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The Inexplicable American Consumer Is Putting The Screws To Health-Care Expenses

testosteronepit's picture




 

Wolf Richter   www.testosteronepit.com

There has been anecdotal evidence. But now The Wall Street Journal in its story about GE’s quandary confirmed it: the toughest creature out there that no one has been able to subdue yet, the inexplicable American consumer, is apparently accomplishing a miracle: putting the screws to runaway health-care costs. One of their targets: over-used, over-hyped medical services, such as MRIs and CT scans—an industry bubble that has been ballooning by the double digits for decades. Motive? Profit.

It may be early for a victory lap: critics contend that “the health-care system is still overrun by unnecessary imaging at prices that are much higher than in other countries,” the Journal writes. “A study by the International Federation of Health Plans found that US fees for an MRI were about 80% higher than Germany’s.”

American health care costs are beyond legendary. Employer plans that cover a family of four are expected to break the sound barrier of $20,000 this year, up 7% from 2011, and up 117% from ten years ago. The country is spending $2.6 trillion on health care a year, or 17.9% of GDP! Yet, in terms of life expectancy, these expenditures don’t add up. Depending on who is counting, the US ranks somewhere between 38th and 51st place. On the latter list, US life expectancy of 78.49 years is almost 11 years lower than Monaco’s.

The Journal describes the inherent conflict between GE’s health-care division, which generates $18 billion in revenues by selling MRI machines, CT scanners, and the like, and the health insurance program for its employees, which costs $2.5 billion. While the health-care division wanted to sell as many imaging devices as possible, cost cutters wanted to contain the spiraling health-care costs. The cost cutters won—and introduced high-deductible health plans. After two years, the use of imaging technologies dropped by as much as 25%.

Other large corporations are implementing similar plans. In my experience, high-deductible plans have become nearly standard in small companies—to combat skyrocketing costs. What they have accomplished in the process, without planning it, is introduce a new watchdog into the equation, and not any old watchdog, but the sharpest one out there: consumers motivated by profit.

Many companies offer options, where the employee portion for family coverage may drop from, say, $1,200 per month for a classic plan to $600 per month for a high-deductible plan with a maximum out of pocket of $4,000. People do the math. They’d save $600 per month, or $7,200 per year. Any expenses would be capped at $4,000. Savings: $3,200. Plus any out-of-pocket expenses they would have to pay under the traditional plan. These plans qualify for Health Savings Accounts—and contributions to them are deductible from federal income taxes (but not from California income taxes!!!).

For healthy people, a high-deductible plan with an HSA account is financial nirvana. For people with chronic illnesses that are expensive to treat, such a plan may be less advantageous, but may still be a good deal (check your numbers carefully!). It’s a tough plan for those who don’t have the discipline to put aside the monthly savings so that they can pay their big deductible down the road. But it’s a fiasco for those who can barely pay their premiums and have nothing left to put aside—a growing part of the population [read.... The Pauperization of America].

While it’s still nearly impossible to get accurate pricing in advance of medical treatments—and thus price competition remains illusory—it is possible to question the need for certain procedures. Insurance companies who are trying to deny coverage for procedures they deem unnecessary can get into hot water. For them, the path of least resistance is to pay, and then raise premiums. But when a consumer, motivated by profit and a desire to stay healthy, deems a procedure unnecessary, it’s a different story. Suddenly, the profit motive of the industry smacks into the profit motive of the consumer. Rudiments of checks and balances!

Those are personal decisions. But consumers are motivated to think about them and empowered to make them—rather than handing the entire process over to the industry. And when the toughest creature out there has a major medical event that fulfills the deductible, he or she can spend the rest of the year catching up with accumulated elective procedures: cataract surgery, hip replacement, brain transplant.... For free.

It has had an impact. In 2012, plans with deductibles of $1,000 or more made up only 19% of employee-sponsored health plans, according to the Journal. But the radiology industry is now contemplating stagnation: demand by privately insured patients (rather than those covered by Medicare) declined by 5.4% in 2010. And GE saved 15%.

