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One Reason Why Sickcare Is Outrageously Expensive: Needless Scans/Tests
Submitted by Charles Hugh-Smith of OfTwoMinds blog,
Add easy profits from needless tests to defensive medicine and no cost controls or real competition, and we have the perfect formula for waste, fraud, profiteering, bad medicine and dysfunctional, unaffordable healthcare.
Why is sickcare (a.k.a. "healthcare") absurdly unaffordable in America? There are many structural reasons which I have covered in depth for years, but one that most of us can relate to from personal experience is needless, hyper-costly scans and tests.
Even those of us who have never had a CT or MRI scan (and I hope I never will) know the drill from friends and family: practically every injury is now scanned by one device or another at enormous expense--not for treatment, as M.D. Ishabaka explains, but as defensive medicine to ward off future lawsuits or in response to patient demands.
Ishabaka (M.D.) walks us through the maze of CT and MRI by using his own injuries and treatments as examples of how our system has become unaffordable and ineffective.
"When I first got into the hospital as a medical student in 1977, MRI scanners did not exist, and the Royal Victoria Hospital in Montreal had the first CT scanner in Canada. A scan took an hour, and the images were blurry as heck, compared to modern scanners which take a few minutes and produce crystal clear images - but it was MAGNIFICENT. All of a sudden, we could see brain problems that could only be seen by operating, or doing a cerebral angiogram - a good but somewhat dangerous test (up to 3% of patients who have one suffer a stroke caused by the test).When used appropriately, CT scans save lots of money and lives. One example is head trauma. Most people who are knocked out just have a concussion, but a few have bleeding either around or inside the brain that will kill or permanently disable them unless they are operated on ASAP.In the old days, just when I was starting practice, most hospitals did not have a CT scanner. People who had been seriously knocked out were ALL admitted to the hospital for "neurological observation" - a nurse would check on them every hour to see how alert they were.Two problems with that: for most patients it was a total waste of time and money (and hospitalization is way more expensive than a CT scan), and for some with a bleed - it wasn't detected until too late.Now, when someone gets knocked out, you do a CT scan, and within 30 minutes know whether it's safe to send them home, or you need to call a neurosurgeon to operate on them - as an emergency physician working in a trauma center from 1985 - 1990 this was a REALLY GOOD THING.Then MRI scanners came along. They show some things really well that a CT scanner doesn't and vice versa. For example, an MRI scanner is unparalleled for showing a brain tumor. A CT is much better for showing bleeding inside the skull. An MRI scan will also show torn cartilage and ligaments in a joint with almost crystal clarity - a problem for which CT scanning is almost useless.So - used appropriately, CT and MRI scans are two of the greatest inventions in my medical career.But they are hellaciously expensive due to the fact that the machines are so expensive, and like computers, become obsolete within about 5 years - you have to pay of the multi-million dollar cost of the machine and make a reasonable profit within about 5 years.Let me tell you from personal experience how they get overused: In 2004 I tore a cartilage (posterior third of the media meniscus if you need to know) in my right knee. I KNEW I tore a cartilage - I had the right kind of injury, the right symptoms, and the right findings on exam. I called up an orthopedic surgeon friend of mine and asked "Do you want to operate on my knee?" Somewhat dryly he said "Well, I think I should examine you first!".So I went to see him. He did a regular X-ray - only $60 - pretty reasonable, and my exam showed ALL the classic findings of a torn meniscus. I told him I was ready for surgery (I couldn't run or do the martial arts classes I was taking at the time) - but he insisted on an MRI - I suspect because he was nervous about malpractice operating on a doctor in case the surgery was unnecessary - a risk I was willing to take - I would have signed papers releasing him from all liability.Guess what - the $1,700 MRI showed a torn cartilage, I had surgery, and my knee is 99% as good as before I tore the cartilage - so basically the $1,700 (which was about half my total operation cost) was health care money down the toilet.This is important: in the pre-MRI days, I would have been operated on based on my history, exam findings, and X-ray.Now, my back and my neck - I have had recurring problems with both. The back issue came from lifting a heavy table the wrong way. It flares up every 8 - 9 years, I rest it, use a heating pad, take some ibuprofen or naproxen and cyclobenzaprine - and it gets all better.In 1993, I tore something in my neck - I was lifting weights with my neck with a head harness. I was going up in weight and got to 37.5 pounds. As I extended my neck, I heard and felt a tearing sound. Idiot that I am, instead of dropping the weight, I finished the rep and REALLY heard and felt something tear. I had God-awful pain - for about a week, if I had to roll over in bed, I had to hold my head with my hands so my neck didn't bear the weight - but I got better.Once or twice a year it flares up, I have trouble swiveling my neck to back up my car. A chiropractor friend of mine gives me a free adjustment and it's all better within 24 hours.Now - here's the deal - I don't NEED an MRI of my neck or back. I'm SURE I have torn discs and/or ligaments - but I ALWAYS get better with very inexpensive meds, and a heating pad, plus chiropractic adjustment. BUT - every patient with spinal pain wants an MRI these days. ALL of them.The fact is - it doesn't matter a hill of beans if an MRI shows torn disc/ligaments UNLESS surgery is being contemplated. The indications for surgery are VERY CLEAR - they are loss of sensation or strength in a limb, loss of bowel or bladder control in the case of a very low back injury, or what is called "parasthesias" - burning, tingling, shock-like feelings, etc in a limb.The most serious of these is weakness - if a person has injured their spine, and are weak in a limb, they almost all need surgery or they will be permanently paralyzed/disabled. In these instances, and MRI is marvelous - it will show the surgeon perfectly where the problem is, so he/she knows exactly where to operate and what needs to be done.But for the gazillion and three patients who have pain only, and demand an MRI (and if I refuse one, they WILL find a doc to order one) it is complete and utter mal-investment of health care dollars. I have a friend who is REALLY in shape - a serious surfer and weight lifter. He injured his neck in a surfing wipe-out in his early 30's and his right triceps became weak. He asked me what to do and I told him to get an MRI and see a neurosurgeon.Well, he didn't want to, so he tried all kinds of useless remedies - he kept coming to see me (as a friend, not as his doctor) - and I could see his weight-lifter's triceps shrinking away to nothing. Finally I got him to see a neurosurgeon friend of mine, an MRI was done showing a ruptured disc pressing on (and slowly killing) the nerve that activated his right triceps - he was operated on - and ALL his strength came back.So - bottom line - in appropriate circumstances, CT and MRI scans save lives and limbs - they are wonderful tools. However, my rough estimate is that probably around 90% of MRI scans and 80% of CT scans done in the USA now are a complete waste of time and money.The real point about scans - and so many tests - is you treat the PATIENT - not the scan, or the test. Tests are just an aid in determining what is the best treatment for the PATIENT.The corollary to this - and what it is SO HARD to convey to many patients - is that if the results of a test will not change the treatment - there is no reason to do the test. A classic ER example is an injured small toe (the big toe is different). It DOESN'T MATTER if the toe is broken or just sprained - the treatment is the same - taping, ice and elevation for 24 hours, rest, and mild pain medication. Try telling an injured patient that you are not going to order an X-ray of their toe - they will complain to the hospital administrator, and you will be lucky if you are not fired."
