Why Are Medical Costs So High?

[mRx 16]

While I agree with much of Matt85's posts in this thread, I have to disagree with dismantling the AMA and FDA. Granted, both can be difficult at times and may even increase the overall cost. However, the AMA constitutes certain medical regulations, without which, anyone could conceivably hang a shingle outside their front door and claim to be a physician. Going to college and medical school would be irrelevant. What if someone attended both, but never graduated? They could say -- without lying -- that they went to both. No one ever thinks to ask, "Did you graduate?" How many people really look over a doctor's degrees hanging in his or her office? Not many, I'd gather.

The FDA also regulates drugs that are safe to dispense to the public. The FDA enforces testing. How many companies would bother doing that if it was not required? Probably not a lot as that, in of itself, costs money. Is the FDA always right? Of course not. I'd rather take my chances with them over hearsay, however.

DeadPoolX,

They would operate as any other legitimate business without coercive control. Doctor's would be competing directly with each other, and be certain, if one fouled up an operation, or in any way left their customer dissatisfied, word would spread, the doctor would lose revenue due to possible clientele hearing about his practices, and then this doctor would be gracefully forced out of business through free market mechanisms. This fact naturally fosters competition. This leads to an overall increase in quality of service and lowering of prices. The ultimate result is high quality, efficient service. We don't need the government to put a stamp or a license on something to tell us it's suitable for us. And we sure don't need the AMA, which only harms us more.

As for the FDA, they are no different. They function solely as a covert form of protectionism. They are the monopoly maker. For no drug goes onto the market without their approval. This keeps competition out, and prices extremely high.

In many countries, you can go to a corner pharmacy and buy many cheap drugs that are made in the same plants as the FDA approved drugs we get for 10X more. It's absolutely ridiculous. The FDA's rigorous testing requirements are a crock, they are merely tools to keep competition out, not to increase quality. Look at how much the pharmaceutical corporations lobby in DC, and you think they care about us? Without the market stranglehold of the FDA, companies would be forced to have a reputation instead of a politician in the pocket. If Drug company A put an un-tested drug on the market that caused injury, then their reputation would be severely damaged. And the free market would punish this as I've already stated.

These institutions are not sustainable and serve only to strip you of your money and your choices.

[DeadPoolX 9]

While I agree with much of Matt85's posts in this thread, I have to disagree with dismantling the AMA and FDA. Granted, both can be difficult at times and may even increase the overall cost. However, the AMA constitutes certain medical regulations, without which, anyone could conceivably hang a shingle outside their front door and claim to be a physician. Going to college and medical school would be irrelevant. What if someone attended both, but never graduated? They could say -- without lying -- that they went to both. No one ever thinks to ask, "Did you graduate?" How many people really look over a doctor's degrees hanging in his or her office? Not many, I'd gather.

The FDA also regulates drugs that are safe to dispense to the public. The FDA enforces testing. How many companies would bother doing that if it was not required? Probably not a lot as that, in of itself, costs money. Is the FDA always right? Of course not. I'd rather take my chances with them over hearsay, however.

DeadPoolX,

They would operate as any other legitimate business without coercive control. Doctor's would be competing directly with each other, and be certain, if one fouled up an operation, or in any way left their customer dissatisfied, word would spread, the doctor would lose revenue due to possible clientele hearing about his practices, and then this doctor would be gracefully forced out of business through free market mechanisms. This fact naturally fosters competition. This leads to an overall increase in quality of service and lowering of prices. The ultimate result is high quality, efficient service. We don't need the government to put a stamp or a license on something to tell us it's suitable for us. And we sure don't need the AMA, which only harms us more.

As for the FDA, they are no different. They function solely as a covert form of protectionism. They are the monopoly maker. For no drug goes onto the market without their approval. This keeps competition out, and prices extremely high.

In many countries, you can go to a corner pharmacy and buy many cheap drugs that are made in the same plants as the FDA approved drugs we get for 10X more. It's absolutely ridiculous. The FDA's rigorous testing requirements are a crock, they are merely tools to keep competition out, not to increase quality. Look at how much the pharmaceutical corporations lobby in DC, and you think they care about us? Without the market stranglehold of the FDA, companies would be forced to have a reputation instead of a politician in the pocket. If Drug company A put an un-tested drug on the market that caused injury, then their reputation would be severely damaged. And the free market would punish this as I've already stated.