The cellphone in your pocket is NASA-smart. Yet it costs just a couple of hundred dollars. So why is it that rising technical capabilities lead to drastically falling prices everywhere, except in your medical bill? The answer may surprise you. Read.... “Why Your Health Care Is So Darn Expensive,” by Alex Daley and Doug Hornig.

 

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Wed, 09/19/2012 - 13:39 | 2811857 Jena
Jena's picture

 

There is a limited amount that any medical system can do for a populace that thinks it can eat whatever crap it wants without incorporating any form of exercise other than shoving more crap into its gaping maw.  The thought process for many of these stupid, stupid people is, and long has been "Here I am, now fix me!".  That they are complicit in their state of ill health is nothing they want to consider, let alone hear about from their doctors -- who don't do much more than pass out prescriptions to deal with the effects of the American lifestyle:  Statins, antihypertensives, drugs for diabetes (mostly Type II), antidepressants, antianxiety agents, various drugs for gastroesophaphageal reflux disease (again, so they don't have to deal with the fact that they ought to lose weight) and more.  Americans are overweight, obese, morbidly obese and dying from all the consequences of being obese.  

It's remarkable that the U.S. life expectancy is still 78.49, given how fat we are getting.  Once the process of diabetes is started -- and it is pretty much inevitable once a body reaches a certain point of obesity, the concomminant issues of cardiovascular and peripheral vascular disease via inflammation.  Living with chest pain, shortness of breath, neuropathy in the form of pain, tingling and numbness in your feet before they turn cold and start to die off bit by bit (or toe by toe) is no way to go through life.  Or the problems of dying kidneys, because the blood vessels become so scarred from inflammation that they no longer are able to function.  Being hooked up to a dialysis machine must be a miserable way to while away the days... for those are conscious, I guess.

And that doesn't even address the vulnerabillity of diabetics to infection, but given the above I would imagine that anyone could surmise a few of the ways in which they are at a higher risk than a healthy person.  

This is why the last five years of life get so expensive:  Managing the wildly expensive cardiac, vascular and end-stage renal effects of diabetes.  If they are smokers (and so many are), add in pulmonary complications.  (Should they have coronary bypasses, as an earlier post mentioned?  I think if they received truly informed consent which depicted what hell they'd be in post-op and realistic odds of the eventual outcome, I don't think many would choose the surgery.  But that's not the paradigm under which the health industry operates.  Or what I suspect the average patient wants to hear.)

Yes.  The great American consumer.

 

Mon, 12/10/2012 - 06:54 | 3048153 aaliyah
aaliyah's picture

Human growth hormone (HGH) is a natural substance, which is released by the body's pituitary glands Growth Hormone

Wed, 09/19/2012 - 11:19 | 2811228 johnjkiii
johnjkiii's picture

Here's the Bullshit factor: "the US ranks somewhere between 38th and 51st place. On the latter list, US life expectancy of 78.49 years is almost 11 years lower than Monaco’s."

When comparing life expectancy it pays to have every country count the same way. We count abortions and any baby that "has a sign of life; whereas other countries do not. Some - the French for example - only count births after two weeks of life. This is where the quoted phrase becomes meaningless.

We spend too much on medical expenses because the combination of government nannyism and the insurance companies that have figured out how to profit from it, make it happen. This along with a business model that has the average hospital at less than 60% occupancy and absolutely no requirement that prices be published, drive prices through the roof. Hospitals are allowed - and do - amortize all of their costs on a per patient basis. They know their costs and maintain facilities rarely used so thay can "compete" with the neighboring hospital. If the total cost of a days stay is $500 per patient at 100% capacity; at 60% it is $833. Because of system rigging by the insurance Cos., they get to negotiate the rate so it becomes a complicated algorithm to figure out the charges to actually make but my local hospital bills over $3 Billion per year to collect approximately $800 million - which is + or minus break even. State Regs under the McCarran–Ferguson Act prevents insurance competition and further complicates price discovery. Obammy Care will succeed - in driving insurance rates thru the roof. Wait for it.

Wed, 09/19/2012 - 10:23 | 2810902 JohnKozac
JohnKozac's picture

I have no gripe with doctors and can negotiate with them but hospitals are the evil ones---overcharging,arrogant, etc.

Docs have put in tons of time from what I can see---4 years college, 4 med school, internship, residency then the problems of going into private practice.

