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Author Topic: The Real Problems with American Healthcare  (Read 633 times)
r1s2g3
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April 24, 2019, 05:22:54 PM
 #21

I guess healthcare is costly because hospitals have to treat everybody even the patient is able to pay or not .so they charges a premium fees so that they can remain profitable at end.

Only option I find to cut the cost is to stay healthy.

I've never read into a stat about this -- I'm going to have to research this and get back to you, as I'd like to see the amount of healthcare serviced used by those that have no ability to pay and won't be paying their bills.


Sure, I am referring to the below fact sheet.
https://www.aha.org/system/files/2019-01/uncompensated-care-fact-sheet-jan-2019.pdf

38.4 billion of uncompensated care is provided last year. Hospital already know that they have to give uncompensated care so the charge very high to those who are able to pay.

One for article for your read.
https://www.modernhealthcare.com/article/20180106/NEWS/180109940/hospital-profits-uncompensated-care-climb

On top of  it Pharma companies are trying to show that they are caring for patient and will help in cost cutting of health care but in reality their profits are increasing.


Wishing you a good luck in researching this on deep but something is very wrong, even big corporation are not happy with the current system.

https://www.businesswire.com/news/home/20180130005676/en/Amazon-Berkshire-Hathaway-JPMorgan-Chase-partner-U.S

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April 24, 2019, 09:06:49 PM
 #22

Have you ever had a doctor tell you something along the lines of "You don't need this procedure, but the insurance company is going to cover it so why don't we just check anyway, we're just being safe!"

Not really. With the massive deductibles and coinsurance payments these days the conversation is often the opposite. "Doctor, how much is it gonna cost?" (doctor has no clue, she doesn't do billing). "Sounds expensive, what's the risk if we don't do it?" (doctor is wasting her time solving financial problems for the patient instead of health problems).

This sort of behavior, this wasteful behavior that is filled with greed (on the side of the doctor) and carelessness from the patient is what causes a large amount of waste in the healthcare sector.

You need to switch doctors Wink. Most of those I've dealt with were passionate about their job, helpful to the extreme, if somewhat limited by the time they can afford to spend with the patient.

That's not to say there is no fraud, particularly in the prevalent pay-per-procedure model. I just don't think that adding monetary negotiation to the doctor-patient conversation is going to change much. It would probably reduce cost somewhat (you can skip MRI but you'll need to get X-ray done and have that appendicitis cut out no matter what) and would increase health problems (already happening with people skipping unaffordable doctor's visits and medications and ending up in emergency rooms).

I don't know if this is an issue all around America, though I know where I live the Hospital around me is allowed to veto development of a new hospital in the area if they'd like to. I don't understand the rationale behind a decision like this, though all it is doing is allowing a Hospital to avoid competition which is vital to our market.

I don't know your specific situation but adding more hospitals just for the sake of competition can backfire. One hospital that is 80% full replaced by two hospitals at 40% would probably result in fixed costs driving up the total cost of care and eventually one of them ending up bankrupt. Good for capitalism, sucks for health.



Healthcare demand is generally quite inelastic even when paying out of pocket. I think market-driven fixes are doomed to fail. There is a good reason why most of the developed world solved that problem the way they did. The US will probably experiment for a few more decades at the cost of trillions of dollars and millions of preventable health issues, and still end up with a single-payer system. If not at the federal level then at least in some states.

When I spoke I did not mean every single doctor, or every single patient was like that. I meant that their are doctors that are in it for the $ at the end of the day, some portion of people are like that in every profession.

Patients that are on some sort of healthcare plan that doesn't charge them (Medicare, Other gov plans, Work plans, etc) and simply has a deductible for the entire visit are going to be abused by those doctors that are just going to bill the insurance for more than they must. It's a rite of passage in the Healthcare industry.

In regard to Hospitals being able to veto the development of other hospitals. I think yes, this might be better for costs of the hospitals -- as a large hospital company is going to be able to negotiate better prices and (maybe) pass these cost savings onto consumers. The issue in my mind is that this stifles innovation and competition, as the Hospital that is already present doesn't have to change as they know no one is going to be able to take over their business. They're safe, and can just keep the status quo going.


The problem with US healthcare:  It's singular focus is profit.

