[paraclete]

Not sure how you get the "still in denial" remark, but at any rate I do hear what you are saying. It just makes me suspicious. "Why, we just hold down the price of health care." Ok, but if it's all just that simple, then why not do the same thing with food? Why not just say that milk producers can only sell milk for 2 dollars a gallon? That would be nice except that the supply of milk would be cut tremendously since you cannot sell milk at that price and stay in business. So I wonder if the same dynamic works with health care. It will be interesting to see how it all works out over the next decade.

The video I linked above said a person can get an MRI in Japan for 150 dollars, but in the U.S. it is a couple of thousand or whatever it was. That just strikes me as strange. How do you go from 1500 in the U.S. to 150 bucks in Japan? It just makes me wonder how they are doing that. Is the quality the same? Is the government subsidizing? What makes the difference of 90% in price?

What is the 1.5% levy? 1.5% of what?

Taxable income, what else, but the system has worked for about 40 years, as to milk is sells here at $2 a litre because the supermarkets use it as a promotion and yes the dairy industry has taken a pounding but they still exist.

MRI are expensive here when out of the system $250 - $400 dollars depending on the machine but what this has done is stopped GP ordering them up on a whim. Government regulation has done that too, no blanket tests in pathology everything has to be specified. You see, doctors don't know what they are looking for and take the high road of investigating the worst case first instead of taking the simpler view and this escalates costs. Last week I was in the public hospital system, ER, and they did blood tests and an MRI, the outcome they found I had a brain but no condition and I was sent home. What had caused the problem, who knows

[jlisenbe]

Milk here is about 75 cents or so a liter, so at least we've got you there.

It helps me sometimes to put these things in a different venue. Suppose the government decides that pickup trucks are too expensive. They can easily run above 50 thousand. So the feds say that no one can sell a truck for more than 20 thou. Everyone gets excited thinking they will get the big, expensive trucks for 20, but we know it won't work that way. The truck companies would go out of business in a hurry, so what you will get is a MUCH cheaper version of the big trucks with a 4 cylinder engine and not much else. As the old saying goes, there is no free lunch, so I don't see that putting price controls on all this will get us the same level of care we have now at half the price.

Another example would be computers. Computers now are wildly more capable than they were twenty years ago, and yet adjusted for inflation are actually cheaper. No government program did that, the free market did. Why isn't that working with health care?

[paraclete]

Milk here is about 75 cents or so a liter, so at least we've got you there.

It helps me sometimes to put these things in a different venue. Suppose the government decides that pickup trucks are too expensive. They can easily run above 50 thousand. So the feds say that no one can sell a truck for more than 20 thou. Everyone gets excited thinking they will get the big, expensive trucks for 20, but we know it won't work that way. The truck companies would go out of business in a hurry, so what you will get is a MUCH cheaper version of the big trucks with a 4 cylinder engine and not much else. As the old saying goes, there is no free lunch, so I don't see that putting price controls on all this will get us the same level of care we have now at half the price.

Another example would be computers. Computers now are wildly more capable than they were twenty years ago, and yet adjusted for inflation are actually cheaper. No government program did that, the free market did. Why isn't that working with health care?

The free market doesn't work with everything because you don't have perfect conditions of supply and demand. Manufacturing in low cost countries have reduced the price of many items, however you may not want some of these products. You can get a Chinese SUV for $25,000 here but would you want one, we have seen many brands of cheap vehicles come and go, logic suggests they should take the market but they quickly disappear. Protection causes some products to be more expensive than they should. Personally I wouldn't want a yank tank in my driveway, wouldn't fit, but they are a nuiance when trying to park, can't see around them, and I don't get it really, but then I don't have to navigate snow and ice

[talaniman]

Marketers hocking their wares don't care about the consumer or his life. Just can the consumer afford to pay, and will he sign on the dotted line. There are industries that collect debt on default, and retrieve the product. Heck there are industries for everything. Even silly season is a holiday for political TV commercials. Big pharma has all kinds of commercials for it's new drugs. The costs borne by consumers. That's the business model to create revenue streams and increase profits. If laying off half the workers creates profits, so what? If closing down a town increases profits, then kiss the town good bye. CEO's embezzles the profits, hire a company to clean up your image and rebrand and spin your way back to profits. Doesn't matter what you call your government, or you national identity, it's still about profits.