Unlike paper-pushers, doctors are probably one of the remaining productive groups in America.

Wed, 09/19/2012 - 10:17 | 2810881 Graph
Graph's picture

Entire US system is crooked, so why expect medical profession to be different and under some scrutiny and control?

"Troubled youth", turned actor, plays a doctor in his role, lives extremely lavish real life. Real doctors may have noticed that.

Wed, 09/19/2012 - 10:02 | 2810800 JamesB
JamesB's picture

One note to your article - Obamacare killed medical savings accounts.  Whether or not high deductible plans will be allowed under Obamacare remains a question being pondered by the regulators. 

The whole point of Obamacare was to kill any incentives in the system caused by customers thinking about their bills.

Wed, 09/19/2012 - 10:21 | 2810790 Mercury
Mercury's picture

Much of the overuse of unnecessary procedures/therapies is probably attributable to the lawyer-driven shift away from a more paternalistic medical culture (say, pre-1980s) to the “consumer” driven one we have today.

 

In the old days you pretty much did what the doctor recommended but increasingly decisions were put in patients’ hands to avoid lawsuits after the fact over whether this or that procedure/drug/therapy could have delivered a more favorable outcome.

 

Many female infertility treatments and pre-natal tests for instance are expensive as hell and many, depending on the exact circumstances in question have only a marginal chance doing any “good”. Further, many of these things are quite invasive and generate significant health risks on their own. At one point the educated professional (the doctor) would weigh the trade-offs involved and make the call on what was the best risk to take.  Now, it’s more or less whatever the patient wants to do and the bill is covered by a third party.

 

What's going to happen next is that decision making authority is going to shift not back to doctors but to centralized, government entities. High-deductible plans are great because they encourage more rational decision making and discourage waste but the government's goal here is to create a very comprehensive entitlement which means they're going to have to ration care and they aren't going to let health care consumers  (and thus the price mechanism) make those yes/no decisions beyond a narrow range.

Wed, 09/19/2012 - 09:31 | 2810653 dolph9
dolph9's picture

I'm a physician who sees the writing on the wall for healthcare.  I'm dropping out and will mostly be doing locum tenens (temp.) work while I sit on my metals investments.

When it comes to healthcare, people just don't know the half of it.  It's like the financial world...you can only understand what's going on after reading zerohedge for years.

If there was a blog exposing the healthcare racket that you could read for years on end, you might begin to understand.  But to the best of my knowledge, such information just isn't widely available, and if it is, nobody would read it, because everybody is convinced modern medicine will cure them of all of their ills while costing nothing to do so.

Sat, 09/22/2012 - 01:50 | 2819892 BigDuke6
BigDuke6's picture

Hope you get this dolph but i'm an australian MD and am interested in talking about how the system in the USA can really begin to work.

No one wants something unsustainable which the usa system seems

i came to australia from a different system and the aussie system is the best

the patients are content in the public and private set up where basically if you have a job you are pushed into having insurance.  the governement has strict regulations over the insurer and there is competition.

anyone can join (no refusals) and there is a 12 month wait and your period is over - no restrictions.

i tell people to join up - wait the year and then have your operation with or without expensive implants in the private hospital.

doctors are happy - you still get the dollars but you have to work hard for them.

the patient sees a doctor working fucking hard so has a lot of respect, that endears the system to the public.

as a doctor your skills are high so you feel fulfilled and like i say the dollars are good.

the system struggles here when doctors dont want to work less.... but i think USA dr's work very hard, right?

 

Wed, 09/19/2012 - 13:17 | 2811762 RockyRacoon
RockyRacoon's picture

I agree with cifo above, but can understand why you wouldn't want to.  Dealing with all the trolling comments and folks who just want to harass would take some of the shine off the endeavor.  Good luck anyhow.

Wed, 09/19/2012 - 09:56 | 2810758 cifo
cifo's picture

"If there was a blog exposing the healthcare racket that you could read for years on end, you might begin to understand.  But to the best of my knowledge, such information just isn't widely available, and if it is, nobody would read it, because everybody is convinced modern medicine will cure them of all of their ills while costing nothing to do so."

