Interesting read on the problems with cost of insurance/medicine

[southsider2k5]

Its kinda interesting because from an economic standpoint this is an absolute truth: The cheaper something is, the more of it that will get used. The uninsured aren't going to use as much healthcare, because they economic incentive not to do so, while the insured, will use way more, because they have no incentive not to.

 

http://www.chicagotribune.com/features/hea...,1,236737.story

 

Don't blame the uninsured

 

By John R. Graham, director of health care studies at the Pacific Research Institute

Published March 5, 2007

 

 

From Massachusetts to California, politicians seem to think they've discovered a groundbreaking solution to the problem of the uninsured: use the law to bully everyone into becoming insured.

 

California Gov. Arnold Schwarzenegger has made this idea the centerpiece of his second term. Former Massachusetts Gov. Mitt Romney thought he had a solution too, but now that he's campaigning for the presidency, he's trying to avoid responsibility for a new government bureaucracy that's driven premiums up to almost twice what he had promised.

 

Covering the uninsured is certainly a worthwhile goal. But simply mandating coverage won't necessarily bring it to those who lack it.

 

Just look at auto insurance. Even though it's against the law to drive without it in California, 25 percent of the state's drivers are uninsured. Why are they breaking the rules? Because they don't expect to be in an accident.

 

The same rationale applies for those without health plans. Just as they forgo auto insurance, many people choose not to buy health insurance, even if they have the means to do so. Not even Mr. Olympia himself could strong-arm all Californians into buying coverage.

 

But leaving aside the fact that insurance by force simply cannot happen, there's another problem behind this drive toward "universal coverage." It's predicated on the flawed notion that the insured subsidize the care of the uninsured. While appealing, this idea doesn't pass muster.

 

Consumer-advocacy groups, such as Families USA, estimate that the uninsured used about $29 billion worth of health services nationwide in 2005, which the privately insured paid for through higher premiums. Once everyone has insurance, the argument goes, fewer people will use expensive options such as emergency rooms for their primary care.

 

But the uninsured are not the primary reason for spiraling health costs.

 

They consume far less care than the insured. In 2000, just over half of the total uninsured population had any medical expenses at all. By contrast, more than 80 percent of those with insurance had medical expenses during the same period.

 

Or consider this: Of the 1.9 million California children who visited emergency rooms in 2003, only 80,000 were uninsured, according to UCLA's Center for Health Policy Research.

 

Simply put, the uninsured population is too small to have a significant impact on the premiums of the insured, as consumer advocates claim. Those proposing to contain soaring health-care costs by "covering the uninsured" are trying to squeeze a lot of blood from a small stone.

 

On top of that, there's another problem with the argument that those with health insurance subsidize those without. Many uninsured Americans pay extra taxes because their income is not sheltered by insurance-based tax breaks.

 

In fact, the uninsured pay about $60 billion in additional income taxes by forgoing those breaks. That explicit figure swamps the so-called hidden tax of the uninsured.

 

Ironically--and counterintuitively--the real problem behind out-of-control costs is "overinsurance." Across the country, many of those with health insurance are consuming far more health care than they actually need.

 

Insured Americans use health services twice as much, per person, as the uninsured. Sen. Tom Coburn (R-Okla.), an obstetrician, estimates that as much as one-third of health care is wasted because almost nobody has the right incentives to use it wisely.

 

Further, the concentration of health expenses is almost identical among both the insured and uninsured populations. That means that about half of each group has little or no health expenses, while just 5 percent of each population incurs 50 percent of its group's health care expenses.

 

In other words, compulsory insurance won't magically transform the incentives for the uninsured to consume health care. Instead, it will simply move them onto a higher spending baseline.

 

The real "hidden tax" in today's health-care system is levied by the insured on their fellow insured. Most politicians have no interest in talking about this tax. Asking the millions of insured Americans to willingly consume less health care is a path to electoral defeat.

 

Until someone has the courage to tackle this real problem, Americans can expect to be deluged with proposals for mandatory health insurance that are unhealthy, unwise and expensive. And if instituted, the proposals will do nothing but drive our costs even higher.

