Yeah!! My health insurance is only going up 13% this year.

The moment patients start being able to see and compare healthcare costs themselves is the moment that we see the beginning of the end to this problem. Health insurance companies = 3rd party black box between patients and the healthcare industry.

Just about everything in life can be rationalized through supply and demand, with price being the mediator.

In the case of healthcare, the majority of participants in the system don't care about cost. You walk into a Dr, pay $10 - which is frankly not much, or you pay $5 or $10 for a drug, which again isn't much. The Dr or pharmacy charges the insurance $300 and settles on a negotiated rate of $150. The Dr/pharmacy doesn't care about cost because their clients don't care - any Dr they go to (in network, but the network is vast) costs $10; any pharmacy will charge $5 or $10. So does the insurance care about cost? To an extent, all companies seek to reduce costs, but if they are able to make a profit and grow, so be it.

The presence of a middle man (insurance, government) inbetween consumer and provider is what has thrown the system out of whack and sent prices soaring. This is exactly what has happened with college tuition (government).

Everyone needs to participate in the healthcare market (well.... will need to at some point) however no one really competes on cost, so there's no incentive to provide or seek value.

This is why the shift to high deductible plans with lower premiums and HSA's is good - people have to actually think about how they spend their healthcare dollar.

Quote from Dr. J : Just about everything in life can be rationalized through supply and demand, with price being the mediator. In the case of healthcare, the majority of participants in the system don't care about cost. You walk into a Dr, pay $10 - which is frankly not much, or you pay $5 or $10 for a drug, which again isn't much. The Dr or pharmacy charges the insurance $300 and settles on a negotiated rate of $150. The Dr/pharmacy doesn't care about cost because their clients don't care - any Dr they go to (in network, but the network is vast) costs $10; any pharmacy will charge $5 or $10. So does the insurance care about cost? To an extent, all companies seek to reduce costs, but if they are able to make a profit and grow, so be it. The presence of a middle man (insurance, government) inbetween consumer and provider is what has thrown the system out of whack and sent prices soaring. This is exactly what has happened with college tuition (government). Everyone needs to participate in the healthcare market (well.... will need to at some point) however no one really competes on cost, so there's no incentive to provide or seek value. This is why the shift to high deductible plans with lower premiums and HSA's is good - people have to actually think about how they spend their healthcare dollar.

I wasn't nearly as eloquent in my post above yours. You nailed it

244 dollars to apply dermabond to my nose

Quote from travfar : Exactly. Healthcare by it's nature is not self regulated by market forces. It's hard to comparison shop when you are having a heart attack. It is a de facto monopoly. Unlike other monopolies though, it is not heavily regulated. I would be happy to see that hospitals/doctors be required to publish pricelists. The standard retort is that the hospitals don't know how much to charge since they don't know what needs to be done until it's over. You can say the same for car mechanics, yet they have published industry rates they charge. You pay to get a transmission swapped out. Sometimes it takes less time and sometimes it takes more but there is a standard book price they will quote. Why should healthcare be any different? At a minimum, they should be able to tell you how much they've charged other people. As things are, it's like they make up the prices. Even going to the same hospital, getting the same proceedure with the same outcome the price for two people can be $50,000 different. That's ridiculous. Other countries don't have a problem doing this. If they can do it, why can't we? http://www.denverpost.com/nationw...alth-study

Not only that, but once I was given a price, and the hospital tried to charge me twice as much as their own quote. I told them to send me a bill for the amount they quoted and I would pay it, but they refused and so did I. This was for a mostly routine in and out procedure with no complications.

Quote from Radeck : sorry dude, we haven't had a free market in the medical care industry since medicare and medicaid were created...they were the original market intervention, that effectively placed a price floor on any services that are covered by those systems: providers have NO REASON WHATSOEVER to charge you less for a service than the government pays for it...thus no competition...and it got worse since then.

How can you say that with a straight face (maybe you didn't) when the only thing we hear from doctors is that Medicare and Medicaid is not profitable and they have to charge other insured more to subsidize M&M patients?

