Why does healthcare cost so much in America?

[JackRT]

You have been told lies, ask anyone who lives in the rest of the civilized world what they think of their health care and they will tell you the truth.

As a Canadian, I get real tired about the misinformation that so many Americans have been fed about the health care system not only in Canada but also in the other western democracies. It is as if they were simply repeating a party line or a credo.

 

[The Stamp]

It's even better than that as my employer pays 100 percent of premiums. The only downside is that I don't have dental coverage.

But if you lost your job for whatever reason you would be without medical cover, am I right?
Only in America is that allowed to happen, when you are down because you lost your job they kick you again, great country.

 

[OldWiseGuy]

But if you lost your job for whatever reason you would be without medical cover, am I right?
Only in America is that allowed to happen, when you are down because you lost your job they kick you again, great country.

If I lost my job or retired I would sign up for Medicare Part B and purchase supplemental coverage.

 

[Ygrene Imref]

Certainly with being among the more expensive healthcare systems, it would seem quality should likewise correspond...however, the reality be a lot of people make a lot of money on disease.

...To the point that, it could be financially ill-advisable to let knowledge of the many cures for various conditions become public knowledge.

I suppose the answer to your question could be summed up with:

Profit before people.

Yes, this is what it ALL comes down to: profit.

Anyone know why United State of America is REGISTERED (R)?

 

[The Stamp]

If I lost my job or retired I would sign up for Medicare Part B and purchase supplemental coverage.

What would have happened if you had not been old enough to sign up for medicare? would you have found yourself uninsured?

I suppose what I'm really asking is why are Americans so happy to give billions and billions of dollars to insurance companies when they don't need to? there is a better way in fact there are lots of better ways.

 

[ThatRobGuy]

The issue is that people are being conditioned to want to pay more merely to prop up this facade of "self reliance" and "making sure that lazy bums aren't coasting off of my dime".

Essentially, the two scenarios are
1) Implement a method that would cut all of our costs, from top to bottom, by 25-50%...however, it would mean that the "lazy bums" would be covered (everyone would be)

2) Pay the inflated costs set by the insurance companies and providers (purely profit driven), all under the guise of "making sure that lazy people aren't coasting off of your dime" and promoting "free market" and "getting government out of business".


I used to be anti-singlepayer at one point, however, after looking at the hard data (which is irrefutable and not open to debate...people can have their own opinions but not their own facts), the solution that makes the most sense is single payer with a certain element of price fixing. Part of being fiscally responsible is going with the solution that gets you the best value for your buck.

That'd be like if there were two grocery stores, and one charges 30% less on everything and gives free handouts to unemployed people who come in, and the other store charges 30% more, and is very strict about the "no handouts, gotta pay your own way" mentality. Even if I agree with the latter store's philosophy on a personal level, it'd still be absolutely stupid to pay $150 for my weekly groceries there (just to prove a point) when I could be buying literally the exact same groceries at the first store for $45 less.

The majority of GOP base is looking at this scenario and saying "nah, I'll gladly pay 30% more to shop at this other store, it's more important to teach those lazy people a lesson than it is to actually save money and lower costs".

Despite what people try to say in defense of this position..usually their answer is one of the following things:
1) Prices are high because of a lack of unrestricted competition
2) Prices are high because of the burdensome regulations the government has on the industry

Those two things are flat-out false. We have more competitors in our market per capita than any other country in the first world, and we have lower levels of regulation too.

The major players in the healthcare industry have convinced everyone that "regulations are what's making us charge more" so that they'll blame the government instead of them. And companies gleefully opted for cheaper corporate healthcare benefits packages, and transferred larger portions of the cost onto their employees (to give their employees less coverage or more money), and intentionally timed it so that they implemented those changes at the same time as ACA was being implemented and allowed their employees to believe "it's not us doing this to you, it's ObamaCare's fault!"

 

[bhsmte]

This dude is correct, but their are other reasons as well. The US has chosen to make healthcare a capitalistic opportunity vs having a culture and priority, where providing healthcare for all is the goal. Pharma, insurance, medical device, physicians and even so called; non profit hospitals, make billions upon billions in profits. All the administration costs, allow insurance and hospitals to charge more for their service and one thing people forget, it keeps millions of people employed. Physicians in the united states, make 3-4 times the income, of similar physicians in other countries. Large non profit hospitals, are often top heavy, with ceo's making over a million a year and a whole bunch of senior managers, making several hundred thousand a year. Physicians also leave medical school in massive debt, when other heavily subsidize education for those capable of entering medical school. I could go on, but we just prioritize healthcare much differently than other advanced nations.

