When it comes to health care in the United States, you don’t get what you pay for. Americans pay more but get more confused and error-prone treatment than people in other Western countries, according to a new survey — the largest of its kind.
“This provides confirming evidence for what more and more health policy thinkers have been saying, which is, ‘The American health care system is quietly imploding, and it’s about time we did something about it,’” Lucian L. Leape of the Harvard School of Public Health, told The Washington Post.
Posted by Melissa Cooley
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58 Comments
Well, let’s see, $1185 per month for family health insurance without prescription benifits. Presciptions cost 20 to 50 per cent more than other countries. Medical PACs spend millions in political contributions to maintain the status quo. Think maybe Congress has be bought and paid for?
Congress took the wrong approach on health care in 1994–vive la ‘free market’!–and we’ve been paying for it ever since. Big Pharma, on the contrary, has made, well, a killing. Many killings, in fact.
As the Republican Congress fiddles, America burns.
America’s corporate greed has certainly taken hold of health insurance and drug companies, it’s all about profit, not providing care. The FDA and CEOs of the drug companies are all in bed together. Health insurance companies have all kinds of ploys to avoid paying their customer’s health care costs. The hospital’s managers are out of touch with their staff and patient’s needs. They’re more concerned with building projects, buying “state of the art” equipment, and providing leather chairs in the waiting rooms and fancy art in the hallways than providing the hospital with adequate staff to provide decent and safe patient care. Then they sit around scratching their heads wondering why there is such a nursing shortage. The truth is there are plenty of nurses, but few want the stress of working in the hospitals, we’d rather work in a private surgery center, home health, a doctor’s office, or be a school nurse. The pay is comparable and the stress is minimal compared to working in the hospitals. In the end, it’s the consumer who suffers with out of control health care and drug costs and inadequate health care services.
Yup, don’t you just love it? When we complain about big HMO and drug companies making obscene profits off of people’s medical misery, WE’RE accused of “class envy” or “class warfare.”
But when Big rich and powerful Pharma gouges the poor and middle class for drug costs, oh hell, that’s just business as usual.
No “class warfare” there. Nothing to see, move along . . .
BTW, Japan and Sweden with their GASP! socialized medicine are ranked one and two in the world for lifespan.
The US is ranked 17th.
Oh well, we are literally dying because of our religious fervor for free and unfettered capitalism.
Even business professionals with college degrees are stopped in their tracks by the maze of obstacles put to a suffering patient who is trying to navigate through the immoral (and borderline criminal) paperwork, appeals and phone calls that are necessary to keep from being turned over to collection (or worse).
Really? Go ask a canadian what the wait time to get an MRI is
Second, The process is really simple and not confusing if you are actually paying for the healthcare that you are recieving. Things only get complex when you are trying to get taxpayers or other healthy people to pay for your cancer treatments after smoking for 20 years.
dr sez:”The process is really simple and not confusing if you are actually paying for the healthcare that you are recieving.”And who do you think pays for their own healthcare? I don’t know anybody who does. Either insurance pays for it, or you go to the emergency room because you don’t have insurance. The taxpayers pay for that. I guess that all that waiting for an MRI is what makes Canadian healthcare rank so much higher that ours. We have the highest healthcare costs on the planet, yet we rank at about 17th for quality. We also have the highest error rate. Face it dr, our form of healthcare sucks!
I’m an RN (BSN) with 8-10 patients every day on a hospital med-surg floor in Wichita. Now, please tell me, how can I be expected to give excellent care to each patient? I do my very best under the circumstances. Out of 10 patients, you hope 2-3 are sleeping or otherwise engaged, two may need occasional care, and only three-four will need constant running back and forth–mostly pain or nausea meds. It’s not California, here, with five (but under Gov. Schwartzy six because he’s dragging his heels on the law) patients per nurse max. And it is like that coast to coast–except California. The only thing that keeps us going are our track shoes.
Every thing that is wrong with the healthcare delivery system in the US can be trace to government involvment. Every thing.
