[lit-ideas] Re: The flu

Why health care is so expensive?

30% to 40% goes to insurance company expenses, according to a relative who
is VP in charge of a health care system in a community near where I live.

The most efficient insurance scheme is Medicare.  Beyond that, there is an
incredible amount of fraud in the system.  This is by doctors, etc., etc.

It took me three months to get an insurance company to stop paying for my
expenses in a nursing home.  I have never been in a nursing home, except as
a visitor.

Thirty or so years ago I had co-pay on medicines.  The drug store kept
shorting me on the no. of pills.  I called the insurance co. and they told
me to take it up with the drug store.  In other words, go to the crook and
tell him to stop it.  Fat chance.

The new Medicare Prescription Bill prohibits Medicare from negotiating with
pharmaceutical companies for lower prices.  I could believe Pres. Bush won.
I thought retirees would vote against him by the zillions for this.  

Veronica


> [Original Message]
> From: <JimKandJulieB@xxxxxxx>
> To: <lit-ideas@xxxxxxxxxxxxx>
> Date: 11/21/2004 8:42:43 AM
> Subject: [lit-ideas] Re: The flu
>
>  
> <<But some pretty serious  economic diddling went on in the early 1990s,
and
> suddenly I was among the 45  million Americans who were deemed
"uninsurable"
> because of an underlying  health condition.>> 
> Private  insurance companies will do anything to avoid paying out.  My 
> husband had  by-pass surgery a few years ago.  His Blue Cross Blue Choice
insurance  
> pre-approved the surgery.  After it was done, when they were sent a
claim,  
> they said it was a pre-existing condition and refused to pay.  We'll be 
paying 
> the hospital bill long after our natural lives. 
> <<But  why have MDs raised their rates so dramatically? Why can't MDs
afford  
> to
> maintain small private practices the way they used to--and as many  still
> want?>> 
> Most people would point to high  medical malpractice insurance (more 
> insurance .....it's all a con game, you see)  which comes back to
egregious errors on 
> the part of Dr's who are over-worked and  working unbelievably long
shifts in 
> hospitals.  Our previous pediatrician  cut her costs by refusing to bill
any 
> insurance companies at all, requiring that  her patients pay in cash up
front 
> and try to recoup their losses directly from  their insurance.  Saved her
tons 
> in man-hour secretarial/billing  hours.   I have some experience in
billing 
> insurance companies and  there are a hundred different hoops you have to
jump 
> through for each one.   The chance of an average patient successfully
billing 
> one of them without  spending hours reading up on the rules?  Slim. 
> Julie Krueger 
>
>
> ========Original  Message========     Subj: [lit-ideas] Re: The flu 
Date: 
> 11/21/04 1:56:10 AM Central Standard Time  From: _carolkir@xxxxxxxxx 
> (mailto:carolkir@xxxxxxxx)   To: _lit-ideas@xxxxxxxxxxxxxx 
> (mailto:lit-ideas@xxxxxxxxxxxxx)   Sent on:    
> > The thing that I don't understand at all, is  how you
> > can spend that much on healthcare and still not have
> >  universal coverage?
>
> ck: I hope some thinktank is working on this one. In  the meantime, I'll
> proffer a few guesses related to corrupt fat cats, lack of  regulation,
and a
> astonishing amount of unchecked greed. For one thing,  prescription drugs
in
> the US are more expensive than anywhere else in the  world. (How much
more?
> Double, triple, etc. Depends on the drug.) Other  factors are the
extremely
> well-nourished insuranceb(health and liability) and  pharmaceutical
> industries themselves, which enter into the overall healthcare  costs in
many
> studies.
>
> The issue of health insurance coverage used to  be separate from actual
> healthcare in the US, to some extent. That  distinction collapsed in the
> early 1980s, with the advent of health  maintenance organizations. Many
> people used to pay out-of-pocket for a  doctor's visit and prescription
> drugs. The wealthiest people in the US still  do that, eschewing health
> insurance. (By contrast, my parents were  middle-class, never had health
> insurance, and didn't seem to lack for health  care as needed. I didn't
have
> health insurance either...)
>
> In pondering  my answer to Teemu's question, I'm realizing that I really
> don't know why  health care costs are so high. Paul Starr's book, "The
> Transformation of  Modern Medicine," did a pretty good job of explaining
how
> medicine was  practiced and paid for in the US, to the brink of the 1980s.
>
> But some  pretty serious economic diddling went on in the early 1990s, and
> suddenly I  was among the 45 million Americans who were deemed
"uninsurable"
> because of  an underlying health condition. More to the point, a visit to
the
> doctor,  with standard lab work, cost me $800--compared to the $50 to $100
> I'd been  used to paying. And the costs have been uphill since then. (Same
> with  dentistry, only more so. Nice-looking, functional teeth in middle
age
> will  soon be a status symbol, if it isn't already.)
>
> But why have MDs raised  their rates so dramatically? Why can't MDs
afford to
> maintain small private  practices the way they used to--and as many still
> want? True, some  technological advances are awfully expensive...Okay, why
> so? (Why should an  in-office ultrasound cost a patient more than a few
> bucks, for  instance?)  What's really driving up US health costs, such 
that
> unwealthy, uninsured people aren't fixed up for nominal costs--or  at
> all--when they have lower-tech infections or broken bones? Somehow, I 
don't
> think the real answers are all that  fancy.
> Best,
> Carol
>
>
>
>
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