These institutions are not sustainable and serve only to strip you of your money and your choices.

I understand what you're saying and in some ways, I agree with you. My point is that if a doctor screws up, someone's life may be lost. The free market will not guarantee the family of the departed any reparations.

Going to see a physician is a lot different than going to Best Buy and getting an iPod. If the iPod doesn't work, it's not a problem -- just return it to the store and they'll either refund your money or supply you with a new one. If a physician makes a mistake and someone dies, what's he going to do? Give the family a refund? Maybe get a replacement?

Incidents can be covered up. Many people have had problems with stores ranging from Wal-Mart to Saks Fifth Avenue. How many of these stories beyond family or friends have we really heard about? I know it hasn't been on the nightly news, any of the cable news channels or in the newspaper. How many people keep shopping there even after being told of such problems? A lot, since most don't believe they'll receive the same treatment or have similar problems.

Once again, getting a damaged purse is hardly equal to a surgical operation or dispensing medication. Even though I am generally in favor of the free market and capitalism as a whole, there needs to be some regulation in this matter.

[NickD 203]

It's like anything else, can take your car to a mechanic with a problem, he knows exactly what's wrong and can fix it in five minutes where another guy would spend days and get nowhere.

Same with doctors, could barely walk after my accident, saw three specialists, all said I need major back surgery with a 50-50 chance that I would be much worse afterwards. Quite by accident, found a doctor where is found a non-cancerous growth caused by a bad bruise that was pinching nerves, removed it outpatient in less than 45 minutes, and after a couple of weeks was running again after suffering with this for five years. I complained to these other doctors about this lump I could feel on my back, said it didn't have anything to do with my problems, now I considered them idiots and won't go back to them.

Same with guessing on prescriptions, is an art more of a science, and when you see a doctor, you pay through the nose whether he hits it right or not. Talking to the tradesmen in town, doctors are the worse customers they have, want extensive warranties and the job done for the lowest possible price, you have to do it right the first time or don't get paid.

To me, the greatest gift in life has been the internet, not only finding the woman of my most wildest dreams, but for solving medical problems. With the latter, a ton of BS accompanies anything concerning medical, well I guess that also applies to finding a mate. Have to read carefully and learn to determine the truth from the BS. You have to learn about what your problem is and be able to express it to your doctor, ha, learned about procedures my doctor never heard about, but leave it up to him for the determination. Have to do that in this country, we have strict laws on prescriptions and procedures, can't do it yourself.

A close priest friend told me, don't pray for a cure, pray to find a good doctor, a lot of truth in that, but not sure if praying works as good as being able to ask the right questions. Prefer a humble doctor that listens, lot's of arrogant guys out there that think they are god and know everything. And you have to know your own body.

Tees me off when you pay 400 bucks for a prescription that doesn't work and you can't return it, if my doctor wants to try something new, I get samples and try a very small dose first, and get back to him immediately with the results as to whether it's doing what he thinks it should be doing, that saves a lot of money and time.

The next miracle I am looking forward to is to remove all the BS off the web.

[Reba 2]

Uninsured people use the ER as their doctor's office because GPs won't take uninsured patients. Not all towns have free clinics for uninsured residents, and those that do have waiting lists two and a half blocks long. Where I live now, the free clinic has only been open 5 days per week for less than a year (I dont' know how the full time doctor gets paid, mostly private donations I think, which obviously are not very many these days). Before that, it was open one day per week, and on a "lottery" basis. If you were uninsured and needed to see a doctor, put your name in the hat, if we pull it out, you get to see the doctor! Anybody else waiting is SOL, or sitting in the ER because they've got a sore throat.

Heck, I tried to make an appointment for myself for my annual yesterday. I was on hold for about 20 minutes while she "tried to find me a time slot" and she finally got back on the line and said "I'll have to call you back, I can't find anything available for the next 2 months". She never called back. The offices where I go are short on physicians, because they keep leaving town for greener pastures.