 

----------

 

John R. Graham is director of health care studies at the Pacific Research Institute.

[EvilMonkey]

Its kinda interesting because from an economic standpoint this is an absolute truth: The cheaper something is, the more of it that will get used. The uninsured aren't going to use as much healthcare, because they economic incentive not to do so, while the insured, will use way more, because they have no incentive not to.

 

http://www.chicagotribune.com/features/hea...,1,236737.story

That is one of the reasons that many insurance plans are trying to use a form of medical savings account. My wife works for a major insurance company, and our plan is something like $2000 per year, no dedectible or questions asked. After that, we are on our own for the next $2000. After that, it is a complex formula (for me!) that basically breaks down to 80/20 for most things. We rarely use the $2000, and up to $1000 of it can carry over to the next year. But it also caused me to look around. I had injured my shoulder and looked for a new doc after I moved. I found one by my house, and one right across the street from where I work. So I tried the work one since it would be easier to just get away for 15 minutes for a visit than to try and leave early and see the one at home. It turns out that an office visit at the work one was $250!!! For 15 minutes of stuff that mostly his nurse did. Not happy. I called, and the one by my house was $50. Guess where I go now? The insured often feel as if it isn't their money, so who cares how much it costs, but that lack of oversight is what contributes to rising health care premiums. We have $3000 heading into this year, and I an gonna use it all this time, going to get my knee checked again. I fear replacement will be needed sometime in the not too distant future. But I am gonna call around first, at least for the initial visits.

[Texsox]

I think the problem is also localized based on unique situations, and when we average nationwide, we lose a true picture.

 

 

 

This area has a huge problem with uninsured patients. Even worse because of our "born here, you are a citizen" policy that encourages "tourists" to magically go into labor while on a vacation. There are also a high rate of seasonal farm jobs that can not offer benefits. Add in an umemployment rate quadruple the national average and a terrible environment because of decades of pesticide overuse, and you have a tough situation.

 

 

 

Average that with Lake Forest Hospital and the picture doesn't seem too bad.

 

 

 

This also highlights the interconnection between two dissimilar areas. Immigratiuon and healthcare. Remove the incentive to have a baby in the US and I guarantee the hospitals here see an immediate drop in births. I understand that birthplace is a centuries old, international standard, but in a mobile society like ours, it no longer makes sense, economically or politically.

[Jenksismyhero]

I don't understand this nonsense about overusing healthcare. Last time I checked nothing bad happens from making sure that you're 100% healthy in every way. Aren't the odds of getting treated for major problems usually dependent on how soon you catch it? Wouldn't it be unwise to start telling people to go to the doctor only when you see a problem? I think if you're paying for it you can get whatever you want. I'll continue to go to the dentist twice a year even though I probably need to go only once. I'll continue to go to the dermatologist a couple times a year to make sure my skin is cancer free (hereditary concern there, but still).

 

Any time you go to the doctor and get something looked at or checked out it can't be a 'waste' or overconsumption of a benefit. It's your body and your health, you should be able to do what you want with it. If the system is getting too expense, how about we start questioning the medical industry and their insane costs of treatment. Why does it cost me hundreds of dollars for an f'n physical? They check my vitals and jewels and I'm out the door in 20 minutes.

 

Also, I'm a big believer in the pharmacutical industry inventing new problems. Restless leg syndrome? Drippy eye syndrom? Have you seen these insane commercials? Everything needs to be medicated these days. How much waste does that create?

[Texsox]

I think they are talking about running to the ER when an office visit the next day would work. Wanting needless tests because your neighbors, sister's, cousin, had a droopy eyelid and then had a heart attack.

[kapkomet]

I've had enough of ER's for a few years after the last two weeks. First, Baby Kap, and now Mrs. Kap. Ugh.

[Queen Prawn]

I think they are talking about running to the ER when an office visit the next day would work. Wanting needless tests because your neighbors, sister's, cousin, had a droopy eyelid and then had a heart attack.

 

Probably but after my dad almost died from a low blood sugar attack (it came on faster than he had ever experienced before), his insurance decided that he should have waiting to make an appointment with the doctor.

