Enormous Cost of US Health Care

[KeithE]

I’m going to be highlighting some of Ricky Andersson’s solutons to our big national problems. Stare at this Key Figure for a while.



The U.S. health care system is a fee-for-services, for-profit insurance-based health care system; the rest of the OECD countries with the exception of Mexico has universal health care system of various sorts.

They try to put several factors on this chart but the important one to realize is the high cost of the US system. Notice the US red line. Now the righthand y-axis is life expectancy and the US is below average at that (probably as much to do with eating and exercising habits than the health care system, imo). But we also rate below average in:
- infant mortality
- recovery from life threatening illnesses
- mortality of men 15-60
- mortality of women 15-60

and high in:
- bankruptcies due to health care bills
- uninsured people

Read from the prestigious New England Journal of Medicine for more gory details and why current approaches (ObamaCare) will not hack it. Of course continuation of present system should be considered a non-starter (for all but few of the chief beneficiaries).

recommends a single-payer, universally available* health care insurance, with private doctors of the patient’s choice and private hospitals. Patterned after Taiwan or Canada. Alternative is Medicare could serve as an interim. We simply cannot let the costs of heath care continue to line the pockets of the insurance companies, pharmaceuticals, and large hospital conglomerates who in turn lobby for advantageous inserts into often unrelated bills, take an ever increasing amount for administrative costs (17% vs Medicare’s 3%) and advertising (now at 30%), urge doctors to overtreat so that they can be overpaid, and line the coffers of sympathetic (really pathetic) candidates who spur great lines about the UnAmericanness of “socialized medicine” and the so-called "loss of liberty" it involves.

You know we lose a lot of liberty by the large amounts of dollars taken by the health care industry and we lose a lot of job mobility by the pre-existing conditions prohibitons we often must go through to change jobs or retire. And let us not forget we are the only OECD country that have over a few percent uninsured (and we have ).

* You know a country can have universally “available" health care coverage w/o a mandate. I’m not sure what Ricky says here - I’ve seen it mentioned both ways. I’d be pragmatic and let the Supreme Court decide on the Constitutionality of mandated coverage but will call for at least universally available health care coverage. Unlike car insurance which is and should be mandated, a choice of being non-insured hurts mainly the chooser. Cost can be made up by some combination of more efficiency (like all the other countries), a reduction in overtreatment, defense cuts (but not Missile Defense , just those offensive wars), and higher taxes on the rich (I’d be more than willing to pay more).

[Gene Scarborough]

It is difficult for me to see the chart without a magnifying glass. Any way to make it a little larger and bolder?

My wife works at Nash General Hospital Physical Therapy. Let me share some of the things going on there as an example of why healthcare costs are a problem in America.

Ever since she started there 10 years ago there has been constant pressure to do more work per person from nurses to techs. The pay is not that great and raises have been minimal. It is difficult for me to buy their "high quality patient care" mantra when the work demands prevent many of their key employees from spending quality time with patients.

This hospital is constantly building new buildings and modifying everything from carpets to computers to make them "look nice." Meanwhile, much very usable carpet and computers are tossed out the door to "get the latest." This major renovation approach is causing much "do and re-do" wasted change. The Administrator gets a big raise and public praise for putting on a big show of "improvements."

The most recent development in our area is a regional hospital concept whereby a number of community hospitals are being drawn together under the umbrella of a new name: Viadant. They say the name was chosen because it implies "life." They are spending more money in commercials and signs to promote their system and get patients to come to them.

We have the East Carolina University Medical Center which has offered "down home" services which used to be found only in the Raleigh-Durham area at Duke or Chapel HIll. Also Winston-Salem has Baptist Hospital associated with the Wake Forrest University Bowman-Grey School of Medicine. All of these major teaching hospitals is an asset, but an expensive one needing patients to pay their high cost through their insurance policies.

Sometimes I think we are obsessed with fancy procedures being made more simple with new technologies avoiding invasive surgery. The process of putting in a stint to widen an artery has taken the place of open heart procedures---BUT the cost of such does not reflect the simplification. It is like our chocolate bars full of air now = you get less basic ingredient and more air bubbles to keep the size looking the same = more profit to the manufacturer.