You should start one, seriously.


Wed, 09/19/2012 - 09:26 | 2810628 Shizzmoney
Shizzmoney's picture

I work for a living, and my company(run by cheap Jews), uses a 3rd party health care provider.

I pay a high cost for individual insurance here in MA.  I have to go to the ER to take care of an infected wound.  I get billed $1700, and after haggling the insurer for claims, they cover $150 of the cost (lol).

Yet there's this guy in MA who kills his wife, and get not only his sex transplant comped by the taxpayers, but also his legal fees.

I clearly need to kill someone to get the quality and good price I need for healthcare.

This is the type of shit that starts riots.  I can't wait til someone "John Q's" some dickhead Hospital Administator someday.  It's going to be full of anarchist LOL.

Wed, 09/19/2012 - 09:23 | 2810611 americanspirit
americanspirit's picture

For many years neither my wife nor I had health insurance - we have always been self-employed and any insurance worth having was just too expensive. But we discovered long ago that you can almost always negotiate a substantial discount for medical services if you pay cash. As an example, my wife had to have knee replacement surgery. We negotiated with both the surgeon and the hospital and wound up paying @ 25% of what they would have billed our insurance - if we had had any. I know this because when they sent us the receipts the "full amount" and the 'discounted total" were both shown. If we had insurance the total would have been close to $50k - we paid just under $13k. And incidentally, you know that neither the hospital nor the doc were losing money on the deal - just goes to show you what "insurance" has done to the cost of health care in the US.

Wed, 09/19/2012 - 10:17 | 2810886 myptofvu
myptofvu's picture

I needed to get some xrays every year and always paid cash. Saved me about 8 bucks. The problem was they ALWAYS lost the record of payment and would turn it over to a collection agency. Without fail no matter what I would do at the time of payment to ensure that it was logged they would lose it, year after year. I would have to call them screaming my head off and they would have to go and restore my credit rating every single year. It was much more of a hassle for them then me but they never learned.

Wed, 09/19/2012 - 08:13 | 2810346 marathonman
marathonman's picture

The most common procedure prescribed by doctors is the walletectomy.

Wed, 09/19/2012 - 04:08 | 2810073 disabledvet
disabledvet's picture

Sorry WSJ but "we're not gonna make it." Cutting the massive health entitlement complex...and it is well underway btw...will not be good enough to save the State. there has to be TRILLIONS in savings...not a couple of billion. hence "don't even bother reading the Wall Street Journal either." living in la-la land just like the rest of 'em.

Wed, 09/19/2012 - 00:16 | 2809828 besnook
besnook's picture

isn't it amazig what happens when all the factors of price discovery are allowed to do what they do.

Wed, 09/19/2012 - 09:30 | 2810647 Paul E. Math
Paul E. Math's picture

Now if only we can do something similar with college tuition.

Tuitions are visible but deferred by government loans so that the consumer isn't forced to take cost into account when selecting a college.  Government-backed mortgages have the same effect on home prices.

If we could keep the costs down on these 3 key items (1.health care; 2. education; 3. housing) we would actually see a rising standard of living.

P

Tue, 09/18/2012 - 23:48 | 2809775 barroter
barroter's picture

A while back, I had a echocardiogram done.  The cardiologist wasn't finished with me yet. When I mentioned I had no insurance to cover a stress test they wanted done, the incessant phone calls, originated by them, to set up an appointment, stopped.

Gee, I wonder why?

Wed, 09/19/2012 - 02:50 | 2809990 HungrySeagull
HungrySeagull's picture

I had one take a look at my chart and said, I ain't gonna cut you up to fix something that comes and goes. Not yet. See me in two year.

 

I know a vet who recieved a Stent for a very similar issue. He says to me "Have the doc throw it in there..."

 

There is a 30,000 dollar charge for the Stent I believe plus the surgery to put it in.

 

Nah. I'll wait.

Tue, 09/18/2012 - 23:33 | 2809732 Stuck on Zero
Stuck on Zero's picture

In Southern California the absolute best medical care is provided free of charge to the poor and illegal immigrants.  These hospitals have the latest equipment, best machines, finest facilities, and sharpest staff.  They are often teaching hospitals, too.  All paid for by the gummint.  For the rest of us, who are laying out $25K a year for a health plan, the facilities are at best mediocre and have the oldest equipment.  I've worked many years in medical device research and I know about these places. 