My husband recently had to have a battery of tests for a still un-diagnosed chest pain. The bills just keep rolling in, and we're about broke now. And we have insurance. Plus, one of his medications is not covered by our insurance, and it costs $155 per month. My husband has been out of work for nearly 2 years now, and my take home pay is about $200 per week. How the hell are we expected to survive on that? I just can't help thinking, every freakin day that if we were living in Canada, we just would not have to worry about any of this shite. His tests would have all been covered by provincial health plan, and his meds would not cost nearly as much because of government regulation of pharma companies. Which, btw, are the same damn companies that are here in the US, grubbing your hard earned dollars for your monthly medications, that would cost you half as much in any other country on the planet.

SOMETHING needs to be done.

[one...two...tree 2,762]

Uninsured people use the ER as their doctor's office because GPs won't take uninsured patients. Not all towns have free clinics for uninsured residents, and those that do have waiting lists two and a half blocks long. Where I live now, the free clinic has only been open 5 days per week for less than a year (I dont' know how the full time doctor gets paid, mostly private donations I think, which obviously are not very many these days). Before that, it was open one day per week, and on a "lottery" basis. If you were uninsured and needed to see a doctor, put your name in the hat, if we pull it out, you get to see the doctor! Anybody else waiting is SOL, or sitting in the ER because they've got a sore throat.

Heck, I tried to make an appointment for myself for my annual yesterday. I was on hold for about 20 minutes while she "tried to find me a time slot" and she finally got back on the line and said "I'll have to call you back, I can't find anything available for the next 2 months". She never called back. The offices where I go are short on physicians, because they keep leaving town for greener pastures.

My husband recently had to have a battery of tests for a still un-diagnosed chest pain. The bills just keep rolling in, and we're about broke now. And we have insurance. Plus, one of his medications is not covered by our insurance, and it costs $155 per month. My husband has been out of work for nearly 2 years now, and my take home pay is about $200 per week. How the hell are we expected to survive on that? I just can't help thinking, every freakin day that if we were living in Canada, we just would not have to worry about any of this shite. His tests would have all been covered by provincial health plan, and his meds would not cost nearly as much because of government regulation of pharma companies. Which, btw, are the same damn companies that are here in the US, grubbing your hard earned dollars for your monthly medications, that would cost you half as much in any other country on the planet.

SOMETHING needs to be done.

I'm sorry to hear that Reba. A powerful argument.

[Heracles 417]

It's the malpractice lawsuits and insurance companies that hurt us all. Doctors need to pay anywhere from $80,000 to $200,000 per year simply to cover their butts. In addition, insurance companies pay the doctor whatever they feel is adequate. Knowing this, it's obvious why physicians charge the prices they do and often order unnecessary tests.

Exactly. Funny how the same group of people in this dam country who beat their little peckers about UHC and NHS fail to mention this very important point. This same group (starts with L ends with s) is obsessed with the courts and the legal system. After all, they have been using it for years now to get their way. Now that the hen has come home to roost these same guys are playing dumb and turning a blind eye to the real cost. Yes Litigation. Evey actions has an equal and opposite reaction. A side-effect per say.

411 for many: When someone frivolously sues a company, the government, the county etc we the people (yes us) end up paying for it. All while the lawyers and the plaintiff walk away with millions. So when someone frivolously sues a hospital and doctor for $50 million because of a accident and wins, ding ding ding you guessed it, we end up paying for it. These same sort of lawsuits are generally thrown out abroad as you cannot sue a doctor if they make a reasonable effort to minimize complications.

Edited December 3, 2008 by Aficionado

[one...two...tree 2,762]

It's the malpractice lawsuits and insurance companies that hurt us all. Doctors need to pay anywhere from $80,000 to $200,000 per year simply to cover their butts. In addition, insurance companies pay the doctor whatever they feel is adequate. Knowing this, it's obvious why physicians charge the prices they do and often order unnecessary tests.

