Why Are Medical Costs So High?

[mRx 16]

Great quote here by congressman and doctor Ron Paul regarding malpractice:

the root cause of the malpractice crisis: the shift away from treating the doctor-patient relationship as a contract to viewing it as one governed by federal regulations. The third-party payer system, largely the result of federal tax laws and the HMO Act of 1973, invites insurance company functionaries, politicians, government bureaucrats, and trial lawyers into the equation. This destroys the patient’s incentive to keep costs down, because he feels he is part of “the system” and someone else pays the bill. In other words, the costs of medical care have been socialized, even though HMOs are ostensibly private businesses.

Yet the assessment of liability and compensation should be determined by private contractual agreements between physicians and patients – in other words, by the free market. The free-market approach enables patients to protect themselves with “negative outcomes” insurance purchased before medical treatment. Such insurance ensures that those harmed receive fair compensation, while reducing the burden of costly malpractice litigation on the health care system. Patients receive this insurance payout without having to endure lengthy lawsuits, and without having to give away a large portion of their award to a trial lawyer. This also drastically reduces the costs imposed on physicians and hospitals by malpractice litigation.

[Trumplestiltskin 5,791]

So essentially individual patients in concert with doctors (AKA private health authorities - which in this context is essentially the same as a trade union) should determine the standards by which the quality of medical work is measured and which risks are to be considered acceptable (and financially covered in the event things go wrong) as part of a medical procedure?

The immediate question that springs to mind is exactly how much such "negative outcome" insurance cost in addition to co-payments and deductibles?

The second thing that comes to mind is that probably doesn't bode well for the elderly or anyone who isn't mentally competent to make a decision on "fair risk" or who is unconscious or otherwise incapacitated and who is unable to provide informed consent and read/sign legal documents.

[mRx 16]

So essentially individual patients in concert with doctors (AKA private health authorities - which in this context is essentially the same as a trade union) should determine the standards by which the quality of medical work is measured and which risks are to be considered acceptable (and financially covered in the event things go wrong) as part of a medical procedure?

The immediate question that springs to mind is exactly how much such "negative outcome" insurance cost in addition to co-payments and deductibles?

The second thing that comes to mind is that probably doesn't bode well for the elderly or anyone who isn't mentally competent to make a decision on "fair risk" or who is unconscious or otherwise incapacitated and who is unable to provide informed consent and read/sign legal documents.

I see it quite the opposite actually. The insurance would be covered by private insurance companies, with no union or agreement between the doctor and insurance company. This transfers the burden of the costs of legitimate malpractice claims from the medical field to the insurance companies (where it should be anyways). I really don't see it raising prices, as the cost of such premiums are currently built into the healthcare costs, so divorcing the two, and freeing them of harmful regulation, would allow them to operate individually with maximum efficiency, and lowering prices altogether. That's how I see it.

As for the second thing, I dunno, I guess I want to assume that an elderly person has an immediate family member that can be made an agent to act on their behalf, this can be done through something like a living will, who would be able to assist in these decisions. I know personally, that if my Mom or Dad were in such a situation, I would want to ensure their safety, and talk through the agreement along with doctor. I don't need the state to.

[Trumplestiltskin 5,791]

I think its difficult enough already to find out which conditions on your insurance plan are covered for treatment - and it makes your insurance completely useless if you develop some condition that they don't cover (I guess the appropriate response would be "who knew?" or "who knew I would need that?". As it is - the current system is already overloaded with bureaucratic red-tape and ambiguously worded legal loopholes. Short of going over everything line-by-line with a lawyer it puts all of the power in the hands of the health insurance industry. I don't see how that is a good outcome for the interests of patients...

On the other point some people do indeed have people to help look after their interests, but that isn't really the point. The measure of how effective the system is - is surely in how it treats the most vulnerable people (which is kind of where we are at the moment).

Edited December 3, 2008 by Paul Daniels

[Heracles 417]

Great quote here by congressman and doctor Ron Paul regarding malpractice:

He is a Liberian though.

How can someone with cancer negotiate a lower rate. Unless someone is a billionaire and Oprah their ability to negotiate / buying power is negligible. I don't see any issue with some needed government regulation. It is wrong to leave people's health up to a bunch of companies for them to decide. As we don't leave security up to shareholders.

There is another way for the US government to work around this. Build a NHS on the side to compete with private industries. This way they can own and run hospitals which not only allows them to cover the poor but also provide more competition to the private sector, further reducing the costs. There federal buying power would enable them to purchase equipment and medication at a reasonable price. Of course this can only work with reform and caps to the malpractice laws.

Edited December 3, 2008 by Aficionado

[Heracles 417]

oops libertarian not Liberian

[mawilson 2,133]

(Just like in the days of Katrina)

"Even when Government fails them at every level, Still the people demand more of it".

The lesson being - that you should demand higher standards from the people you elect

Yeah, good luck with that.

Let's face it, elected officials can do pretty much whatever they want.

Whatcha gonna do, barge into their office and hold them accountable?

Don't vote for them next time? Who are you going to vote for then?

[Trumplestiltskin 5,791]

(Just like in the days of Katrina)

"Even when Government fails them at every level, Still the people demand more of it".

The lesson being - that you should demand higher standards from the people you elect

Yeah, good luck with that.

Let's face it, elected officials can do pretty much whatever they want.

Whatcha gonna do, barge into their office and hold them accountable?

Don't vote for them next time? Who are you going to vote for then?

I didn't say it was feasible - it isn't as long as people insist on playing the game.

The fact is that most of us want to be led and aren't interested in governing ourselves - but would rather elect singular figures to do it for us via a corrupt electoral system that creates an illusion of choice.