Thank you, Ishabaka, for the detailed explanation. I should also add that scans costing thousands of dollars each in the U.S. are available in other countries with the exact same machines for a fraction of the cost in the U.S.
As I noted in Sickcare Will Bankrupt the Nation--And Soon (March 21, 2011), Pittsburgh has as many MRI machines as the entire nation of Canada.
Why is this so? Studies have found that a doctor who owns his own machine is four times as likely to order a scan as a doctor who doesn't. Garsh, I wonder why.
Add easy profits from needless tests to defensive medicine and no cost controls or real competition, and we have the perfect formula for waste, fraud, profiteering, bad medicine and dysfunctional, unaffordable healthcare.
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free obamacare for immigrants
Obama care-------> You pay rent or health care
Healthcare is so costly because so much money goes to the middleman...health insurance companies...because they bribe the our government officials with campaign contributions to make it so.
Health insurance companies do not provide any healthcare. Zero. Zip. Nada. None.
Obamacare guarantees profits for health insurance companies like UNH and eliminates competition, just like the Federal Reserve Act did for big banks.
Just look at the score board...
Thank you Obozocare. Couldn't do it without your corrupt assistance...
Revenue: $36.12B
Gross Profit: $28.21B
http://finance.yahoo.com/q/ks?s=HCA
Listen.
Paging Dr Goldstein, paging Dr. Goldstein.
http://www.zerohedge.com/news/2014-09-04/you-have-health-insurance-you-c...
How do health insurance companies like Humana make money? They don't provide healthcare! Very simply, they charge patients premiums, and pay healthcare providers fees. They are intermediaries,
middlemen. When they charge higher premiums, and pay providers less,
or nothing (via high deductibles and high coinsurance), then they are
more profitable. They take this profit and invest it.
Why have United Healthcare, Humana, and the healthcare insurance companies done so well since Obamacare?
investment returns? Maybe, but not enough to justify their stock's
return vs the broader market.
How? Just as cereal manufacturers decrease their costs by
putting less cereal in the same box but still charge you the same price,
health insurers have raised the deductible amounts and co-insurance
amounts, but not lowered premiums.
Listen Horseman,
Paging Dr Goldstein.
United, the too big to fail health insurer, just go to my blog, 7 years worth of deception from them search it and fall off your chair. It was either Humana or United that created the risk fiddler algorithm that billed CMS for "said fraud" of $70 billion and now CMS can't get it back or they will cut servcies to the seniors, such a nice spot to be when you want to create algorithmic crime and ride it until you get caught, lasted 5 years before CMS caught it.
http://ducknetweb.blogspot.com/2014/09/seniors-facing-some-sharp-medicare.html
http://ducknetweb.blogspot.com/2014/08/cms-discovers-that-insurers-offering.html
Goddamn!!!
No. Sick care is so costly, simply because of monoply protections granted to the sick care industry, by the government.
Ask any ER MD if they need all the tests they get, and they will tell you absolutely not, BUT if they don't get the tests, it's outside the "standard of care" meaning they'll get sued. Defensive medicine has BECOME the standard of care replacing sound judgement and reasoning.
That's simply false. If they do not run the unnecessary tests, then they will not get paid for running the tests and/or their employer will bitch at them for not running the tests. Defensive medicine is a really diplomatic way of saying insurance fraud. Essentially, because the vast majority of medical professionals are under the impression that they should practice "defensive medicine," the practice becomes sanctioned. It's no different for the malpractice insurance companies, who convince the doctors that they'll lose their entire net worth to a single lawsuit at any given moment just because. Thus, one hand is washing the other...
Ask yourself whether monies paid out in lawsuits has risen in lockstep with medical costs... hell, ask yourself whether the monies paid out in lawsuits has matched medical malpractice insurance premiums... the answer ought to paint a clear picture.
You have never worked in an ER.
I have. Even in ones that you did not make a profit running extra tests. Guess what? We did anyway, because in this nation anyone can sue for anything, even though 80% of malpractice lawsuits are thrown out. And loser doesn't pay.
Docs in the ER (and elsewhere) have to run gold standard tests many, many times or risk liability for relatively simple ailments. But these simple ailments have a 1 in a thousand chance of not being so simple....hence the tests.
I could give you examples, but it would be of no use.
A lot of rules are in place to prevent docs from getting kickbacks, but I am sure some get around it.
Of course this could end if we reigned in the lawyers....but you probably know who their #1 campaign benefactor is....
