Isn't this fun? Health insurance premiums jumping 20%

[creekland]

I agree.  But some people who are complaining about cost would be the same people complaining about cost.  KWIM?

 

There will be a few who complain simply because that's their personality I suspect... ;)

 

I seriously doubt many would be paying all that much more than they - or their employer - pay now.  Once profit for insurance (and all the paperwork & employees that go with it) is taken out of health care, costs go down a fair bit.  There's a reason why other countries pay significantly less for the exact same procedures than we do.

[SparklyUnicorn]

There will be a few who complain simply because that's their personality I suspect... ;)

 

I seriously doubt many would be paying all that much more than they - or their employer - pay now.  Once profit for insurance (and all the paperwork & employees that go with it) is taken out of health care, costs go down a fair bit.  There's a reason why other countries pay significantly less for the exact same procedures than we do.

 

Well that is a factor (insurance profit), but then the other side to that is that insurance companies provide a lot of jobs.  I mean A LOT.  I grew up in a state where a large number of people work for insurance companies (I worked for an insurance company and half my family did too). 

 

DH and I were talking about this and I wondered what if there was just no such thing as insurance...insurance companies...etc.  Could the lab have charged me $2000 for routine piddly labs?  No.  Because nobody I know could afford that for basic labs.  Or I wouldn't pay for it.  Nope.  It's an insane amount of money.  So something would have to give.  Prices would have to drop or a lot of people would just not be able to afford it.  Which would would mean fewer medical people would be needed.  (I'm not saying I think this is a good scenario.)

 

What I'm not seeing at all are attempts to reign in on costs. 

[creekland]

Well that is a factor (insurance profit), but then the other side to that is that insurance companies provide a lot of jobs.  I mean A LOT.  I grew up in a state where a large number of people work for insurance companies (I worked for an insurance company and half my family did too). 

 

DH and I were talking about this and I wondered what if there was just no such thing as insurance...insurance companies...etc.  Could the lab have charged me $2000 for routine piddly labs?  No.  Because nobody I know could afford that for basic labs.  Or I wouldn't pay for it.  Nope.  It's an insane amount of money.  So something would have to give.  Prices would have to drop or a lot of people would just not be able to afford it.  Which would would mean fewer medical people would be needed.  (I'm not saying I think this is a good scenario.)

 

What I'm not seeing at all are attempts to reign in on costs. 

 

We're all talking about dropping insurance companies and going with universal coverage - not dropping insurance companies and everyone pays out of pocket.  Universal coverage is important because then no one has to pay for basic things on the spot.  If a medical issue happens that one week/month/year/lifetime you're strapped for money - it's ok - you can still get it looked at and dealt with.

 

Saving insurance jobs is a pretty poor excuse as to why we need health insurance companies IMO.  If folks can't find jobs otherwise, I'm more in favor of a basic guaranteed income than creating ditch digging jobs (or the equivalent via insurance companies) just to employ people.  It's not all a loss of jobs either, some would be needed in the universal coverage deal - not as many for sure - but no different than anything else that changes in life - like going to the automobile knocking out most harness maker jobs.

[SparklyUnicorn]

We're all talking about dropping insurance companies and going with universal coverage - not dropping insurance companies and everyone pays out of pocket.  Universal coverage is important because then no one has to pay for basic things on the spot.  If a medical issue happens that one week/month/year/lifetime you're strapped for money - it's ok - you can still get it looked at and dealt with.

 

Saving insurance jobs is a pretty poor excuse as to why we need health insurance companies IMO.  If folks can't find jobs otherwise, I'm more in favor of a basic guaranteed income than creating ditch digging jobs (or the equivalent via insurance companies) just to employ people.  It's not all a loss of jobs either, some would be needed in the universal coverage deal - not as many for sure - but no different than anything else that changes in life - like going to the automobile knocking out most harness maker jobs.

 

Oh I don't disagree with you at all.  On either point.

 

[Guest]

What I'm not seeing at all are attempts to reign in on costs.

I am watching a monopoly develop in my area. When it bought my peds' practice, it reqd the doctor to advise patients to bring the children in for followups on simple things like ear infection or pinkeye, and prescribe the latest nongenerics. The hospital it owns is beyond belief...can't go in to details,but remember you have the right to refuse a bed. We have learned to go to the city.

 

I know people who have shopped around for elective Surgery, Such as back surgery and found substantial.price difference...but they worked backward, pricing the hospital, then finding the surgeon.that had the ability to do the procedure at that hospital. Others have gone overseas.

 

Then there are groups like CalPers described here:

http://www.consumerreports.org/cro/magazine/2014/11/it-is-time-to-get-mad-about-the-outrageous-cost-of-health-care/index.htm.

 

My elderly inlaw is outraged this month because her doctor walked her to the nutritionist and sat her down to learn the portion size info. She has the view that she should be free to do as she pleases, with the doctor providing the prescriptions to enable that,and surgery/organ transplants to fix anything...all at taxpayer expense. Her out of pocket is so low that she has no financial incentive to make lifestyle changes.