Oh really, esod. Everything? Not the Doctors and their Business Managers who could care less about efficiencies? Not the Drug Companies who give kick backs to doctors and huge spending accounts to their Sales Reps? Not Hospitals for over-charging and mis-charging? When I questioned Wesley about my hospital bill, their Business Manager said “isn’t insurance paying for this?” Not the fact that their is no real competition for services? Note how the price of Brand Name drugs come down when generic’s are introduced into the market.
So you see, esod, government may be one of those bones in the root cause analysis fishbone diagram, but IMHO, the majority of the root cause bones come from lack of real competition.
Socialized medicine, on the other hand, would reduce competition even more, and now your goverment involvement statement becomes more relevant.
Excuse me dr, I have health insurance for more than 15 years through my husband’s company. When I got diagnosed with cancer 5 yrs ago (and no, I’ve never smoked), it was like pulling teeth to get my insurance company to pay it’s share of my treatment. They made so many “mistakes” when processing my claims, and “lost” my records on more than one occasion. When I tried to get approval for reconstructive surgery, I had to make numerous phone calls, getting the brush off from everyone I talked to, and waited for 3 months before screaming at them so much they finally approved it.I’m a nurse, I know how to wade through the system, and even I had to fight tooth and nail to get my benefits. Insurance companies count on the fact that most people won’t fight them, especially the elderly. It’s a game they play and it saves them millions each year in paying out claims.
Esod, if a person has a Medicaid or Medicare, they get easier access to heath care. It’s the private insurance companies, not the government, that are largely responsible for the screwed up health care system.
Moose, bless your heart, I know how hard you work. You’re a better person than I am because I’m just not willing to kill myself anymore trying to do patient care in a hospital setting. I did 15 yrs in the hospital, but for the last 5 yrs I’ve worked in home health and that’s where I plan to stay. It’s much less stressful.I’m grateful for nurses like you, you must be very dedicated to your profession.
Esod is Hank. Repeat, Hank.
Rational argument is futile . . .
I read an article recently that private health insurances companies spend around 15% of their yearly budgets in efforts to deny paying out claims. Money saved is money earned.
In Sunday’s Washington Post there was a story about California BC/BS HMOs referring their California patients to health care providers in Mexico in order to save money. A hystorectomy in Tiajuana costs $800 versus the $2,400 in the U.S.
I personally believe that insurance companies are doing all that the can to bring competition into the system, but competition alone will not fix this problem. Like it or not, there is going to have to be some government regulation to address the health care problem. Sometimes the “morality” and “wisdom” of the marketplace is just not enough.
Steven, the first two paragraphs make sense, but to believe that companies are actually promoting their own competition? Huh?Maybe you know something that’s new to me.Did Bill Gates welcome Apple with open arms?Would Ted Turner help set up companies that take part of his profits?
Damoon, may God bless you.My wife has been disabled for 12 years and has had to go through all the same immoral treatment by the insurance companies. We’ve had to resort to screaming and yelling to get action also. Let me guess, you’re on the phone for 30 minutes (on hold), after being passed from person to person, when they “accidentily” hang up on you.When you call them back they act like they don’t have your info right in front of them on the computer screen, and the whole damn thing starts over again. Right? And God bless the nurses who end up taking the brunt of the patients frustration.My Father has been a quad on a ventilator for 11 years, I know exactly what you’ve been through, and it’s wrong wrong wrong.
Tracy,Health care companies are looking for ways to lower their costs – as the outsourcing to Mexican medical services example would suggest. They have tried, via their proxies Managed Care Organizations (MCOs), to pay less and less to medical providers in a number of different ways. Thus, their interest in competition is manifest in their efforts to reduce their costs — not in subsidizing competitors.
Our friend Damoon, in my view, is correct: corporate greed has a lot to do with increased health care costs. The money that used to go to providers now goes to MCOs or “middle men”. In the market place evoluntion, health care providers have to spend more in record keeping (and associated personnel costs) in order to meet the demands of MCOs who are always wanting more & more and paying less and less for it. The consumer of health care services get these increased non-subsidized costs passed on the them. Hence, the crisis in health care.
The rich get richer, the poor get dead — to put it bluntly.
During the late 90s and early in this century, MCOs were the fastest growing companies in this country. These enterprises exist solely for the purpose of denying consumers care. Period. Only in America could such a situation exist. MCOs spend a lot of money advertising that they are out to imporove the quality of health care. Bull Shit!!! Is what I say to that.