 

Wed, 09/19/2012 - 08:57 | 2810512 WeAreJellyfish
WeAreJellyfish's picture

Back closer to 9/11 a buddy got really sick. He never could keep a job and liked it that way.

They found a lung infection that was spreading yet could not identify what kind of infection or it's origination (I believe it was from his mouth/teeth based what I seen and known). The CDC was there and used experimental antibiotics according to doctors - 9/11 was still playing green to red safety tabs on the TV.

All in all he was in the hospital for a month. They removed 20% of his lungs (guy still smokes - ugh) and he had to learn to walk again after the hospital never kept his extremities alive as they thought he was a goner. The admitting doctor came in when things looked to see a miracle (my opinion) when he was conscious. Yea they had him in a induced coma to treat this unknown infection.

Total cost he will never pay a dime for:
$5,000,000

How is your insurance company treating you?

Wed, 09/19/2012 - 09:59 | 2810785 cifo
cifo's picture

$5M is not bad for a month worth of work :)

Wed, 09/19/2012 - 01:35 | 2809937 AnAnonymous
AnAnonymous's picture

In Southern California the absolute best medical care is provided free of charge to the poor and illegal immigrants. These hospitals have the latest equipment, best machines, finest facilities, and sharpest staff. They are often teaching hospitals, too.

__________________________________________

So they are training ground for 'american' medical students so they capitalize on their educational investment.

Top equipment, guinea pigs who can not protest when used as material for unproven personal to get some experience etc...

What a nice place. Even a nicer place than the places where all those future physicians are going to make enough money to pay back on their student loans...

Tue, 09/18/2012 - 23:08 | 2809654 tony bonn
tony bonn's picture

i am sure that some, but not all, of the discrepancy between american health care costs and those of foreign countries is the enlarged, bovine, ginormous waist lines of americans cultivated from the most unhealthy nutrient-deprived diet in the world. sugar is toxic and should be avoided like a rat infested sewer.

it is not hyperbole to state that american health care is barbaric and ignorant. you give a surgeon a patient and he decides he needs a scalpel to "help" his patient.....and many doctors are pawns of the gigantic pharmaceuticals who never saw a drug they didn't like....

there is so so so much health care which can be administered through vitamins, enzymes, and probiotics that many doctors should be sued out of business.....iatrogenic disease, and unsanitary hospitals are epidemic....in fact they are the number 1 cause for hospital deaths....most of which are entirely avoidable....it is a miracle for anyone to survive a hospital stay.....

insurance was created not to benefit people, but to enrich insurance companies, pharmaceuticals, the rockefeller axis of evil, and wall street.

Wed, 09/19/2012 - 10:01 | 2810792 TrulyStupid
TrulyStupid's picture

I have a doctor acquaintance, while quite qualified, prescribes himself statins (anti-cholestorol pills) in order to fight the cholesterol buildup from his sweet tooth. Statins, like most pharmacuticals, can have nasty side effects like liver disease yet his faith in the system allows him to take these drugs without having the symptoms of high bad cholesterol.

Prescription drugs are now marketed directly to the end user with instructions to "ask your doctor if XXX is right for you".  The doctor who is being wooed on the supply side by the Pharmas, no doubt obliges with a doctor's prescription. Chemicals like Aspartame, an insecticide, is  added to food as a "sweetener", and approved by the FDA after a little arm twisting by the manufacturer.

These represent a miniscule number of the consequences of ethical lapses by industry, government, doctors unions and the patients themselves. The only way this can be turned around is to cancel your health insurance, become your own HMO, pay more attention to your own health and shop for the most cost effective heroic care... go to India, Thailand or Mexico for radical procedures (its OK.. their hospitals are modern and well staffed). Smoke pot for stress and alleviation of pain.

Tue, 09/18/2012 - 22:48 | 2809624 Encroaching Darkness
Encroaching Darkness's picture

Yep. It's amazing ....