Quote from 124nic8 : How can you say that with a straight face (maybe you didn't) when the only thing we hear from doctors is that Medicare and Medicaid is not profitable and they have to charge other insured more to subsidize M&M patients?

nic, he is is 100% correct. it is ILLEGAL for me to charge a patient LESS than i charge medicare. feel free to look this up and prove me wrong. Medicare does this bedause if you drop your prices you must offer them the same dicounted rate. course, you wont be in business long.... but you can do it.

Quote from Radeck : s Ask yourself, why is Lasik surgery half the cost it used to be with much better technology and results? Precisely because IT IS a free market system free from government and insurance company intervention. Because the end-use pays for it, there is competition from the providers for the consumers to choose them: they find ways to do it cheaper and better, come up with better and newer techniques and equipment that produce better results

LASIK costs the same amount unless you use outdated technology. I'm sure if you had the choice to use an MRI from the 80's it would be cheaper too.

Quote from SigX : nic, he is is 100% correct. it is ILLEGAL for me to charge a patient LESS than i charge medicare. feel free to look this up and prove me wrong. Medicare does this bedause if you drop your prices you must offer them the same dicounted rate. course, you wont be in business long.... but you can do it.

Re read what I wrote. I'm not claiming that doctors want to charge other patients less than the Medicare rate. Doctors keep claiming they HAVE to charge other insured patients more than they otherwise would, to subsidize the low rate Medicare patients.

If anyone tries to pin ONE reason why healthcare is expensive, they're either naive or willfully ignorant.

Here is a short list:

1) unhealthy american habits
2) lack of focus on preventative care
3) administrative costs are outrageous (from both government and private insurance)
4) drug patent games (with extending patents)
5) disconnect between who pays, who delivers and who receives the care
6) government has assumed the liability for the most expensive part of our lives--and with spiraling costs, they try to push costs down by regulating costs/increased oversight/etc.
7) medical malpractice (and the expectation that people receive PERFECT healthcare)
8) insurance providers (both healthcare and malpractice)
9) over-delivery of healthcare
10) fraud
11) uninsured
12) overuse of emergency care (inefficient allocation of medical resources)
13) cost of medical degrees

etc., etc., etc.

Quote from 124nic8 : Re read what I wrote. I'm not claiming that doctors want to charge other patients less than the Medicare rate. Doctors keep claiming they HAVE to charge other insured patients more than they otherwise would, to subsidize the low rate Medicare patients.

his original argument was:

Quote : ...they were the original market intervention, that effectively placed a price floor on any services that are covered by those systems

which is true

I will gladly admit though, that you are correct as well. that private payers must be present or doors will close. Are you aware the the changes that took place at University of Chicago when Michele Obama was there? do you know why they were sending patients to other hospitals? do you know why they shrank the size of the emergency room? any idea of the harsh realities of an inner city hospital that heavily relies on medicaid?

Quote from SigX : his original argument was:

If the "floor" is at or lower than profitable operation, then it is not a new floor established by M & M, it is the practical floor of profit or loss.

I thought medicare/medicaid rates were too low. Now you're blaming them for pushing costs up? It really gets confusing when you guys talk out of both sides of your mouths.

Quote from politicaljunkie : I thought medicare/medicaid rates were too low. Now you're blaming them for pushing costs up? It really gets confusing when you guys talk out of both sides of your mouths.

it really hard when people who know nothing about an industry jump in and act like they know everything....

Some of the payments from Medicare in the early years were way too high. go ask an older surgeon from back in the day. docs that did cataract removal or prostatectamies were instant millionaires up until the 80s. they paid WAY too mcuh back then. now they pay just enough or too little depending on the proceedure or office visit being discussed. For the most part however, as the years pass, medicare is paying too little for most services provided. medicaid is even worse, where it is mostly below cost and for patients who are usually harder to deal with (less educated, miss appointments, less compliant, etc. etc.)