Edited February 19, 2017 by Heigh Ho

[SparklyUnicorn]

I am watching a monopoly develop in my area. When it bought my peds' practice, it reqd the doctor to advise patients to bring the children in for followups on simple things like ear infection or pinkeye, and prescribe the latest nongenerics. The hospital it owns is beyond belief...can't go in to details,but remember you have the right to refuse a bed. We have learned to go to the city.

 

I know people who have shopped around for elective Surgery, Such as back surgery and found substantial.price difference...but they worked backward, pricing the hospital, then finding the surgeon.that had the ability to do the procedure at that hospital. Others have gone overseas.

 

Then there are groups like CalPers described here:

http://www.consumerreports.org/cro/magazine/2014/11/it-is-time-to-get-mad-about-the-outrageous-cost-of-health-care/index.htm.

 

My elderly inlaw is outraged this month because her doctor walked her to the nutritionist and sat her down to learn the portion size info. She has the view that she should be free to do as she pleases, with the doctor providing the prescriptions to enable that,and surgery/organ transplants to fix anything...all at taxpayer expense. Her out of pocket is so low that she has no financial incentive to make lifestyle changes.

 

When I have attempted to price shop, it was pointless.  Many facilities flat out refused to tell me their prices.  The insurance company also won't tell you contract details, including prices. 

 

The lifestyle change thing, well that's a whole other can of worms.  For one thing I think the typical dietary advice is absolute bull.

[kroe1]

The paperwork and processing of claims still has to be done whether it is done by the government or insurance companies. On average, it costs more for government to process paperwork than private companies. It has been awhile since I checked, but profits in the insurance industry are very small compared to most industries, somewhere around 7%. Somebody may want to check for more up to date figures.

 

Since the exchange, many insurance companies claimed they lost money. I do not think actuaries figured in just how much sicker the uninsured is compared to those with private insurance. But, there is no one answer, in my opinion, for the reason behind the exhorbitant costs of healthcare, nor one solution.

 

And, no one yet has mentioned the piss poor lifestyle our country leads. The number one cause of the most costly medical care is tobacco, second is obesity. So there are a multitude of ways to start saving money. I just hate that I am paying so much per month in the meantime. And, no, I am not willing to spend more for others. I am maxed out.

[Guest]

When I have attempted to price shop, it was pointless. Many facilities flat out refused to tell me their prices. The insurance company also won't tell you contract details, including prices.

 

The lifestyle change thing, well that's a whole other can of worms. For one thing I think the typical dietary advice is absolute bull.

I agree that insurance should disclose.

 

I am talking simple lifestyle choice, like moving more than 1000 steps a day, and eating appropriate portions of food instead of triple the amount needed in junk food.

 

Diet recommendations have to be personalized. I have the folic acid issue that forty percent of US pop has...my health improved and medical costs decreased when I found methyl b12 And dropped the folic acid enriched food products.

[SparklyUnicorn]

I agree that insurance should disclose.

 

I am talking simple lifestyle choice, like moving more than 1000 steps a day, and eating appropriate portions of food instead of triple the amount needed in junk food.

 

Diet recommendations have to be personalized. I have the folic acid issue that forty percent of US pop has...my health improved and medical costs decreased when I found methyl b12 And dropped the folic acid enriched food products.

 

It's hard to eat appropriate portions of food if your blood sugar is out of whack.  You are very hungry.  All the time.

 

I do agree on the personalized thing. They don't do it though.  At least that has never been my experience.  My doc just mumbles stuff about low fat.  I did recently lose weight.  She asked me if that was through low fat.  I said no low carb.  "Oh, I guess that works."  Either way just blurting out some line about low fat isn't terribly specific or helpful. 

 

In terms of minerals, etc....I once asked her about that and she said "it's not important, you get it from food".  Ok first of all it IS important.  Second, if I'm eating a crap diet, I'm not getting it through food.  Really she says stuff I find rather disturbing, but I've tried so many doctors who are the same way that I just gave up.  I needed someone to sign a paper so I could get sedation dentistry and she was willing so I keep going back to her.  LOL

[Guest]

It's hard to eat appropriate portions of food if your blood sugar is out of whack. You are very hungry. All the time.

 

I do agree on the personalized thing. They don't do it though. At least that has never been my experience. My doc just mumbles stuff about low fat. I did recently lose weight. She asked me if that was through low fat. I said no low carb. "Oh, I guess that works." Either way just blurting out some line about low fat isn't terribly specific or helpful.

 

In terms of minerals, etc....I once asked her about that and she said "it's not important, you get it from food". Ok first of all it IS important. Second, if I'm eating a crap diet, I'm not getting it through food. Really she says stuff I find rather disturbing, but I've tried so many doctors who are the same way that I just gave up. I needed someone to sign a paper so I could get sedation dentistry and she was willing so I keep going back to her. LOL

Must shop around for doctors to find the practice that is knowledgeable.

