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Why is the Entire Healthcare System So Expensive?

04/19/2010 2:41 AM

Ok, I am no expert in any of this stuff, but I would like to get some educated theories as to why our heath care system is so fundamentally expensive? Where a trip to the hospital can make you bankrupt! I know doctors make a lot of money and pharmaceutical companies make millions in patents, but where does it take such a huge leap into outrageously expensive to us when we need it the most!!!

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#1

Re: Why is the Entire Healthcare System So Expensive?

04/19/2010 12:20 PM

In my opinion, it all boils down to the toxic excess model of medicine, and the lousy safety rating of patentable chemicals.

To begin with, when a chemical (usually a natural source or phytochemical) is identified as having medicinal potential, the development process is first to make it patentable. This is achieved by making similar-but-not-the-same molecules, add a few halogens etc, test for the activity and then patent your "new" chemical.

Testing in animals is the next phase, for effectiveness and toxicity. The problem is, virtually 90% of all the research dollars up to the first clinical trial on humans are down the drain. That's how many new drugs are rejected when they are first tested in humans, many of them because they have unacceptable levels of toxicity, according to the 2004 report 'Innovation or Stagnation' you'll find somewhere at this site.

Secondly, not only 'patentability' outranks 'safety' as a primary consideration, there is definitely something wrong with the model of treatment. Not only the drugs are unnecessarily toxic, but the way they are used - large doses that flood your system and supplant natural processes - also makes the whole business more toxic - but of course, more profitable, since more drug is used (and lets not even mention the stuff that's physically addictive or that you will have to use for the rest of your life!).

Treatments that are toxic mean there can be serious adverse outcomes for the patient, too. Health care is a serious risk to your health! As a consequence, the insurance premiums paid by pharmaceutical industry and by medical doctors are huge.

So there you have your ridiculous cost:

- billions thrown down the drain to come up with a useable patented drug, which is still likely to be toxic to a significant extent.

- toxic model and its risks means enormous insurance costs for the providers.

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#2

Re: Why is the Entire Healthcare System So Expensive?

04/19/2010 1:53 PM

The short answer:

Greed, the driver of capitalism. Prices will rise to the point at which such a large segment of the population goes without care that overall profits fall. We are not there yet. GM wants to sell more Escalades than Aveos. The medical system is the same.

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#3
In reply to #2

Re: Why is the Entire Healthcare System So Expensive?

04/19/2010 1:56 PM

The long answer:

You can see the actual costs if you review your medical bills. I recently bought a prescription drug, the concentration of which had been increased slightly to renew the patent protection. A tube of this stuff was $190, and cost perhaps $5.00 to make. Doctors get kickbacks for prescribing the newest, most costly and profitable stuff, and most consumers simply go ahead and get the prescription because the insurance company pays for it, they think. In fact we all pay for it, because the insurance companies guard their profits and pass the cost along to us (usually through our employers, who could otherwise pays us more).

The pay for doctors is obscene, but again, we are insulated from the direct cost by insurance. For generally healthy people, 90% of what we ask doctors to do can be done by 1. ourselves or 2. a nurse practitioner, or 2. a nurse. Most of us can easily self-diagnose a cold vs bacterial infection, and could order a strep test when in doubt. Often, the patient's preferences play a role in the prescription. Many times, the doctor has said to me: "Well it appears to be viral, but we can give you an antibiotic just to be sure. What would you like to do?" I think my experience may be typical: I have very rarely come away from the doctor thinking, "Wow, I'm glad I came here... I got some real insight that I could not have developed on my own."

My pharmacist can tell me what antibiotic to use for a strep throat. Instead of going to the doctor for a possible strep throat, I could go directly to the pharmacy, take a strep test there and have the prescription filled, all for about 1/10 the cost of a doctor visit. Allowing pharmacists to prescribe certain drugs would cut costs dramatically, I'd think. The AMA would lobby strongly against such, of course, as would all the other interested parties.

People are over a barrel re medicine. No one wants to get just "adequate" medical care, but if we paid for care more directly, we would shop more carefully. If most of us had $2500 deductibles, then we might drive the cost of routine care down a bit, and seek out nurse practitioners more frequently.

As it is, the system is constructed to maximize profits, as is any capitalistic business system. If you have medical companies in your 401 K mix, you want these companies to perform well. We want profitable malpractice insurance companies, profitable drug companies, profitable health insurance companies, profitable legal firms, etc., etc.

If the system is driven by capitalistic market forces, as it is in the US, then the costs will continue to rise as fast as they can. If the firms involved were making products like computers, we'd cheer them for making huge profits -- the idea with computers (and everything else) is to charge the absolute highest price that the market can bear -- thus investors cheer for Apple, who can price their computers at twice the price of a Dell. Investors cheer for highly-profitable drug companies and highly profitable insurance companies.

We have socialized roads, socialized military, socialized support for old people and poor people, social national parks, etc. (Shouldn't a military guy, who puts his his life on the line for his country, be paid more than a doctor? A crisis for a doctor is when his Mercedes starts to make a funny noise.)

Everyone in the medical system in the US benefits from high prices... except for the consumer. Capitalism has nothing at all to do with providing needed services to people who cannot afford them. Even the most tentative steps toward the kind of socialized medical system seen in the rest of the world is met with very strong resistance in the US.