 

Mind you that by the time he arrived (via ambulane from about 2 blocks away where he managed to get the car to the side of the road and fell out of the car trying to crawl to the ER), he was having seizures and had a blood sugar of 16. The doctor told me that had it been any longer to when the sargeant found my dad, he would have died within the hour.

 

Reason #1316573548758471 I hate insurace companies.

[Mplssoxfan]

I don't understand this nonsense about overusing healthcare. Last time I checked nothing bad happens from making sure that you're 100% healthy in every way. Aren't the odds of getting treated for major problems usually dependent on how soon you catch it? Wouldn't it be unwise to start telling people to go to the doctor only when you see a problem? I think if you're paying for it you can get whatever you want. I'll continue to go to the dentist twice a year even though I probably need to go only once. I'll continue to go to the dermatologist a couple times a year to make sure my skin is cancer free (hereditary concern there, but still).

 

Any time you go to the doctor and get something looked at or checked out it can't be a 'waste' or overconsumption of a benefit. It's your body and your health, you should be able to do what you want with it. If the system is getting too expense, how about we start questioning the medical industry and their insane costs of treatment. Why does it cost me hundreds of dollars for an f'n physical? They check my vitals and jewels and I'm out the door in 20 minutes.

 

Also, I'm a big believer in the pharmacutical industry inventing new problems. Restless leg syndrome? Drippy eye syndrom? Have you seen these insane commercials? Everything needs to be medicated these days. How much waste does that create?

 

The problem is not so much seeing the doc whenever you're sick (though if you go when you have a cold, that might be a bit much), it's the treatment and labs the doc might give you. If someone with basic care goes to the doc and complains of a headache they've had for two days, the doc will probably give them some meds and tell them to call back in a week. If the headache sufferer has a really god insurance package with no deduction, they might try to convince the doc to call for more advanced tests (i.e. MRI), which most of the time aren't necessary.

 

"What the hell, I'm not paying for it. I want an MRI!"

 

Then folks like QP's pop have to drive themselves to the ER when they're almost in a coma. It's messed up.

[Texsox]

The problem is not so much seeing the doc whenever you're sick (though if you go when you have a cold, that might be a bit much), it's the treatment and labs the doc might give you. If someone with basic care goes to the doc and complains of a headache they've had for two days, the doc will probably give them some meds and tell them to call back in a week. If the headache sufferer has a really god insurance package with no deduction, they might try to convince the doc to call for more advanced tests (i.e. MRI), which most of the time aren't necessary.

 

"What the hell, I'm not paying for it. I want an MRI!"

 

Then folks like QP's pop have to drive themselves to the ER when they're almost in a coma. It's messed up.

 

And to highlight how screwed up the system is, if the Doc doesn't do the extra tests, and there happens to be something serious, a jury is going to award the patient $$$$ in a malpractice suit. I've heard Doctors tell that at least 15% or more of their tests are ordered as a CYA.

[Rex Kickass]

I finally got health insurance for the first time in three years. I have received more medical care since Jan 20 than I had in the five years preceding it.

[EvilMonkey]

And to highlight how screwed up the system is, if the Doc doesn't do the extra tests, and there happens to be something serious, a jury is going to award the patient $$$$ in a malpractice suit. I've heard Doctors tell that at least 15% or more of their tests are ordered as a CYA.

So, maybe some lawsut reform would go a long ways towards ending needless tests and increasing medical costs, eh? Stop needless tests for CYA stuff, keep costs down a bit and so on. but I guess the trial lawyers wouldn't stand for that, would they?

[Texsox]

So, maybe some lawsut reform would go a long ways towards ending needless tests and increasing medical costs, eh? Stop needless tests for CYA stuff, keep costs down a bit and so on. but I guess the trial lawyers wouldn't stand for that, would they?

.

 

Nope but we keep electing lawyers so we're screwed.

[Jenksismyhero]

So, maybe some lawsut reform would go a long ways towards ending needless tests and increasing medical costs, eh? Stop needless tests for CYA stuff, keep costs down a bit and so on. but I guess the trial lawyers wouldn't stand for that, would they?