[mRx 16]

I think its difficult enough already to find out which conditions on your insurance plan are covered for treatment - and it makes your insurance completely useless if you develop some condition that they don't cover (I guess the appropriate response would be "who knew?" or "who knew I would need that?". As it is - the current system is already overloaded with bureaucratic red-tape and ambiguously worded legal loopholes. Short of going over everything line-by-line with a lawyer it puts all of the power in the hands of the health insurance industry. I don't see how that is a good outcome for the interests of patients...

All of these problems you describe are problems that are occurring now, with the current system.

Regulation got us in this mess, more regulation can never get us out.

[Trumplestiltskin 5,791]

I think its difficult enough already to find out which conditions on your insurance plan are covered for treatment - and it makes your insurance completely useless if you develop some condition that they don't cover (I guess the appropriate response would be "who knew?" or "who knew I would need that?". As it is - the current system is already overloaded with bureaucratic red-tape and ambiguously worded legal loopholes. Short of going over everything line-by-line with a lawyer it puts all of the power in the hands of the health insurance industry. I don't see how that is a good outcome for the interests of patients...

All of these problems you describe are problems that are occurring now, with the current system.

Regulation got us in this mess, more regulation can never get us out.

That's a very simplistic answer to be honest.

It really doesn't matter whether you're being screwed by the government or by private industry - the point is that you're being screwed.

I've never really believed in trickle-down Reaganomics - as it encourages an increase in personal and national debt to keep money flowing through the system. If you need further indication of how flawed an ideology it is you need only look at some of the biggest companies on the stock market who are now calling for government to bail them out with taxpayer money.

As far as healthcare goes - the profitability of the private system is totally at odds with the ethic of providing quality and accessible care. That is the fundamental difference of ideology that pervades this entire subject - it creates a class divide over who has a right to live based on how much money they have.

Edited December 4, 2008 by Paul Daniels

[mRx 16]

I think its difficult enough already to find out which conditions on your insurance plan are covered for treatment - and it makes your insurance completely useless if you develop some condition that they don't cover (I guess the appropriate response would be "who knew?" or "who knew I would need that?". As it is - the current system is already overloaded with bureaucratic red-tape and ambiguously worded legal loopholes. Short of going over everything line-by-line with a lawyer it puts all of the power in the hands of the health insurance industry. I don't see how that is a good outcome for the interests of patients...

All of these problems you describe are problems that are occurring now, with the current system.

Regulation got us in this mess, more regulation can never get us out.

That's a very simplistic answer to be honest.

It's a condensed version of exactly what I've been saying throughout this thread.

It really doesn't matter whether you're being screwed by the government or by private industry - the point is that you're being screwed.

I've never really believed in trickle-down Reaganomics - as it encourages an increase in personal and national debt to keep money flowing through the system. If you need further indication of how flawed an ideology it is you need only look at some of the biggest companies on the stock market who are now calling for government to bail them out with taxpayer money.

Free-Market economics and Reaganomics are very different. Ever since US economic advisers universally embraced the ideology of John Keynes, we have had an interventionist and regulation oriented economy. His book, The General Theory of Employment, Interest, and Money is the main influence of all modern government fiscal policies. Regulation can and does favor certain classes. Current Conservatives in the GOP regulate in favor of big business, while Liberals regulate in favor of the lower class. But there is inequality in both sides.

If Reagan really wanted a free-market, he would have abolished the Federal Reserve. But I do agree with you, Reaganomics was a huge failure. But it was not a fault of the free market. I'm not sure what your point was bringing Reaganomics into this.

As far as healthcare goes - the profitability of the private system is totally at odds with the ethic of providing quality and accessible care. That is the fundamental difference of ideology that pervades this entire subject - it creates a class divide over who has a right to live based on how much money they have.

Private businesses are concerned with profit, that is a fact. The free-market normally would determine by what codes and ethics they make their profits(wins) or losses. As it stands now, the government determines the winners and losers. This removes any force on a company to act in a way that customer's want. (ethical, honest, etc.) So again, regulation is to blame.

Removing insurance from healthcare, will lower the cost of the healthcare, and as I've said previously, the premium for insurance is currently built into the cost. I've already stated many times in this thread what I think needs to be done to free the market (the abolition of the AMA, allowing alternative healthcare, allowing the free-market to determine the supply of medical staff), but another thing that I'm not sure I mentioned: Insurance should be used only for unforeseen illness and injury. Not as a means of funding all one's healthcare. Isn't that the basis of insurance, to insure oneself against such circumstances? I mentioned earlier a business that could arise out of the free market to handle all the little things that bring people into the ER. Like a 24-hour facility staffed by LPN's, RN's and a few pharmacists. This would enable efficient, low cost healthcare. It would cost far less to operate these types of facilities, and such savings would be passed to the patient.

But not to avoid your point, let's take a look at this situation: A homeless, jobless poor person get's sick and needs a medical procedure. There is no way he can afford it. The question is not whether or not he should receive the care he requires, but who should fund it? This has nothing to do with healthcare, or insurance. This is a question of charity. Should we fund it through taxation of our wages, and let the government determine whether or not to give those wages to the individual? Or should we decide, through our own free will, to give charity?

People wonder why we have so few American funded charities that actually operate in the US. It must be universally assumed that the government will seize the fruits of our labor to help others in need, forcing private charity out of the USA. Just my opinion, take it as you will.

[HAL 9000 96]

Which is why we have folks argumentative about doing regulation the right way, not leaving the green light on constitutively. Doing so only benefits those already in possession of capital.