There a MANY examples of very effective and cost efficient universal healthcare, there are literally ZERO examples of successful purely for profit healthcare systems, but hey lets not let actual real world examples affect our thinking!

As Suchmoon mentioned this is really not difficult and literally the entire rest of the develop world moved on from this half a fucking century ago LOL.  Yup a few more more decades, a few more trillion dollars, a lowering level of healthcare and lowering age expectancy and eventually the US will figure out not EVERYTHING needs to be purely profit driven!

Now to start to fucking haggle with a doctor or to shop around for something like surgery FUCK that shit OMG, can my doctor focus on fixing my problems and not selling me his cheap ass services, fuck me sideways, I don't want some hack cheap cunt slicing me open with cut rate shit so he can do it cheaper...

I think that the customer seperation from the cost is a problem, it causes people to be lazy and to disregard the different prices that different companies are charging. The medical industry should be like every other industry in that regard, where you shop around for prices and see what's the best thing to work with. I'm not saying go to the cheapest doctor in town, but I don't think it would kill people to actually take some responsibility with their money instead of just using the first service (like they've always done) because of convenience.

I guess healthcare is costly because hospitals have to treat everybody even the patient is able to pay or not .so they charges a premium fees so that they can remain profitable at end.

Only option I find to cut the cost is to stay healthy.

I've never read into a stat about this -- I'm going to have to research this and get back to you, as I'd like to see the amount of healthcare serviced used by those that have no ability to pay and won't be paying their bills.


Sure, I am referring to the below fact sheet.
https://www.aha.org/system/files/2019-01/uncompensated-care-fact-sheet-jan-2019.pdf

38.4 billion of uncompensated care is provided last year. Hospital already know that they have to give uncompensated care so the charge very high to those who are able to pay.

One for article for your read.
https://www.modernhealthcare.com/article/20180106/NEWS/180109940/hospital-profits-uncompensated-care-climb

On top of  it Pharma companies are trying to show that they are caring for patient and will help in cost cutting of health care but in reality their profits are increasing.


Wishing you a good luck in researching this on deep but something is very wrong, even big corporation are not happy with the current system.

https://www.businesswire.com/news/home/20180130005676/en/Amazon-Berkshire-Hathaway-JPMorgan-Chase-partner-U.S

I may go ahead and either make a post on this thread or an entirely new thread with the costs of illegal immigration, we'll see!





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April 24, 2019, 09:50:36 PM
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 #23

I think that the customer seperation from the cost is a problem, it causes people to be lazy and to disregard the different prices that different companies are charging. The medical industry should be like every other industry in that regard, where you shop around for prices and see what's the best thing to work with. I'm not saying go to the cheapest doctor in town, but I don't think it would kill people to actually take some responsibility with their money instead of just using the first service (like they've always done) because of convenience.

Consumers are not rational when they're buying cheap plastic junk from China that they don't even need, they sure as hell are not going to be rational when they're in pain and in need of medical attention. So yes, I think it might actually literally kill quite a few people if they're forced to make financial decisions under duress. The goal should be to not have money in the equation at all. If there is fraud on the provider's side - that's where it should be addressed and not left for the patient to deal with. Healthcare is not a privilege and not a luxury. I doubt people get sick on purpose in order to abuse the system.

The problem is that we're too far deep in the rabbit hole hoping the market will solve healthcare problems that we are unable to admit it hasn't been working. We still hope that we can cure cancer with bandaids, we just haven't applied enough of them.

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April 24, 2019, 10:28:24 PM
Last edit: April 24, 2019, 11:51:23 PM by yeosaga
 #24

I think that the customer seperation from the cost is a problem, it causes people to be lazy and to disregard the different prices that different companies are charging. The medical industry should be like every other industry in that regard, where you shop around for prices and see what's the best thing to work with. I'm not saying go to the cheapest doctor in town, but I don't think it would kill people to actually take some responsibility with their money instead of just using the first service (like they've always done) because of convenience.

Consumers are not rational when they're buying cheap plastic junk from China that they don't even need, they sure as hell are not going to be rational when they're in pain and in need of medical attention. So yes, I think it might actually literally kill quite a few people if they're forced to make financial decisions under duress. The goal should be to not have money in the equation at all. If there is fraud on the provider's side - that's where it should be addressed and not left for the patient to deal with. Healthcare is not a privilege and not a luxury. I doubt people get sick on purpose in order to abuse the system.