One last little anecdote . . . I knew a woman from college who, along with her significant other, set up a managed care organization in Nevada. They owned the company for 10 years, got rich, sold the company – got richer – and then retired to a Caribbean Island before they reached middle-age. I may still be a wage slave, but I betting if my acquaintance has any conscience at all, I am sleeping better than she does. And I don’t think that is just sour grapes.
Sorry about the length of this rant, but this is a subject that gets me going.
I wanted to revise my last post, a bit. Actually, the poor don’t have it too bad in terms of health care coverage given Medicare and Medicaid. It is the people in the middle who are not rich, nor poor, who are assuming the brunt of corporate greed in the health care arena. I do think that’s it is possible Bush will figure out a way to totally foul up Medicare & Medicaid — so my comment about the poor, will likely be true before long.
As you read, the subject has had me going for years!And where’s the accountability?With all the obvious roadblock tactics put before us, there’s no one person you can ever talk to who will straighten out the nightmare of requirements.I’ve found one useful tactic is to tell the company, hey I know you’re recording this call, I know you have a record of my last call when I was “accidentily” hung up on after talking to 4 people and being on hold for an hour! You have to make them accountable any way you can! If this doesn’t work you may try sending them a letter about negligent service, but make sure it’s on your favorite lawyer’s letterhead. Go ahead and rant as long as you want, I like reading this stuff!I do get your point from the above post, their cost cutting strategy is to deny payments and services to policy holders who are truly entitled to them. Wrong, immoral and should be a criminal offense!
If you REALLY want to go with a totally market driven economy, then you can’t ASSUME that what is profitable and what is right coincide. You have to bias the economic decision to give the “right” answer.
Pollution is a perfect example. If you don’t include a “cost” for air pollution or for chemical dumping, then air pollution and chemical dumping are the logical economic choices. But in the end, that dumping has to be paid for and cleaned up by someone. It SHOULD be the polluter. If you include a cost for pollution in the product equation, then the economics change and irresponsible polluters become stewards of the environment. Note that the ethically correct solution was arrived at without invoking ethics, only proper economics.
The same type of arguments can be made for any economic situation. The “ethical” result can be arrived at if the prroper economic model is applied.
Now developing the economic model….. there’s the rub.
There are common sense things that need to be done to start with.For instance why don’t we have nationally standardized billing codes?We have standard codes in other industries, it shouldn’t be that big of an issue to get health care providers to all use the same billing codes.
Dear Tracy,
The healthcare industry has been using standardized codes for over 30 years.
Brian,As usual, excellent post — you get to the heart of the matter.
Tracy,I like your idea of the Attorney’s letter head. But, Managed Care Organizations are nearly exempt from litigation. The geniuses from these criminal gangs figured out a way to sell themselves as guardians of employee benefits (health care coverage) and thus were able to put themselves under the protection of a federal law (that was passed long ago when unions had influence on congress) that exempts them from law suits. Only in Amnerica can people who steal from you, get rewarded with legal protection in order to carry out their HELPFUL job!
Michael Moore was going to do a film on managed care, and though I think one could argue that he is not always completely fair and unbiased in his coverage — but, if there was ever a group more deserving of his scrutiny, I don’t know who they are.
MCOs routinely write into their contracts with providers that the provider is never to say a discourging word to a patient about their coverage. Maybe I am crazy, but would they need to do that, if they knew they were doing a good job? They are guilty and they KNOW IT! I don’t see any evidence that they are ashamed or repentent.
Managed Care Mantra: “Just hand over the money and shut up . . .”
I was just previewing this post and though this subject may sound like my “Zionism” (via our friend, Ed), I swear what I telling you is the truth . . . it just seems unbelievable.
Thoroughly believable, immoral and should be illegal. Another good one is when your employer is also the benefits payer. No regulation because they are not an insurance company. Take what they pay or quit and get a job with real benefits. Fair enough?
