Another freedom gone

[Dr.Who]

Insurance costs are already low - they only make 4% profits.

If innovation saves money, and the insurance company "...only make 4% profit...", why has the cost of medical care gotten so expensive? Where is the money going? If both those are true, costs should have gone down or at least not be higher than inflation. Smoke and mirrors?

Because thee are other causes of high prices than just insurance companies.

Some of them are: hospitals and providers, drug companies, medical products, government regulation, better services, unnecessary services, etc.

Of those the better services we are receiving as a result of new technology accounts for most of the high costs. It just costs more to do a triple bypass that we can do today than to watch a person die back when we were unable to do a triple bypass. When you get more you pay more. However, just like TV sets do a whole lot more than they did 30 years ago and at times we had to pay for those improvements, eventually the prices of improved set came down through innovation.

Even if the big ol bad insurance companies were even more regulated and their profits were reduced to zero the factors that account for high costs would still exist.

The job of gov is to stop companies from violating peoples rights. the gov does regulate insurance companies so either the gov is incompetent, evil itself, or the insurance companies are not violating anyone's rights.

 

[dahermit]

Insurance costs are already low - they only make 4% profits.

Of those the better services we are receiving as a result of new technology accounts for most of the high costs. It just costs more to do a triple bypass that we can do today than to watch a person die back when we were unable to do a triple bypass. When you get more you pay more. However, just like TV sets do a whole lot more than they did 30 years ago and at times we had to pay for those improvements, eventually the prices of improved set came down through innovation.

As have the price of computers, paid $1500 for a computer with 256k memory and two disk drives. Now, less than $500 for 6GB memory, huge hard drive, etc. Prices for computers have come down. I get more but pay much less even without considering inflation of dollars since then.

Now, (remember you say innovation reduces price), when is the price of health care going to come down because of innovation? The price of health insurance has skyrocketed for more than 30 years. Just when is your wonderful "innovation" going to kick in to reduce costs?

If you follow the money, doctors say they are not getting it, the hospitals say that they are not getting it, the expensive equipment is eventually paid off via high charges to patients (and the new equipment is worn out and must be replaced like the computer example, the costs should be lower), and the insurance companies say they are only getting 4% profit (they are not getting it), so again, where is the money going?

 

[PLC1]

Insurance costs are already low - they only make 4% profits.

Of those the better services we are receiving as a result of new technology accounts for most of the high costs. It just costs more to do a triple bypass that we can do today than to watch a person die back when we were unable to do a triple bypass. When you get more you pay more. However, just like TV sets do a whole lot more than they did 30 years ago and at times we had to pay for those improvements, eventually the prices of improved set came down through innovation.

As have the price of computers, paid $1500 for a computer with 256k memory and two disk drives. Now, less than $500 for 6GB memory, huge hard drive, etc. Prices for computers have come down. I get more but pay much less even without considering inflation of dollars since then.

Now, (remember you say innovation reduces price), when is the price of health care going to come down because of innovation? The price of health insurance has skyrocketed for more than 30 years. Just when is your wonderful "innovation" going to kick in to reduce costs?

If you follow the money, doctors say they are not getting it, the hospitals say that they are not getting it, the expensive equipment is eventually paid off via high charges to patients (and the new equipment is worn out and must be replaced like the computer example, the costs should be lower), and the insurance companies say they are only getting 4% profit (they are not getting it), so again, where is the money going?

There's the question. We know why health insurance costs so much: It's because of the cost of health care. Why does health care cost so much? Why should a trip to the emergency room cost $29,000 when the patient dies within minutes of arrival? Why does a simple test that takes only a few hours and is done on an outpatient basis cost $10 - $20 grand? Until outrageous costs are brought under control, there is going to be no affordable medical coverage.

 

[Dr.Who]

Insurance costs are already low - they only make 4% profits.

Of those the better services we are receiving as a result of new technology accounts for most of the high costs. It just costs more to do a triple bypass that we can do today than to watch a person die back when we were unable to do a triple bypass. When you get more you pay more. However, just like TV sets do a whole lot more than they did 30 years ago and at times we had to pay for those improvements, eventually the prices of improved set came down through innovation.

As have the price of computers, paid $1500 for a computer with 256k memory and two disk drives. Now, less than $500 for 6GB memory, huge hard drive, etc. Prices for computers have come down. I get more but pay much less even without considering inflation of dollars since then.

Now, (remember you say innovation reduces price), when is the price of health care going to come down because of innovation? The price of health insurance has skyrocketed for more than 30 years. Just when is your wonderful "innovation" going to kick in to reduce costs?

