4 ms·

The Crushing Cost of Health Care

15 points by jayzee 14y ago

ftwinnovations 14y ago
I know the term "Death Panels" pushes a lot of peoples buttons, but it sounds to me like a government agency that decides that someone, and later when money is more tight that some-subset is too expensive, is basically just that - a Death Panel. As rough as it is to stomach sometimes, I'd have to say that the people who "deserve" better treatment are the ones who worked hard and smart and are able to pay for it. Life is not fair, and saving for terrible contingencies helps mitigate those very risks.
- jonhendry 14y ago
  More importantly, it ignores the fact that this already happens, except it's insurance companies, not a government agency, that do it. "Life is not fair, and saving for terrible contingencies helps mitigate those very risks." For many hard-working people, it's impossible to save enough, or to have saved enough, for such contingencies. The simplest example would be a young couple whose child has some wildly expensive condition.
  - ftwinnovations 14y ago
    That was the point about "life is not fair" and again about "mitigating" the risks. I didn't say it removes the risks. Nothing does, not even big brother taking all our personal responsibility and freedoms away.
- gooddaysir 14y ago
  I take it you haven't experienced the kinds of challenges the poor face every day, challenges that act as a cruel gravity that keep them poor. This heat wave much of North America has been having. If you are poor, you probably can't afford air conditioning. If You have a/c, you can't afford to run it. You need to make rent. The rest of your money is used to buy food, except you can't afford much. Your diet certainly wouldn't be varied. But let's get back to this heat wave. If you've ever been on a second story apartment with no a/c during a heat wave, it's like HELL. The air doesn't move. You shut all the shutters and use house fans (if you got them) and lay low, but it's almost intolerable. You worry for your children and pets. Nobody can sleep at night, yet the constant heat sucks the life out of you. You get totally drained just trying to survive the day, but then the next day is also unbearable hot, and then the next day. You get sick just trying to regulate your tempurature. Your head is in a constant fog and you walk like your on the moon. It's hard to live that way. Hard to run a family, or work a job. You want to get up but life keeps you down. You're damn right life is unfair. Especially when nobody cares. All I ask is that you have some empathy. Imagine what it's like to always have a proverbial boot at your throat. Being poor is hard. It keeps you down.
chairsofter 14y ago
The thing that most people don't realize and the media surprisingly never talks about is the fact that Medicare and Medicaid consistently underpay for treatments given. Somehow the government gets away with only paying 2/3-3/4 of the actual cost, leaving the hospital to foot the bill. It's so bad that many clinics don't accept Medicare because it simply causes them to hemorrhage too much cash.
- wikkiwa 14y ago
  Yeah that's the scary thing. The actual cost is much higher. How much of this is inefficiency/"overcharging" is up for debate but it's pretty clear that since the bulk of the cost of healthcare for most people is paid by someone else, there's no incentive to economize. Plus modern medicine is AMAZING, but the surrounding economy isn't strong enough to support it. People simply aren't productive enough to pay for the cost of the most advanced treatments.
- lclarkmichalek 14y ago
  Have you got a link to a source for that? I'd be interested in seeing the precise figures.
- travisp 14y ago
  Yes, I learned this from a talk at the University of Chicago Hospitals -- Medicare/Medicaid almost always paid less than a dollar for every dollar in costs that they incurred (I think the quoted average number was closer to 50 cents on the dollar but I could be wrong). The only way they made up for these costs was from patients with certain types of private health insurance (not all types because some like Blue Cross had essentially negotiated rates very very close to cost). Without these patients, the hospital would not have been able to afford the Medicare and Medicaid patients.
- rdl 14y ago
  How does that work once more and more people are on medicare (baby boomers) and medicaid (larger absolute numbers and probably percentages of poor people in a failing economy, and possibly if there's a "public option" for healthcare in a few years)? Presumably both medicare and medicaid are highly localized user communities, too -- I suspect very few people in Aspen use either, even if eligible for medicare.
mmagin 14y ago
Poor title. It's not clear that these very expensive patients really account for the bulk of the cost problem we're facing. On the other hand, it is worth considering the ethics of such a situation. At least as depicted in the article, it seems hard to understand how prolonging treatment in this case really benefited the patient, regardless of the cost.

