150 for a ticket to see the Titans play on Sunday, or purchase a big bass boat or Harley, but we will balk when it comes to paying for health insurance or paying a deductible at the doctor's office.

===========

Well, it may not be THE problem, bur for sure I agree that in this country we surely have our value system screwed up, with sports stars making so much and professional people, like doctors making measurably less, and those in charge of the future of our country , the teachers, barley getting by.
And, I did read what you said about the doctors not getting the bulk of it.

A personal story I think I have related before:

In 1974, before Reagan let lawyers and hospitals advertise and compete openly, I ran my hand thru the storm door at my house, and my wrist looked like Medusa's head with so many ligaments hanging out.  Wife rushed me to Baptist Memoral Hospital in Memphis ER. They happened to have a "hand specialist' on staff and he sewed on me for 2 hours, pulling each tendon to see which finger would respond and tieing it into the right one on my arm.

When he was done, I went to the "checkout" to pay . At the time, the insurance I had did not pay doctors or hospitals directly, but after I filed, they cut a check to me, and I was responsible to pay the bill, and most docs and hospitals would delay billing so that insured people could get payed, and then pay them.

Well, when I checked out, my total bill was $18 for the use of the ER and $18 for the ER doctor.

I wrote a check, and was out of there. I still don't know if they made a mistake, or not, and that seemed to me to be very cheap even at the time. but that experience still comes to mind.

seeweed,

I can only relate to what I have seen and what I have heard from others.  The British system works well for most things.  I have friends in Norway and their system work as well.  The drawbacks are a higher percentage of their income goes to the hospital / medical system, and their training programs are not expensive. The average osts of medical school in this country is probably around $150K. When you finish medical shcool in the US you go to post graduate training, where in most cases you cannot afford to make the payments on those loans, or make a big dent in them.  In Europe you go in to the NHS system, and you work as a resident or intern in the system until you progress far enough to be an attending physician.  The only compaints I have heard from my friends in the European system is that the wait times associated with some procedures can be months and the fact that after certain ages you are not entitled to things such as joint replacement, etc.

Another item which also contributes to the erroneous statistics is that in Europe a fetus born prematurely will in most cases NOT receive the intensive neonatal care that we provide for neonates here.  Those infants born prematurely are also included in the death statistics, something not done in most European countries.

I for one would not mind the European system in this o****ry if the government was willing to provide medical eduaction at no additioanl cost in return for a stent of government service, or if they forgave existing school loans and provided retirement like they do in the European system.

There are more stringent regualtions on medications in this country than in Europe, not sure why this is the case, but that fact, along with the huge number of litigations against medical products and medicines have contributed to the higher costs of meds and products here in the US.  Remeber, rarely do you see the types of high profile litigation in the medical fields like you see here in the US.  They do have therapeutic misadventures in those models as well, but most are not highlighted or go to extreme multi-million dollar verdicts.

I have a local friend who did training in Australia and he loved the system, but it is nowhere as busy as this system, and again there is some form of legal protection.

Do not get me wrong, I do not think this system is perfect...at all...but the propsed single payor system is not going to make a lot of people happy here.  You cannot go from the system we currently have to system where everyone things they are going to get it for free and think it is going to work.  The first key in the chain is that you have to have people (nurses, doctors, providers) and without those no system is going to prosper.

 

Remember as well that the cost quoted in this article is most likely the costs of insurance per person.  I would say for the money the Europeans get a better bang for the buck,  but the costs are not to dissimilar.  I know that in my case just helath insurance for my family costs me $13K per year, with a $1500 deductible and $30 copay.  It costs the same whether it is me and my wife or if we include the one child we still have at home.  Prescription meds are not included.  I am self employed so all of that costs comes out of my pocket. I sympathize and know what it costs.

 

  • The United States spends more on health care than Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain and Australia combined.
  • Approximately 60 percent of all personal bankruptcies in the United States are related to medical bills.
  • The U.S. health care industry has spent more than 5 billiondollars on lobbying our politicians in Washington D.C. since 1998.
  • If the U.S. health care system was a country, it would be the 6th largest economy on the entire planet.
  • the U.S. ambulance industry makes more money each year than the movie industry does.
  •  During 2013, Americans will spend more than 280 billion dollars on prescription drugs.