Any system that provides benefits to all people regardless of their ability to pay is communistic or socialistic. That's not what the majority of people in the US want, unfortunately. Personally, I think we'd be better off with socialized medicine, because I think it is abhorrent to make a person of modest means choose to avoid needed medical care or pay the mortgage. I've spent a lot of time in countries where medicine is socialized, and it just works better. Many of those countries have higher standards of living than the US does, and have higher happiness indices, and much lower crime rates.

The vast majority of US citizens know little or nothing of political theory and "know" that communists are evil, and that socialists are just one step away. If you actually read Obama's book, you see that he is anything but a "socialist" in the mass market sense. But the conservative leaders paint him as one. As long as medicine is based on capitalism, prices will climb so that only the rich can afford medical bills without saying "ouch", just as only the rich can afford a Mercedes in one stall, a Bimmer in the next and an Escalade in the third. Any interference in that system is a move toward dreaded socialism. In real capitalism, there are no controls on prices.

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#4

Re: Why is the Entire Healthcare System So Expensive?

04/19/2010 3:47 PM

The answer is greed. A cycle of lawyers finding patients willing to sue, courts willing to levy huge awards, and insurance companies paying the awards. Then the insurance companies raise rates to cover losses, doctors and hospitals have to pay huge malpractice insurance premiums, and doctors and hospitals use 'defensive medicine' to protect themselves from lawyers. You have to have lots of expensive, and often unnecessary, scans, tests, and procedures done to protect the doctors from the lawyers and the courts.

Congress refuses to enact tort reform, because so many of them are lawyers, or they are getting huge payments from the medical, legal, and insurance industry. The patient comes last, we are sheep to be shorn.

And all of this is without even mentioning the pharmaceutical industry.

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#5
In reply to #4

Re: Why is the Entire Healthcare System So Expensive?

04/19/2010 5:22 PM

The patient comes last, we are sheep to be shorn.

Indeed. Nicely worded.

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#6

Re: Why is the Entire Healthcare System So Expensive?

04/20/2010 9:21 AM

As Walt Kelly once had Pogo say, "We has met the enemy and he is us."

The entire system (patients, health care institutions, physicians, insurance companies, phramaceutical companies, and attorneys) are the problem, each wanting an ever-larger piece of the pie.

For example, John Doe eats way too many jalapeno peppers for a man his age. He suffers heartburn. In a reasonable world, he would cut back on the peppers or get a large bolster pillow and sleep partly elevated. Instead, he goes to the doctor and asks for drugs. The doctor, who has recently been wined and dined by a pharmaceutical rep, gives John Doe some of the "free" samples left by the drug rep.

John takes the samples and finds he can now eat twice as many jalapenos and still sleep in comfort. After two weeks the sample runs out and John goes back to the doctor to obtain the prior authorization he needs to get his employer paid drug plan to pay for a regular prescription of these expensive pills.

The insurance company should just tell him to take an anacid instead, but they know they can just pass the extra costs along to John's employer in the form of higher premiums (and they get a percentage of profit on the increased cost). Of course, John's employer doesn't really pay for the premiums; that's part of John's compensation package so it somewhat cuts John's pay (and some gets passed along to the consumer sometimes, as in the auto industry).

So, John gets to do whatever he likes, knowing there's a "magic" drug fix, the doctor gets the office visit fees (he'll need to monitor John every three months now to watch for liver damage from the drug), the doctor's office staff gets all the free food and little gifts that the drug rep drops off, the local career school that does what high schools used to do now gets to train some of those office staff, the drug company gets the money from the drugs, the insurance company (like the guy who runs a floating craps game) gets a cut off everybody.

And, of course, when John's liver finally does give out, the local ambulance chaser gets to sue everybody in sight. Oh, there's also the advertising dollars.

It's a helluva good time for all, till John's money runs out.

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#7
In reply to #6

Re: Why is the Entire Healthcare System So Expensive?

04/20/2010 9:55 AM

"..the insurance company (like the guy who runs a floating craps game) gets a cut off everybody."

A floating craps game, best explanation I ever heard of what insurance is about. Thanks.

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#8
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Re: Why is the Entire Healthcare System So Expensive?

04/20/2010 9:13 PM

Nice... very nice.

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#9
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Re: Why is the Entire Healthcare System So Expensive?

04/21/2010 1:03 AM

You would think that we, as the people, have the power for change, yet we ALL choose to get raped by the system, and go back for more.

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#10
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Re: Why is the Entire Healthcare System So Expensive?

04/21/2010 12:49 PM

I'm sure it's greed. Each American is hoping he will be the next recipient of a massive malpractice settlement, so they don't push hard enough for reform. The lawyers just love it, it keeps them in business, at 30%.

The Ugly American is alive and well. Until we change our ways, we will continue to live in this sewer, and the rest of the world will hate us.

It seems the seven deadly sins are viewed as goals.

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#11
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Re: Why is the Entire Healthcare System So Expensive?

04/21/2010 1:17 PM

... never say ALL. We don't all choose it, some of us stay out of it as much as possible!! if not completely.

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#12

Re: Why is the Entire Healthcare System So Expensive?

04/27/2010 10:25 AM

Its free here in little old England.

As A diabetic i even get all my medicines free.

Why cant such a system be introduced in the USA

ours has been going since 1948

http://www.nhs.uk/tools/pages/nhstimeline.aspx

http://www.google.co.uk/search?q=nhs+history+timeline&sourceid=ie7&rls=com.microsoft:en-gb:IE-SearchBox&ie=&oe=&redir_esc=&ei=hfPWS6SjJ5Ci0gSPnsiICA

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