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

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

quote:

---

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?

---

Most plans don't allow this as the default approach.

Decades ago this was an issue, as technological advancement hit the medical arena and people thought it was a panacea. It wasn't, and it was recognized as a money waster.

The Medicare Act of 1965 is responsible for the current state of affairs. It dramatically increased demand because it dramatically increased subsidies. Demand goes up, prices go up. It's a vicious spiral. The govt caused all of this, and govt's reactions to the problems it caused have just made it all worse.

This whole medical care cost stuff is pretty simple to understand, as far as the root cause of dysfunction is concerned:
the govt got involved and changed the rules of the game.

No longer is it just a doctor and a patient working together to insure one is healthy and the other compensated for making that happen. No longer is there just an insurance mechanism in place to help facilitate this.

Now we have a govt overlord that greatly constrains the patient, the doctor, and the insurer. The govt is the only one of these parties that gets to enforce its part at the point of a gun. The govt costs people money due to compliance and makes the interaction among all key players too complex and too constrained.

Get the govt out of healthcare and healthcare will get fixed.

I believe we can fix 90% or more of the problems by getting govt out, save for a requirement to have a health savings account started by the parents, for each child they have. If you were to demand $2000 be deposited by parents by the time a child hits the 1st birthday, for instance, it could surpasss $1M easily by the time that child hit 55yrs old. Let people get insurance coverage as well, mainly to cover routine and non-emergent costs, or to have a catastrophic policy in place.

Medical costs hit a peak, typically, for the last 1-3yrs of one's life. That will typically be after someone passes 60yrs of age. That health savings account would be established by then. A compounding interest would make that account quite substantial by that time. For every person that has lifelong, exhorbitant medical bills, there will be 10 or more that have very few and costs would be covered in that manner. In all likelihood, there would be a surplus from such a fund. Also, if you hit massive costs when you are say, 34yrs old, payment can be made based on the projected growth in that health savings account, or out of pocket, or via use of a simple catastrophic insurance policy.

I think part of your federal tax liability each year should include $10 to fund an auditing body to investigate fraud and so forth at the federal and state level. That would produce around $2 billion each year for that purpose. That would make sure there is no fraud, but would allow providers to charge what they want - so long as they are delivering what they charge for (ie you can't charge for Tylenol if you don't give the pills to the patient). This would open up the market. If you want a boutique doctor, you can have one. If you want open heart surgery at some palacial estate hospital, you can do that - so long as you can afford the residual between your health savings account and your bill.

TLDR - get 90% or more of the govt influence out of healthcare and you eliminate just about all problems in healthcare.

generic vs name brand meds are sometimes made in the same factory, on the same assembly line. just packaged differently.

even over the counter. ibuprofen vs Advil same med... people mostly buy the name brand

also, a lot of what we consume is banned in other countries, they deem it bad/unhealthy/harmful, we say go ahead, it's your life, enjoy.

There's no universal fix for the overall problem, because it may have started with one root cause but it has spiraled into MANY contributing factors. Trying to slap a single catchall fix to it will just make matters worse.

quote:

---

What if it is due to consumer choices?

---

quote:

---

HailHailtoMichigan

---

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.

quote:

---

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?

---

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

quote:

---

What if it is due to consumer choices?

---

What if it is due to artificial scarcity due to government imposed barriers to entry, a lack of transparency in pricing preventing customers from being able to adequately price-shop, a third-party payment model that reduces consumer responsiveness to price, a lack of feeling of choice when faced with spend or die immediately, and a culture that encourages an unhealthy life style? What if literally every facet of our healthcare system has been f&%ked by the government at the expense of consumers to make it as expensive as possible in order to justify a long creep towards a socialist single-payer healthcare system for the masses while the elite and politbureau hoard the good healthcare for themselves.