T Nation

Health Care

Great timing. I just found out that my Health Care costs are going up 7% in 2005. It’s not a lot, but I’m curious. Who’s fault do you think that is, and who can make it better in the long run?

Probably the fat ass chain smokers that have the same insurance as you.

Heh, I think KevinKovach does have a point.

The biggest driver of prices is demand. Demand is soaring for health care services. Poor health is certainly part of it (not all).

Obesity, for example, has driven healthcare costs into the stratosphere - estimated to be $123 billion, or 9% of all healthcare costs.

Add to that smokers and a pharmaceutical approach to health rather than a preventive one - ie, instead of trying to prevent problems, I’ll just count on a prescription to bail me out - and prices are bound to go up.

Also, skyrocketing medical malpractice insurance costs borne by will continue to be passed along to consumers. And the price of R&D in the pharmaceuticals will continue to go up, and that will show up in higher prices for drugs that insurance companies pay for.

Best way to save money on health care is eat your fruit and vegetables, exercise, and save money in a tax-free HSA.

It’s an interesting question. I don’t know enough about economics and that obviously posses a problem for me. Should we go the way of the Libertarians and get rid of alot of the regulation or is a universal healthcare plan really the way to go?

My wife is the one who has the health insurance. But I decided the deductible. What?s funny is that people keep arguing with me when they find out I took the higher deductible.

Our choice is $350, $500, $750, and $1,000.

If we were to take the lowest deductible, it would cost us an extra $1,430. If only one of us hits the deductible, it will cost us an extra $520, which means that if both of us hit the deductible, it will cost us an extra $1,040. So the worst case is that I only save $390.

Anybody who does the math can figure this out, but many don’t.

There is a reason for this discrepancy. And that is the paperwork. It costs the insurance companies a lot more to process those small claims because there are so many. Naturally they pass that cost on to the consumer.

Many people who had to buy insurance on their own have been buying a catastrophic care policy with a $5,000 deductible, because it only costs 1/5 what a normal policy does. Besides, this is the real purpose of an insurance policy. To protect you from financial hardship, not to pay every little bill for you.

This is one of the reasons I fully support the health savings accounts. The insurance is a lot cheaper.

Oh yeah, having some doctors paying as much as $100,000 a year for liability insurance is also a big factor. I assume people know that is added to their bill don’t they?

While I’m sure that the trial lawyers affect the price of health care. The biggest reason it’s so expensive is just the fact that we as a country are so unhealthy. We are a country of pill poppers. We feel we should be able to eat McDonalds every day for 40 years and then when we get heart disease at 50 take a pill or get a surgery and fix it. But somebody has to pay for this.

I hear all the bitching about the socialization of health care, but aren’t the insurance companies, PPO’s and HMO’s just smaller socialized groups. For example since I got my job (this is my first one out of college so it’s the first time I’ve had my own health insurance) I haven’t used it once. But I know some fat ass chainsmoking drunk is ringing up huge bills somewhere else making my premiums higher.

Also I’ve been hearing Bush say that if medicine was socialized that the government would be making decisions instead of doctors, but what is so different about that and many insurance companies. I mean Insurance companies won’t pay for everything and most are managed care now so they try and cut down on costs anyways by sending them to “their” doctors or having you do “this” treatment instead of “that” treatment.

Another thing I keep hearing is the quality of health care we have in this country. I gotta tell ya something we spend far more money on health care in this country than any other industrialized country and have far worse health. So is our quality of health care really that good?

Oh on health savings accounts. You would really need a huge amount of money saved up if you got AIDS or Cancer or any type of disease which required either surgury or a lot of medication like HIV.

I hate to say it guys, but everybody here is wrong. The reason your health care costs are going up this year is to pay for my big, fat pay-raise, beeyatches!!! That’s right. It’s about damn time, too. I’ve been working this shit hospital job for friggin’ peanuts until now. Y’all, I just want to say that I appreciate all that you guys are sacrificing for me. Thanks.

Hehehe, if you’re interested in a perspective from inside the health care business, then I’ll give you one. I would say that everybody here has made a good point or two about this issue, and y’all are right in your own regard. It’s a little bit of everything that chips away at the quality we can provide coupled with the increased cost that you have to pay. It sucks, because what is happening is a loss of value to a system that is already straining to make ends meet.

KevinKovach: socializing health care already took place, when they started the Medicare fund. The fund is barely solvent, and has been that way for years, despite the fact that we pay out of our asses in taxes for it. Basically, socialized medicine involves expanding the amount of people who draw from that fund, and making it more difficult for the people who barely manage to run the thing as it is. What sounds good on paper rarely pans out in reality. So, let’s say we give them (the Medicare managers) more money, and then throw more patients at them. They will most likely fuck it up even more than it is already. Sad but true, my friend.