 

Agree on sugar roller coaster....but after being trained, what should be done for those who refuse to ma,e the choices to get off? Let's just talk about those on insulin. What do you say when they won't test, and adjust the meal? What I say is 'remember how you felt in rehab After the last surgery, When the nurse insured that you tested, ate welll, and remained in control? That is what you need to do to feel good and be able to breathe easily and walk more than twenty steps at a time. ' I am thinking the only way is to convert the fast food to automatic, and when they pull up to the drivethru window, they get real food meals for free in exchange for downloading their data. Of course some will still trade.

[Guest]

On the 100k complainers...the ones I have heard are paying so much in taxes that they don't have enough left to live in the area, pay for high school (college prep is fee based here), and put something in 401k. Making health Care almost Ten percent of Income was the final straw. They are moving south as fast as they can unload the home.

 

Do.the math....100k - 9500 health insurance, 6000 property tax, 17000 federal income tax...and we haven't put in state income tax, ss or workmans comp and 401k....comparing with friends,.they find they will keep more if they move south and make less. No need to hustle on the side either. A 50k family income with a pension or a 150k+ income is what works here.

 

The economic areas across the US make it difficult to pla a one size fits all that will work. A UBC for a person in low income subsidized housing will be different than the guy living rural renting a room and piecing together seasonal jobs.

Edited February 19, 2017 by Heigh Ho

[Frances]

Yes, that was not my point.

 

My point was this stuff is not low cost. The money comes from somewhere one way or another.

But with universal healthcare we could also do more to control the costs. In many ways, we in the US subsidize the low costs in other countries.

[SparklyUnicorn]

But with universal healthcare we could also do more to control the costs. In many ways, we in the US subsidize the low costs in other countries.

 

I agree, but I won't hold my breath that things will change anytime soon.

[Frances]

I agree, but I won't hold my breath that things will change anytime soon.

I absolutely agree. I don't expect to see universal healthcare in the US in my lifetime.

[SparklyUnicorn]

Must shop around for doctors to find the practice that is knowledgeable.

 

Agree on sugar roller coaster....but after being trained, what should be done for those who refuse to ma,e the choices to get off? Let's just talk about those on insulin. What do you say when they won't test, and adjust the meal? What I say is 'remember how you felt in rehab After the last surgery, When the nurse insured that you tested, ate welll, and remained in control? That is what you need to do to feel good and be able to breathe easily and walk more than twenty steps at a time. ' I am thinking the only way is to convert the fast food to automatic, and when they pull up to the drivethru window, they get real food meals for free in exchange for downloading their data. Of course some will still trade.

 

Yeah, but how many times am I going to keep going to doctors?  I am so tired of it.

 

I think what these people are told to do doesn't work well enough and they become very frustrated.  Sure there are always going to be some who won't be bothered, but some people who try very hard to follow what they are told cannot control it with what they are told.  Period.  They can't.  And so they give up.  My sister can't control her diabetes with what she is told to do. 

 

If it is a complicated roller coaster of drugs, injections, testing, controlled meals that never lower blood sugar much followed by being very hungry, followed by attempts at self control, followed by being human, some more drugs, injections...etc etc.  You are asking people to be super human! 

[SparklyUnicorn]

I absolutely agree. I don't expect to see universal healthcare in the US in my lifetime.

 

Basically this is turning big business into a public service.  Or at least far more public service friendly.  The only time I see the govt. getting worked up over healthcare costs is if it might cut into their bottom line since they are a very large customer (to drug companies for example).  Otherwise, where is the outrage? 

 

And I don't get it.  Why don't so many people seem to want to have decent health care at a price that isn't choking them financially?  That seems like a no duh to me.  But people don't want it.  Even my crazy neighbor.  He was outright flaming mad that he now gets free health insurance.  How dare he be forced into it.  I don't understand!  He did have to sign up for it, but he doesn't pay anything.  Not one thin dime!

 

But then I do get the anger when people end up with lousy coverage and super high premiums or they pay so much in premiums that they can't even afford to use it.  That's not right. 

[Guest]

 

If it is a complicated roller coaster of drugs, injections, testing, controlled meals that never lower blood sugar much followed by being very hungry, followed by attempts at self control, followed by being human, some more drugs, injections...etc etc. You are asking people to be super human!

Seems to depend on the nutritionist and how honest the person is with themselves. My elder diabetic relative does well in rehab because she has to follow protocol. The rehab facility has no junk food available for purchase and won't give her extra platefuls and they insist that the PT is done. Its not asking for superhuman control to follow the plan when at home, especially when rehab has taken you off the roller coaster and you visit the pt at no cost to you other than gas. I agree,getting off takes more control than some people have. Staying off after being stabilized is habit and choice...I propose making it easier by giving away nutritious food (a cash incentive) and offering free fitness classes at the senior center.

[Guest]

 

And I don't get it. Why don't so many people seem to want to have decent health care at a price that isn't choking them financially? That seems like a no duh to me. But people don't want it. Even my crazy neighbor. He was outright flaming mad that he now gets free health insurance. How dare he be forced into it. I don't understand! He did have to sign up for it, but he doesn't pay anything. Not one thin dime!