Add to this the preying Lawyers waiting to sue doctors and pharma and companies producing devices to help. No telling how much in legal expenses an artificial heart valve company pays!

The cost of US healthcare is astronomical compared to many other countries world-wide. For example, I have a relative who recently had a stint procedure in Accra, Ghana, the capital of the West African nation. It was $1,500! I suspect the exact same prodedure with an equally qualified surgeon here would be at least $15-150K. Quite a difference and the above approaches in hospitals is more the cause of high costs.

Our facilities are fancy and our costs of everything from personnel to carpet does not always guarantee better healthcare. When the mundane workers who make the difference are paid a pitance and a Dr. sticking his head in the door for a "consult" gets him $200 added to the patient's bill.

Something is wrong and we can do better.

[KeithE]

[Dave Roberts]

I have talked with hospital department heads, who are no longer with our local for-profit hospital, who described their situation as having to go to a weekly meeting in which each department had to describe what it was doing to make their process more profitable. While that certainly fits in the free-enterprise scheme, it means that departments were pressured to show a profit each month and criticized if they could not. This means continuing to order tests and procedures so that the bottom line stays up.

[Gene Scarborough]

The PT Department where my wife works is the same.

Part of her annual is a look at her time cards making sure there is no overtime even if her services are needed.

There is now a concern that 2 of the PT's in her department competed against the hospital to get a contract at the local State Prison facility. Her old boss saw it as a conflict of interest, but the higher-ups did nothing.

Where there is collusion among the staff, they are making enough with that most profitable department not to stir the waters. The PT's are the cash cow without the cost of expensive medical equipment and diagnostic tools like an MRI scanner which cost them several million and is being used for procedures not necessary many times.

It's all about the money, honey----and protection from lawsuits!!!!

[Sandy]

So, do you think that the propaganda that is put forth, about our high standards of medical care, and how terrible socialized medicine is in 'Canada and England is bought and paid for by profiteers in the insurance business?

George W. Bush sold this country out to the highest bidder. The end result is a one percent class of corporate wealthy that control the rest of the country. Unless something is done, they will have complete control of everything, and the government will be unable (or unwilling) to protect its citizens from what already amounts to an immoral level of legalized robbery. If Romney gets in there, the process will be accelerated.

It's becoming clear that the enemies of Obamacare are being bankrolled by the health insurance industry. They are paying a fortune for the publicity, the rumor mills, and all the crap that is disseminated by Limbaugh, Hannity and Beck, and all these other idiots like Drudge.

[KeithE]

[Gene Scarborough]

I am confident that, if legislators would get together, we can solve the problems of the uninsured.

If doctors and hospitals and pharma work for their clients instead of using them for large profits, it will succeed.

Part of the problem is rediculous lawsuits so the legal profession has to get on board as well.

[Neil Heath]

One recent afternoon as I was listening to NPR news at 5 PM, I heard a conversation with one of the state attorneys-general who filed the lawsuit now in before the Supreme Court. He said that if the law had created a single payer system instead of what they did create, that it would be constitutional and the lawsuit would not have been filed.

[ET]

[KeithE]

[KeithE]

[Gene Scarborough]

I can tell you this about my wife's observations at her PT Department where they are treating the obese masses of WIC abusers and porch sitters.

They are now having people wanting hip and joint replacements because of their 300# and up size. Medicare is refusing to pay for such. Now, that is a money-saving measure toward people who brought on their disease with too much eating and sitting and not working daily as we do!

[ET]

[KeithE]

[KeithE]

[Gene Scarborough]

Gluttony is a sin which separates us from the ability to walk without breathing hard and straining our bodies into a potential stroke or heart attack----and I speak to myself as well with my 200# overweight condition.

Maybe universal healthcare should include "chester drawers" syndrome = my chest done fell into my drawers!

[Gene Scarborough]

[Gene Scarborough]