You have been Grubered.
You're telling me that you ran extra tests for which you (or your employer) were not paid? How are you still in business? “It is difficult to get a man to understand something, when his salary depends on his not understanding it.” - Upton Sinclair
You realize that tort reform started at the same time personal injury suits were developed, right? This has been going on, in one form or another, for millennia (yes, you read that right...). The last big push of tort reform was in the 1970s... essentially, the only thing left to do at this point is grant tort immunity (which is what doctors really want). Unfortunately, each time that has happened (some of the more notable times in american history were with the railroads in the 19th century), the benefitting parties tend to become a bit... err... more reckless. This caused many states to pass constitutional provisions prohibiting the limit of damage awards. Now, with enough greased palms, many states have passed unconstitutional limitations on damage awards... just waiting to be challenged. Some have actually been upheld, which is pretty hilarious... but if obamacare can be constitutional, then who knows what the fuck it means.
PS, there is also the issue of good intentions... medical professionals can be mislead by those who want to sell them insurance on the risks of a malpractice lawsuit. I'm sure many believe that they're actually practicing defensive medicine. The problem is getting them to articulate exactly what it is they're defending against. Generally speaking, they have dramatically overestimated the risk.
free Obamacare for ILLEGAL ALIENS. Fixed it for you.
i recently had a baby and have definately seen some unneeded tests/costs. everyone who is pregnant is supposed to take a glucose screening. this consists of drinking a sugar drink around 20some weeks and they draw blood to test. of course i failed this test by 3 points. also 2 of my friends who were pregnant both before and after me failed by a few points. failure triggers the next glucose test which is a stronger sugar drink and then a blood draw every 4 hours (fun). you have to pass 2 of the 4 draws of which i failed 3 by 2 points. this failure triggered a visit to the diatitician and a glucose monotor and test strips etc. note: during this whole ordeal i had only gained about 10 pounds total (which is not much for over half way through the pregnancy) and my baby was not measuring big (he was normal). i told my doc that it was unnecessary due to those facts and that i only failed by 2 points. of course he insisted i go through with the diaticitian and monitoring for 1 week (likely because he didn't want to worry about me suing him if i actually had gestational diabetes). just as i suspected, i didn't have gestational diabetes. all this unneeded testing came to about $600+ out of pocket for me. then after i had a normal size baby (and i only gained a total of 15lb for the entire pregnancy), the hospital billed me $1500 for the nursery. my baby NEVER was in the nursery. we were only in the hospital for 2.5 days, so i certainly didn't use that many diapers. i bitched about that charge and was told "it was a standard charge for everyone". complete racket!! overall it cost close to 25K (before insurance) to have the baby which i think is insane. out of pocket for me was around 3+K since i hit my deductable (NOT O'DIPSHIT CARE, i have insurance through my job). now think about how many babies are born everyday and how many deadbeats don't have insurance/jobs. and people wonder why it costs so much for everything. having a baby is a complete racket for the hospitals!
Our first child was born in 1986 and the bill was $2,000 all-in. Tuition for me that year at a Big 10 school was maybe $1,500. Since then higher ed and healthcare costs have both gone through the roof. Thank our friends in DC?
Pittsburgh has as many MRI machines as the entire nation of Canada.
But Pittsburgh has more wealth than the entire nation of Canada.
You can bet your life that doctors in Pittsburgh can come up with enough victims to keep the machines running.
High healthcare costs is the main reason that US unfunded liabilities are $130 trillion and rising $7 trillion a year.
Let's not forget that US with 4.3% of world's population accounts for 50% of world pharma spending
About $50 billion a year spent on statin drugs a year in USA which MIT scientist calls "poison."
Statin Drugs are Poisonhttp://www.youtube.com/watch?v=TZomZEPBdbM
Pittsburgh needs all that healthcare because of eating tubs of french fries with gravy.
Pommes Frites, w/ melted cheese, and/or with gravy is one of the 4 main food groups.
Just don't eat them but once a week.
Forsake the Kale, embrace the French Fry.
Flash-fried battered kale is VERY nice too. But it has to be fried just enough to crisp the batter, no more (so no soggy kale interior).
Same goes for many of the Brassicas - the combination of a crispy outer with very tasty inner is something to experience on a regular basis. An alternative is the egg-and-breadcrumbs approach - just as nice, and if you include a small amount of PeriPeri in the breadcrumb mix, it certainly adds a little something extra.
A very effective way of getting the offspring to "eat their greens".
It is no doubt accurate to say that CAT scans and MRi scans are way overutilized. You can partially thank malpractice lawyers and disgruntled patients who sue for that one. But this belies the fact that obamascare favors the corporate bureaucratic hospitals which charge outrageous amounts by padding their bills in collusion with insurance companies. Any care you receive at the hospital will cost you up to 10x or more than if you were to receive the care at an office based or evan an independent ambulatory care center.
E.g., a friend's wife needs a yearly MRI of her head. They had it done at the hospital and received a bill for $4500. If it were done at an independent free standing office or imaging center, the cost would be around $800 ( at least in the state where I live).
Another friend with back pain went to the hospital ER and got an MRI. The bill for the ER visit and MRI scan was $11,000. If he were to be seen in an office, the office visit would've been $150 and the MRI $500.
If your mother or grandmother or aunt were to get an osteoporosis spine fracture, and if it were treated in a hospital the bill could be as high as $25-30K. In an office, $3K.
So, in the era of obamascare where deductibles are up to $12000 and the average dedecutible (at least I'm told by my business manager) is over $6500 and will likely go higher along with premiums in 2015.
So, trying to ascribe the blame for outrageous health care to one entity greatly over simplifies the matter. So thank your hospital and insurance company lobbyists who essentially co-wrote obamascare so they can collect windfall profits at your loss. BTY, also, thank your ruling political elite turd congressmen and senators who voted and passed to exempt themselves from obamascare....