Several years ago, I talked to a number of Canadian Mennonite nurses who were here doing volunteer work in nursing homes, and their universal question was “How do you Americans live with your health-care system?”Until we get a Canadian or Scandinavian type system, we’re going to keep having the best possible health care that nobody can access or afford!
I have a small sample of maybe 5 or so, but every one of the people I’ve talked to who’ve had first hand experience with Canadaian health care say that it is much better than ours.
None of these folks complained about “wait times” the free-market people like to bring up.
I have a small sample of maybe 5 or so, but every one of the people I’ve talked to who’ve had first hand experience with Canadaian health care say that it is much better than ours.
None of these folks complained about “wait times” the free-market people like to bring up.
News Flash out of Canada.
Their health care system, which is going broke, is now trying to decide the age cutoff for heart by-pass surgery.
Ah socialism! Good news grandma! Your suffering is about over! The government has decided to let you die.
Those decisions are already made here. If you’re over a certain age and/or your health is poor, you won’t be considered for dialysis or organ transplantation.
Those decisions are already made here. If you’re over a certain age and/or your health is poor, you won’t be considered for dialysis or organ transplantation.
Those decisions are already made here. If you’re over a certain age and/or your health is poor, you won’t be considered for dialysis or organ transplantation.
It also comes down to how comfortable you are with your health-care fate being decided by for-profit companies whose bottom line is considerably more important to them than your life.
Managed Care: Esod/Hank, we’d love to help you buy you that Lipitor, but we have some CEO salaries that need to be paid — good luck with your heart attack.
This blog is acting weird today, sorry about the earlier double post.
Investment Tip: Money invested in any company that promotes “health-care tourism” to India will provide nice returns. Currently, it is cheaper for a person to buy air fare to AND health-care in India than it is to purchase out of pocket health-care here in the States. This investment will be a good bet for at least the next 3 years (assuming the continuation of the Bush “we don’t do torture” Junta).
Again…..90% of the “problems” come from the involvement of insurance and medicaid/medicare. people who for whatever reason ARE NOT paying for the treatment they recieve.
You people act as though it is a inaliable right to have healthcare!
Who do you thinks pays for all this? Obviously you think the money grows on trees!
You people like to slam evil rich all day, but you are so dependant on thier greed its not even funny. I would love to have one of those back room meetings you think they have to keep the little man down, And the evil rich just decide ok, shoot we have enough money to live, I’m tired of being called evil and taxed at 50%….ehh screw it let’s all just quit right now….close the doors, We dont NEED to sell life saving drugs let’s just take our ball an go home.
Again…..90% of the “problems” come from the involvement of insurance and medicaid/medicare. people who for whatever reason ARE NOT paying for the treatment they recieve.
You people act as though it is a inaliable right to have healthcare!
Who do you thinks pays for all this? Obviously you think the money grows on trees!
You people like to slam evil rich all day, but you are so dependant on thier greed its not even funny. I would love to have one of those back room meetings you think they have to keep the little man down, And the evil rich just decide ok, shoot we have enough money to live, I’m tired of being called evil and taxed at 50%….ehh screw it let’s all just quit right now….close the doors, We dont NEED to sell life saving drugs let’s just take our ball an go home.
I would prefere a health care system based on free interprise. I can go anywhere I want for my health care.
With all of its limitations and all of its government imposed restrictions the US has the greatest health care delivery system in the world! Period.
dr apparently doesn’t understand the theory of insurance, actuarial tables, and the like.
Look, I am all for the responsible utilization of health-care resources/insurance. It is just that the expense and effort that gets invested into management (read: cost savings) by insurance/MCOs is just ridiculous. If the money spent on health care MANAGEMENT was returned to the PROVISION of health care — it would help a great deal with the health care problem.
There was an article in a Sunday Eagle a couple of months ago about two women physicians – I forget their names. But, one of them was telling the story about conversations with Utilization Review staff at an MCO — it went something like this (I am retrieving this from my imperfect memory):
UR person: “Doctor, is this walker REALLY necessary?!”
Physician: “Yes. And, I wanted to tell you that we don’t usually have able-bodied free-loaders coming in here to demand those, oh so desirable, walkers.”