 

 

I get it,because I have elderly neighbors. They do not want to be considered pets, or slaves and have master pay for them. They expect the market to work, and prices to drop to reasonable once development costs are paid for.

 

The AFA for ex, increased my generic med price to what the name brand went for preAFA. Was 100 Per year without insurance, then on Jan 1st went to 2500 and can't be bought without insurance. Remember all the meds on the $4 list? Can't be had now. That is just crazy.my senior friends want profit to be made on volume, not overpricing. That employs more people and more can access the meds they need for quality of life.

Edited February 19, 2017 by Heigh Ho

[SparklyUnicorn]

Seems to depend on the nutritionist and how honest the person is with themselves. My elder diabetic relative does well in rehab because she has to follow protocol. The rehab facility has no junk food available for purchase and won't give her extra platefuls and they insist that the PT is done. Its not asking for superhuman control to follow the plan when at home, especially when rehab has taken you off the roller coaster and you visit the pt at no cost to you other than gas. I agree,getting off takes more control than some people have. Staying off after being stabilized is habit and choice...I propose making it easier by giving away nutritious food (a cash incentive) and offering free fitness classes at the senior center.

 

None of my family members ever controlled their blood sugar following any dietician they ever saw.  None.  The goal was always how many drugs and meds do we need to pump into your body so that stuff is a little less out of whack.  At this point my sister injects before she eats and after she eats.  Plus drugs.  This has been a vicious cycle.  In fact at this point she eats very little because she is so miserable.

 

She is also not overweight btw. 

[Guest]

 

She needs to do inpatient , so she can get off the roller coaster.

[SparklyUnicorn]

Already done that.  It did not work.

 

 

[Lanny]

But with universal healthcare we could also do more to control the costs. In many ways, we in the US subsidize the low costs in other countries

 

We live in Colombia and I am trying to understand what you mean by that... The people in the USA are  subsidizing lower costs here? I DO NOT THINK THAT IS HAPPENING...   What do you mean by that?

 

When I had my LASIK surgeries, in 1997, the Ophthalmologist was working to get FDA approval for the LASIK procedure.  She was, at that time, #2 in the world, for the LASIK procedure. That's Cosmetic surgery and should be included in my comment here... But IMO some of the FDA approvals are based upon studies done here in Colombia...  Much lower cost than the same studies would be if they were done in the USA.

 

And then, a month or 2 ago, Senator Oren Hatch (R-UT) threatened Colombia, with the loss of USD $450 Million in aid, that we need, so we can support the FARC guerrillas after the so called "peace" treaty, so they can live a comfortable life.  Why did Senator Hatch threaten us?  Because the Colombian government threatened a Pharmaceutical company, based in Europe, that if they did not lower the price of a certain Cancer drug, that is a one of it's kind apparently, they would authorize Generic production of that drug here in Colombia.  One must assume that Senator Hatch (and probably many others) receive $$$$$, in contributions, from that European based company. He wasn't even protecting a U.S. based company. It is based in Europe.

 

And then there are the Clinical trials they do here.  Guinea Pigs for testing new drugs.  

 

IMO the Pharmaceutical companies are a big contributor to the increasing cost of medical care, whether it is in the USA, or here in Colombia.

 

I read (or saw on TV?) a month or two ago, that one cannot just call a hospital or  other provider in the USA and ask what the price of some procedure is.  There is no one price. The price depends upon the contract between the insurance company and the provider.   So, the same provider can (and probably does) have many different prices, for the same procedure.

 

I thought the policies purchased on an ObamaCare Exchange had a lock on the monthly premium for 12 months.  That may or may not be the case? Other policies, like the one I had when I lived in TX, I do not remember (that was years ago) ever increasing in cost more than once a year.  I do remember that I would typically raise my Deductible, to try to keep the Monthly Premium approximately the same...

 

I take a Generic medicine every day. One capsule every day.   About 2 or 3 years ago, a European based Pharmaceutical company bought the excellent Colombian company that makes that medicine.  Immediately after they purchased the Colombian company, the price shot up.  I told my wife at that time, "I think they want to get back what they paid for the Colombian company, in one year, by raising the prices of all of their medicines".  

 

Two of my doctors here moved to the USA, about 10 or 15 years ago.  I doubt that they have any hair left now and I suspect that they are very sad about the kind of non-relationships they must have with their patients in the USA, and the way the system there places so many restrictions on how they practice medicine.

 

Complex problems do not have simple solutions... 

[Guest]

Already done that. It did not work.

Have to wait for organ replacement right? And get some genetic results and see if there is any insight to be gained.

[SparklyUnicorn]

Have to wait for organ replacement right? And get some genetic results and see if there is any insight to be gained.

 

Um no probably that won't happen.

 

Just lots of drugs. 

[Frances]

We live in Colombia and I am trying to understand what you mean by that... The people in the USA are subsidizing lower costs here? I DO NOT THINK THAT IS HAPPENING... What do you mean by that?