If you follow the money, doctors say they are not getting it, the hospitals say that they are not getting it, the expensive equipment is eventually paid off via high charges to patients (and the new equipment is worn out and must be replaced like the computer example, the costs should be lower), and the insurance companies say they are only getting 4% profit (they are not getting it), so again, where is the money going?

Profits by medical industry:

Medical REITs earn about 24% profit
Drug manufacturers earn about 16% profit
Drug delivery earns about 13%
Healthcare information services earn about 9%
Home health care earns about 8%
Medical labs and research earn about 8%
Medical instruments and supplies earn about 7%
Generic drugs about 6%
Hospitals about 3%
health care plans about 3%

http://static.seekingalpha.com/uploads/2009/8/13/saupload_profits.png

So when you buy a generic drug about 6% of your bill is going to the manufacturer of that drug. When you have a hospital stay about 3% of the bill is kept by the hospital, etc.

When innovation brings down the costs of instruments which are bought by many in the field it will be reflected in the bill, but it will only account for a cut in the 7% of the portion of the bill that is due to instruments.

The largest costs as for any industry is in labor. If you have nurses 24 hours a day when in the hospital then there are three shifts with several nurses in each and each one is earning maybe $60,000 per year. It adds up.

 

[Dr.Who]

There's the question. We know why health insurance costs so much: It's because of the cost of health care. Why does health care cost so much? Why should a trip to the emergency room cost $29,000 when the patient dies within minutes of arrival? Why does a simple test that takes only a few hours and is done on an outpatient basis cost $10 - $20 grand? Until outrageous costs are brought under control, there is going to be no affordable medical coverage.

I don't think it makes much sense for us to be talking about made up numbers. They are as likely to be about as accurate as P Obama's statement about pediatricians removing tonsils.

 

[PLC1]

I don't think it makes much sense for us to be talking about made up numbers. They are as likely to be about as accurate as P Obama's statement about pediatricians removing tonsils.

The $29,000 figure was rounded off:

SACRAMENTO, Calif. (AP) - The parents of a California State University, Sacramento student who was beaten to death by a dorm mate were still reeling with shock when they received another jolt.

Gerald and Elizabeth Hawkins say 10 days after their son Scott died, they got a bill for $29,186.50 from UC Davis Medical Center.

The 10 to 20 grand was a combination of a personal experience with an angiogram + a post by another user of this forum.

Nope. Those scary figures aren't made up.

 

[Dr.Who]

The $29,000 figure was rounded off:

I much prefere to discuss real figures with links. Thanks.

the article you posted said that the bill was detailed - meaning that it listed all the stuff that was charged. clearly if it were full of nonsense we would be seeing discussions of all the nonsense.

The article also said that the boy did not die within minutes of arrival as you said, but that the bill arrived ten days after he was admitted.

I don't know what services were offered to the boy because I have not seen the bill. But if six nurses, two ambulance drivers, two doctors, and all their equipment supplies and supportive staff costs that much over the course of a few days then I guess it costs that much.

I agree that when I see a hospital bill I am often awestruck at how high it is for what seems like so little. But as a person who has operated the inside details of various businesses I know that there are lots of costs that outsiders are not aware of.

I had an ultrasound that costs $900 (rounded off). My share of the machine, the tech, the 45 minutes, the room, the overhead, the three receptionists, etc, would not seem to add up to $900. But since we know that hospitals only make about 3% profit then the actual costs of their bills must, on average, be just about 3% less than what is on the bill.

 

[Mr. Shaman]

The insurance industry only makes about 3.3% profit which places the industry behind 85 other industries in terms of how much profit they make.

Yeah....that's what's needed....the opinion of a blogger who's so "care"-driven!!!


​

 

[Mr. Shaman]

If innovation saves money, and the insurance company "...only make 4% profit...", why has the cost of medical care gotten so expensive? Where is the money going? If both those are true, costs should have gone down or at least not be higher than inflation. Smoke and mirrors?

No, it's not "smoke and mirrors"....it's more-obvious....it's VULTURE KAPITALISM!!!!!!

*

 

[dahermit]

Insurance costs are already low - they only make 4% profits.

Of those the better services we are receiving as a result of new technology accounts for most of the high costs. It just costs more to do a triple bypass that we can do today than to watch a person die back when we were unable to do a triple bypass. When you get more you pay more. However, just like TV sets do a whole lot more than they did 30 years ago and at times we had to pay for those improvements, eventually the prices of improved set came down through innovation.


Profits by medical industry:

Medical REITs earn about 24% profit
Drug manufacturers earn about 16% profit
Drug delivery earns about 13%
Healthcare information services earn about 9%
Home health care earns about 8%
Medical labs and research earn about 8%
Medical instruments and supplies earn about 7%
Generic drugs about 6%
Hospitals about 3%
health care plans about 3%


So when you buy a generic drug about 6% of your bill is going to the manufacturer of that drug. When you have a hospital stay about 3% of the bill is kept by the hospital, etc.