Health insurance is a resource that I am grateful for every day. It is a resource that belongs to all of us and should be treated with respect. I think when corporations treat insurance premiums as resources that they are entitled to with NO, to very little, reciprocity is where the problems start. I am much more worried about the entitlement of faceless corporations than I am the entitlement of health care consumers.
I am amused at the efforts of some to engage in victim blame – “if they have cancer, they probably brought it on themselves.” Actually, I’m not amused by this in the least – instead, I am getting real sick of that B.S. If that’s the best you can do to promote a market-driven solution to the problem, please take that crap somewhere else.
Steven E.
You’re going to die. The government can’t save you. The tort attorneys can’t save you. The liberal politicians that feed of your fears can’t save you. You may unfairly die young. That’s not fair, but it happens.
We need to get the government out of health care.
Give me just one of the things that you think government can help with concerning health care and I will tell you why they are the problem in the first place.
Just one. Steven only.
Esod–that’s rich coming from you, a VET!
So we should shut down the veterans’ hospitals because they’re gov’t run?
Oh, yeah, you betcha. And let’s take away your gov’t pension while were at it.
How’s that grab you?
Galahad,
Just who in the hell do you think I am?
I don’t care if they shut down the VA hospitals! Veteran care should be bid out to private hospitals.
The government should stay out of it!
My grandparents told me about the vast improvement Medicare meant in the lives of older people who did not have resources. They saw first hand what a market-driven health care solution meant in the 1930’s Oklahoma.
Another area where the government succeeded in providing health care was to military veterans. The V.A. has helped many people who were injured in service to their country. Ask Bob Dole about that subject.
Are either of the above systems perfect? No. There can always be room for improvement.
The above are the two most obvious examples of how the government can help with health care. But, let’s be frank, Hank, I am not going to convince you of anything and I am not so deluded as think that I could. There are limits to even the most extreme narcissism.
Ah Medicare,
The Great Society savoir of old people!
I wonder where in the constitution it says, “OK, your 65, its socialized medicine for you now.”
Medicare is an example of everything that is wrong with health care in the US! Before Medicare the elderly were paying approximately 15% of their income on health care. They now spend over 40%.
Medicare is like a festering, cancerous sore on the butt of society.
Hank -Jeez, I hate to point out the patently obvious, but don’t you think that medicine has a little more to offer sick people now than it did in the 1930’s? Hence, the reason it costs so much more today.
I would have you note, that the V.A. does privatize some of its Vets’ medical care. What they discover is that they can do it cheaper and that is one of the reasons they keep doing it themselves.
Notice that Esod won’t go near the gov’t pension thing?
He hates big gov’t, he detests it, big gov’t is the root of all evil.
Later that same day–”Okay, honey, my check from the Navy came . . . let’s go out to eat.”
Found this paragraph from an on-line article.
Insurance companies have tried to hold down costs by reimbursing physicians at a standard rate for common procedures. But that has not kept health-care costs from rising faster than the rate of inflation. Perhaps that’s because medicine is one of those mysterious enterprises where the average consumer can never be sophisticated enough to know what he’s actually buying. Most of us find a physician we like and do what he or she dictates. It’s simply not the same as buying a toaster or a dining room table. You don’t wait for a good sale to get your angioplasty.
For those with an open mind, this author provides some more interesting views on why health care is not an area where market-based solutions are appropriate or wise.
http://www.workingforchange.com/article.cfm?ItemID=17150
I hope that all who favor market based health care solutions are willing to demand discount angioplasties, low cost chemotherapy, blue light special EEGs, and generic drugs developed in the 1950s.
1. insurance is to prevent a catastrophic event bankrupting you. not so you can see the doctor for $10 everytime you get a sniffle, everyone should have $4000 deductibles and pay out of pocket for expenses that are less than thier car payments!
2. Insurance by its very nature means that most people pay in more than they recieve in benefits, the minority suck the majority of costs and that minority is comprised mainly of people who have chronically abused thier bodies and lived irresponsibly
3. The majority of people currently being propped up to live in old age and poor health did not pay in to the system for 65 years. They are taking hundreds of thousands of dollars in todays $$ funded by yesterdays pennies. This counts on an ever expanding population….can we say another panze scheme that like social security completely fails when the tax base is less that 2.5 to 1 ratio!
dr,
I’d say you got some parts right and soime completely wrong.