The problem is that we're too far deep in the rabbit hole hoping the market will solve healthcare problems that we are unable to admit it hasn't been working. We still hope that we can cure cancer with bandaids, we just haven't applied enough of them.

Doctors, however, are a luxury. You can't force them to do their job. They took years to study and go to school, especially the 'in demand' surgeons. They need to get that value back somehow.

On top of that you have an immigration system being taken advantage of by sick and injured people to cause even more stress on everything. The 'refugees' that get sent over are not more doctors, and that is what is needed.


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April 24, 2019, 11:52:19 PM
 #25

The problem with US healthcare:  It's singular focus is profit.

There a MANY examples of very effective and cost efficient universal healthcare, there are literally ZERO examples of successful purely for profit healthcare systems....
But big Pharma/big hospital is eager to get into the profit through the rape of the US public in universal healthcare.

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April 25, 2019, 12:39:34 AM
 #26

I think that the customer seperation from the cost is a problem, it causes people to be lazy and to disregard the different prices that different companies are charging. The medical industry should be like every other industry in that regard, where you shop around for prices and see what's the best thing to work with. I'm not saying go to the cheapest doctor in town, but I don't think it would kill people to actually take some responsibility with their money instead of just using the first service (like they've always done) because of convenience.

Consumers are not rational when they're buying cheap plastic junk from China that they don't even need, they sure as hell are not going to be rational when they're in pain and in need of medical attention. So yes, I think it might actually literally kill quite a few people if they're forced to make financial decisions under duress. The goal should be to not have money in the equation at all. If there is fraud on the provider's side - that's where it should be addressed and not left for the patient to deal with. Healthcare is not a privilege and not a luxury. I doubt people get sick on purpose in order to abuse the system.

The problem is that we're too far deep in the rabbit hole hoping the market will solve healthcare problems that we are unable to admit it hasn't been working. We still hope that we can cure cancer with bandaids, we just haven't applied enough of them.


I just personally think that we've never really had a market-related healthcare system, the government has been involved for far too long which has caused us to never even fathom what it would be like without the government involved.


Don't get me wrong Suchmoon, you could be right -- though I do think that the market is the best place to ensure prices, competition, innovation, etc.




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April 25, 2019, 03:23:36 AM
 #27


Don't get me wrong Suchmoon, you could be right -- though I do think that the market is the best place to ensure prices, competition, innovation, etc.

"You think" when in reality the observable facts prove the exact opposite.  As mentioned we have many examples of good universal healthcare systems while literally ZERO examples of good for profit healthcare systems, and it isn't for lack of trying LMFAO!

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April 25, 2019, 04:21:25 PM
 #28


Don't get me wrong Suchmoon, you could be right -- though I do think that the market is the best place to ensure prices, competition, innovation, etc.

"You think" when in reality the observable facts prove the exact opposite.  As mentioned we have many examples of good universal healthcare systems while literally ZERO examples of good for profit healthcare systems, and it isn't for lack of trying LMFAO!

Pharma companies are charging the absurd prices for their medicines . Finding medicine is research field and money need to be paid for research but why the common medicine is also seeing price rise?

https://www.cnbc.com/2019/03/12/senate-panel-asks-cvs-and-other-middlemen-to-testify-about-drug-prices.html

https://www.cnbc.com/2019/04/09/cvs-cigna-humana-blame-big-pharma-for-high-drug-prices-in-senate-hearing.html

Govt. is aware of problem and they called bigshot pharma and they blamed drug makers. I guess it will go in circle until we find a solution.





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April 26, 2019, 08:59:20 AM
Merited by suchmoon (9), Foxpup (5), squatz1 (5), DrDoctor1234 (5)
 #29


Pharma companies are charging the absurd prices for their medicines . Finding medicine is research field and money need to be paid for research but why the common medicine is also seeing price rise?

https://www.cnbc.com/2019/03/12/senate-panel-asks-cvs-and-other-middlemen-to-testify-about-drug-prices.html

https://www.cnbc.com/2019/04/09/cvs-cigna-humana-blame-big-pharma-for-high-drug-prices-in-senate-hearing.html

Govt. is aware of problem and they called bigshot pharma and they blamed drug makers. I guess it will go in circle until we find a solution.