Do y’all want to know how we (the hospital) determine how much to charge for the stuff we do and give to you? It’s simple really. It has nothing to with the cost to us, or some mark-up factor (like a retail store). What we charge you is EXACTLY how much we can get from your insurance company. So what happens is that some people pay $100 for a blood test, and other people pay $200 for the same blood test. We have to do it this way to survive, because carrying the liability and overhead costs to any hospital is an unreal expense. There are never enough rooms. There are never enough nurses. There are never enough doctors. These things take massive amounts of money to fix. And we are legally liable like no other business for every little thing that happens within our property limits. That makes us easy targets for an enterprising lawyer(s) to make a living.

What are we doing about it? We are not sitting on our hands, let me assure you. The people I work with are innovative, business-savvy, and dedicated to their work. We are bad-asses. We are always looking for new and better ways to improve the quality of our care without increasing the costs. Examples: improved technology in my laboratory, new and improved systems for tracking patient care, new and improved systems to monitor inventory and medications, etc. I could go on all damn day about this. We are doing our best, folks, so don’t get down. We WILL get past this.

If it seems like a big ol’ mess right now, that’s just because it is one. Ain’t gonna get better any time soon, either. There are no easy answers here, but that doesn’t mean that we are powerless to do anything about it. Just let us do our jobs, and stop trying to fuck us in the ass for it, and things will get better. That means stop filing frivolous lawsuits. That means stop coming to the E.R. in the middle of the night when you could just as easily wait to see your doctor in the morning for your stubbed toe. That means stop calling the ambulance when you’re drunk, and need a damn ride and a (what you think is) free meal. That means stop coming into my E.R. when you are a junkie and want a morphine fix, so you stick a rusty nail up your dick to piss blood and pretend you have a kidney stone (true story).

A quick tip: A few years back, 70% of all medicare dollars went to pay for the complications and direct symptoms of diabetes. It’s probably more by now. You wanna help me out? Don’t get fucking diabetes. Thank you.

Uh, I think I might have had too much coffee. I’ll stop ranting now. Sorry!! :slight_smile:

Lothario I agree whole heartedly. What I was talking about was just that we already have choices made for us by other people than just the doctors.

I also agree that medicaid and medicare are out of control. In michigan we had a 75 cent per pack of cigarette tax increase and about 75% of that went to medicaid, only a little bit of that actually went to helping people quit and prevention efforts.

Published Wednesday
October 20, 2004

Obesity increasingly weighs down health care costs

THE WASHINGTON POST

WASHINGTON - More than a quarter of the phenomenal growth in health care spending over the past 15 years is attributable to obesity, Emory University researchers reported Tuesday.

With 60 percent of the U.S. population deemed overweight or obese, report author Kenneth Thorpe said, the only way to control soaring medical costs is to begin targeting prevention efforts and treatment on the most costly weight-related illnesses, such as diabetes, high cholesterol and heart disease.

“We’ve got to find ways to get the rates of obesity stabilized or falling,” he said in an interview. “We need to find effective interventions to deal with this on multiple levels - the schools, at home, in the workplace - because clearly this is a major driver in terms of growth in health care spending.”

From 1987 to 2001, medical bills for obese people constituted 27 percent of the growth in health care spending, he found. The increase in spending was attributable to a rise in the number of obese Americans and to higher costs for treating those patients.

Treating obese patients was 37 percent more expensive than medical care for people of normal weight, Thorpe and colleagues from the Atlanta school wrote in the journal Health Affairs. Put another way, obesity accounted for an extra $301 per person in medical spending over the 15-year study period.

“The actual numbers are probably higher,” Thorpe said, because his team relied on people who self-reported their weight and height.

Obesity is determined by body mass index, a formula in which a person’s weight in kilograms is divided by the square of his or her height in meters. A score over 30 is deemed obese; 25 to 30 is considered overweight. By those standards, a 6-foot man weighing 225 pounds is obese.

Federal officials have estimated that treating obesity-related illnesses costs about $93 billion a year, but Thorpe is the first to examine the effect on the overall growth in health spending. The Emory team based its analysis on inflation-adjusted federal data on medical spending and health status.

“These numbers show that the prevailing approach for dealing with obesity, which is to blame people who have the problem and hope the situation will disappear, is a fantasy,” said Kelly Brownell, director of the Yale Center for Eating and Weight Disorders.

“Something dramatic needs to be done to change the environment in order to prevent this problem from occurring in the first place.”

Before 1980, obesity in the United States remained fairly stable at about 15 percent of the population. In the following two decades, however, the problem reached epidemic proportions, fueled primarily by a more sedentary lifestyle, processed foods and extra-large portions.

Brownell advocates creation of a $1.5 billion “Nutrition Superfund” raised by imposing a 1-cent federal tax on each soft drink can or bottle. The money could be used for a massive advertising and education program, especially aimed at children, he said.

“Once you are obese it is very hard to treat, so prevention makes sense,” he said. “And when you focus on children you get away from the libertarian arguments that adults are just doing this to themselves.”

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