 

[ThatRobGuy]

This dude is correct, but their are other reasons as well. The US has chosen to make healthcare a capitalistic opportunity vs having a culture and priority, where providing healthcare for all is the goal.

Agreed.

The reason why you don't get a bill in the mail for $75,000 when the fire department comes to put out a house fire is because the fire department is operated as a public service whose goal is to put out fires, and not to buy 3 yachts and a summer home for the fire chief. The same is not true for healthcare in our country.

The thing that still puzzles me about this whole thing is why people seem to draw the line at healthcare when it comes to single-payer models. It's essentially the model that's utilized to fund the police department & fire department, and the people who claim that single payers is "evil socialism" seem to love those two entities.

 

[SnowyMacie]

The issue is that people are being conditioned to want to pay more merely to prop up this facade of "self reliance" and "making sure that lazy bums aren't coasting off of my dime".

Essentially, the two scenarios are
1) Implement a method that would cut all of our costs, from top to bottom, by 25-50%...however, it would mean that the "lazy bums" would be covered (everyone would be)

2) Pay the inflated costs set by the insurance companies and providers (purely profit driven), all under the guise of "making sure that lazy people aren't coasting off of your dime" and promoting "free market" and "getting government out of business".


I used to be anti-singlepayer at one point, however, after looking at the hard data (which is irrefutable and not open to debate...people can have their own opinions but not their own facts), the solution that makes the most sense is single payer with a certain element of price fixing. Part of being fiscally responsible is going with the solution that gets you the best value for your buck.

That'd be like if there were two grocery stores, and one charges 30% less on everything and gives free handouts to unemployed people who come in, and the other store charges 30% more, and is very strict about the "no handouts, gotta pay your own way" mentality. Even if I agree with the latter store's philosophy on a personal level, it'd still be absolutely stupid to pay $150 for my weekly groceries there (just to prove a point) when I could be buying literally the exact same groceries at the first store for $45 less.

The majority of GOP base is looking at this scenario and saying "nah, I'll gladly pay 30% more to shop at this other store, it's more important to teach those lazy people a lesson than it is to actually save money and lower costs".

Despite what people try to say in defense of this position..usually their answer is one of the following things:
1) Prices are high because of a lack of unrestricted competition
2) Prices are high because of the burdensome regulations the government has on the industry

Those two things are flat-out false. We have more competitors in our market per capita than any other country in the first world, and we have lower levels of regulation too.

The major players in the healthcare industry have convinced everyone that "regulations are what's making us charge more" so that they'll blame the government instead of them. And companies gleefully opted for cheaper corporate healthcare benefits packages, and transferred larger portions of the cost onto their employees (to give their employees less coverage or more money), and intentionally timed it so that they implemented those changes at the same time as ACA was being implemented and allowed their employees to believe "it's not us doing this to you, it's ObamaCare's fault!"

This dude is correct, but their are other reasons as well. The US has chosen to make healthcare a capitalistic opportunity vs having a culture and priority, where providing healthcare for all is the goal. Pharma, insurance, medical device, physicians and even so called; non profit hospitals, make billions upon billions in profits. All the administration costs, allow insurance and hospitals to charge more for their service and one thing people forget, it keeps millions of people employed. Physicians in the united states, make 3-4 times the income, of similar physicians in other countries. Large non profit hospitals, are often top heavy, with ceo's making over a million a year and a whole bunch of senior managers, making several hundred thousand a year. Physicians also leave medical school in massive debt, when other heavily subsidize education for those capable of entering medical school. I could go on, but we just prioritize healthcare much differently than other advanced nations.

Excellent points. I will also add that many Americans, unlike most of the world, see healthcare as a privilege and not a right. I think it goes back to what Rob mentions, Americans' self-reliance. American culture idolizes self-reliance, that's one of the things the "American Dream" is based upon, which says that if you work hard, you can achieve anything. While I think the intentions of it where good, it gets mixed in with western individualism to create the mentality of "I don't need to be dependent on anyone for anything." That is the mentality of many conservatives in this country, you are only entitled to what you have earned through your independent hard work. We should strive for a society where we all are self-made millionaires. To quote Marco Rubio "We are a nation of haves and soon to haves. A nation of people who made it and people who will make it."

I remember watching a documentary about something entirely irrelevant, but had a great point about how Americans view the government versus the British. It said that Americans are taught that the government is bad and should remain as much out of people's lives as possible. Whereas in Britian, they are taught that the government is good, and is a provider to the people.