Ben Carson for President 2016
runbenrun.org
BTW, the stock prices of United Healthcare and Humana, as noted on ZH prveiously, are up 350-400%
It's the only thing I'm long on (and frankly, have been correct about).
True that. I went to my dentist for a routine check up. He said I had a “cracked molar” which if not root canalled and capped with gold would, “splinter in my jaw and created all sorts of problems.”
That was 8 years ago. Never had a problem with it and two subsequent dentists could not find that there “cracked molar.”
Yes, but he was just practicing "defensive medicine." It's the same dog and pony show... pappa needs to make an obnoxiously overpriced mcmansion payment and wants to take it from your wallet. If you don't have any skin in the game (have to pay out of pocket), then you have no incentive to care...
Only for those who are branded as the surplus population
Carson for President? You are joking right?
Please. Anytime the government subsidizes or mandates ANYTHING costs, fraud, waste, and profiteering become a problem.
Stupid fucks.
it's not problem, problem is that paid by poor people, meanwhile rich have a zero tax
Poor people do not pay for medical care in this country. If you doubt this, spend a day in our local ERs to get an education you will never forget.
Miffed
poor people is a not 0.1%, 99.9% poor.
well said
Thank you. Get .gov completely out of healthcare and prices plummet. Gov was not in healthcare until 1964. We can go back to it.
On a side note: if you go to a clinic you have to pay before they will see you, hence no charity so they can charge much less. Go to the hospital and probably a quarter of the visits are charity as well as the scans.
Family practice for about four years in small rural town ordered few scans and tests, people understood "if it is not going to change how you are treated then why do the test." Now in urban large hospital clinic and everyone gets scanned, and labbed, and prodded. Pt's demand it and Dr's are fearful.
One other thing that would make a huge difference in medicine and for small business is "Loser Pays"
One other thing that would make a huge difference in medicine and for small business is "Loser Pays"
Already been discussed ad nauseum... but we made a choice, at our inception, to allow free access to the court for redress. In other words, poor people get a day in court too.
PS, these cases are typically made on contingency... the lawyer who is going to be out tens (or hundreds) of thousands of dollars for discovery, experts, etc., tends to be a decent gatekeeper for lawsuits. Only pissant lawyers file pissant claims... and other lawyers (defense counsel) tend to treat them accordingly.
PS2, can you articulate exactly the huge difference it would make? I sincerely doubt it is quantifiable, but I'm interested in your reasoning.
i like charles's post here for one reason
health care good example of where our inflation coming from (education - student loans; autos - subprime lending; housing - all cash investors; etc) ... allowing cartels and crony capitalism to flourish in good ole Amerika
NOT federal reserve ZIRP/QE
(which i find disinflationary ... deflationary when asset bubbles burst)
The Ponzi Scam collapsed on itself before it gained any traction. Wait until they start offering a benefit rewards card to earn points on the number of trips you make to the doctor.
yeah i had a sore throat and dr wanted to feel my nuts
And for a extra 20 they milk your prostate!
If you don't know what that is you surely need to ask about it :)
So is it defensive or because patients demand it? Wasn't clear to me at all after reading this.
Zerohedge is really flaky these days. I'm talking about the website servers, not the content.
Mine was like that yesterday. It is the 3rd party ad servers and autoplay that is doing it.
On that topic, chrome has an adblock add on. Smooth as silk now.
pods
There is an excess of medical care, an excess of legal business, an excess of insurance, an excess of government, an excess of military/police and an excess of banking.
The population would do much better, enjoy more freedom and rights as individuals, and live much less expensively if we had less... but then what would we do with all of the people if they could not be inefficiently employed?
Wow... good to know you've got all the answers... you should run the FED with that level of certainty over market affairs.
That's why the A-C-A, is not affordable
we got grubered
I bet that in Pittsburgh when you need an MRI you don't have to wait 6 months and end up having it at 11PM on a Sunday evening (like me in Ontario)
The entire system is broke beyond repair. From monopoly status (limited # of MRI machines) to compliance costs it is a giant bag of suck.
I don't even go to the doctor anymore. Too much red tape. I usually end up self diagnosing anything and treating.
God forbid something is wrong, as you have primary appt, then a week of hemming and hawing, followed by specialist referral (couple weeks), then tests (couple weeks) and finally treatment.
Nevermind the prices. The three party system is broke as fuck.
Some are trying, from concierge doctors to cash only surgery centers. Cartels will try and quash them too.
pods
A system so generous that it promises (and does) service anyone who walks in the door, is doomed to financial failure...not a bug, a feature as the teckies say.
Does not matter if the patient just crossed the Rio Grande and boarded a bus for Vegas, if they can make it into the ER...they are good. Ain't America great?
This way other countries do not have to fix their problems, they can send them to us...cuz we're so nice.
Another fantastic reason why things are broke. The government can force doctors to spend their labor without compensation. They used to call that something?
pods
A big part of the problem is people simply are not taking responsibility for their own health. Conservatively speaking about 75% of my work is on type 2 diabetics. If this were eliminated I certainly would be out of a job. Tough for me but good for society. The problem is people don't seem to have an interest in staying healthy. I guess if your sole point of existence is sitting in a chair watching TV it doesn't matter if your legs are missing.
The healthcare, government, insurance system and Big Pharm promoted this scenario in various ways and the unwind will be painful. However, it is the individuals choice whether to participate in the farce. I do as you and stay as clear as possible. I take no meds, stay in shape and eat well. I have made the decision if I were to develope cancer or any serious life threatening condition, I would not have extraordinary care. I have accepted my mortality and would enjoy my remaining days hopefully as free of pain as possible. I wish more people would face this before they are surprised. I have seen nightmarish situations occur to many who have not.
Miffed
Patients who don't have insurance are much more understanding about not doing tests.