 In my case, graduate students get twelve semesters of support (four years if you stretch it) for a program that normally takes 6 - 7 to finish. Your health insurance is tied to your "tuition waiver", so that when you lose that waiver, you also lose your medical insurance. I haven't enough background to know if this is typical; my conditions are so minor I've gone without health insurance for the last two years. I exercise five days / week, take my vitamins, get my rest, have been losing weight (deliberately). I'm about 25 pounds lighter than I was three years ago, my blood pressure is down (on a generic maintenance med) and I walk about a mile (round trip) to my lab and back home every day.

You don't have to have it; but if I'm hit by a truck, I'll probably have no assets left once the sickcare system gets through with me. Makes me extra careful going about my business.

Anyone else lose health insurance during graduate school? Is this a bug or a feature of the graduate school system nationally?

Tue, 09/18/2012 - 22:46 | 2809619 dirtbagger
dirtbagger's picture

The notion that insurance companies have any incentive to control health care costs is absurd.  Insurance is a cost plus business.  Besides the interest earned on premium float their operating profit is derived as a percentage of total premiums charged  - say around 15%.

What is more profitable - 15% on 1 billion in premiums or 15% on 2 billion in premiums?  The faster health costs escalate the more the insurers earn.   Since the insurers do not provide any real life health services like doctors, nurses, labs, and hospitals, they are essentially a bookie working the spread and holding the bets.   What bookie get 15% margins?  We live in an ass-backward world.

Tue, 09/18/2012 - 22:41 | 2809605 baldski
baldski's picture

I put a lot of blame on doctors for this MRI & CT scan racket!

My wife had a kidney stone smashed by a lithotripsy machine.  We received three bills - one from the urologist, another for the facility where the stone smashing was done, and another for the use of the machine plus an anethesiologist expense. 

After diligent digging into the Nevada Secretary of State's web site, I found that the urology group owned everything! The building, the machine, etc. They had layers of corporations in Nevada hiding this fact! They are a lot of the healthcare problem in America.

If a doctor owns an MRI machine, do you think its usage will increase with his patients?

They are just as bad as Wall Street in their greed!

 

Tue, 09/18/2012 - 23:19 | 2809589 californiagirl
californiagirl's picture

Well, with fluoride (and Draino to counteract the corrosive effects of fluoride on the pipes) in the water leaching calcium out of bones and teeth making them hard and brittle, with chlorine/fluoride, among other things, destroying thyroid function and the immune system, with RoundUp, Bt and soon-to-be Agent Orange (2,4-D) as byproducts in almost all processed foods and corn, soy, canola, pharmaceuticals and vitamin/mineral supplements (that are supposed to make you healthy) thanks to the GMO industry and the fox (ex Monsanto executive) running the henhouse, and with just about every prescribed synthetic drug being designed with a huge list of side effects for which there are more drugs with side effects, the pharmacuetical industry has nothing to worry about.  And these are just the tip of the iceberg.

Tue, 09/18/2012 - 22:36 | 2809588 elementary
elementary's picture

The rapid escallation in medical costs really began with the introduction of HMO's. No one got a bill to see what costs really were, and everything was free. People would go to a doctor with sniffles because it was free.  And the HMO groups encouraged people to see their doctors often, so that their monthly quota of office visits was met.  If you don't get a bill and you have unlimited access to a doctor, the system becomes corrupt. The few times I have gone to a doctor's office, I am amazed by how many people are there to see a doctor for the common cold.  Geez, go to bed, get some rest, and eat chicken soup! 

Wed, 09/19/2012 - 04:06 | 2810072 OpenThePodBayDoorHAL
OpenThePodBayDoorHAL's picture

I live in Australia and the health care system is a dream. Relatively cheap, top quality, available to all. What's the secret? It's called Single Payer. Instead of five girls in the back room with files to the ceiling, figuring out the thousands of co-pays and reimbursement levels and plans and payment details, each doctor has one girl who manages it all.

I went to the doc the other day, put the treatment on my credit card ($85 bucks for a few suspect moles to be removed), and in less than three days the reimbursement was in my account.

But no, Obama took Single Payer off the table at the start of his health care initiative. Wouldn't want any insurance company CEOs having to sell their fourth vacation homes or anything...

