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re: "Americans spend more on health care than anyone". What if it is due to consumer choices?
Posted on 4/23/18 at 8:26 pm to Jake88
Posted on 4/23/18 at 8:26 pm to Jake88
Another hilariously awful fact: If you live in relatively close proximity to a major urban center, it's generally better to have no insurance and be dead arse broke than to make just enough money to have crappy insurance.
Most major academic centers and hospital systems operate free clinics. These clinics are stocked with cabinets full of common blood pressure, cholesterol, COPD and diabetes medications that we literally just grab and hand you. You can generally be seen at least a couple times a year if you qualify financially. You get decebt care and somewhat regular follow up and common medications completely free. Most specialities in these systems block off half days 1-2 times a month to see these people as well, so I can actually refer you to an endocrinologist or a cardiologist and you can be seen by them also completely free.
People with crappy insurance are out thousands for the same services.
Most major academic centers and hospital systems operate free clinics. These clinics are stocked with cabinets full of common blood pressure, cholesterol, COPD and diabetes medications that we literally just grab and hand you. You can generally be seen at least a couple times a year if you qualify financially. You get decebt care and somewhat regular follow up and common medications completely free. Most specialities in these systems block off half days 1-2 times a month to see these people as well, so I can actually refer you to an endocrinologist or a cardiologist and you can be seen by them also completely free.
People with crappy insurance are out thousands for the same services.
Posted on 4/23/18 at 8:32 pm to olemissfan26
quote:
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.
Most medical schools incorporate nutrition education into the curriculum in some manner these days. We had a month long course in nutrition/exercise/lifestyle medicine as 4th years.
Most younger internal and family medicine trained doctors can provide sound dietary counseling. The problem is nobody reimburses us for doing so. Medicare reimburses for tobacco cessation, but not nutritional or exercise counseling.
This post was edited on 4/23/18 at 8:33 pm
Posted on 4/23/18 at 9:01 pm to Roger Klarvin
quote:
Most younger internal and family medicine trained doctors can provide sound dietary counseling.
Of course they can. America’s issue with diet isn’t that we don’t know what constitutes a healthy diet.
Posted on 4/23/18 at 9:05 pm to the808bass
You'd be surprised how many otherwise intelligent people believe dietary/nutritional nonsense. Just go visit a health/fitness forum.
And a lot of physicians, especially older physicians, still push the myth that dietary fats are the biggest illness culprit.
And a lot of physicians, especially older physicians, still push the myth that dietary fats are the biggest illness culprit.
Posted on 4/23/18 at 9:07 pm to HailHailtoMichigan!
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?
Have you seen a place that’s upfront and clear about 100% of their fees and costs?
Because I haven’t.
Especially when you consider all these prices change once your insurance provider is known.
Posted on 4/23/18 at 9:34 pm to HailHailtoMichigan!
quote:We spend more in this country because we have to cover the costs of advancements. We discover more than anyone else. We cover the costs of testing and trials while other nations simply use what we discover.
"Americans spend more on health care than anyone".
Add to that the exorbitant costs of medications, over prescribing of goods and services by doctors, and over charging insurances.
Posted on 4/23/18 at 10:12 pm to HailHailtoMichigan!
quote:
What if it is due to consumer choices?
I tend to think that the pooled nature of group health insurance plans plays some role in this. If you are on a good group plan, it’s easy to spend $20-30 on a name-brand drug vs. $7 on generic, even though in reality the name-brand costs $200 while the generic costs $25. Just drives up the cost for everyone, but nobody notices at the individual level because they don’t see the bill. Even if your insurance doesn’t let you purchase a name brand when a generic is available, there are still cases where you have the option to take a cheaper route. OTC vs. Rx, or even asking the doctor for a different Rx altogether. Same could be said for unnecessary services.
This is why I think high-deductible plans with employer HSA contributions are at least good in principle. When you have to pay full price for everything up front you are much more aware of what those drugs/services actually cost, and you have a larger incentive to go with the lower-cost option. Especially when HSAs roll over each year. But with employer-funded HSAs being part of the high-deductible plans, your actual out of pocket costs don’t change much.
I, for one, have absolutely opted not to fill uneccessary prescriptions and/or had a doctor switch to a cheaper drug since being on a high-deductible plan.
Problem is that while it works great in principle, I’m not sure what impact a subset of employer-funded insurance plans have on the greater (read: Medicare/Medicaid) market. I wonder if taking the same approach to Medicare/Medicaid would be worthwhile.
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