I try to practice by using what I need not what i think someone else thinks I might need.
I just read where it now cost $2.6B to develop a drug. Talk about a scam.
And 20% of that is marketing.
When ICI developed Atenolol (Tenormin) in the 1970's, the "Regulatory Document" pile would have reached the height of the Eiffel Tower, if the individual documents had been stacked atop each other - quite the "paper pile", and this was used as an example of the waste arising from "Regulatory Compliance" in the day.
Fast forward to the "Paper Pile" required for the development and Licencing of Tigecycline (Tygacil) by Wyeth - this managed to reach the cruising altitude of commercial aircraft - 30,000 feet, or 30 x the Atenolol pile height. ALL this has to be paid for by the Manufacturer "up front", along with all the other necessary, and mandated requirements for production of a new drug. Add in the historically very poor return on antibiotics (short-term use only, vs. lifetime use for statins / betablockers / ACEI's and ARBs, / Psychotropic agents) and you slowly realise why "it all costs so much".
Wyeth are no longer interested in antibiotic development. I wonder why . . . . .? ?
The best way to cut social care is by telling people there's to much waste happenig that isn't needed.
So when the next cancer patient walks in, he'll get a asperine and be told to sleep it off and come back in 6 months.
And healthcare will be a lot cheaper.
Do you know why European get to live 15 year on average longer than Americans?
Better healthcare and more off "that wastefull" stuff like scans and cures.
So yeah, vote against it and keep throwing that 15 years of extra lifetime away boys and girls! Get rid of the surpluss population even faster!!!
Question? What happens if you get hit by a car, tumble into a ravine on your moped, stabbed by a loaf of bread or have a nailgun
incident? How do you factor this into additional 15 years lifespan? You could even possibly choke to death eating Greek yogurt.
winks
Lets say we all get 100 years, minus the car hit, the tumble, the stab, and the nailgun, that's closer to the 30 year plan. And then there is everything inbetween.
Now personally i'm near 60 and have never had a broken bone or a stitch in my life, nor had to feel that pain, so i'm countin on the full hundred at this point.
http://www.forbes.com/sites/theapothecary/2011/11/23/the-myth-of-america...
15 years? Bullshit.
CSIS Global Forecast
Just as expected, the wheels are falling off the progressive agenda wagon.
Status-Groups
So I call United Healthcare as I received notice that our insurance is going up 26% starting next month. Never use it, never plan to use it but you've got to have it. Right?
So I ask, any cheaper plans/higher deductible you can move me into? Ha. My plan is still part of the old pre-AHC charade and if I wanted the cheapest AHC ready plan, the premium is double what I pay now.
See why United Healthcare shares are going parabolic? All By Design. Fleece the payers, enrich the shareholders and give free healthcare to the recently arrived Democrats to ensure they keep votind D.
Capitalisme at it's peak :)
In a way, it's a schoolbook example on how to maximize your profits.
The only thing what's wrong with the entire picture is that people count on politicians to have a moral compass while they where elected because the didn't have one.
The reason it's up is because America voted for it to go up.
When is EU going to decrease unemployment levels and stop borrowing from the emerging market piggybank via IMF? How many more banking stress tests do we need to perform to demonstrate that the EU is an insolvent dependent wanker? Not picking on you Sudden. Just valid questions.
Oh, it's breaking appart as we speak.
They can't hide the problems anymore and there's not enough money anymore.
They're to affraid to cut expenses on the civil servant side
So they cut in all the rest and raise taxes on everything
But they now use the devide and conquor tactic where it's always a certain group that needs to pay and those groups are never the mayority.
I'm all prepared now to leave if need be.
My family thinks it's nutty to think and act like this but if need be I can leave in a week.
When this shit over here turns, it's going to be so bad...
You only see it when you take notice of it but it's falling apart.
The infrastructure hasn't been maintained for a decade, they're imaking inventory of everybody's assets and it's all called "fair share"
If I think about it all to much, I panick about it and feel sorry my kids will never have the life we had.
I'm not a proud european, I'm not even a proud Belgium person'
I pay way to much for what I get.
I personally pay 3400 euro's of taxes monthly, if I where to be without job because I would be sick or anything I would not receive anything in return for 6 months.
Man man man, there dozens of fucked up things over here that changed for the worst but all hidden in plain sight.
I've lived in a shielded community for so long, I never really saw how it all changed and how bad some stuff is.
Sometimes it's shamefull to see at what has become normal.
Thanks for reply. It ties into something I have been monitoring. Henry is right, the CB's are terrified.
They haven't seen fear yet. It's time for Central Bankers to pay off their irresponsible gambling debts. When you start hearing about new terrorist attacks from ISIS or a new make believe threat, they are so fucked over.
The charade in Jewland today was a farse. We lose thousands every day in America, Israel PR stunt for 4-5 people. Ask BIBI how many they killed in a mosque in West Bank.
West Bank Mosque Is Torched Near Ramallah| By Joshua Mitnick
Updated Nov. 12, 2014 4:59 p.m. ET
http://online.wsj.com/articles/west-bank-mosque-is-torched-in-suspected-arson-attack-1415806844
MSM Zionist like to spin news. Amnesia apparently set in about the mosque event in West Bank earlier. The more you continue to lie, the least likely people will believe you. Ask Obama!
When I used to visit relatives in Utrecht, we used to drive up from Zeebrugge and pass through the village of Baarle Hertog (Baarle-Nassau) which you will certainly know, owing to it's geographical unusualness.
Decades ago, the crossing was always from the relatively untidy / unkempt Belgium, to the rigorously tidy / very well-maintained Netherlands. Everything from the people, to the roads, shops, all infrastructure - often broken streetlights on the Belgian side, never on the Dutch side.
Always amazing, and always extremely noticeable. Also noticeable that the costs of comparable items were higher on the Belgian side than the Dutch side (e.g. diesel, petrol, milk), so it wasn't because of higher taxation.