It's not the total solution but it saves at least 25-30% IMO.

Wed, 09/19/2012 - 10:11 | 2810853 Metalredneck
Metalredneck's picture

I'm pretty happy here in Kanuckistan. I had an Insulinoma that almost killed me.  The hospital bill did not kill me either.

Wed, 09/19/2012 - 09:17 | 2810588 riphowardkatz
riphowardkatz's picture

Australia is not America. Thanks for sharing how awesome your health care is today. Check in with us in 5 years when China collapses and so do you.

Tue, 09/18/2012 - 22:09 | 2809496 lynnybee
lynnybee's picture

yup.   i'm haven't played the doctor game now for over 15 years & feel fabulous !   i avoid doctors like the plague & am healthier & richer for it.   it's a racket.   

Tue, 09/18/2012 - 22:02 | 2809473 steve from virginia
steve from virginia's picture

 

Eventually everyone will get their way and the government will get out of healthcare which means if you are injured in a car wreck forget about 911, call a taxi to take you to ...

 

... some sawbones with his office in the back room of a bar, a bloody apron and shaky hands.

 

Just like now but without the high fees.

 

'Healthcare' in the US is a racket a close cousin to a Ponzi scheme. 

Tue, 09/18/2012 - 22:00 | 2809463 Colonel Klink
Colonel Klink's picture

The healthcare system is sick and there ain't a fucking honest doctor in the house.

Instead they use financial quackery to cost shift and inflate prices.

Tue, 09/18/2012 - 21:51 | 2809435 impermanence
impermanence's picture

Pay doctors for their time instead of testing, and testing plummets.  Get the corporations out of health care and the costs will plummet. 

Then, eventually, get the government out, and the market will take care it.

Tue, 09/18/2012 - 23:38 | 2809746 LMAOLORI
LMAOLORI's picture

 

Your post is the winner have you read this story

Stung by a Scorpion, Then by a Hospital. This Could Happen to You

snip

An Arizona woman was stung by a scoprion. She went to the hospital. It gave her two shots. Then it charged her $39,652.

Per shot.

In Mexico, the same shot costs $100.

Then it charged her extra fees for the visit. Total bill: over $83,000.

Conclusion: government-regulated health care is not working for patients. It is working great for hospitals.

Tue, 09/18/2012 - 21:38 | 2809380 philipat
philipat's picture

Nowhere in the world has the "Fee for service" model in Healthcare been able to control costs. This mainly because the consumer operates along the lines of "The Doctor knows best" and is not infomed enough to be able to shop around and compare.

Incidentally, "Doctor DOES know best", which is why around 18% of the top 1% income earners are physicians!!

Tue, 09/18/2012 - 21:25 | 2809335 Cursive
Cursive's picture

You should see the insurance rates for OBGYN's.  High rates to combat ambulance chasers.  But if the problem were just trial attorneys, we would have fixed it a long time ago.  One of our local hospitals sold a majority stake HCA over a decade ago; 49% of the hospital is still owned by a surviving Foundation of the original owners.  The proceeds of the 51% sale were the seed money of the Foundation and its net assets now sit at well over $200M.  Through conservative investments in Treasuries, the Foundation makes roughly $8M per year and spends less than half of that.  Just think of all of the hospital bills that could be paid with this largess?  However, there is no concern for lowering pricing to increase access to healthcare.  The Foundation is happy with its money.  Hospitals and non-profits are funny little islands where a small group of doctors/directors spend massive amounts of money (financed by the local bankers) to build one grand project after another.  There is never any concern about cost because sickness is the most recession proof business around and ego is the greatest narcotic among the powerful.

Tue, 09/18/2012 - 21:07 | 2809269 jayman21
jayman21's picture

Why are the prices high?  GE still has to pay Jack's pension.

Wed, 09/19/2012 - 04:11 | 2810077 DosZap
DosZap's picture

GE still has to pay Jack's pension.

GE can afford to pay Jacks pension..................

Wed, 09/19/2012 - 08:18 | 2810364 marathonman
marathonman's picture

GE is paying Jacks pension with TARP bailout money.

