Posted on 06/25/2019 6:13:49 AM PDT by Kaslin
Several years ago, I had a shoulder injury, and the doctor told me I might need surgery to fix the small tear in my rotator cuff. So, I asked, "Doctor, if I have this surgery, about how much will it cost?"
He looked at me confusedly and said, "Steve, I've been doing these surgeries for 20 years, and you are the first patient to ever ask me what it costs!"
Then he thought about it and laughed: "I don't know how much this will cost you."
Wow. Health care is one of the most expensive items we buy each year, and yet most Americans haven't a clue what all of this costs. For everything else we buy as Americans, we are bargain hunters -- for cars, homes and restaurants but not for health and medical services, which are about one-seventh of our entire economy.
Then we wonder why medical costs are running at well over double the rate of inflation over the last 20 years compared to all other consumer items. According to the Bureau of Labor Statistics, since 2000, while prices of most consumer items — from toys to computer to cars — have been level or even falling, medical costs have roughly doubled.
One major reason for this is the third-party payment system, which anesthetizes Americans from the true costs of drugs, hospitals, and procedures. If someone else is paying the tab, who cares what it costs? The over-insurance problem in health care makes it more expensive for everyone.
But a second problem is that we are seldom told the costs of medical procedures or drugs. So it is hard to be a cost-conscious consumer, even if we want to be. This is one of many reasons why "free government-run health care," such as Medicare for All, is such a dangerous idea.
President Donald Trump will sign an executive order this week requiring medical providers, hospitals, drug companies, physicians and others to post their prices so people know what things cost. I'm not generally in favor of regulations and mandates, but given that the government runs and pays for half of the health care costs, this executive order, on balance, makes sense.
One problem is that most of the prices will be the out-of-pocket costs to the patients, not the real costs, including what the insurance company pays for pills or hospital stays. Another problem is that you and I could buy the exact same drug and pay wildly different prices depending on what kind of insurance we have. So this is imperfect, but it will, at the margin, make consumers more price-sensitive and thus should help cut into the exploding cost of medicine.
As one practical example, starting soon, ads for drugs costing at least $35 per month will have to post their prices. This could force drugmakers to lower their prices or lose thrifty customers.
Yes, I know this action by the White House treats symptoms, not the disease, of third-party payers for health care.
But it has always amazed me that America has the highest-quality health care in the world with amazing new cures and treatments — almost all invented here — and yet we use such a dump method of paying the $3 trillion annual cost. The alternative to using markets and price transparency to control health costs is price controls, waiting lines and, eventually, death panels. The latter will drive down costs by driving down the quality of our health services.
By the way, I never did get that shoulder surgery. Turns out it was too expensive.
But it is your health. It does not matter what it costs. That is what everyone says. That is the rubric for ever increasing costs and yet, nobody in medicine ever gets enough. It is an industry that has not yet found the limits of the price that traffic will bear. It is an industry that is essential for life and holds us hostage for it. It is an industry that is out of control. It is an industry that needs a lid put on it. The research will still get done.
I have NEVER found any medical expense that would be discounted for CASH. I have tried and the answer is NO. This is one problem with Christian Health Ministries and having to negotiate your own acceptable price that the ministry will accept.
My wife and I are both 65 and have no health insurance. This is a hot button issue for us. Trump’s EO is HUGE for us. We always ask how much it costs, but to include perspective. We rarely have a need to ask because our medical system has little to offer us.
This sort of thing is why:
https://www.google.com/search?rlz=1C1GCEB_enUS853US853&ei=giISXYOuNOuF9PwP2bKnQA&q=pinworm+medication+cancer+man+healed&oq=pinworm+medication+cancer+man+healed
We could seriously slash the cost of health care if we could find a cure for hypochondria. I worked for a large government agency which required that I review medical records. My best guess is that about 70 percent of all visits to the doctor are unnecessary, amounting to assorted aches and pains that are in most cases, imaginary.