15 points by jayzee 14y ago

I know the term "Death Panels" pushes a lot of peoples buttons, but it sounds to me like a government agency that decides that someone, and later when money is more tight that some-subset is too expensive, is basically just that - a Death Panel. As rough as it is to stomach sometimes, I'd have to say that the people who "deserve" better treatment are the ones who worked hard and smart and are able to pay for it. Life is not fair, and saving for terrible contingencies helps mitigate those very risks.

jonhendry 14y ago
More importantly, it ignores the fact that this already happens, except it's insurance companies, not a government agency, that do it. "Life is not fair, and saving for terrible contingencies helps mitigate those very risks." For many hard-working people, it's impossible to save enough, or to have saved enough, for such contingencies. The simplest example would be a young couple whose child has some wildly expensive condition.
- ftwinnovations 14y ago
  That was the point about "life is not fair" and again about "mitigating" the risks. I didn't say it removes the risks. Nothing does, not even big brother taking all our personal responsibility and freedoms away.
gooddaysir 14y ago
I take it you haven't experienced the kinds of challenges the poor face every day, challenges that act as a cruel gravity that keep them poor. This heat wave much of North America has been having. If you are poor, you probably can't afford air conditioning. If You have a/c, you can't afford to run it. You need to make rent. The rest of your money is used to buy food, except you can't afford much. Your diet certainly wouldn't be varied. But let's get back to this heat wave. If you've ever been on a second story apartment with no a/c during a heat wave, it's like HELL. The air doesn't move. You shut all the shutters and use house fans (if you got them) and lay low, but it's almost intolerable. You worry for your children and pets. Nobody can sleep at night, yet the constant heat sucks the life out of you. You get totally drained just trying to survive the day, but then the next day is also unbearable hot, and then the next day. You get sick just trying to regulate your tempurature. Your head is in a constant fog and you walk like your on the moon. It's hard to live that way. Hard to run a family, or work a job. You want to get up but life keeps you down. You're damn right life is unfair. Especially when nobody cares. All I ask is that you have some empathy. Imagine what it's like to always have a proverbial boot at your throat. Being poor is hard. It keeps you down.

chairsofter 14y ago

The thing that most people don't realize and the media surprisingly never talks about is the fact that Medicare and Medicaid consistently underpay for treatments given. Somehow the government gets away with only paying 2/3-3/4 of the actual cost, leaving the hospital to foot the bill. It's so bad that many clinics don't accept Medicare because it simply causes them to hemorrhage too much cash.

wikkiwa 14y ago
Yeah that's the scary thing. The actual cost is much higher. How much of this is inefficiency/"overcharging" is up for debate but it's pretty clear that since the bulk of the cost of healthcare for most people is paid by someone else, there's no incentive to economize. Plus modern medicine is AMAZING, but the surrounding economy isn't strong enough to support it. People simply aren't productive enough to pay for the cost of the most advanced treatments.
lclarkmichalek 14y ago
Have you got a link to a source for that? I'd be interested in seeing the precise figures.
travisp 14y ago
Yes, I learned this from a talk at the University of Chicago Hospitals -- Medicare/Medicaid almost always paid less than a dollar for every dollar in costs that they incurred (I think the quoted average number was closer to 50 cents on the dollar but I could be wrong). The only way they made up for these costs was from patients with certain types of private health insurance (not all types because some like Blue Cross had essentially negotiated rates very very close to cost). Without these patients, the hospital would not have been able to afford the Medicare and Medicaid patients.
rdl 14y ago
How does that work once more and more people are on medicare (baby boomers) and medicaid (larger absolute numbers and probably percentages of poor people in a failing economy, and possibly if there's a "public option" for healthcare in a few years)? Presumably both medicare and medicaid are highly localized user communities, too -- I suspect very few people in Aspen use either, even if eligible for medicare.

mmagin 14y ago

Poor title. It's not clear that these very expensive patients really account for the bulk of the cost problem we're facing. On the other hand, it is worth considering the ethics of such a situation. At least as depicted in the article, it seems hard to understand how prolonging treatment in this case really benefited the patient, regardless of the cost.