4 ms·

- paying for services for people who don't have/can't afford insurance. - medical malpractice insurance -> legal system - big pharma/med devices industry

spaetzleesser 6y ago
You should add - doctors are paid higher in the US than in another countries - billing staff overhead because of the insane insurance system - highly paid hospital administration - lots of middlemen that stay invisible because there is no price transparency - shiny new buildings that are built by friends of the hospital administration
- excannuck 6y ago
  "billing staff overhead because of the insane insurance system" While true, I would generalize to "insane bureaucratic system" unless you want to include public "insurance" into the mix. Medicaid and Medicare aren't simple!
- ArtDev 6y ago
  Look up the salary of your local hospital president. In my medium town of (Pop 200K) they pay him $980k per year. That is an absurd salary for a relatively small hospital!
  - therealdrag0 6y ago
    How do I look that up?
    - huitzitziltzin 6y ago
      AFAIK, certain non-profits are required to report the salaries of their ten highest paid employees. Doesn't mean it will be easy to find, but you might be able to find it that way. But this is not information the hospital would share w/ you w/ great enthusiasm, obviously.
- zoomablemind 6y ago
  ... Add also the medical equipment prices inflated by layers of distributors.
dominotw 6y ago
Big pharma? Big pharma has actually reduced the hospitalization costs over the past two decades. Edit: can someone explain downvotes?. How is big pharma increasing hospital costs? please take a look at this, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669633/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669633/ "The major empirical finding from this research is that medication use by Medicare beneficiaries is significantly negatively associated with hospital spending. Moreover, the cross-effect is quite large: each additional prescription drug fill reduces hospital costs by slightly more than $100 or about 5 percent measured at the mean level of Medicare payments in 2000 for inpatient hospital services for study subjects. "
- excannuck 6y ago
  For every COVID vaccine, how many BS "re-patented" medications == harmless vitamin + actual_medicine? Or medications that don't really work (p-hacking) but are prescribed anyway?) Or manufacturers that buy out all US competitors to have a monopoly of a particular medicine?
LatteLazy 6y ago
Plus - Gold plating everything to avoid getting sued. - Inflated medical school costs - the price of a huge bureaucracy for billing people, chasing them, disputing it, agreeing rates with insurers, renegotiating rates with insurers, applying the right discounts, billing a dozen different state and federal programs for various bits, those being disputed, managing all that etc.
- annoyingnoob 6y ago
  -Disposable everything, priced at a premium
- dominotw 6y ago
  I moved to usa from a poor country to work at a hospital. I was shocked by how awesome, clean and luxurious everything looked. Top end fancy hotel in my country would look like a slum dwelling compared to a hospital in USA.
  - ArtDev 6y ago
    Going from the USA to a hospital in Thailand is a similar experience. Everything is so clean!
fireeyed 6y ago
Don’t forget AMA antitrust violations but curbing the number of doctors that could get into the system.
- huitzitziltzin 6y ago
  Underrated answer, but it isn't an anti-trust violation when they have permission to accredit med schools! To be clear: I totally agree w/ you that the AMA is a cartel.
huitzitziltzin 6y ago
Everyone hates pharma (not entirely without reason!) but all drug spending is about 10% (slightly less) of US health care spending. If you spent $0 on drugs next year, we would not save that much money. If you want to cut spending, you need to cut spending on doctors and hospitals. If you want sources for these numbers, here is the National Health Expenditure summary from the Centers for Medicare and Medicaid Studies: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

spaetzleesser 6y ago

You should add - doctors are paid higher in the US than in another countries - billing staff overhead because of the insane insurance system - highly paid hospital administration - lots of middlemen that stay invisible because there is no price transparency - shiny new buildings that are built by friends of the hospital administration

excannuck 6y ago
"billing staff overhead because of the insane insurance system" While true, I would generalize to "insane bureaucratic system" unless you want to include public "insurance" into the mix. Medicaid and Medicare aren't simple!
ArtDev 6y ago
Look up the salary of your local hospital president. In my medium town of (Pop 200K) they pay him $980k per year. That is an absurd salary for a relatively small hospital!
- therealdrag0 6y ago
  How do I look that up?
  - huitzitziltzin 6y ago
    AFAIK, certain non-profits are required to report the salaries of their ten highest paid employees. Doesn't mean it will be easy to find, but you might be able to find it that way. But this is not information the hospital would share w/ you w/ great enthusiasm, obviously.
zoomablemind 6y ago
... Add also the medical equipment prices inflated by layers of distributors.

dominotw 6y ago

Big pharma? Big pharma has actually reduced the hospitalization costs over the past two decades. Edit: can someone explain downvotes?. How is big pharma increasing hospital costs? please take a look at this, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669633/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669633/ "The major empirical finding from this research is that medication use by Medicare beneficiaries is significantly negatively associated with hospital spending. Moreover, the cross-effect is quite large: each additional prescription drug fill reduces hospital costs by slightly more than $100 or about 5 percent measured at the mean level of Medicare payments in 2000 for inpatient hospital services for study subjects. "

excannuck 6y ago
For every COVID vaccine, how many BS "re-patented" medications == harmless vitamin + actual_medicine? Or medications that don't really work (p-hacking) but are prescribed anyway?) Or manufacturers that buy out all US competitors to have a monopoly of a particular medicine?

LatteLazy 6y ago

Plus - Gold plating everything to avoid getting sued. - Inflated medical school costs - the price of a huge bureaucracy for billing people, chasing them, disputing it, agreeing rates with insurers, renegotiating rates with insurers, applying the right discounts, billing a dozen different state and federal programs for various bits, those being disputed, managing all that etc.

annoyingnoob 6y ago
-Disposable everything, priced at a premium
dominotw 6y ago
I moved to usa from a poor country to work at a hospital. I was shocked by how awesome, clean and luxurious everything looked. Top end fancy hotel in my country would look like a slum dwelling compared to a hospital in USA.
- ArtDev 6y ago
  Going from the USA to a hospital in Thailand is a similar experience. Everything is so clean!

fireeyed 6y ago

Don’t forget AMA antitrust violations but curbing the number of doctors that could get into the system.

huitzitziltzin 6y ago
Underrated answer, but it isn't an anti-trust violation when they have permission to accredit med schools! To be clear: I totally agree w/ you that the AMA is a cartel.

huitzitziltzin 6y ago

Everyone hates pharma (not entirely without reason!) but all drug spending is about 10% (slightly less) of US health care spending. If you spent $0 on drugs next year, we would not save that much money. If you want to cut spending, you need to cut spending on doctors and hospitals. If you want sources for these numbers, here is the National Health Expenditure summary from the Centers for Medicare and Medicaid Studies: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...