 

[The Stamp]

The issue is that people are being conditioned to want to pay more merely to prop up this facade of "self reliance" and "making sure that lazy bums aren't coasting off of my dime".

Unfortunately every time someone without insurance goes to the hospital the cost is passed in increased premiums on to the people who do have insurance.

Implement a method that would cut all of our costs, from top to bottom, by 25-50%...however, it would mean that the "lazy bums" would be covered (everyone would be)

You could well be right and it could be too late for the US to adopt a single payer system because you have such a large number of people who would take advantage of the system, you have two million people in prison who do not work when they are not in prison.

 

[JohnHarthover]

Unfortunately every time someone without insurance goes to the hospital the cost is passed in increased premiums on to the people who do have insurance.You could well be right and it could be too late for the US to adopt a single payer system because you have such a large number of people who would take advantage of the system, you have two million people in prison who do not work when they are not in prison.

Americans are not inherently worse than people from other countries. Single-payer works in other countries and it would work in the US too.

The thing is, how many people are really going to "take advantage of the system." Very few people want to go to a doctor or hospital unless they need medical coverage. What the data shows is that people "take advantage" of the system less in single-payer systems like Canada than in the US. Why? Because when it is unclear if a specific diagnostic or treatment is useful, doctors in Canada tend to tell their patients that they don't need it, while doctors/ads tend to tell people in the US that they should get it.

 

[CRAZY_CAT_WOMAN]

I have less of a problem with that than I do with giving welfare out with no requirement to do anything for it. If we did we could increase the "wealth of the population" and fill the needs of the poor. I envision the poor doing public works as in the depression era. The workforce, which includes many skilled workers, of the poor and unemployed is enormous. Match those with pubic works that cannot now be done for lack of revenue and we could move ahead in many areas quickly. Sadly politics (and a general lack of vision) gets in the way of marshaling these resources.

In Ca. there are requirements. They try to get you employed. It's very liberal run state. I believe.

 

[The Stamp]

Americans are not inherently worse than people from other countries. Single-payer works in other countries and it would work in the US too.
The thing is, how many people are really going to "take advantage of the system." Very few people want to go to a doctor or hospital unless they need medical coverage. What the data shows is that people "take advantage" of the system less in single-payer systems like Canada than in the US. Why? Because when it is unclear if a specific diagnostic or treatment is useful, doctors in Canada tend to tell their patients that they don't need it, while doctors/ads tend to tell people in the US that they should get it.

1.5 million people are homeless in the US, in a US single payer system they would all try and have at least a couple of weeks of the year in hospital especially if the weather is bad.

In the UK we have what we call "bed blocking" and it's a big problem, when some old patients are ready to be discharged from hospital, if they have no one to look after them at home they must stay in hospital even though there is nothing wrong with them other than a small loss of mobility or they may need help going to the toilet.

 

[OldWiseGuy]

Agreed.

The reason why you don't get a bill in the mail for $75,000 when the fire department comes to put out a house fire is because the fire department is operated as a public service whose goal is to put out fires, and not to buy 3 yachts and a summer home for the fire chief. The same is not true for healthcare in our country.

The thing that still puzzles me about this whole thing is why people seem to draw the line at healthcare when it comes to single-payer models. It's essentially the model that's utilized to fund the police department & fire department, and the people who claim that single payers is "evil socialism" seem to love those two entities.

Police and firefighters aren't in it for the money. It is the money that draws people to the insurance and healthcare field. If they had the same reason/motivation they wouldn't demand such high pay.

Another overlooked reason for high medical costs is the 'chair side assistance' by the various tech workers. When I was young my dentist (and my family doctor) worked alone, did everything himself. Now dentists are like medical doctors as they employ more people to do the mundane tasks. Hygienists are a relatively new field as well.

Before discharge from the army everyone gets their dental work completed. The officer that did mine had a private practice but hired on to the army (his rank was Lt. Colonel) so he could practice dentistry, not run errands, schedule appointments, and do bookkeeping (he also said that he could never afford the equipment that the army provided, or the dental assistant). By doing this he was freed to see more patients, just as are medical doctors. These additional workers have to be paid as well, thus the higher costs.

Another benefit of having lots of helpers is flexibility. My dentist leaves several hours 'open' each week for emergency patients. If none occurs during the week he takes off early on Friday and plays golf. I have needed such treatment over the years and I can always see him that same day as he reshuffles other appointments into the open schedule.

