4 ms·

Cost inflation in the US is huge due to a combination of red tape, CYA, customers with good insurance subsidizing people with bad/no insurance, and many other f

by wyager 10y ago

Cost inflation in the US is huge due to a combination of red tape, CYA, customers with good insurance subsidizing people with bad/no insurance, and many other factors. There's no simple answer, unfortunately. No one is entirely sure why medical costs are so high in the US. It doesn't appear to be any one factor that people commonly blame. Fundamentally, they don't need to be expensive; via private medical tourism, you can get any sort of scan at a fraction of the US cost.

throwawaydbdksn 10y ago
The problem is everyone gets paid too much. Our doctors salaries are far out of line with most countries , we have the strictest drug pricing laws in the world, and people love to sue. We also have a significant portion of the population paying no medical bills while the rest is overcharged to compensate. On top of that our health insurance is full of middle men like "PBM's" that do nothing but raise costs. The combo means docs, drugs, treatment, and insurance are all more costly. A fix is hard to come by but would work something like this. 1)subsidize the cost of medical school increasing supply of MDS 2)pass laws to protect physicians from frivolous lawsuits or at least limit damages. 3)disallow drug companies from advertising, ban rampant kickbacks to doc's that prescribe their drugs 4)ban anti competitive practices that prevent insurance companies from negotiating prices directly with manufacturers. 5) provide healthcare centers of last resort(the ER) compensation for patients unable to pay. My last point is state specific and really controversial but it's based on what I've personally seen. States with a lot of illegal immigrants spend an enormous amount for healthcare at the ER for these people. Around 1/4 of the people that came into the ER I was familiar with were likely illegal and over 90% either gave a fake name or never paid. The majority of those costs are passed on to those with insurance. I lived in an area with probably 3% of the population were undocumented. Since the ER is healthcare of last resort they are forced to treat you even if you give them completely false info with no intention of paying. Illegal immigrants know this and preferentially go to the ER because they get treated without probing questions or need to pay. They also already have fake ID's in most cases so giving one to the hospital isn't a big deal. This enomous cost gets buried because it's politically unpopular to say and because the hospital just raises prices in everyone else to compensate.
- csydas 10y ago
  Alternatively, increased free clinics for basic healthcare (flu, checkups, non-emergency procedures) could eliminate a large percentage of wasted effort and time. Free regular checkups just a few times a year would catch so many issues before they became big expensive issues and it would eliminate the use of the ER as a general physician visit. We're already paying out crazy amounts for doctors time and for expensive visits, might as well make the basic health checks free. No need to bring insurance in on matters like just having a doctor write "you have the flu. Rest 4 days and take this" when the entire operation is 15 minutes for a quick culture.
- davak 10y ago
  One brief clarification. Doc salaries are higher, but cost and length of training is higher too. Four years of college and four years of med school dig the hole very deep. Then three to eight more years often working below minimum wage as the interest on the debt compounds.
  - throwawaydbdksn 10y ago
    Medical school definitely needs to be less expensive to lower salaries. It's also pushing doctors towards specialities that pay more and leaving us with a thortage of GP's
  - gech 10y ago
    Did they have a choice in their career path?
- gaius 10y ago
  subsidize the cost of medical school increasing supply of MD Won't help - the constraint is that the AMA is a closed shop (same as the BMA in the UK) and won't allow the market to be flooded like that. Meanwhile we computer folks sit back and let outsourcing and offshoring eat our industry.
- ubernostrum 10y ago
  pass laws to protect physicians from frivolous lawsuits or at least limit damages Several US states have harsh caps on medical malpractice damages. They still see massively-rising medical costs. And in uncapped states the rate of growth in malpractice damage awards hovers very close to the rate of inflation of the US dollar. Which sort of destroys the argument that "frivolous lawsuits" and massive damage awards drive medical costs in any significant way.
crdoconnor 10y ago
>Cost inflation in the US is huge due to a combination of red tape, CYA, customers with good insurance subsidizing people with bad/no insurance Or monopoly economics and market power. There's been a huge amount of consolidation in the healthcare sector in the last few years. In other news if we just cut some of Comcast's red tape, prices for sure would fall.

by wyager 10y ago

throwawaydbdksn 10y ago

The problem is everyone gets paid too much. Our doctors salaries are far out of line with most countries , we have the strictest drug pricing laws in the world, and people love to sue. We also have a significant portion of the population paying no medical bills while the rest is overcharged to compensate. On top of that our health insurance is full of middle men like "PBM's" that do nothing but raise costs. The combo means docs, drugs, treatment, and insurance are all more costly. A fix is hard to come by but would work something like this. 1)subsidize the cost of medical school increasing supply of MDS 2)pass laws to protect physicians from frivolous lawsuits or at least limit damages. 3)disallow drug companies from advertising, ban rampant kickbacks to doc's that prescribe their drugs 4)ban anti competitive practices that prevent insurance companies from negotiating prices directly with manufacturers. 5) provide healthcare centers of last resort(the ER) compensation for patients unable to pay. My last point is state specific and really controversial but it's based on what I've personally seen. States with a lot of illegal immigrants spend an enormous amount for healthcare at the ER for these people. Around 1/4 of the people that came into the ER I was familiar with were likely illegal and over 90% either gave a fake name or never paid. The majority of those costs are passed on to those with insurance. I lived in an area with probably 3% of the population were undocumented. Since the ER is healthcare of last resort they are forced to treat you even if you give them completely false info with no intention of paying. Illegal immigrants know this and preferentially go to the ER because they get treated without probing questions or need to pay. They also already have fake ID's in most cases so giving one to the hospital isn't a big deal. This enomous cost gets buried because it's politically unpopular to say and because the hospital just raises prices in everyone else to compensate.

csydas 10y ago
Alternatively, increased free clinics for basic healthcare (flu, checkups, non-emergency procedures) could eliminate a large percentage of wasted effort and time. Free regular checkups just a few times a year would catch so many issues before they became big expensive issues and it would eliminate the use of the ER as a general physician visit. We're already paying out crazy amounts for doctors time and for expensive visits, might as well make the basic health checks free. No need to bring insurance in on matters like just having a doctor write "you have the flu. Rest 4 days and take this" when the entire operation is 15 minutes for a quick culture.
davak 10y ago
One brief clarification. Doc salaries are higher, but cost and length of training is higher too. Four years of college and four years of med school dig the hole very deep. Then three to eight more years often working below minimum wage as the interest on the debt compounds.
- throwawaydbdksn 10y ago
  Medical school definitely needs to be less expensive to lower salaries. It's also pushing doctors towards specialities that pay more and leaving us with a thortage of GP's
- gech 10y ago
  Did they have a choice in their career path?
gaius 10y ago
subsidize the cost of medical school increasing supply of MD Won't help - the constraint is that the AMA is a closed shop (same as the BMA in the UK) and won't allow the market to be flooded like that. Meanwhile we computer folks sit back and let outsourcing and offshoring eat our industry.
ubernostrum 10y ago
pass laws to protect physicians from frivolous lawsuits or at least limit damages Several US states have harsh caps on medical malpractice damages. They still see massively-rising medical costs. And in uncapped states the rate of growth in malpractice damage awards hovers very close to the rate of inflation of the US dollar. Which sort of destroys the argument that "frivolous lawsuits" and massive damage awards drive medical costs in any significant way.

crdoconnor 10y ago

>Cost inflation in the US is huge due to a combination of red tape, CYA, customers with good insurance subsidizing people with bad/no insurance Or monopoly economics and market power. There's been a huge amount of consolidation in the healthcare sector in the last few years. In other news if we just cut some of Comcast's red tape, prices for sure would fall.