Have a gander of cities in the US. Same business model with the same people focusing on creating a new poverty development territory aim. i.e. Detroit.
Shower them with free shit until the working taxpayer funded calamity runs dry.
How can you call a completely government controlled debacle 'capitalism'? It's the farthest thing from it.
If you think it's expensive now, just wait till it's free!
You're 100% right!
In my country it's "free"
But... I pay a 55% on my salary
22% on everything I buy
And...
I have a extra personal insurance plan that costs 200 euro's a month, that's a extra 260 dollars, because when you have to go to the hospital and when they see you've got a job, the extra's all cost to much money and they don't charge you for it, they just don't give it to you.
My mother had a car accident a few years back and she perforated her lungs and her colum whas ruptured.
There was a experimental cure but the costs where crazy and they didn't have a personal insurance plan.
The costs if they really wanted is was over 180.000 euro's.
Do you know how we handled it? :)
I had a personal plan for my family, so I quickly divorced my wife for a few months and moved in with my parents. In that way, my plan also worked for them and the operation was on my insurance and was all free.
And about 4 monthhs later we remarried :)
It was kind of cool to do so and my kids got to see mom and dad remarry so we had a lot of fun with it.
But free... Is never free.
You mean like in much of the rest of the developed and third world?
In Thailand you can get an mri, minor surgery performed by a competent doctor & ananesthesiologist and two beautiful women to care for you for under $500
And you wake up without a dick and 2 breasts...
Well, on the plus side, you'll be able to experience your "Other Self".
The risk of hospital-acquired infection is lower than in the West. There are many factors (including a healthier Patient population), and extremely clean hospitals is certainly one of them (along with very modern and very easy-to-clean-thoroughly overall design).
You get what you pay for. http://youtu.be/HReaWdysrfE
I get free or nearly free medical care in an un-named South American country every year when I go there. I don't even bother in the US any more.
I just had an MRI of my brain in Colombia....$250...took an hour to do....and comes with a doctors report of what he found....I felt lucky...he found a brain..I always wondered.....
Did they pull the pins and needles trick on you?
All they need is to require the posting of all medical procedures.
Try to find out what a knee MRI costs--no answer. Price range will be from $600-$3500. But you cannot find who the $600 provider is, and worse, the $3500 provider has a deal with the major insurance companies for a 85% discount (proprietary, so you'll never know) so in essence the only peeps who actually pays the $3500 is the one with no insurance at all.
Imagine a world with supermarkets and every item has no price--you find the price after leaving the store.
That is our medical system in a nutshell.
Carmine the magician says for you to stay away from razor blades, they could be harmful to your health. Now Nailguns, that's a different story.
ignore, dbl post, sorry
If the Government state and Federal Deregulated the Medical insdustry MRI and CT scans would be so cheap they'd become part of everyone routine yearly physical. Years ago two companies which performed MRI and CT scan setup shop in town. When Company B began undercutting Company A in costs it sued them and had them shutdown through the courts and the State Regularity board. Who sits on this board? All of the heads off all the major hospitals in the state. When someone wants to build a new hospital who decides whether it can be approved or not? Why the same board. Yep no conflict of interest anywhere in that system.
This happened to me in 2000. I flew from Toronto to LA, but Air Canada changed my flight, and routed me through Vancouver instead of flying direct, so I arrived in LA at 4:30 pm instead of 11:30 AM, and got caught in a massive traffic jam as I tried to go south to Irvine. By 10 pm, I was still on I-5, and feeling quite tired, as I'd been up for almost 22 straight hours. I pulled off to check directions, and when driving back to the highway, fell asleep and crossed into the oncoming lane. Low speed collision (25 mph), so no one was seriously hurt; I had a broken foot, but was also knocked out by the airbag.
I get taken to Irvine Medical Center. They did: A CAT scan (showed nothing). Meanwhile, I was lucid, all my vitals (BP, pulse, respiration, temp, etc.) are normal, I'm able to answer questions, and more important, able to ask questions: who is paying for this? (I knew Cdn. healthcare didn't cover US costs). I am told, repeatedly, "Don't worry". The CAT scan shows nothing, so they decide to do an MRI. Again I ask "Who's paying?" "Don't worry". The MRI shows nothing. Now they want to inject me with a 'contrast' dye and do a second MRI. "Who's paying?" "Don't worry". They find nothing, I'm discharged the next day (in the hospital from 1o pm to 4 pm - 18 hours).
Bottom line: I come home with my foot in a cast, and a month later, get a bill for $35,000 US (nearly $50k Cdn at the time). Wife threatens divorce, I'm panicking. Luckily, find obscure clause in automobile insurance policy that covers me. I tell the story to Cdn doctors, and they shake their heads - "We would have set your foot, and kept you for observation overnight - total bill would have been $3,500".
Punchline: They worried so much about a possible concussion and brain/abdominal injury that they did, according to my Cdn ortho after the cast came off, 'the worst job of setting a foot I've seen", and now, nearly 15 years later, I am facing surgery to correct the misaligned bones as a result of them botching the only visible injury I had.
I like Americans, but you can keep your healthcare system, thanks very much - both the old one, and the new, worse one.
Nancy Pelosi Says She Never Heard of Jonathan Gruber
Government false advertising goes straight up to SCOTUS who voted to approve. Chimes of taxation and fraud have reached a crossroad. All the ACA forensics, legislative signatures are evidence to US taxpayers.
Yeah lets get rid of "expensive" MRI's and have crappy eurocare. I'd like to have a star trek style scan instead of relying on a doctor's opinion.
One reason sick treatment is so expensive:
GUBBERMINT
Free trillions of FED money for the banks. Why not free FED money for free medical care? Just asking.
The Federal Reserve really doesn't have the money. They’re a currency counterfeit ring trying to maintain the Fiat market share circulation under Henry Kissinger petrodollar recycling agreement.
