The Cost of Care

[Dale Moser]

Put a hard cap on malpractice settlements, and put hard and fast rules on filing them that help weed out the welfare grabbers.


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[TwoHighways]

End the third party payment system for all but the most catastrophic/costly of medical conditions to treat. Cash for everything else via HSA for everyone that can be tapped into at retirement to incentivize actually taking care of yourself when you're younger. The lifestyle you adopt in your 20's and beyond will save you from a lot of the age related decline we see when we enter into our 70's and beyond. And FFS, stop eating **** food. Shop the outer aisles. It's not rocket science.

[jmeghunts]

#1 problem with our health care system?

The industry is 100% focused on what to do once you get sick. Why not start focusing on what to do so that you don't get sick in the first place???

Once you realize that, then start following the money. For insurance companies and Dr's, there is no money to be made if people stay healthy. All the money is in pills, surgery, etc, in general, treating the symptoms, not the cause of the symptom.

Also OP, I wouldn't believe a stat like 90 of 99 Canadians like their health care. I've met way too many Canadians that come to America to get treated for basic stuff (Like the flu) that they would have to wait days for treatment for in Canada. I've met dentists who make all their money in the first nine months of the year, so they just go on vacation the remaining three months. I've met dr's that complain about the Canadian bureaucracy. I've worked with guys in Canada who, after having gotten hurt (One guy broken arm, another a pretty severe cut), drove to and crossed the border into America while injured, to be treated.

There is no way that stat is true. If it is, it's a highly isolated case.

I did a few searches and the responses were all over the map on Canadian healthcare. Some love it, some hate it, some complain about the wait times, some say they never wait. Guess it just depends on who ya ask.

[jmeghunts]

A few things:

We have two examples of government run healthcare in the US. The VA and CMS...I've seen too many examples of how horrible they are with literally rationing of care, poor care and horrible referral wait times, yet alone for primary care. I do not think it is a good system for quality patient centered care.

I think we need de-regulation to some extent and encourage more private competition. It's literally a monopoly of giants running the private sector...aka BC/BS etc....

I've been a patient of the VA, I'm in healthcare as a physician...these are just my experiences and partial conclusions I've drawn. At the end of the day, I'm just a worker bee and nobody gives a **** what doctors think...not insurance companies, not the government, not hospitals and not most patients.

So your a doctor, I got a question. Have you ever thought about just printing a menu up to leave in the lobby for your patients?

Stitches: $10 each
Xrays: $50 each
Prostate Exam: $5000 each (limit 2 per visit)

Can medical billing really get that simple?

[BrianL]

And yes healthcare costs vary from market to market state to state and region to region. Think of it like a restaurant. A burger at McDonalds in rural Texas is going to cost less than a steak dinner at a fancy restaurant in NYC.

The way it is now, that McDonalds burger may be priced different to everyone standing in line in the same store.

[JBJTX81]

A few things:

We have two examples of government run healthcare in the US. The VA and CMS...I've seen too many examples of how horrible they are with literally rationing of care, poor care and horrible referral wait times, yet alone for primary care. I do not think it is a good system for quality patient centered care.

I think we need de-regulation to some extent and encourage more private competition. It's literally a monopoly of giants running the private sector...aka BC/BS etc....

I've been a patient of the VA, I'm in healthcare as a physician...these are just my experiences and partial conclusions I've drawn. At the end of the day, I'm just a worker bee and nobody gives a **** what doctors think...not insurance companies, not the government, not hospitals and not most patients.

I would agree with you in regards to the VA. Its one of the most poorly run systems in our govt. I would disagree with you in regards to CMS. I'd prefer working with CMS over pretty much any non govt health insurer I've had the pleasure of dealing with.

[camoclad]

So your a doctor, I got a question. Have you ever thought about just printing a menu up to leave in the lobby for your patients?

Stitches: $10 each
Xrays: $50 each
Prostate Exam: $5000 each (limit 2 per visit)

Can medical billing really get that simple?

Good question.

That's a good deal on the prostate exam

[JackRyan]

The provider should give everyone the same price. I recently had implants put in both eyes. Billing was for $41,000. Insurance paid about $4000 and I paid about $600. If I didn't have insurance the price would be about $41,000 and they would expect me to pay every penny of it. What makes insurance dollars better than my dollars? I can even pay faster than the insurance company.

I don't disagree with you on the discrepancy between what is billed and what insurance companies actually pay. But I do disagree with the idea that you would have paid the same amount billed to the insurance if you didn't have insurance. I have had basically catastrophic only insurance for years and pay for my family's medical bills out of pocket. We have found when you ask for a cash price on everything from routine care to MRIs to procedures it's typically 25-35% of the original "insurance" price. I have paid $350 for an MRI when the insurance cost was $2000. Have had procedures for about the same reduction for paying cash. Most Dr's will gladly accept cash payment immediately at a discounted rate vs dealing with insurance payments.

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[jmeghunts]

Good question.

That's a good deal on the prostate exam

Yeah and he probably won't answer. I have never ever got a doctor to answer me on simple billing.

[rubicon51]

It is funny that everyone is targeting the physicians/providers. Google the trend of physician salary vs hospital administrator salary over the last 20+ years...we have a system the uses "insurance" unlike any other insurance in that we file a claim with every interaction with the the medical system...we don't file a claim with homeowner insurance to change a light bulb

[jmeghunts]

It is funny that everyone is targeting the physicians/providers. Google the trend of physician salary vs hospital administrator salary over the last 20+ years...we have a system the uses "insurance" unlike any other insurance in that we file a claim with every interaction with the the medical system...we don't file a claim with homeowner insurance to change a light bulb

Another very good point. I'm all for lowering rates and having a catastrophic-only policy. I can handle most things out of my HSA account.

Edit: But if we do that I want to know up front how much I'm spending.

[rubicon51]

Another very good point. I'm all for lowering rates and having a catastrophic-only policy. I can handle most things out of my HSA account.

Edit: But I do that I want to know up front how much I'm spending.

I think this is a feasible solution. Make most things a reasonable price that majority can afford on their own, but reserve insurance for the things that would be financially devastating to most of the population such as cancer or cardiothoracic surgery