     
  • Prescription drugs cost about 50% more in the United States than they do in other countries.
  • Children in the United States are three times more likely to be prescribed antidepressants as children in Europe
  • According to a report by Health Care for America Now, America’s five biggest for-profit health insurance companies ended 2009 with a combined profit of $12.2 billion.
  • It has been estimated that hospitals overcharge Americans by about 10 billion dollars every single year.

we have major problems in the healthcare industry. they have to be addressed. there's no way round it.

Teyates, I think it is you that is not reading what is written here. This is what I said.

 

"This article was not about the average Dr's pay. This was about the industry as a whole."

 

I agree that the Dr's are not getting rich off of these outrageous healthcare charges. I don't think anyone even hinted at such. What I am saying, and I believe this very re put able journalist has so painstakingly proven, is that the "healthcare industry" is out of control. If you can't see that the amounts we Americans are paying for basic health care is unrealistic and completely out of the reach for many then I guess nothing anyone says are proves to you will change your view.

@ Teyates 

First,  we have discussed tort reform before, and I think you and I are not really as far apart on that subject as we could be.    I just don't remember that being much of a problem before the legal and medical industries were deregulated back in the early '80s. I see no political will in Washington to reregulate those industries , so that illness called greed has no cure.

The matter of schooling for a doctor , or for an engineer, or a teacher or whatever , and the cost therin is awful. Clinton actually tried to get a system much like you said was the European model of the gov paying for the education and getting some number of years working in a free clinic or whatever in return. Of course, Congress would have none of it and it died on the vine. 

You mentioned drug cost, and maybe there are drugs avaliable in Europe that are not avaliable here, but there is something wrong when the SAME drugs in our country cost 500% more than they do overseas, or even in Canada.  There is something wrong when the government is prohibited by law from using it's volume buying power to obtain a lower price on drugs, 

You have to admit, something there is wrong !

Congressional Republicans, have been waging war with the President on how we should pay for health care, BUT  I think they have been arguing about the wrong thing. While how we pay for healthcare is very , very important, WHAT we pay for should be getting at least that much scrutiny, and I think that both the D's and the R's are missing an opportunity in not chasing that rabbit.

Yes seeweed,

We are not far apart and actually chasing the same rabbit, just in different directions.  There is no doubt that big Pharma has some strong lobbying power which is one reason that the drug issue and prices are astronomical.  However, also take into account that the average time for a drug from completion of development to its first profit sales is about seven years, or was so 15 years ago.  The FDA approval process is strenuous to say the least.  Clinical trilas and studies are conducted and every T is crossed. Then most companies do an analysis based upon the therapy regiemn, along with the target base and look at the likelihood of liability exposure.  I am sure you have seen the class actions suits advertised every fifteen minutes on TV..."if you or a loved one suffered any of the following while taking ExLaxia, call us"....The cost of potential lawsuits and settlements is already figured into the costs.  There are nowhere near the lawsuits in the European system against pharm and medicine as we see here in the US.  Patients deserve to be protected but the system should not be a lottery.  Unfortaunately, the most propserous of the people in these suits are the attorneys, on both sides.  The same attorneys who populate the House and Senate, and in most instances the seat of POTUS and Governor.

I agree costs are high, however the physicians and nurses and techs taking care of the patients make less, when accounted for inflation, than they did 30 years ago.

Another factor which Jank does not take into account is the effect that all of these employees have on the community.  Look at the number of healthcare workers in this area alone. Not only do the three major hospitals contribute significantly to the employment numbers but then include home health, nursing homes, assisted living, pharmacy, and medical aid.

I will get off of my soapbox, but yesterday when I got home I turned on the television and within 15 minutes I saw three commercials, one for a walk in bathtub that might be paid for by Medicare, next a set of "knee braces" to relieve pain at "no cost to you" obtained thru Medicare, and a commercial for a law firm looking for people who might have suffered a heart attack while undetgoing dialysis.  I turned off the television and went outside despite the rain.

Originally Posted by teyates:

but yesterday when I got home I turned on the television and within 15 minutes I saw three commercials, one for a walk in bathtub that might be paid for by Medicare, next a set of "knee braces" to relieve pain at "no cost to you" obtained thru Medicare, and a commercial for a law firm looking for people who might have suffered a heart attack while undetgoing dialysis.  I turned off the television and went outside despite the rain.