If you want to feel Berany’s consumption theory as pinnacle importance, buy a FIAT 500. Bank of International Settlements is the Fix It Again Tony miracle worker. LOL
F*ck all the Caducean death dealing douchebags
Most Western Doctors care about you in the following order of importance (#1-#5 may be interchangeable):
#1 Their Medical License
#2 Their Medical Practice
#3 Their Medical Malpractice Insurance
#4 Their Profit
#5 Their Ego
#6 You
You're not even in the top 5. Which explains why they willingly and criminally expose people to so many needless toxins and known carcinogens, the dangerous and deadly side effects of drugs and radiation
"75% of Cancer Doctors And Scientists said they would NOT take Chemotherapy due to it destroying the body and the low success rate. - http://ncresearch.org/gpage32.html
"Polls were taken by accomplished scientists at the McGill Cancer Center from 118 doctors who are all experts on cancer. They asked the doctors to imagine they had cancer and to choose from six different “experimental” therapies. These doctors not only denied chemo choices, but they said they wouldn’t allow their family members to go through the process either!" - - http://ncresearch.org/gpage32.html
“The majority of the cancer patients in this country die because of chemotherapy, which does not cure breast, colon or lung cancer. This has been documented for over a decade and nevertheless doctors still utilize chemotherapy to fight these tumors.”
(Allen Levin, MD, UCSF, “The Healing of Cancer”, Marcus Books, 1990).
“According to medical associations, the notorious and dangerous side effects of drugs have become the fourth main cause of death after infarction, cancer, and apoplexy”
(Journal of the American Medical Association, April 15, 1998)
I could go on posting for decades with references like the ones above
The story doesn't mention the cases where MRIs or CTs aren't done and the hospital/doctor is sued. This counts for the prime motivation for over-use
No, the prime motivation is pecuniary gain. If the medical professionals suffered a total loss for all of the "defensive medicine" they perform, then I would listen... However, someone gets paid for running those tests. This is the motivator, anything else is a convenient excuse to attempt to plausibly deny insurance fraud.
You can't understand what is wrong with medicine without understanding three things:
1) We destroyed the economic feedback loops that kept the system self contained.
2) We forgot that medicine is an art of percentages and likelihood, not certainty.
3) We conflated quality of life with quantity of life
Longer explanation:
In the old, pre-Medicare days, back before the collective institution of insurance decimated medicine by removing the awareness that resources that exist in limited quantity must be rationed carefully, interventions were considered on a case by case basis. Young people got more heroic interventions. Old people were allowed to die with dignity, their urge to live forever soothed by the recognition that by forgoing treatment themselves, they therefore left more resources for their offspring, and tempered by the awareness that it was unethical to take resources from other members of society for personal use, regardless of whether that theft was blessed by the hand of government or not. Treatments consisted of a lot of hand holding and prolonged periods of rest, recuperation, sun, good food, and pretty young nurses. Doctors were not afraid to state that they did not have any treatment for a condition, that many times it was best to let nature take its course, and were not shy about reminding patients that choices have consequences that cannot be outrun.
But then the pace of knowledge aquisition accelerated, and society whole heartedly embraced the idea that "scientific" things beat the old and shabby "natural" things hands down. It was the Jetson era, when pundits confidently predicted that future meals would consist only of scientific pills and science would slowly eliminate disease through the process of "fixing" all the processes where the human body and natural selection had screwed up. Symptom elimination became all the rage, and research blossomed as it was irrigated liberally with newly printed fiat. Clinical gestalt was replaced by yes/no tests, which of course were much more reliable than will-o-the-wisp human judgement. The "scientistic" doctor was born, in gleaming white coat and wielding his unerring tests, and he was oh-so-sexy compared to his whisky swilling practical country brethren.
Somewhere along this path, we forgot a lot of things. We forgot that every man dies, and that it is not important how we die but rather how we live. We forgot that death was a part of life, and instead decided that every death was a tragedy that deserved to be resisted at all costs. We forgot that people tell you what their priorities are through their choices, and that pouring resources into an effort to counterbalance the consequences of those choices is like trying to prevent head injuries by giving football helmets and pads to kids -- they just run and hit that much harder.
Because we forgot all of these things, we believed that the scientific management of group resources through the medium of insurance would be capable of overpowering the tragedy of the commons. But we were wrong. All insurance did was to make the link between utilization of a resource and payment for that resource longer and more tortuous and thus more difficult to track, but this did not in fact create any more resources. Instead, it just produced obfuscation of how the resources were being squandered at an accelerating pace. Freed from the onerous burden of matching resources to utilization, both doctors and patients ran the company credit card up smartly. All stops were pulled out, and the fiction that cost was irrelevant when it came to saving lives became SOP.
Meanwhile, bracket creep crept. Tests that used to be done for things with 30% probability of finding a problem were soon done on cases with less than a 1% chance of finding a problem. Why? Because patients trust the test, not the doctor, and doing the test makes the patient walk out the door happy with a minimum of fuss because they feel like they've been scientifically "examined", and doctors can always point to the test rather than their clinical judgement when the odds are inevitably bested and the test is wrong.
So, where does that leave us today? It leaves us with patients trying to take 20 different medications daily and feeling like shit. It leads to exhaustive and expensive workups for vague symptoms that generates an enormous amount of diagnostic smoke but for which no fire can ever be found. It leads to routine ER bills running into the thousands of dollars, and the hard workers getting screwed by high costs and unaffordable insurance, while the chronically sick rest easy on disability and medicaid and medicare, freed from the need to ever pay the price for the smoking or obesity or alcoholism or cheeto overdoses that are the cause of their problems. It leads to us keeping everyone's bodies marginally functional long after their minds are gone, feeding them through tubes jammed into their abdomen, unable to walk or talk, screaming any time their joints are moved because 5 years of no movement has left their joints fused such that the only position left for them to occupy is smack dab on top of their decubitus ulcer.
