What is the best way to address America's health care dilemna?

Question

When health insurance began, the patient paid the doctor then submitted a claim to insurance company. That original system allowed patients to stay on top of what was being charged for care. Then, it all changed. Today, no one seems to know how much this or that test or hospital room will cost; bills are submitted without the patient's knowledge and the patient is expected to pay for non-covered items when he or she never approved the items in the first place.

Ask your nurse in the hospital how much that injection will cost and she won't be able to tell you. Ask for someone who can tell you and you'll be given the run around and marked down as "problem patient." I submit, taking the patient out of the costs loop lies at heart of the problem of continuously rising health care costs. And since insurance companies justify their enormous profits by way of ratio to their costs, it is against their interests to see those costs reduced.

I'd like to hear the opinions of others.

According to the National Academy of Sciences, very year in America's hospitals between 90,000 and 150,000 people are killed (source: NAS, "To Err is Human"). These wrongful deaths represent a greater rate of death than seen in any of America's wars. Misinformed people, the medical industry and their insurance carriers would have people believe it's somehow wrong to force doctors and hospitals to pay for the deaths and countless injuries they cause, so much of these real-life costs get shifted to the American taxpayer due to what is called "tort reform" (i.e. arbitary limits on recovery of civil damages). Minnesota has no such limits, yet is is rated as first in America for quality of health care, fewest injuries and deaths, mortality and morbidity rates in hospitals.

When you remove the threat of crushing civil lawsuits, doctors and hospitals are free to practice assembly line medicine and let the dead and injured be damned.

The standard hospital admission form has been held by the courts to be what is called "an adhesion contract," meaning it has little force at law since the terms are "agree or be denied medical treatment (in other words, "die") and these forms are most often signed by people so ill it is ludicrous to say that they knew what they were signing (thereby invalidating the contract on the ground of incompetence). The reason you are not told what things cost is to keep you from taking action or pursuing alternatives. This is a serious deregation of the free market system so vital to maintain accountability in our health care system.

Americans have been grossly misled, by a poweful and well-healed media blitz, that frivilous malpractice suits are part of the reason for rising healh care costs. That is a huge lie. Here are the facts: repeated studies have shown that only a mere 2% of all potentially MERITORIOUS cases ever find a lawyer, and of that meagre 2%, only 2% of those ever make it to a jury. Frivilous lawsuits aren't worth the time and money of contigency-fee lawyers and there is no shortage of good cases to pursue. Malpractice awards (in cases with real merit) amount to only 0.46% of all health care costs. Yet, without such malpractice cases being brought, there is absolutely no deterrent to what is the real problem---rampant medical malpractice. The U.S. Dept. of Health and Human services commissioned a study (the "Pew Report") which concluded that across the nation medical quality review boards were competely ineffectual, only rarely suspended licenses, and almost never revoked medical licenses.

Answer 1

Ding, ding! You are correct!

Our system does nothing to discourage overuse of our health care system thus costing more money, thus increasing our prices. Only when people become aware of what they are being charged and seeing the money go out will they began to monitor their usage. Less usage will drive down insurance rates.

I began using an HSA two years ago and I have two excellent examples of how/ why being aware of your healthcare costs reduced unnecessary procedures,

1) I had a kidney stone while on vacation (side note: terribly painful experience). The Doc at the emergency room gave me medication and said I could get a cat-scan when I got home, no hurry. So two weeks later I follow up with my Doc and she says lets schedule a cat-scan. I ask why and how much. She has no clue how much and then I explain it better be medically necessary because I have to pay for it. She says, no big deal if you don't get it but if you have another stone then we have to get one. Since I had no more stones I didn't incur a $600 procedure. If I had regular insurance I would have never questioned getting one and added that cost to the system.