Exactly. Funny how the same group of people in this dam country who beat their little peckers about UHC and NHS fail to mention this very important point. This same group (starts with L ends with s) is obsessed with the courts and the legal system. After all, they have been using it for years now to get their way. Now that the hen has come home to roost these same guys are playing dumb and turning a blind eye to the real cost. Yes Litigation. Evey actions has an equal and opposite reaction. A side-effect per say.

411 for many: When someone frivolously sues a company, the government, the county etc we the people (yes us) end up paying for it. All while the lawyers and the plaintiff walk away with millions. So when someone frivolously sues a hospital and doctor for $50 million because of a accident and wins, ding ding ding you guessed it, we end up paying for it. These same sort of lawsuits are generally thrown out abroad as you cannot sue a doctor if they make a reasonable effort to minimize complications.

Frivolous lawsuits are nothing more than a Right Wing wet dream.

[Heracles 417]

Frivolous lawsuits are nothing more than a Right Wing wet dream.

So then take them out of the equation. Bring the American legal system in par with those nations which offer NHS where you cannot sue a doctor for $50 million for accidentally dropping a scalpel and consequently cutting a toe nail. You guys have to get over this Michael Moorish approach of pick-n-choose various points of a country yet ignore the others. The overall picture. In the above example the plaintiff would not receive a dime abroad. Whereas here you can sue a company for spilling hot coffee on yourself let alone a doctor.

Edited December 3, 2008 by Aficionado

[one...two...tree 2,762]

Frivolous lawsuits are nothing more than a Right Wing wet dream.

So then take them out of the equation. Bring the American legal system in par with those nations which offer NHS where you cannot sue a doctor for $50 million for accidentally dropping a scalpel and consequently cutting a toe nail. You guys have to get over this Michael Moorish approach of pick-n-choose various points of a country yet ignore the others. The overall picture. In the above example the plaintiff would not receive a dime abroad. Whereas here you can sue a company for spilling hot coffee on yourself let alone a doctor.

Just the facts, Boo-yah. Use Google and post them here...then we'll talk.

[Heracles 417]

Frivolous lawsuits are nothing more than a Right Wing wet dream.

So then take them out of the equation. Bring the American legal system in par with those nations which offer NHS where you cannot sue a doctor for $50 million for accidentally dropping a scalpel and consequently cutting a toe nail. You guys have to get over this Michael Moorish approach of pick-n-choose various points of a country yet ignore the others. The overall picture. In the above example the plaintiff would not receive a dime abroad. Whereas here you can sue a company for spilling hot coffee on yourself let alone a doctor.

Just the facts, Boo-yah. Use Google and post them here...then we'll talk.

In most developed nations you cannot just sue someone for the sake of it or for an accident. A UHS or NHS would go bankrupt without changes in tort and malpractice laws. Only in cases of obvious negligence can you sue and even then only for a reasonable amount. Usually under a million. You would have to show the doctor or hospital was deliberately and knowingly negligent.

Edited December 3, 2008 by Aficionado

[Trumplestiltskin 5,791]

What's a typical example of a "frivolous" law suit?

[Heracles 417]

What's a typical example of a "frivolous" law suit?

I'll give you something better.

Doctors' fear of lawsuits tied to added costs of $1.4b

$1.4 billion in added costs in Massachusetts alone just to minimize the risk of litigation.

The findings, which roughly mirror the experience reported by doctors in other states, come amid skyrocketing malpractice insurance premiums for doctors nationwide and a heated debate in Massachusetts and across the country about overhauling the malpractice system.

[Trumplestiltskin 5,791]

OK - Doctors may be afraid of litigation but I'm trying to get an idea as to what kind of suits are considered frivolous.

I mean you said the other day that you didn't think the family of the Walmart worker killed in the Black Friday stampede should sue for damages.

Do you think its right that before you can even get on the operating table you have to sign a bunch of disclaimers to the effect that you won't sue them for anything for any reason?

Aren't patients entitled to have some rights to sue if they - for example - contract MRSA in a hospital, or if a surgeon removes the wrong kidney?

As I say - if its perfectly acceptable business practice for insurance companies to protect their bottom lines by looking for ways to deny coverage - is it somehow wrong for the public to look for their own shortcuts around the system?

