"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.

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People in this country go to the ED for headaches and feeling tired

Everything is overutilized

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True, but to get the fancy diagnostics and pharmaceuticals that really hit our cost factor, they would have to pay for that, or have insurance and a diagnosis to cover the testing.

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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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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.

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False

They get it for free, dont pay and hospitals eat the cost/pass it on to people with insurance

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

If a patient with Hep C is admitted for hepatic ecephalopathy (i.e. confusion), they are given meds to fix the symptoms (lactulose), stabilized, and sent home. They don't get a transplant. Don't get Sovaldi. Don't even get scoped. Just sent home with a good luck and instruction to follow up with a clinician.

If you walk into the ER with a torn ACL, do they surgically repair it for you there?

If you walk into the ER with a knot in your throat that turns out to be throat cancer, do they treat you there? For free?

If you roll in with neuropathy secondary to your diabetes, do they arrange for your diabetes education, insulin pump and glucose monitoring? No. They refer you to me, and I charge you for all of it. Same with the GI that treats your HCV. Same with the ortho that repairs your ACL. Same with the oncologist who prescribes your chemo.

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.

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starsandstripes

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good post

Not entirely sure how much I agree with, it's alot to digest and think about

I dont think we can have an honest discussion about the cost of healthcare without tort reform though.

this is very true. a major issue is that our consumers demand immediate access (if they have a funding source). that costs money

more socialized societies have to wait for care

also, our rooms are much more private and loaded than in more socialized countries

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Would be way cheaper to treat on the front end.

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i think we all agree, but

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Thing is, those patients often have emergencies because they don’t go to the doctor until things get to that point.

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that's, by and large, not a function of ability to pay

that's just typical underclass bad decision making

again, it's an example of consumer choice

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I dont think we can have an honest discussion about the cost of healthcare without tort reform though.

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Get govt out of healthcare and tort reform will begin taking care of itself.

Healthcare costs not driving by litigation but instead by the industry dynamics and by medical errors.

Get the govt out of healthcare, and let the lawyers go HAM on medical errors and you can rest assured that the AMA will finally begin policing itself with regard to medical errors. There are far too many errors made and medical professionals should be ashamed of this. Instead they run from it, cry about malpractice insurance costs, and take no steps to prevent it.

In their defense however, the govt overlord and its onerous restrictions on how things must be coded and so forth so that Uncle Sam pays, all the paperwork all the admin time they spend - all of that takes away from doing proper exams, makes patient encounters shorter, and increases the chances of error. Doctors need to be doing doctoring. That alone will help fix the errors as well.