===============

Those adds pizz me off as well, as do the lawyers advertising that they can eliminate your IRS debt , and the ones promisingn to help people get on disability.  In fact about the only class action lawsuit(s) I have ever really supported is the ones against the tobacco industry, (I'm an ex smoker and you know how we are)  and the current ones against BP for the environmental destruction done to the Gulf Coast. (I love the Gulf coast). However, I just don't know for sure how to be able to throw out the bathwater without the baby going down the drain as well.

 

BTW, most of the TV I watch is Netflix on my ROKU. No adds. You said you were having trouble with yours - did you get it fixed ?

Yes, I did, thanks for asking, the ROKU setup is functioning,it was a router problem.

I know what you mean about the lawsuits, it is a two edged sword.  I know there are incidents that require renumeration, but in our society we absolutely expect perfection and when our expectations are not met, or the outcome is not what we think it should be, there is always a lawyer somewhere who is willing to take on the case. In regards to the commercial I was speaking of in relation to dialysis, these people are deathly ill, lest they would not require dialysis. Typically they have been afflicted with a chronic disease that has left them debilitated and weak, they are very suscepitble to electrolyte imbalance and infections. A large number of these people will die within the first three to four years of dialysis treatment, unless they qualify and can obtain a kidney transplant.  It is a horrible affliction, and the therapy although exhausting and tedious, can give them a little more time with their family or tide them over until a transplant can be found. It irks me to see these commercials targeting a populace who is already having such a hard time with this illness, and getting rich off of their ailments.

The OP's article sort of gives a bad name to MD Anderson Cancer Center, but in a government run system a place like this would likely not exist, at least one that is present in this country.  And despite what the article states, there is probably a huge "write-off" of care for those who have no ability to pay.  but these types of places are much like a car lot.  They will do a financial assessment and make darned sure you cannot pay before they write it off.  I read weekly about new "tourist" hospitals being built on islands and in countries where people can come for treatment.  Ironically, these places are being built in places where Europeans and Asians can come to get procedures that they may have to wait for in their own country.  It is my understanding that the appeal is the lack of dealing with insurance companies, current health regulations in the US (such as CMS, CLIA, FDA, etc), or the red tape and "cover your hiney "practices that cripple healthcare in the US.

In the future if a single payor system comes of age here in the US, you might be able to go to Guam or Costa Rica to have your hip or knee replacement when the government decides that you are no longer of suitable use and denies your procedure. If you have $10K you can go to Costa Rica, get a new hip, and recover for a few weeks while watching the ocean.

I can't fix the healthcare system, I know it is expensive, I know it does ot cover everyone.  The only thing I can do is continue to provide in the capacity I was taught, to the best of my ability, and continue to be expected to do more for less and pay higher taxes for the priviledge of doing so.

Teyates, I do take into account the employees that work in the healthcare field. My sister works at a local nursing home. She has been doing it for over 20 years and only makes 1.50 above minimum wage. She works long, hard hours but she loves what she does and sincerely cares for the patients. She has ruined her back and knees, she has been hit, bitten, and screamed at. Yet, she goes to work everyday with a smile on her face because she wants to help them regardless of the hard work, and low income. Each patient at the nursing home is paying (or medicare) a LOT of money for the care they recieve, however the actual caregivers see very little of that money.

 

I have 2 first cousins that also work in healthcare. One manages a Dr's office and the other works as a surgical nurse. They are not rich...not by a long shot. However, they completely agree with me and others that the industry is the problem. The big corporations that have taken over healthcare. The insane coding systems and how hard it is to get payment from insurance companies. They have discussed how there is so much waste and redundancy in the industry. We have had long talks about how much big Pharma is nothing more than legal drug dealers who jack up prices on the most needed drugs, the ones that keep people alive because they know they can get grandma to do without a few meals every month to be able to pay for her meds.

 

The healthcare INDUSTRY is our problem in America. Left to their own devices they have become big greedy corporations.

Add Reply

Post

Untitled Document
×
×
×
×
Link copied to your clipboard.
×