re: "Americans spend more on health care than anyone". What if it is due to consumer choices?

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What if it is due to consumer choices?

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HailHailtoMichigan

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Our system is broken.
It is teetering at the tip of a butte separating two paradigms.
It will either tumble into full out socialism, or to competitive capitalism.
One or the other.

Think about it.

We now have a system of, as you surmise, "consumer choice".
That sounds like a capitalistic model.
It isn't.

Usually, such a system would entail competitive mechanisms to draw consumers. Competition drives cost down and quality up. Regulation and government interference ensures that is not so much the case here though.

For example, our system establishes that the best orthopedic surgeon on the planet cannot not charge any more for a hip replacement than a new grad from from the least favorable training program in the country. Only difference is the former is booked out for 6-9 months. Just stupid!

Our system establishes that an outpatient clinic run by a physician must operate entirely off of the physician's earnings. Rent, salaries, equipment, supplies, insurance, etc. must all be funded by returns on the MD's fee alone. However, if that MD cedes control of his clinic to a hospital, the hospital can bill a separate 'facility fee' and make a ton of money. Meanwhile the MD can keep all of his own earnings for himself. In other words, the government is willing to pay twice the fee in the latter situation for identical care. Again, just stupid.

Interestingly, hospitals tend to run such facilities less efficiently than an onsite owner. So while quality suffers, costs are driven upward.

In our system, Stark Laws establish severe restrictions on physicians' "self-referral" even when such self-referral could save major money. However, there are virtually no such restrictions on hospital systems. So hospital administrators with zero medical background are free to make personal "business decisions" directing referrals for nonclinical reasons.

The consumer is blinded to any of this. His/her post-insurance costs (deductibles) are often identical.

I could go on for pages, but suffice it to say those consumer choices you reference are rarely what they should be. They certainly have limited impact on the cost equation.

Haven't seen the studies that confirm that. Do we pay more at the point of service or in totality when compared to taxes taken from individuals to pay for healthcare in other countries? Both? Would like to see the numbers.

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What if part of the reason we spend so much on healthcare is because some consumers opt for expensive, pricey medical devices, tests, new procedures, etc that aren't actually more efficient/better than the older, cheaper technology and methods?

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Look over the costs associated with obesity and diabetes and consider the choices that are made (or not made) to change lifestyles. You can’t fix everything with a pill. We’re a nation of instant gratification and quick fixes, and a large portion of the healthcare epidemic can’t be fixed through either scenario.

A lot of it has to do with Americans as a whole are an extremely unhealthy bunch

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less honorable aspects of the medical market

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What do you perceive those "less honorable aspects" to be??

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Good point. I'll opt for whiskey over anesthesia the next time I go under the knife.

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A lot of it has to do with Americans as a whole are an extremely unhealthy bunch

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The same freedoms we have in our crazy mixed up healthcare, are the same freedoms that allow us to eat super unhealthy everyday. We will probably never have "cheap" healthcare: it's just not the American way

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An ER stabilizes and sends home. ER's do not treat diseases.

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But when you come in with respiratory failure, get intubated and spend a month in the hospital before you're stable for discharge you've eaten up a ton of resources that we won't be reimbursed for.

I work at a for profit hospital and we get reimbursed for about 60% of the services we perform. Of the 60%, over two-thirds is from Medicare/Medicaid which pays pennies on the dollar.

About 80% of the hospital's revenue comes from 10-20% of the patients, and a large portion of that is private donations.

It's a joke

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Americans spend more on health care than anyone

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Because the majority of Americans don’t give 2 shits about their own health and won’t take responsibility for their own actions. Actions have consequences. Eating like shite will make you fat. Being fat and lazy gives you health problems.

None of this is rocket science but doctors/hospitals/pharmaceutical companies make too much money fighting symptoms to care to stop the cause. Hospitals would close if they didn’t have to do expensive bypass, transplant, etc. same with pharmaceutical companies. They want you to be hooked on pills your whole life. Not to fix your diet.

ETA: if you don’t believe me ask any doctor you know how much time they spent on human diet in med school. Or how much continuing education they have to do on the importance/advancement of diet.