I did notice that in old medical records that doctors routinely noted that the patient was a hypochondriac and was essentially just humored, and given some sugar pills. In extreme and particularly annoying cases, patients were told that there was nothing wrong with them and that they could not come back. No more of truth-telling. Now, vast amounts of very expensive testing and medication are the rules. Naturally, the testing comes up negative and most of the meds contain a big dose of anti-depressants.
Instead of paying for prescriptions through our insurance, we use the GoodRx (Gold) plan, paying a mere fraction of what our copay would be.
Most of the high cost of prescription medicine it pharmacy markup. GoodRx works in the same way the insurance company intermediaries do, negotiating with the pharmacies, but GoodRx does it for the cash-paying consumer, obtaining up to 90% discounts.
The only way to bend the medical cost curve is to abolish healthcare insurance in all forms. Then and only then will the supply and demand curve for healthcare function as a free market. Back to reality though, the President’s executive order amounts to nothing more than pandering.
He looked at me confusedly and said, "Steve, I've been doing these surgeries for 20 years, and you are the first patient to ever ask me what it costs!"
Early 2000, I was between jobs, COBRA ran out or wasn't re-newed, so I had no health care insurance.
Had an incident that sent me to the hospital in an ambulance and the original diagnosis was a heart attack.
I was admitted and the following day they docs wanted to perform multiple tests and I axed how much would it cost me.
They were shocked that someone in a hospital bed with a supposed heart attack wanted to know the price of their service. I was paying, it was my money and my heart, and I wanted to know the cost to me.
Long story short, they finally told me it would be around $2,500 and I said put it in writing, they declined.
I said OK, go ahead but I'm not paying anything higher than what ever your best price is to medicade.
We argued for over a year, it was messy, with bill collectors, lawyers, and nastygrams.
I finally settled for about 15% of the original bill.
Not just drugs. I had a blood and urine test. The bill I got had a list price of $1500. My insurance company's contract rate with the hospital group was $75 of which $5 was my copay.
What was the reasonable price for collecting a couple of fluids, mixing some chemicals in for the tests and maybe looking into a microscope? I have no idea. But a 20 times difference between billed and paid rates is insane. It's like having a sticker price on a car as $150,000 but only $7500 if your car insurance company buys it for you.
The costs will continue to go up for anything and everything the gov ‘controls’ that just also happens to be unconstitutional. For instance healthcare and schools but also at a local level housing/rentals costs for urban areas like San Francisco, New York etc. Anywhere the gov. is ‘helping’ even though they’ve overstepped their limits.
Health care prices are the direct result of epidemic political corruption.
We will not fix the former without first fixing the root cause.
Right - shorter version of what I said in the prior post.
If we’d just review the 10 planks of communism then we’d see how our gov is slowly whittling the constitution and our rights down to nothing and charging us taxes for this transformation. I’m afraid even Trump doesn’t get it unless he’s suddenly gonna start eliminating gov jobs and depts. in a major way.
It is extremely difficult to find out what things cost.
One of the reasons is that things in healthcare (except in the “cash only” private sector) really don’t have prices. They have “charges”, and the charges are never what anyone pays.
Charges are a term of art that arise from the delicate dance between hospitals, physician groups, and payers. Most payers except Medicaid pay a negotiated percentage of “charge”, so to get to an actual price (presuming that a provider KNOWS what things cost), the “charge” has to be set high enough that for a given payor mix (and therefore sliding scale of “discounts”), you can make payroll every two weeks.
This system really got going after 1965, and at this point charges only bear the slightest resemblance to cost+profit.
Anyone who thinks this is NOT going to end up with single payer of some type (there are many variants on single payer, some better than others) is, IMO, out of his mind.
If you are 65 you qualify for Medicare.
Yes. Plan B is free and the only one I’ll get when I retire, because I have no choice. But it’s pretty much worthless.
It wouldn’t be so high if we weren’t billed for the illegal who didn’t pay right before you went in (hello, Baylor Scott and White). Or they wouldn’t bill you for two lenses when you only had one eye done and double the national cost (hello, Baylor Scott and White) and for a million other things you didn’t have done.
“If you have to ask, you can’t afford it...”
I consider it worthless.
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