I heard a story once about how a certain family kept bringing their demented, bed ridden relative into the ER every two weeks for years. When her kidneys failed, they went on dialysis. They had a trach put in because of recurrent pneumonia and COPD exacerbations. They were on chronic antibiotics, and thus had chronic diarrhea, which of course really helped those bedsores. Finally, an exasperated ER doctor tried to discuss the choices they were making, at which point the family stated that they were waiting for "God to take her." At which point, the ER doctor thought to himself, "Good God people! He's tried to take her with dementia, with kidney failure, with recurrent infections of various stripes and with repeated failures of her lungs. What are you waiting for him to do? Come down here and choke her to death with his bare hands?"
What it leaves us with is a medical system whose function is entirely dependent on the steady creation of ever more fiat currency, and God help us when that inevitably fails.
"We forgot that death was a part of life"
So was an average lifespan of 22 years and death from disease, infection, or injury at at any time in that short life.
"3) We conflated quality of life with quantity of life"
The quality of a person's life is not for you to determine.
There is a middle ground between 22 and a miserable 87 that you are ignoring.
"The quality of a person's life is not for you to determine." Agreed. No one is making that determination anymore, not patients nor doctors. They simply and mindlessly chase quantity.
Hence my comments.
"Why is sickcare (a.k.a. "healthcare") absurdly unaffordable in America? There are many structural reasons which I have covered in depth for years, but one that most of us can relate to from personal experience is needless, hyper-costly scans and tests."
I see it everyday, and its not just CYA testing to keep the lawyers away. Its really stupid, never learned how to perform a physical exam, poor as shit and that's a fact doctoring going on out there. I'm not talking esoteric oddball pathologies that walk in the door. I'm talking run of the mill stuff. These guyh's (and girls) quite symplyu never learned ANY diagnostic flow sheet physical testing protocols for doctor to patient physical examinations.
(this is areally, really sad state of affairs)
ZH'ers, I'm sorry to tell you, you are on yer own on this one. I strongly suspect other countries health care payment paradigms are producing better diagnosticians, I really do.
A doctor at the local hospital is thinking to himself: "We've got ourselves a real sucker here, let's spring some expensive, unnecessary tests on him so that we can get a fat bonus. He won't care, his insurance will pay or it."
Cordial Sounding Doctor: Mr. TalkToLind, before we realease you, we'd like to do a test to rule out meningitis. We will stick a small needle into your spine and draw out some spinal fluid.
TalkToLind: What for? I have no symptoms of meningitis.
Less Cordial Sounding Doctor: We just want to rule it out, sir.
TalkToLind: Fuck you, you're not going to stick a needle into my spine based on a whim.
Visibly Annoyed Doctor: But you could die without this test!
TalkToLind: No Thanks.
Dejected Doctor: Okay goodbye, you're released. Please don't linger, we need the bed!
Needless to say, TalkToLind is still alive and kicking. But I have a hunch that many people will just accept bogus tests and procedures just because an official sounding doctor/salesman in a lab coat tells them to.
Bingo. Who better to provide the technique of suggested selling than someone who we are forced to trust? And the "sucker" part is debatable... if it's not going to be unreasonably painful or lengthy, then why not have a test done if your insurance company picks up the tab? So long as there is any plausible connection between your symptoms and the test that's run, the doctor is probably in the clear on fraud...
when doctors charged more, the hospitals then charged more, then medical supply co.'s, and drug co.'s charged more, then insurance co.'s weren't going to loose money so they charged more to cover the price escalation, plus the govt. was their taxing, and regulating at every step.
long ago the health-care system took on govts. business model, millions, and billions of increases took place in these two systems but there are millions paying into these to systems.
you didn't see, or care to see, the rise of health-care spending, your private ins. might of went up a few dollars a month out of your pay check, the employers took the brunt of the rise.
the rising cost of ss, medicare-medicade, billions a year, who cared it was a few extra dollars out of your check, but as were more aware of now, trillions of those dollars were diverted to other spending.
if o'bama-care continues to furition there will be no ins. co.'s, and 100% of your medical care will be given by union employees, and 100% of your billing will be done by the irs..
you'll be praying for socialism, in a facist america.
This is like my girlfriend in college who was admitted to the ER in a manic phase of her bipolar. Her symptoms were mania. As I arrived, they were wheeling her out of the Xray room with an IV drip in her arm...
This is an old topic and yes there is abuse. I did some software work for a doctor who had a CT scanner and I didn't see any abuse there, as a matter of fact he hated it after the big body scanning fad that Opra made famous died. It was used reasonably and it was convenient for the 3 doctors being in house, but they were honest and not cranking out scans but that doesn't speak for everyone I realize.
Healthcare is ridiculously expensive because many people have convinced themselves of three things: The answers for good health outcomes rest with pills and procedures rather than good diet and exercise. Death at late stages of life is some strange, recent development in human history which justifies and necessitates extreme, exorbitant payouts to delay it for every possible last second. And last but not least, thinking that mixing all the myriad of "health care" transactions that result from the just mentioned concepts with health insurance as originally conceived to protect a person from unforeseeable, catastrophic events like an accident is a good idea.
Last night I received notice my health care cost were jumping to $1,365 from $1,065. The year before $934 and the year before that and prior to Obamacare they were at only $750 a month. While I have not used the policy once or even visited a doctor. and I have no healthcare issues they site increased cost as the reason. I should mention I have a $5,000 deductible policy meaning this is not great coverage!Just because we can preform or do some kind of medical procedure does not mean we should, healthcare is like a tape worm ever ready and always wanting to grow larger. More on why healthcare is so expensive in the article below.
http://brucewilds.blogspot.com/2013/05/healthcare-going-forward.html