2) My wife suspected my daughter might have sleep apnea. She has no signs other than large tonsils, adenoids, snoring. No other signs but we inquired of the Doc. She said really couldn't tell but let's schedule a sleep study. How much? No idea says the Doc but your insurance should pay for it. Not so with the HSA so we go inquiring. It takes my wife two weeks and a dozen calls to figure out it costs $1,500. I say, let's try something else so she sees the Doc again and says since we have to pay can we try another way? Now we schedule an appointment with a ENT pediatric specialist. He says bring a home video cam of her sleeping. Within 2 minutes he says, no she probably doesn't have sleep apnea. The one real way to tell is the sleep study BUT (NOW HERE's THE KICKER)... He says even if the sleep study said she had it, he wouldn't recommend we do anything and that she'd likely grow out of it. Wow! I could have spent $1500 to find out something that a) I suspected didn't exist AND b) wouldn't change the course of action which was basically wait and see. Of course if I had regular insurance with a $15 deductible I would have scheduled the sleep study and let the insurance company pay $1500 without hesitating.

So there you have two personal examples of how being in charge of your healthcare expenditures saves money. In a traditional insurance plan I would have gladly let them pay for those procedures thus increasing the overall healthcare costs.

Answer 2

the premium for family medical coverage where I work is $100/wk. that is just what employees pay. the company has been absorbing the remainder and the increases for 5 years now. Coverage is average, high co-pay, no dental, minimal vision. with premiums close to $200/wk total for family coverage that is about 22% of my weekly earnings. I can't see how universal single payer health insurance could cost much more if it was paid as a "tax" the other thing is that if there were Socialized medicine a' la' Veterans administration, the wealthy people would have to get in line behind the poor people.... and because the wealthy have the power, they would rather the poor not have insurance. Sister Godzilla, are you saying that you do not have health insurance? and that you pay the for all your medical yourself? Self insured? ever have an operation? how about an MRI, PT for that shoulder tear?

Answer 3

The best way to address things, would be putting laws in effect holding insurance companies accountable, and for that matter too, doctors. If i go to a restaurant and order a meal, I know what the cost will be. If I go to the doctor, I should know what it costs to have a full physical for instance. And for whatever it costs, insurance should pay for everything they are charged, as long as the charges are proven to be worth, and yes, it includes a bandage wrap and such. I switched jobs a couple years ago, and went 90 days with no insurance, and I had to see the doctor, and I told them what the problem was, and asked how much it would cost, and they had no idea. I still think doctors should charge what they deem is necessary, and there should be NO government involvement in what a private doctor does. But I have had insurance statements come back to me, showing on two different appointments for the same thing, two different costs.

Answer 4

Close the health insurance companies and pay the health industry about a third of that sum. Also must make anything to do with health non profit. Removing the health insurance companies as the middle man is the only thing to do let the hospitals manage their cost under a board of regulators to keep things on the up and up. We also must have tort reform to help keep frivolous law suits out of the courts. There is more but that is a start.

Answer 5

Ah, but you did approve them. You signed an admission slip for treatment, didn't you!

And it depends on the type of insurance whether you get billed at all!

A Tylenol (1) cost about $10.00. A CAT scan, over $1,000! That doesn't include doctors fees for reading them!

Insurance companies are like no other, they are driven by profits, and all you have to do is look at an American automobile to deduce they sell pure junk! With few exceptions.

The insurance companies, who are contracted, say by the state, get their money, then start denying benefits. That way stockholders make a lot of money, and CEO's, like Anthems, make $14 million a year in salary and bonus. That does not include the perks. It is obscene when you think about how many HMO's there are!

Answer 6

I really like Mitt Romney's plan. As Governor of Massachusetts worked out a way to get everyone in his state that had no insurance covered by private medical insurance. He proved that with a little innovation it can be handled on a State level using private insurance.

This is way superior to socialized medicine. That is like having your health care provided by the Department of Motor Vehicles. A gigantic impersonal bureaucracy.


.

Answer 7

It would be more cost effective to spend money on things which would prevent people from getting sick so much, for example, on cleaning up the environment.

We have an established system with a lot of vested interests and a lot of shareholders expecting high returns on their investments. If there weren't so many sick people, it wouldn't be so profitable.

We're also encouraged not to think for ourselves on health matters. When you hear "ask your doctor" so many times, eventually it becomes an automatic response.

Answer 8

When there are so many third-party payers, the users are insulated from the costs.

When there are so many lawyers and greedy clients running around, the hospitals and doctors spend too much time running around covering their butts.

And when there are so many politicians running loose in this totally unconstitutional territory, nobody is safe.