All that said I believe single payer is the way to go, but doctor salaries must be retained at a high level to attract good people into the field.

 

[cow451]

All of this shows that the healthcare field is the place to be if you want to make a good living. As a successful enterprise it's second to none in America. And it's so easy to make loads of money. Here's what recently happened to me.

I went to the ER for chest pains (I had bypass surgery several years ago). All my vital signs were good and the chest pains weren't serious or related to my surgery. Before I was discharged the cardio doctor doubled my dosage of Lipitor, despite my cholesterol numbers being satisfactory. It was simply an opportunistic move on the part of the industry to make more money (Lipitor/atorvastatin) is very profitable. On another visit another cardio doctor wanted me to take yet another blood pressure drug before I went to bed, despite my bp being good. Even my family doctor was surprised that my cholesterol med was doubled since my numbers were already satisfactory. That ER cardio doctor said that it was the 'new' standard.

Aren't you pleased to benefit from a private enterprise healthcare system?

 

[cow451]

Police and firefighters aren't in it for the money. It is the money that draws people to the insurance and healthcare field. If they had the same reason/motivation they wouldn't demand such high pay.

I have to call bull baloney here. You want everybody else to work cheap and be uneducated? Think how great the care will be with high school dropouts assisting the surgeon. Do you really want your cardiac stent placed by somebody that was bagging groceries last week?

Report me, but your ignorance on this matter is astounding. And your insults to people in healthcare are disgusting.

 

[OldWiseGuy]

Aren't you pleased to benefit from a private enterprise healthcare system?

I am as it is not a financial burden on me. I also live in a city with 'world class' hospitals, which is quite reassuring. That doesn't mean that I think the system is perfect by any means.

 

[OldWiseGuy]

I have to call bull baloney here. You want everybody else to work cheap and be uneducated? Think how great the care will be with high school dropouts assisting the surgeon. Do you really want your cardiac stent placed by somebody that was bagging groceries last week?

Report me, but your ignorance on this matter is astounding. And your insults to people in healthcare are disgusting.

So our police and firefighters are uneducated high school dropouts? Who knew?

Firefighter and police are well paid, but are not in the field for the money. The pay, prestige, and lifestyle of being a 'doctor' is quite appealing however.

 

[W2L]

Education is misunderstood. Ive known many who dont have high school diploma, yet they can build and create things. Nothing wrong with being a lowly carpenter. The Lord was a skilled worker, so were many of the disciples he chose. Greeks seek wisdom and Jews a sign, The foolishness of the message preached is Gods wisdom however. Throughout the scriptures we see that humility is greater than academic achievement.

 

[ThatRobGuy]

All that said I believe single payer is the way to go, but doctor salaries must be retained at a high level to attract good people into the field.

I would agree, and the countries that have single payer in place still have well-paid physicians.

I'm all for keeping physicians' salaries right where their at...and in all actuality, physicians aren't what's spiking the healthcare costs. I can give you a prime example of what I'm talking about.

I had to go into the local ER a while back (probably over a year ago now) because I had a severe ear infection in the middle of the night and my ear drum perforated and couldn't get the bleeding and draining to stop... (TMI, I know lol).

Luckily my insurance is decent so I only had a $200 co-pay, however, I still got the itemized bill that was sent to my insurance company. The charge for the attending physician was only $115...and the on-site nursing staff charge was only $60.

However, the facility itself billed the following line items.
Middle Ear Endoscopy (nurse taking small camera tube, and putting it in the ear): $275
Bacteria Lab Rapid-Culture: $535
Facility Charge: $400

(they were going to try to do a chest x-ray, but I declined since I had no respiratory symptoms and assumed that the staff was told to do that on a routine basis because it's an easy $$$ for the facility)

So, in terms of the awful price gouging that takes place, that's coming from the facility owners themselves and not the physician and nursing staff who work in them. And in order to get that $1,385 bill negotiated down to a reasonable $400, I have to pay a insurance company $220/month, every month, for the last 12 years lol. They use the excuse that their recovering their costs for their purchase of the equipment used when they charge such high fees, however, whenever I've looked at cost analysis reports for these medical facilities (and we have a number of facilities who are clients so I've seen them for multiple facilities), they hit their break even point on those purchases after 14-16 months, however, they're using that equipment for 5-6 years in many cases.

As much as I hate to admit it, the only facilities that seem to have an even remotely reasonable pricing structure are the ones that are part of the Catholic health system...and the issue with those is that religion dictates which services are and aren't offered for certain things.