 

When I had my LASIK surgeries, in 1997, the Ophthalmologist was working to get FDA approval for the LASIK procedure. She was, at that time, #2 in the world, for the LASIK procedure. That's Cosmetic surgery and should be included in my comment here... But IMO some of the FDA approvals are based upon studies done here in Colombia... Much lower cost than the same studies would be if they were done in the USA.

 

And then, a month or 2 ago, Senator Oren Hatch (R-UT) threatened Colombia, with the loss of USD $450 Million in aid, that we need, so we can support the FARC guerrillas after the so called "peace" treaty, so they can live a comfortable life. Why did Senator Hatch threaten us? Because the Colombian government threatened a Pharmaceutical company, based in Europe, that if they did not lower the price of a certain Cancer drug, that is a one of it's kind apparently, they would authorize Generic production of that drug here in Colombia. One must assume that Senator Hatch (and probably many others) receive $$$$$, in contributions, from that European based company. He wasn't even protecting a U.S. based company. It is based in Europe.

 

And then there are the Clinical trials they do here. Guinea Pigs for testing new drugs.

 

IMO the Pharmaceutical companies are a big contributor to the increasing cost of medical care, whether it is in the USA, or here in Colombia.

 

I read (or saw on TV?) a month or two ago, that one cannot just call a hospital or other provider in the USA and ask what the price of some procedure is. There is no one price. The price depends upon the contract between the insurance company and the provider. So, the same provider can (and probably does) have many different prices, for the same procedure.

 

I thought the policies purchased on an ObamaCare Exchange had a lock on the monthly premium for 12 months. That may or may not be the case? Other policies, like the one I had when I lived in TX, I do not remember (that was years ago) ever increasing in cost more than once a year. I do remember that I would typically raise my Deductible, to try to keep the Monthly Premium approximately the same...

 

I take a Generic medicine every day. One capsule every day. About 2 or 3 years ago, a European based Pharmaceutical company bought the excellent Colombian company that makes that medicine. Immediately after they purchased the Colombian company, the price shot up. I told my wife at that time, "I think they want to get back what they paid for the Colombian company, in one year, by raising the prices of all of their medicines".

 

Two of my doctors here moved to the USA, about 10 or 15 years ago. I doubt that they have any hair left now and I suspect that they are very sad about the kind of non-relationships they must have with their patients in the USA, and the way the system there places so many restrictions on how they practice medicine.

 

Complex problems do not have simple solutions...

In general, we pay more for our drugs here because we are subsidizing the cost of drug development and allowing drug companies to charge what the market will bear.The same with other medical things like artificial joints for joint replacement surgery. Most countries with some form of universal healthcare negotiate with drug companies and other medical device companies for lower prices in exchange for a high volume of sales.

 

This is one of many reasons that other countries with universal healthcare can spend less per capita on healthcare and have better outcomes.

[LMD]

We have a medicare scheduled amount and rebate amount. Doctors can and do charge over the scheduled amount, however the market just won't sustain crazy rates, most charge the suggested rates from the Australian medical association and they are subject to the trade practices act which provides protection around price fixing and price advertising (it's been a long time since I've looked at the act so don't trust my memory completely!).

[Lanny]

In general, we pay more for our drugs here because we are subsidizing the cost of drug development and allowing drug companies to charge what the market will bear.The same with other medical things like artificial joints for joint replacement surgery. Most countries with some form of universal healthcare negotiate with drug companies and other medical device companies for lower prices in exchange for a high volume of sales.

 

This is one of many reasons that other countries with universal healthcare can spend less per capita on healthcare and have better outcomes.

 

I wonder if you are paying more for name brand (non Generic) medicines than we are?  I doubt that people in the USA are the only ones subsidizing development and trials of new medicines.  

 

However, I suspect (with no actual comparison figures available to me), that we do pay less for Generic medicines, because we do not normally have interaction  with a Pharmacist, when we go into a Pharmacy to buy Medicines.  There is a (growing) drug abuse problem here, but it is nothing like the catastrophic situation in the USA/Canada/Europe, so there are only certain restricted medicines that require one to go to special pharmacies to get them.  

 

In 1999, we went up to Miami for a week.  I got sick. We had purchased temporary medical insurance coverage. They sent a doctor to our hotel room and he gave me a prescription.  That was in the morning. We went to a Pharmacy to get the prescription filled.  I think we were told to come back in the late afternoon. I was sick and I needed the medicine then, so that wasn't a big help to me.  We went back, hours later, and I got the prescription.  I guess that is necessary in the USA and having the requirement of Pharmacists to dispense medicines is another thing that drives up the cost of medical care in the USA.

 

There are lots of things like that that add to the overall total cost of providing medical care.  

[Laura Corin]

The paperwork and processing of claims still has to be done whether it is done by the government or insurance companies. 

 

 

Not necessarily.  Under the UK single-payer system, the doctors are on salary, so there isn't any claims paperwork.  You go, you are treated,  a record is kept for the sake of future treatment, you go home.  The doctors get their salary (normally based on the number of patients they have on their lists (GPs) or the hours they work (specialists), not the number they treat, I believe), the hospital gets central funding.