When innovation brings down the costs of instruments which are bought by many in the field it will be reflected in the bill, but it will only account for a cut in the 7% of the portion of the bill that is due to instruments.

The largest costs as for any industry is in labor. If you have nurses 24 hours a day when in the hospital then there are three shifts with several nurses in each and each one is earning maybe $60,000 per year. It adds up.

So then, is it fair to conclude: 1) Health care in the US is does not have a problem? 2) The problem is that people are too stupid to know how to get health care? 3) The US needs a federal outreach program to instruct people how to get health care when they are sick?

 

[top gun]

Insurance costs are already low - they only make 4% profits.

Of those the better services we are receiving as a result of new technology accounts for most of the high costs. It just costs more to do a triple bypass that we can do today than to watch a person die back when we were unable to do a triple bypass. When you get more you pay more. However, just like TV sets do a whole lot more than they did 30 years ago and at times we had to pay for those improvements, eventually the prices of improved set came down through innovation.

As have the price of computers, paid $1500 for a computer with 256k memory and two disk drives. Now, less than $500 for 6GB memory, huge hard drive, etc. Prices for computers have come down. I get more but pay much less even without considering inflation of dollars since then.

Now, (remember you say innovation reduces price), when is the price of health care going to come down because of innovation? The price of health insurance has skyrocketed for more than 30 years. Just when is your wonderful "innovation" going to kick in to reduce costs?

If you follow the money, doctors say they are not getting it, the hospitals say that they are not getting it, the expensive equipment is eventually paid off via high charges to patients (and the new equipment is worn out and must be replaced like the computer example, the costs should be lower), and the insurance companies say they are only getting 4% profit (they are not getting it), so again, where is the money going?

You're herding this nicely my friend but even though you've boxed in the argument very well I doubt he'll admit something is obviously a miss with his figures.

Let's look at some recent history & not just at look at today.

Bush years golden ones for health insurers. The industry's overall profits grew 8.8 percent from 2003 to 2008. So there are higher profit taking times than just 4%.

But the next thing is this. Even 4% of a gazillion is a whole lot of money. It's like having the exclusive right to oxygen. You could make only 4% and the banks wouldn't be able to hold all your money because everyone needs it. On the other hand you might have to make 50% 60% or or more on perfume to stay in business because that's a very selective and much smaller overall market with tons of options for people to choose.

Healthcare IS one of those things that is necessary to every human being. When the corporations refuse to make it affordable then it is up to government to step in.

And please no one give me the Tort Reform argument. That only accounts for one third of one percent of healthcare costs. Tort reform is a way for Republicans to act like they have another path to a solution with a buzz word when they truly don't.

It's like saying... I know the engine on my car is about to blow up. But the good thing is I have AAA so my car gets a free tow to the junk yard.

That's the Republicant option in a nutshell. You're car (your health) can blow up and that's fine. But they will save you on part of the cost. The part that a AAA membership cost compared to the cost of your entire car (your health).

MINUSCULE (really no) HELP IN RELATIONSHIP TO MY REAL PROBLEM!

 

[PLC1]

I much prefere to discuss real figures with links. Thanks.

the article you posted said that the bill was detailed - meaning that it listed all the stuff that was charged. clearly if it were full of nonsense we would be seeing discussions of all the nonsense.

The article also said that the boy did not die within minutes of arrival as you said, but that the bill arrived ten days after he was admitted.

I don't know what services were offered to the boy because I have not seen the bill. But if six nurses, two ambulance drivers, two doctors, and all their equipment supplies and supportive staff costs that much over the course of a few days then I guess it costs that much.

I agree that when I see a hospital bill I am often awestruck at how high it is for what seems like so little. But as a person who has operated the inside details of various businesses I know that there are lots of costs that outsiders are not aware of.

I had an ultrasound that costs $900 (rounded off). My share of the machine, the tech, the 45 minutes, the room, the overhead, the three receptionists, etc, would not seem to add up to $900. But since we know that hospitals only make about 3% profit then the actual costs of their bills must, on average, be just about 3% less than what is on the bill.

The article doesn't say that the student survived for ten days. It says the bill arrived ten days later.

It also says:

The bill from the hospital details the hospital's effort to revive the 23-year-old student.

It's hard for anyone to see how efforts to revive someone could possibly total nearly thirty grand.

A spokeswoman for the hospital says the bill was a mistake - it should have gone to an insurance company.

And, what would the company have done with it? Would all of the charges have been paid? It seems unlikely.