 

 

The over-hyped, over-sensationalized view of medical malpractice is hysterical. Personally I say let's blame the judges/jury's for handing out the ridiculous awards. I'm all for a cap, but let's not go crazy. We have to keep doctors in check or the standards would drop. Threatening them with a loss of their license and heavy fines/lawsuits is the most effective way of doing this, IMO.

 

It sounds lame, but there are lots of people that get really messed up by the poor decisions of doctors and should be able to recover something for their loss. It's easy to say 'let's stop the needless med malpractice claims,' but try telling someone that their problem isn't severe enough to warrant a lawsuit.

 

Let's not blame the doctors who don't do their job correctly. Let's blame the lawyers for exposing those problems and helping victims recover for their loss...

[NorthSideSox72]

The over-hyped, over-sensationalized view of medical malpractice is hysterical. Personally I say let's blame the judges/jury's for handing out the ridiculous awards. I'm all for a cap, but let's not go crazy. We have to keep doctors in check or the standards would drop. Threatening them with a loss of their license and heavy fines/lawsuits is the most effective way of doing this, IMO.

 

It sounds lame, but there are lots of people that get really messed up by the poor decisions of doctors and should be able to recover something for their loss. It's easy to say 'let's stop the needless med malpractice claims,' but try telling someone that their problem isn't severe enough to warrant a lawsuit.

 

Let's not blame the doctors who don't do their job correctly. Let's blame the lawyers for exposing those problems and helping victims recover for their loss...

I'd say its not even the lawyers that are the problem, since they are just filling a need. The problem is what is allowed to go to trial, and further, what awards are granted. Part of the cause there is that the jury trial system doesn't work (but I realize I'm going nowhere with that unpopular argument). A real solution would be to have small panels of judges review cases in brief format (perhaps a 5-page limit per side for evidence and argument), explore anything that needs exploring, and then reject the ones that are obviously frivilous. Then further, since we can't get rid of the juries entirely, you can take them out of the monetary end of it at least. Juries can decide guilt or not on specific acts or omissions, and then another, seperate panel of judges look at the plaintiff and defense claims and come up with a reasonable amount (like the jury is supposed to do).

[Texsox]

The over-hyped, over-sensationalized view of medical malpractice is hysterical. Personally I say let's blame the judges/jury's for handing out the ridiculous awards. I'm all for a cap, but let's not go crazy. We have to keep doctors in check or the standards would drop. Threatening them with a loss of their license and heavy fines/lawsuits is the most effective way of doing this, IMO.

 

It sounds lame, but there are lots of people that get really messed up by the poor decisions of doctors and should be able to recover something for their loss. It's easy to say 'let's stop the needless med malpractice claims,' but try telling someone that their problem isn't severe enough to warrant a lawsuit.

 

Let's not blame the doctors who don't do their job correctly. Let's blame the lawyers for exposing those problems and helping victims recover for their loss...

 

I'm going to press Add Reply and see if the earth starts shaking, or lightening strikes, I agree with you.

[southsider2k5]

The over-hyped, over-sensationalized view of medical malpractice is hysterical. Personally I say let's blame the judges/jury's for handing out the ridiculous awards. I'm all for a cap, but let's not go crazy. We have to keep doctors in check or the standards would drop. Threatening them with a loss of their license and heavy fines/lawsuits is the most effective way of doing this, IMO.

 

It sounds lame, but there are lots of people that get really messed up by the poor decisions of doctors and should be able to recover something for their loss. It's easy to say 'let's stop the needless med malpractice claims,' but try telling someone that their problem isn't severe enough to warrant a lawsuit.

 

Let's not blame the doctors who don't do their job correctly. Let's blame the lawyers for exposing those problems and helping victims recover for their loss...

 

The key word is "excessive". We have to prevent the excessive stuff, which distorts the rest of the system. Its just like in sports where one stupid contract distorts the payout system for the rest of the league.

[Jenksismyhero]

 

I'm going to press Add Reply and see if the earth starts shaking, or lightening strikes, I agree with you.

 

Wow....I never thought I'd see the day that TexSox and I agree on something!