[Frances]

I wonder if you are paying more for name brand (non Generic) medicines than we are? I doubt that people in the USA are the only ones subsidizing development and trials of new medicines.

 

However, I suspect (with no actual comparison figures available to me), that we do pay less for Generic medicines, because we do not normally have interaction with a Pharmacist, when we go into a Pharmacy to buy Medicines. There is a (growing) drug abuse problem here, but it is nothing like the catastrophic situation in the USA/Canada/Europe, so there are only certain restricted medicines that require one to go to special pharmacies to get them.

 

In 1999, we went up to Miami for a week. I got sick. We had purchased temporary medical insurance coverage. They sent a doctor to our hotel room and he gave me a prescription. That was in the morning. We went to a Pharmacy to get the prescription filled. I think we were told to come back in the late afternoon. I was sick and I needed the medicine then, so that wasn't a big help to me. We went back, hours later, and I got the prescription. I guess that is necessary in the USA and having the requirement of Pharmacists to dispense medicines is another thing that drives up the cost of medical care in the USA.

 

There are lots of things like that that add to the overall total cost of providing medical care.

I'm not saying that those in other countries don't pay any of the cost of new drug development, just that in general they pay less for drugs and other medical devices under universal healthcare because their government has negotiated deals with the drug companies and other providers of medical supplies.

 

Yes, there are many factors that make medical care more expensive in the US, but treating it like any other item in a capitalistic system definitely contributes to the problem.

[mommyoffive]

This makes me nervous.  

 

I can't imagine paying that much.

[Bluegoat]

Although to be fair we need to compare stuff like taxes.  One way or another, this stuff is being paid for.  My husband for years would go on and on about how much better the insurance situation in Germany is, but when we sat down and compared numbers, it wasn't much of a difference in terms of the bottom line for our situation.

 

What IS different is the cost may be spread out differently in Australia.  Also, you may have nobody going without care.  But again, this isn't free and it's a cost that anyone who can afford to pay for it is paying.  You might also have caps on what can be charged (something we do not have here).  So it's also likely doctors in the US are being paid more (whether or not that is good or bad, I don't know, just stating what might be part of the difference). 

 

Some of the complaints you read about here of people paying XYZ amount are coming from people who must be making 6 figures or close to it if they aren't receiving any sort of subsidy.  (Not that there aren't a segment of people who are being asked to pay way more than most would agree is fair.)  They aren't necessarily hurting financially.  They just don't want to pay that much (and I'm not arguing that they should be forced to), but they'd be taxed far more heavily in other countries with different healthcare systems.  So they wouldn't necessarily be paying less. 

 

Yes, of course it is still paid for, althoug the US pays more per person than any other place, with worse outcomes.

 

But the big differences is that everyone gets care, bankrupsy due to medcal costs is unusual (it'c common in the US,) people can go about their lives without worrying about how to manage medical costs, and also people who are out of work, or want to change jobs, or start a business, or stay home and care for kids or parents etc, don't need to worry about not being covered.

 

It's less stressful, it creates a different attitude to health care, and it creates some important system effects.

Edited February 19, 2017 by Bluegoat

[Ausmumof3]

I get it,because I have elderly neighbors. They do not want to be considered pets, or slaves and have master pay for them. They expect the market to work, and prices to drop to reasonable once development costs are paid for.

 

The AFA for ex, increased my generic med price to what the name brand went for preAFA. Was 100 Per year without insurance, then on Jan 1st went to 2500 and can't be bought without insurance. Remember all the meds on the $4 list? Can't be had now. That is just crazy.my senior friends want profit to be made on volume, not overpricing. That employs more people and more can access the meds they need for quality of life.

The view that universal healthcare makes people into pets or slaves who have masters who pay for them is incredibly insulting. The reality is that everyone pays in via tax to some degree - some more than others but often simply or more or less at various stages of life to smooth the gaps.

[Ausmumof3]

In general, we pay more for our drugs here because we are subsidizing the cost of drug development and allowing drug companies to charge what the market will bear.The same with other medical things like artificial joints for joint replacement surgery. Most countries with some form of universal healthcare negotiate with drug companies and other medical device companies for lower prices in exchange for a high volume of sales.

 

This is one of many reasons that other countries with universal healthcare can spend less per capita on healthcare and have better outcomes.

I don't know the percentage but I know that Australia has a fair bit of investment in medical research. One of Dh's big jobs through work a couple of years ago was with a very ugly building that is supposed to be a new state of the art medical research building.

[SparklyUnicorn]

The view that universal healthcare makes people into pets or slaves who have masters who pay for them is incredibly insulting. The reality is that everyone pays in via tax to some degree - some more than others but often simply or more or less at various stages of life to smooth the gaps.

 

Don't know that it is insulting.  I find the view rather strange.  But there was a hint of that with my parents too.  They didn't want to feel controlled and would have seen that as controlling.  But I'm sure they have (would have) changed their tune given their heavy reliance on health care.