Look at #2..Do you really think that the majority of people who collect benefits are doing so because they abused their bodies in their youths? Pull up the statistics on that, please. In fact, the very idea of insurance is NOT to collect. You pay in in the HOPE of NOT using it. That’s how it works. It’s like a lottery..you pay for protection IN CASE, but you PRAY NEVER to collect. That’s why insurance works. If EVERYONE were collecting, then the whole edifice would collapse.
With regard to #1, you seem to be referring specifically to Medicare and Social Security. In fact, most people either co-pay for insurance with their employers, pay individually without employer help, or go without insurance, throughout the majority of their lives while paying into SS at the same time. Now, SS and Medicare do have problems related to actuarial effects and ever expanding coverage, but those systemic problems are fixable. They are, at least, no more serious than they would be in a purely private insurance scheme.
Health care does not “obey” market rules. If your life or your health is involved, you are almost sure to pay anything to resolve the problems. It’s not like you’ll evaluate the cost and decide to live or die. Therefore supply and demand is NOT elastic. And this reveals part of the problem..the ever increasing expense to keep someone alive in the last year or so of life. Maybe it’s just more humane and economically more viable to deny to those in their final stages life prolonging treatments. It’s the quality of life that’s important, followed by quantity. I know that I plan to take my own life when I reach the point that things are failing as fast or faster than I can fix them.
Dr, I sincerely hope you or your loved one never get seriously ill. Being callous and hardhearted is a great way to tempt fate.Just think if we put all the money this country has wasted on a useless war into health care and disease prevention, what a difference it could make.
More personal attacks and namecalling from Galahad. What more cold you expect from the fraud?
Brian, you never know what you’ll do when faced with your own mortality until you get there. I feel the same way, but the instinct to survive can be really strong. I think that’s why so many people who need to die cling to hope and life no matter what the cost, it’s just what we humans do.
Damoon, I hear ya. But I think it depends on your attitude going in. I like to compare it to skiing. At the top of the expert hill, you’re reluctant to set on down the hill. At the bottom, however, that fear has turned into exhileration. I’m kinda anxious to find out what’s on the other side. I hope the end point is as exhilerating as the starting point is scary.
I don’t believe in life after death. That’s why living is so important to me, having survived cancer gave me a different perspective and I’ve never looked at anything or anyone the same way since. It was a blessing in disguise, because it made me determined to live my life to the fullest. I think just being alive is such a miracle in itself.
Oh, Damoon, I guess I was just griping for a moment. It is really challenging work and I get a lot of satisfaction from being a nurse. And I guess as a Catholic it gives me a chance to feel a bit like Mother Theresa. I just wish people would not use tobacco, not drink alcohol (or at least use moderation) or use other drugs, but eat a balanced diet, get exercise, enough sleep, and if they do get sick–to please be compliant with their treatment. And it seems kind of silly to have a smoking room at the back of a hospital.
Moose, I can remeber when nurses were allowed to smoke in the nurses station!! I work with mostly Medicaid patents now, it’s amazing how much money the government has to put out for the care of those who have ruined their health by smoking and/or overeating. It would be nice if more funds would go into education and disease prevention. But you’re right, in the end self responsibility is the only thing that makes a real difference. Thank you for the valuble work you do, you are appreciated!
My children receive medicaid. My husband and I do not qualify. My husband is an educated web developer who can’t find work in this town. He works his ass off making $9.00 an hour until something better comes along. We can’t afford the nearly $400 a month family premium plus deductables and co pays and prescriptions. I stay home because we can’t afford the $500 a month for daycare for our baby. Not everyone who receives medicaid are lazy welfare leeches. My husband works hard and we pay our taxes. My husband and I were declined for coverage. If our kids get sick they can go to the doctor thank God but if we get sick we’re screwed. It’s only a matter of time before my husband has heart problems from all of the financial stress we are always under. The reader who wrote “The rich get richer and the poor get dead” could not have been more right. I’d rather wait a few months for an MRI than to die in 10 years because a problem was never discovered because I couldn’t afford to see a doctor.