The best drug for big pharma isn't prevention or a cure. It is treatment. Especially an exclusive patented drug that provides ongoing 'treatment' for your condition and requires weekly/monthly top ups to improve your symptoms or increase your lifespan. Oh and it happens to be costly.

That is why all the research funding goes into treatments, rather than cures. What about vaccines and cures? Well Governments fund those or they don't get funded at all.

I could go on and on about this. Money in big pharma is also one of the reasons why relatively little funding is allocated to find new antibiotics. Anti-microbial resistance is a time bomb and I really hope we happen to find a new antibiotic within the next couple of decades even though most of the money goes elsewhere.

Big pharma pours money into the most profitable areas, not areas of greatest health need. A cure/treatment for male hairloss? Well that gets more funding than Malaria, which kills more than 400,000 people per year.

Outside of big pharma, the entire American healthcare system is broken. USA pays almost double per capita than other developed countries for healthcare, and doesn't get better outcomes (sometimes worse). In fact, based on life expectancy USA is actually worse than many countries - too much eating junk food and not going to the doctor early due to high upfront costs, so instead incurring greater costs down the track when serious conditions are left unchecked for too long.

And before people say 'oh well those OECD countries have higher taxes!' well the taxes they pay cover healthcare, which is half the price or better than the cost in the USA. If I had a choice between paying $1000 in taxes (which then goes to healthcare), or $2000 directly in healthcare for the same treatment, I know what I'd pick. Adding the middleman of the Government reduces healthcare expenditure by half.

Really, the American system is an example of how NOT to structure a healthcare funding model that puts the citizens needs first.
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April 26, 2019, 12:25:33 PM
 #30

Healthcare is a commodity, not a right, and it is simple to prove. You have a right to travel, you have a right to defend yourself, you have a right to free speech. You do not have a right to the time and resources of others. In order to make healthcare a right you literally have to take time and resources from others by force, ie you take rights from some to give rights to others. The US healthcare system is broken, but if you can afford it you can get some of the best healthcare in the world right away, not 6 months after you get a referral which you waited another 6 months to get.


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April 26, 2019, 01:16:14 PM
 #31

The problem with US healthcare:  It's singular focus is profit.

well usa is empire of capitalism, people that become doctor and stay doctor are usually socialists, thats why you neighbour cuba has a very good welfare system and usa has a horrible one that only serves the central bankers.

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April 26, 2019, 01:21:03 PM
Last edit: April 26, 2019, 02:06:20 PM by yeosaga
 #32

Healthcare is a commodity, not a right, and it is simple to prove. You have a right to travel, you have a right to defend yourself, you have a right to free speech. You do not have a right to the time and resources of others. In order to make healthcare a right you literally have to take time and resources from others by force, ie you take rights from some to give rights to others. The US healthcare system is broken, but if you can afford it you can get some of the best healthcare in the world right away, not 6 months after you get a referral which you waited another 6 months to get.

I was just trying to explain to someone how that the current issue is how we look at medicine in the US. I have started to put emphasis on medical industry. The sooner they get politicians who highlight that word, the sooner they can realize the problem. I fear politicians and media will play on people's fear and start coming out with terms like 'medical crisis' and 'medical bubble', just like was seen with the house/property industry. Industrialized causes result in industrialized outcomes. Right now what that means is as technology improves, only the wealthiest get access to the new tech, naturally. What people want is a more balanced system. One idea I heard recently is a lottery system where anyone who needs a specific treatment can 'win' a spot regardless of how full their pockets are. If only there was a way to have a provably fair lottery for it...

That idea only works when everyone agrees that every human life is valuable, however. Is it worth the time/resources to give a random lottery winner a better shot at life?

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TheHas
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April 26, 2019, 02:00:16 PM
Merited by Foxpup (3), o_e_l_e_o (1)
 #33

Healthcare is a commodity, not a right, and it is simple to prove. You have a right to travel, you have a right to defend yourself, you have a right to free speech. You do not have a right to the time and resources of others. In order to make healthcare a right you literally have to take time and resources from others by force, ie you take rights from some to give rights to others. The US healthcare system is broken, but if you can afford it you can get some of the best healthcare in the world right away, not 6 months after you get a referral which you waited another 6 months to get.

Even IF you wanted to take the argument of right vs 'commodity', it is still irrelevant to judging how broken the US health system is and its expenditure. You don't need to make a philosophical or political argument to show it.