None of the above means that the hospitals are gouging patients. Part of the problem is the fact that the insurance companies only pay a fraction of what is billed, so the bill has to reflect that. What the rest of the problem is I'm not sure. I do know that I've personally received EOMB forms (Explanation of Medical Benefits) from my own insurance giving what seems to be outrageous charges, but only a fraction was paid and the rest written off.

Regardless, such a charge for trying to resituate someone who couldn't be resituated is hard for us laymen to understand. Does the hospital have to have a billion dollar resuscitation machine?

 

[Dr.Who]

Yeah....that's what's needed....the opinion of a blogger who's so "care"-driven!!!


​

You didn't read it, did you?

The information was posted by a blogger. It was compiled by an organization that makes financial reports for the fortune 500 companies who rely on the accuracy of the information to run their businesses.

But you go ahead and research it yourself to find out how much profit the insurance companies make after their costs are deducted.

 

[Dr.Who]

So then, is it fair to conclude: 1) Health care in the US is does not have a problem?

It has lots of problems. Those problems do not include people who do not have access to health care because they do not exist.

2) The problem is that people are too stupid to know how to get health care?

We have seen a report going around that many people die because they do not seek medical care until it is too late. One large group on that list was a group of people who failed to get breast exams even though those exams are offered free all over the US. they knew they could get them but failed to follow through mainly because they just put it off. We have all put off medical care so we all know what that is like. another group of people are those who did not get their blood pressure monitored - even though walmart and walgreens and many other stores have free machines to do just that. Another group was people who would have to pay an out of pocket copay or would have to pay for the service themselves but they just did not think it was worth it to fork out the hundred dollars for an exam. Remember this:

"Halderman recounted the story of a woman patient who had not had a mammogram in several years even though her family had a long history of breast cancer. "But I don't have insurance," the woman told Halderman when the doctor asked why she had neglected to get a test that costs $90. Yet the woman was in Halderman's office for $400 Botox treatments that she was paying for."
http://www.realclearmarkets.com/articles/2009/11/11/health_reforms_moral_hazard_97502.html

In a country when most of the poor (not just most people but most poor people) have multiple tv's, phones, cable, jewelry, new nikes, a house, 2 cars, and a whole host of luxuries those who choose to spend on luxuries instead of on health care have only themselves to blame - unless someone has convinced them that they can ignore personal responsibility and rely on gov for help.

3) The US needs a federal outreach program to instruct people how to get health care when they are sick?

[/QUOTE]

The way to get health care is so utterly simplistic that such a program would be ridiculous:

1. go to a doctor and pay for it. 2. use your employer provided health insurance or buy your own to pay for it. 3. use your gov provided health care system of medicare or medicaid to pay for it.

I used to direct a home for people who were developmentally disabled (mentally retarded) and without a doubt even those with the lowest IQ's knew that when they were sick they should go to a doctor and present their public aid card. Others who did not have public aid (because even the mentally retarded can sometimes get jobs good enough to not be on public aid) knew to go to the doctor and bring their checkbooks.

 

[Dr.Who]

The article doesn't say that the student survived for ten days. It says the bill arrived ten days later.

It also says:

Ooops my mistake.

It's hard for anyone to see how efforts to revive someone could possibly total nearly thirty grand.

Unless maybe they read the bill and discuss it with someone who can explain it (medical billing advocate). Or maybe when they discuss it with someone who can explain it they would know that it is inflated. But neither of us are reading any of those bills are we and discussing them with someone who can explain it? We are just guessing.

And, what would the company have done with it? Would all of the charges have been paid? It seems unlikely.

None of the above means that the hospitals are gouging patients. Part of the problem is the fact that the insurance companies only pay a fraction of what is billed, so the bill has to reflect that. What the rest of the problem is I'm not sure. I do know that I've personally received EOMB forms (Explanation of Medical Benefits) from my own insurance giving what seems to be outrageous charges, but only a fraction was paid and the rest written off.

Regardless, such a charge for trying to resituate someone who couldn't be resituated is hard for us laymen to understand. Does the hospital have to have a billion dollar resuscitation machine?

I too don't know.

Katie Couric did a report on this issue. It was found that about 5% of a hospital bill on average is mistaken billing. But for a moment does anyone here think that if the hospital was charging much more than they had to for whatever reason (especially large profits) that katie would not have screamed that at the top of her lungs. Why the lack of reports coming from the left of hospitals making profits in the 30% or higher range speak to the fact that the real profit is in the 3% range like was reported here earlier. And what does the left complain about? Not anyone's profits, instead the complain about the salary of the ceo because profits are just not high enough to complain about.

In trying to find the real answer about why bills are so high I read these:

http://www.ttmitchellconsulting.com/Mitchblog/how-come-my-hospital-bill-is-so-high/

This one is pretty detailed:

http://www.cato.org/pubs/pas/pa211.html