Tue, 09/18/2012 - 20:59 | 2809233 max2205
max2205's picture

Groupon the entire system. Way overpriced. Starve this beast

Tue, 09/18/2012 - 23:18 | 2809691 Unbezahlbar
Unbezahlbar's picture

When I was a child my doctor treated everything I had with "a shoot."

Now every time I see the doctor ---for anything, even a cough---he says he needs an MRI or CAT Scan.  I guess it's just coincidence that he owns the machines?

Wed, 09/19/2012 - 00:49 | 2809898 bunnyswanson
bunnyswanson's picture

When you tell your doctor you have a cough, he has to follow a procedure that rules out malignancy, a punctured lung, pneumonia, bronchitis.

If he does not do this, and you return in 6 months with bloody sputum, you have every right to sue him for negligence.

He also has to say "follow up in 6 months" in his report until it is determiend "benign and stable."

I've worked in this field for 30 years and have come across a few swindlers (Pakistani doctor in neurology who turned out to be working with 2 attorneys in workers compensation and minor car accident soft tissue "injuries".  He lost his license to practice.

 

I had cancer myself several years ago and ended up in Santa Barbara's Sansum Clinic as it is close by.  My oncologist wanted me to take chemo.  In fact, I received 3 different opinions and they all wanted me to do chemo.  I then found out that oncologists buy chemotherapy meds from pharmaceutical companies and then sell them out of their office at a marked up price.

In the end, I refused chemo in the end and of course lived to tell about it.  I refi'ed my home and sent all my laboratory studies and slides to John Hopkins for 2nd opinion, had a gene profile run on my tumor cells at a lab in San Fran.  In the end, I spent about 180,000 for a small nonaggressive tumor (65,000 for radiation therapy with was mammosite - like seeding prostate but somewhat different.  

I of course was run ragged in the medical care system.  But, thanks to information on the internet at web site forums, and the ability to have your slides read by others (always get 2nd opinion with cancer) for nominal fee (65.00 at John Hopkins) I was able to take charge of my medical care and not put my body through chemo which is quite toxic to heart among other things.  So I have run into some crooks

(The Oncotype DX test determines how specific genes are expressed (that is, their level of activity) within a tumor sample. The measurement of these genes is calculated to yield an individualized result called a breast cancer Recurrence Score®.

Wed, 09/19/2012 - 09:32 | 2810656 CheapBastard
CheapBastard's picture

Very good info bunny. Thanks.

Tue, 09/18/2012 - 21:31 | 2809358 Cursive
Cursive's picture

@max2205

It's hard to starve regulated monopolies.  Every ER x-ray has to be diagnosed by a doctor.  I have an IT friend who set up a FTTH connection for a local radiologist so that he could remotely "diagnose" ER patients at surrounding rural clinics that do not have a radiologist on staff.  This radiologist may get a notification/email in the middle of the night so that he can "diagnose" the x-ray.  He earns $2500 per remote diagnosis.  The last figure I had (before he began the remote business), he was making in excess of $700k.  He's radiologist for goodness sake.  It's not like he's fixing hips or doing spinal surgery.

Tue, 09/18/2012 - 22:08 | 2809494 bunnyswanson
bunnyswanson's picture

Radiologists do make a lot but they are diagnostic and without an x-ray, who knows what is going on.  Remote radiology reading is very common.  Nighthawk Radiology is the most common team I have heard of along with Alta Vista Radiology and they cover the midnight shift for radiologists in most hospitals.  Where radiologists make their money is having the hospital in their local town covered and then separately creating an outpatient radiology clinic under a corporatoin they form.

A patient coming into the ER with "abdominal pain" could be suffering from a number of things - an aneurysm, gallstone, bowel obstruction or perforation.  You must find out exactly what it is initially so the patient does not die in the ER from the consequences of delayed treatment.  MVA patients get the full head to toe diagnostic studies to rule out arterial injuries and fractures or contusions to solid organs among other things.  Time is of the essence in certain cases.

90 year old and above patients who are given joint replacements, bypass grafts, care just like a 70 year old would is really what I believe needs to be addressed.  They may get a 100,000 procedure only to die of a stroke, cardiac arrest or cancer less than a year later. 

Radiologists and surgeons do deserve the money they earn in my view.

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