As an example, if you look here you'll see that the US Government spends the same as most other countries on health (public funding through taxes), but your private expenses (that is, your out-of-pocket costs when you see the doctor) are TRIPLE that of comparable countries.

So the taxes spent by US Government on health are the same as other countries, but you're still charged triple in private expenses. It's pathetic. In reality, even the whole 'oh I don't want to pay more taxes for healthcare' argument doesn't fly. Other countries pay pretty much the same in taxes for health purposes but don't get slugged with excessive private fees.

But reforms still don't happen as the US hyper capitalist mentality apparently even extends to people dying in hospital. I mean, really?

On top that, people jump to assumptions that it can be explained away by a philosophical argument of 'socialist healthcare' (its not socialist, but I'll put that to the side) not being right for the US. And that the US is making a choice of paying less tax = higher private costs vs paying more tax = less private costs. Well, clearly not actually - the amount of US tax revenue going to healthcare is the same as other OECD countries not less - the US health funding model just lets doctors, specialists, hospitals and big pharma get a nice pay day literally at your expense.
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April 26, 2019, 05:14:48 PM
Merited by o_e_l_e_o (1)
 #34

Healthcare is a commodity, not a right, and it is simple to prove. You have a right to travel, you have a right to defend yourself, you have a right to free speech. You do not have a right to the time and resources of others. In order to make healthcare a right you literally have to take time and resources from others by force, ie you take rights from some to give rights to others. The US healthcare system is broken, but if you can afford it you can get some of the best healthcare in the world right away, not 6 months after you get a referral which you waited another 6 months to get.

Even IF you wanted to take the argument of right vs 'commodity', it is still irrelevant to judging how broken the US health system is and its expenditure. You don't need to make a philosophical or political argument to show it.

As an example, if you look here you'll see that the US Government spends the same as most other countries on health (public funding through taxes), but your private expenses (that is, your out-of-pocket costs when you see the doctor) are TRIPLE that of comparable countries.

So the taxes spent by US Government on health are the same as other countries, but you're still charged triple in private expenses. It's pathetic. In reality, even the whole 'oh I don't want to pay more taxes for healthcare' argument doesn't fly. Other countries pay pretty much the same in taxes for health purposes but don't get slugged with excessive private fees.

But reforms still don't happen as the US hyper capitalist mentality apparently even extends to people dying in hospital. I mean, really?

On top that, people jump to assumptions that it can be explained away by a philosophical argument of 'socialist healthcare' (its not socialist, but I'll put that to the side) not being right for the US. And that the US is making a choice of paying less tax = higher private costs vs paying more tax = less private costs. Well, clearly not actually - the amount of US tax revenue going to healthcare is the same as other OECD countries not less - the US health funding model just lets doctors, specialists, hospitals and big pharma get a nice pay day literally at your expense.


I don't need to make a philosophical argument to show it, I need to make it to point out these knee jerk reactions will not only make the problem worse, they will cause SO many more issues people have no concept of. People like to run around saying things like "healthcare is a right", and it simply can not be, because in order for some one to have that right you have to help yourself to the rights of others, be it time or resources. That is not how rights work.

IMO we need to strangle the insurance industry for starters, they along with the litigious nature of this nations laws are the primary culprits. These systems were abused until systems of protectionism were created, then those protective systems themselves became the systematic abuse. You will often find doctors who run a cash only practice will charge considerably less because of the removal of all of these compliance and documentation issues for example. Doctors spend more time doing paperwork than anything else, and that is retarded. Giving the government more power is not a solution because it is what got us here today.


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April 27, 2019, 06:38:40 AM
Merited by Flying Hellfish (5), o_e_l_e_o (2)
 #35


 You will often find doctors who run a cash only practice will charge considerably less because of the removal of all of these compliance and documentation issues for example. Doctors spend more time doing paperwork than anything else, and that is retarded. Giving the government more power is not a solution because it is what got us here today.


I'm enjoying this discussion and I get where your head is at, but in this case more Government power and regulation is the answer.

I know this is bitcointalk and there is a tendency to lean towards being anti-centralization, and to have concerns about Government overreach. But there is virtually no evidence that the health system in the US would be better if there was less Government involvement. I can say that, because every other OECD country doing better than the US on healthcare has much more Government involvement.