[Guest]

The view that universal healthcare makes people into pets or slaves who have masters who pay for them is incredibly insulting. The reality is that everyone pays in via tax to some degree - some more than others but often simply or more or less at various stages of life to smooth the gaps.

They aren't commenting on your country's system.

They are saying they don't believe in a free lunch, But they also don't believe in a lunch priced so high that some are forced to freeload for ordinary old technology things. For ex, in the past I could call the ped and describe symptoms and he would call in a prescription for simple things like ear infection or pinkeye. Total cost $4. Now with The AFA its 2 appointments at 150 each and 30 for the Rx, total $330 unless the deductible has been met. That is an insult to a working man who could afford treatment before, bit now has to scrimp or ask for help. Strips people of their dignity.

[SparklyUnicorn]

They aren't commenting on your country's system.

They are saying they don't believe in a free lunch, But they also don't believe in a lunch priced so high that some are forced to freeload for ordinary old technology things. For ex, in the past I could call the ped and describe symptoms and he would call in a prescription for simple things like ear infection or pinkeye. Total cost $4. Now with The AFA its 2 appointments at 150 each and 30 for the Rx, total $330 unless the deductible has been met. That is an insult to a working man who could afford treatment before, bit now has to scrimp or ask for help. Strips people of their dignity.

 

Yep.  My parents were pretty poor, but they paid the hospital bills for my birth and my sister's birth. Also, all doctor visits and prescriptions for us before the whole HMO stuff came along.  They of course had a running tab and made small payments.  Doctors were willing to do that because plenty of people were in that boat.  Now?  They won't see you without a large sum of cash up front.  The average income can't pay for all the associated costs of a child being born. 

[Bluegoat]

They aren't commenting on your country's system.

They are saying they don't believe in a free lunch, But they also don't believe in a lunch priced so high that some are forced to freeload for ordinary old technology things. For ex, in the past I could call the ped and describe symptoms and he would call in a prescription for simple things like ear infection or pinkeye. Total cost $4. Now with The AFA its 2 appointments at 150 each and 30 for the Rx, total $330 unless the deductible has been met. That is an insult to a working man who could afford treatment before, bit now has to scrimp or ask for help. Strips people of their dignity.

 

Most people are very inconsistant about this - they are happy to use other public dervices funded by taxes witout considering it freeloading.

[Tree Frog]

I agree that insurance should disclose.

 

I am talking simple lifestyle choice, like moving more than 1000 steps a day, and eating appropriate portions of food instead of triple the amount needed in junk food.

 

Diet recommendations have to be personalized. I have the folic acid issue that forty percent of US pop has...my health improved and medical costs decreased when I found methyl b12 And dropped the folic acid enriched food products.

 

What are the issues? I've never heard of problems with folic acid.

[FaithManor]

Don't know that it is insulting. I find the view rather strange. But there was a hint of that with my parents too. They didn't want to feel controlled and would have seen that as controlling. But I'm sure they have (would have) changed their tune given their heavy reliance on health care.

My parents have openly said they would rather die and have their family die too than have "the government tell me what to do". Sigh...because they honestly believe that Congress is going to make all of the medical decisions for 300 million people, dictate every level of care. And all this crazy despite the fact that living in France and having universal healthcare saved her life more than once and she has experienced zero healthcare rationing.

 

Meanwhile they have easily incurred $350,000+ in medical care in the last four years between them all paid for by Medicare. So apparently they are entitled to healthcare but not Dh and I or our kids.

 

Having once begged first responders to let me die but save my son because I wasn't certain we could pay deductibles on both of us at the same time, seriously injured and frantic to get them to find my purse and get the credit card out for my boy, I can say there is not a single redeemable thing about our current system that works EXCEPT our trauma care which is amazing and first rate.

 

I cannot handle the members of the older generation who will not listen to reason and are so self centered that they would rather people die than embrace change.

[Frances]

They aren't commenting on your country's system.

They are saying they don't believe in a free lunch, But they also don't believe in a lunch priced so high that some are forced to freeload for ordinary old technology things. For ex, in the past I could call the ped and describe symptoms and he would call in a prescription for simple things like ear infection or pinkeye. Total cost $4. Now with The AFA its 2 appointments at 150 each and 30 for the Rx, total $330 unless the deductible has been met. That is an insult to a working man who could afford treatment before, bit now has to scrimp or ask for help. Strips people of their dignity.

I'm not sure what the AFA refers to, but it's been a very long time since most doctors would prescribe meds based on a phone call, at least where I live. Our vet won't even do it anymore. And due to the life saving nature of medical care, the prices are not going to decrease without some sort of government involvement. Medical care doesn't work like other commodities in a free market system. And universal healthcare is not a free lunch, people pay taxes to fund it. So a working man would be contributing towards the healthcare they get. And if they or a family member got something much more serious than pinkeye or an ear infection they wouldn't lose everything or worry about their ability to pay.

[xixstar]

I'm not sure what the AFA refers to, but it's been a very long time since most doctors would prescribe meds based on a phone call, at least where I live.

 

 

This is why so many of these conversations are helpful, they help open up the experiences of others to see how thing vary for other people.