Edited December 3, 2008 by Paul Daniels

[Heracles 417]

OK - Doctors may be afraid of litigation but I'm trying to get an idea as to what kind of suits are considered frivolous.

I mean you said the other day that you didn't think the family of the Walmart worker killed in the Black Friday stampede should sue for damages.

Do you think its right that before you can even get on the operating table you have to sign a bunch of disclaimers to the effect that you won't sue them for anything for any reason?

Aren't patients entitled to have some rights to sue if they - for example - contract MRSA in a hospital, or if a surgeon removes the wrong kidney?

As I say - if its perfectly acceptable business practice for insurance companies to protect their bottom lines by looking for ways to deny coverage - is it somehow wrong for the public to look for their own shortcuts around the system?

Six what kills me about you as that you sound as if you never lived in the UK. As an example, how many people have you heard of suing a company after they themselves spilled coffee on their own pants and consequently burned themselves? Same goes with medical malpractice suits. A good proportion of lawsuits here would be thrown out in the English courts and any payout, if there was actual and premeditated negligence, would be quite reasonable.

We are talking about the human body here. Not some production line car where most fixes are the same. It is common sense that accidents happen and that a doctor is not some sort of 24th century super computer able to scan and detect every symptom or side-effect a person may have. Unless a doctor or the hospital was down right negligent, we should not be able to sue. Any payout should be reasonable. This is how NHS works abroad. It would fail even in the richest and highest taxing country in the world if people there could sue at the drop of the hat and received similar payouts, as is the case here.

I want a doctor to operate in an environment where they are free to do what they do best, treat people. Rather than constantly worrying about being sued. It is not only demoralizing for them but unproductive and reduces the quality of care for the other honest patients who just want to get better rather than pursue payouts from lawsuits. The same thing happens in teaching where teachers are scared of parents and students and are forced to watch their every move rather than actually teach. The people who suffer in both examples are the majority who are doing the right thing. The answer in both cases is take out the minority who are abusing the system and ruining it for everyone else.

Edited December 3, 2008 by Aficionado

[Trumplestiltskin 5,791]

OK - Doctors may be afraid of litigation but I'm trying to get an idea as to what kind of suits are considered frivolous.

I mean you said the other day that you didn't think the family of the Walmart worker killed in the Black Friday stampede should sue for damages.

Do you think its right that before you can even get on the operating table you have to sign a bunch of disclaimers to the effect that you won't sue them for anything for any reason?

Aren't patients entitled to have some rights to sue if they - for example - contract MRSA in a hospital, or if a surgeon removes the wrong kidney?

As I say - if its perfectly acceptable business practice for insurance companies to protect their bottom lines by looking for ways to deny coverage - is it somehow wrong for the public to look for their own shortcuts around the system?

Six what kills me about you as that you sound as if you never lived in the UK. As an example, how many people have you heard of suing a company after they themselves spilled coffee on their own pants and consequently burned themselves? Same goes with medical malpractice suits. A good proportion of lawsuits here would be thrown out in the English courts and any payout, if there was actual and premeditated negligence, would be quite reasonable.

We are talking about the human body here. Not some production line car where most fixes are the same. It is common sense that accidents happen and that a doctor is not some sort of 24th century super computer able to scan and detect every symptom or side-effect a person may have. Unless a doctor or the hospital was down right negligent, we should not be able to sue. Any payout should be reasonable. This is how NHS works abroad. It would fail even in the richest and highest taxing country in the world if people there could sue at the drop of the hat and received similar payouts, as is the case here.

I want a doctor to operate in an environment where they are free to do what they do best, treat people. Rather than constantly worrying about being sued. It is not only demoralizing for them but unproductive and reduces the quality of care for the other honest patients who just want to get better rather than pursue payouts from lawsuits. The same thing happens in teaching where teachers are scared of parents and students and are forced to watch their every move rather than actually teach. The people who suffer in both examples are the majority who are doing the right thing. The answer in both cases is take out the minority who are abusing the system and ruining it for everyone else.

That's nice and all - but that's not what I asked.