The relentless, decades-long rise in the cost of health care has left many Americans struggling to pay their medical bills. Workers complain that they cannot afford high premiums for health insurance. Patients forgo recommended care rather than pay the out-of-pocket costs. Employers are cutting back or eliminating health benefits, forcing millions more people into the ranks of the uninsured. And state and federal governments strain to meet the expanding costs of public programs like Medicaid and Medicare.
Health care costs are far higher in the United States than in any other advanced nation, whether measured in total dollars spent, as a percentage of the economy, or on a per capita basis. And health costs here have been rising significantly faster than the overall economy or personal incomes for more than 40 years, a trend that cannot continue forever.
It is the worst long-term fiscal crisis facing the nation, and it demands a solution, but finding one will not be easy or palatable.
Before health insurance became a standard issue, health care was far less expensive. As a young mom, not gainfully employed, married to a grad student who was working part time, paying bills for child delivery, pediatric care etc. was not a great burden. Room rate was I believe $19 a day at the local hospital, and visits to the pediatrician were $10 a pop. Today health care bills cover huge insurance costs for all medical professionals, plus huge administrative costs for all insurance programs, plus a lot of extra staff time filling out forms. Health care would have become more expensive like everything else (our first house cost $10,500 and is now valued at $300,000), but the proportion would have been better without all the multiple insurance costs.
the proportion would have been better without all the multiple insurance costs.
Including of course the insurance against being sued. Which is also the reason why batteries of unnecessary and expensive tests are required, just in case something is missed and the physician is sued. Is it not the case that much of the difficulties of the US health care system is caused by lawyers?
Terry I will agree with what you say and add to it. I remembering reading about how some states dared to put a cap on medical lawsuit awards and the biggest noise was from the lawyers “..how dare they take the food from our mouth..”
[blockquote]We rely more on costly specialists, who overuse advanced technologies, like CT scans and M.R.I. machines, and who resort to costly surgical or medical procedures a lot more than doctors in other countries do. Perverse insurance incentives entice doctors and patients to use expensive medical services more than is warranted. [/blockquote]
As a specialist, I would add to Terry’s and Harvey’s comments on malpractice and defensive medicine being the “enticement” for ordering extra tests. I try to be circumspect rather than using the shotgun assessment. An example, I see a lot of dizzy patients. Many of my colleagues order an MRI on all of them. I do not. Might I miss a brain tumor? Possibly. Would I be sued for delayed diagnosis? Probably. Why do I not get MRI’s on everyone? Because even if the patient is only paying 20%, it is a big chunk of change. If I get sued for such a circumstance, will I change my test ordering habits? Probably. Do I have special enticements for ordering extra tests other than covering my rear? No.
I have 2.5 employees working on getting money owed to me by insurance. It is outrageous what insurance companies do. They reject claims just to make their quotas. A favorite technique (not) experienced by my employees is when they call up insurance companies and are on hold for thirty minutes or more and when they finally reach a person…click, they get hung up on. This happens so frequently with all carriers that it cannot be accidental.
I would add. Is single payer the answer? I do not know why they call it Medicaire for all. It should be called medicaid for all. My medicaid patients are the worst in terms of compliance. They have nothing invested financially. Invariably, they are the ones that treat my staff poorly. The no-show rate is outrageous. They even no-show for surgical procedures even though we carefully explain that they are letting down dozens of people and costing thousands of dollars in wasted OR time.
(This being said, I do not turn away Medicaid. It is my calling to serve the poor. My staff knows and understands this.)
My quote of the day generator gave me this pearl this morning:
[blockquote]We Americans live in a nation where the medical-care system is second to none in the world, unless you count maybe 25 or 30 little scuzzball countries like Scotland that we could vaporize in seconds if we felt like it. Dave Berry
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