 

Within the past month I've been able to get a called in prescription from just a phone call to my doctor (a call to his home, in fact).

 

If you asked me 2-3 years ago about high-deductible plans and HSAs being a solution to helping people connect to real health care costs and making positive changes in behaviors, I probably would have agreed heartily because my experience was with a (lower) high-deductible plan. I didn't have the experience I have now and I had not listened and talked with so many others about their experiences. My view has shifted.

 

I am very grateful this conversation comes up again and gain because I think hearing about others experiences and how it differs from ours is even more important than some political arguments that leave out the lives realities for many different situations.

[creekland]

but it's been a very long time since most doctors would prescribe meds based on a phone call, at least where I live. Our vet won't even do it anymore. 

 

Weird.  We can still do this - both vet and doctor.  Neither are new to us, so perhaps you meant a "new" doctor/vet who one hasn't been to yet?

[Joker]

Weird. We can still do this - both vet and doctor. Neither are new to us, so perhaps you meant a "new" doctor/vet who one hasn't been to yet?

Ours do it here too and we've lived here less than two years so not long relationships with vet or doctor.

Edited February 20, 2017 by Joker

[Frances]

Weird. We can still do this - both vet and doctor. Neither are new to us, so perhaps you meant a "new" doctor/vet who one hasn't been to yet?

Nope, all of our doctors stopped doing it many years ago when my son was still young enough to be seeing a pediatrician. Our vet stopped a few years ago. Both will still give us prescriptions in advance at an appointment that we can fill if needed, but nothing over the phone. Our pediatrician even stopped calling in any prescriptions to a pharmacy after an office visit. They would only write them. All explained that it was for liability reasons.

Edited February 20, 2017 by Frances

[Joker]

Nope, all of our doctors stopped doing it many years ago when my son was still young enough to be seeing a pediatrician. Our vet stopped a few years ago. Both will still give us prescriptions in advance at an appointment that we can fill if needed, but nothing over the phone. Our pediatrician even stopped calling in any prescriptions to a pharmacy after an office visit. They would only write them. All explained that it was for liability reasons.

That's really odd. I haven't had a written prescription in years except for certain kinds of pain meds. It seems to all be done electronically.

 

ETA: Our pediatrician has even started verifying ds's HSV 1 outbreaks on his face via text messages and will send the prescription to the pharmacy without ever seeing him.

Edited February 20, 2017 by Joker

[Laura Corin]

I get it,because I have elderly neighbors. They do not want to be considered pets, or slaves and have master pay for them. 

 

 

It's odd, because many people are very careful to point out that single-payer systems are not free, that the money has to come from somewhere.  When my 92yo mother sees the doctor, or when I do or my sons do, this is paid for by everyone's taxes.  That's not being treated as a pet or a slave - it's paying through the taxation system whenever one is able to work for healthcare that will benefit you and everyone else and is free at the point of need.

[kroe1]

Not necessarily. Under the UK single-payer system, the doctors are on salary, so there isn't any claims paperwork. You go, you are treated, a record is kept for the sake of future treatment, you go home. The doctors get their salary (normally based on the number of patients they have on their lists (GPs) or the hours they work (specialists), not the number they treat, I believe), the hospital gets central funding.

Nope, according to my former UK physician DH, it is still itemized coding that goes to the government just like Medicare, Medicaid, and private insurance here. My brother-in-law, who is still in the U.K. Is being treated regularly for a problem now. Same type of forms get filled out (or data transmissions as it is mostly automated now). The difference is that the U.K. patient is not as big a part of the hassle as what patients are in the US.

[SparklyUnicorn]

Weird.  We can still do this - both vet and doctor.  Neither are new to us, so perhaps you meant a "new" doctor/vet who one hasn't been to yet?

 

Not in my experiences ever.  They want you to come in. 

[creekland]

Nope, all of our doctors stopped doing it many years ago when my son was still young enough to be seeing a pediatrician. Our vet stopped a few years ago. Both will still give us prescriptions in advance at an appointment that we can fill if needed, but nothing over the phone. Our pediatrician even stopped calling in any prescriptions to a pharmacy after an office visit. They would only write them. All explained that it was for liability reasons.

 

This must be a regional thing.  I haven't had a written prescription in my hand in a long time.  I have meds in my house I never plan to use because doctor offices call them directly into the pharmacy (a very local mom & pop one) and I don't want them to lose anything, so I buy them - then wonder what to do with the meds.  Recently I've learned to speak up at the doctor office rejecting the meds if it comes from an appt.  Antibiotics I just have to call for and pick up.

[Laura Corin]

Nope, according to my former UK physician DH, it is still itemized coding that goes to the government just like Medicare, Medicaid, and private insurance here. My brother-in-law, who is still in the U.K. Is being treated regularly for a problem now. Same type of forms get filled out (or data transmissions as it is mostly automated now). The difference is that the U.K. patient is not as big a part of the hassle as what patients are in the US.

 

That's interesting.   You are right, the coding etc is completely invisible to patients.