If you're suggesting less Government involvement, then by default there would be more private company sway and freedom for doctors to treat and prescribe medicines as they wish, with essentially no Government body of oversight that can represent the consumer/citizen who needs healthcare. This is an issue. The power imbalance and information asymmetry between doctor and patient is massive, and there needs to be protections in place for a consumer to not get ripped off, receive poor treatment, or get given drugs they don't need.

As an example, those big pharma ads in the US about 'ask your doctor about how xyz drug can help you today' are criminal in other countries, because Government made the call that profits do not determine health treatment. Doctors are also not allowed to get kick backs from pharma companies for over prescribing their drugs. If you want health needs to come first, the answer is not less regulation and Government involvement, but more.

To put in perspective - none, and I mean none, of the OECD countries have a model anywhere close to the current US model which clearly suffers from private company profits prioritising consumer needs. The US should look to other OECD countries who are absolutely dominating the US system on providing a more affordable, efficient and a better health system. Many (not all) OECD countries do not even have a private insurance or private treatment component - it is all publicly and centrally funded, so Government can achieve economies of scale, set fair subsidy rates for drugs and work with the medical profession to subsidy treatments based on evidence (not on where doctors get kick backs from big pharma).

IMO this very US idea that 'Government should stay out of my life' just doesn't work when we are talking about healthcare. You want the Government accountable to meeting the health needs of the population, just like you want them accountable for national security, education and public infrastructure.
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April 27, 2019, 11:00:07 AM
 #36

There is no such thing as health care these days, Most "medicine" is allopathic, and is designed to suppress symptoms rather than cure illness. America wont regain its health until it stops poisoning it population with destructive drugs that weaken immune system, and destroy cartilage and other essentials. It is also designed to enrich the globalist pharma companies, and to help them with their global eugenics programmes.

I've added a photography section to Fit to Talk -  The photography and content production board

Hopefully we can use this to help members earn from using budget photo kit whilst they practice their English
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April 27, 2019, 11:35:11 AM
 #37

...
IMO this very US idea that 'Government should stay out of my life' just doesn't work when we are talking about healthcare. You want the Government accountable to meeting the health needs of the population, just like you want them accountable for national security, education and public infrastructure.

That's your opinion, but you are wrong. The reason is that in the USA the health care and Pharma companies are a powerful enough force to subvert legislation to their wishes. Thus your (or any) proposed "solution" simply becomes a tool for these forces to use to legislate themselves large chunks of our money.

You can't get around that.
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April 27, 2019, 11:46:24 AM
Merited by Flying Hellfish (2)
 #38


IMO this very US idea that 'Government should stay out of my life' just doesn't work when we are talking about healthcare. You want the Government accountable to meeting the health needs of the population, just like you want them accountable for national security, education and public infrastructure.

Agree with this. I work and study in the medical field although I'm not a doctor despite my username. While most medical professionals do the right thing there are a few I have seen that are a little too interested in getting the maximum payment even if their patients can't afford it. Sometimes they'll charge and prescribe things that their patient doesn't need.

It is a positive for countries that politicians and governments are responsible to voters for delivering a good health system. Like with many things in life problems start when competition and profits are the driving force. Health is too important and the stakes are too high to leave it to private companies.

Spending tax on health shouldn't be seen as a cost but an investment in the wellbeing and good of the country.
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April 27, 2019, 12:18:03 PM
 #39

~To put in perspective - none, and I mean none, of the OECD countries have a model anywhere close to the current US model...

For some reason what Bitcointalk users "think" is more important that observable facts....

The US literally has the worst and most inefficient healthcare system in the developed world and for some reason the answer found in this board is MOAR PROFIT will fix it, even as every other developed country proves them 100% wrong!

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April 27, 2019, 12:50:46 PM
 #40


Don't get me wrong Suchmoon, you could be right -- though I do think that the market is the best place to ensure prices, competition, innovation, etc.

"You think" when in reality the observable facts prove the exact opposite.  As mentioned we have many examples of good universal healthcare systems while literally ZERO examples of good for profit healthcare systems, and it isn't for lack of trying LMFAO!

The free market does not bring innovation, don't fall for this lie.  Look at all the major technological innovations over the past 50 years, they came from government funded programs like NASA and the military.  GPs, Cell phones, internet, radio, etc.
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