From early man to man today, it's about making profit. Such is the nature of man when wealth is power. The wealthy set the price and not the free market because there is no such thing. Don't believe the hype.

[talaniman]

[jlisenbe]

Marketers hocking their wares don't care about the consumer or his life. Just can the consumer afford to pay, and will he sign on the dotted line.

I think that is largely true, but it is also true of computers and cars. Both have improved in quality ENORMOUSLY. The price of computers has gone down by a great amount. The average price of cars, adjusted for inflation, has gone up from about 22,000 in 67 to about 25,000 now, but you get a car that is vastly better in quality. We drive a car 200,000 miles now and don't think that much of it. That was unheard of in 67.

So why aren't those same dynamics working to bring down the cost of healthcare?

https://wgntv.com/2016/04/25/the-ave...you-were-born/

[talaniman]

They might in the future. We might figure it out or find a better way of doing things. Never know with humans.

[paraclete]

Cars have been made better you could try turning out better doctors. They are still trained the same way they have been for decades.

You can't expect something to change if you do it the same way

[talaniman]

Cars have been made better you could try turning out better doctors. They are still trained the same way they have been for decades.

You can't expect something to change if you do it the same way

They have been trained with the most modern techniques, and equipment that money can buy though.

[paraclete]

They have been trained with the most modern techniques, and equipment that money can buy though.

Thus the higher cost, problem solved

[jlisenbe]

I don't think doctor training is responsible for this incredible rise in health care costs. Might need to be improved, and no doubt could be better, but didn't cause these spiraling costs.

[talaniman]

I think rising costa are inevitable. The real question is why doesn't your paycheck rise with them?

[Wondergirl]

They have been trained with the most modern techniques, and equipment that money can buy though.

When I was a youngster, every doctor I knew was a family doctor, a GP. Specialists were few and far between, practicing in the big cities in big-name hospitals. Now, every doctor I meet is a specialist with years of expensive training and residencies behind him.

Thus, why not rising costs????

[tomder55]

GPs cant make a living as private practitioners . Costs of running a practice are too high . That is why they partner in these walk in clinics . They are basically there for check ups ,subscribing drugs ,and referrals .

[talaniman]

The cost of digitizing patient records is through the roof as well. Pays good though.

[paraclete]

Haven't you done that yet

[jlisenbe]

Med care costs have risen much faster than inflation for decades. The question for this thread is "Why?".

1. You have identified the increased use of specialists. Sounds plausible to me.
2. The widespread use of med insurance for things such as doctor's visits and birth control pills has caused an explosion in paperwork and tends to hide costs from the consumer. This is the same consumer that still has to pay those costs.
3. The development of drugs and treatments for illnesses that once were just in the "send them home to die" category means that people with those illnesses now survive. That's the good news. The bad news is the drugs and treatments are unbelievably expensive.
4. The widespread practice of suing doctors and hospitals for anything and everything, with settlements amounting to millions and millions of dollars, has resulted in a defensive practice of medicine resulting in increased costs.

Comments?

[paraclete]

Seems the solution is apparent

Restrict the use of specialists to serious cases
Restrict what medical insurance can cover
Regulate the price of drugs
Set limits in liability claims

[talaniman]

1. You have identified the increased use of specialists. Sounds plausible to me.

I think we will see this as a norm going forward, given the rise of networks for GP's where they can share overhead costs with other GP's especially in the heavily populated cities of the nation.

2. The widespread use of med insurance for things such as doctor's visits and birth control pills has caused an explosion in paperwork and tends to hide costs from the consumer. This is the same consumer that still has to pay those costs.

GP's do very well just with office visits and routine exams and health monitoring for older patients like me with more than a few health issues. Yes insurance covers more things than they did in the past, but let's face it, they have to with the discovery of more and better ways to deal with those illnesses and issues they can no longer IGNORE for lack of knowledge, and the removal of caps on treatments of those very expensive procedures. Logic suggest the more people the higher the costs as we add the poorest among us, and we had to see the growing population of aged citizens seeing doctors, coming decades ago.

3. The development of drugs and treatments for illnesses that once were just in the "send them home to die" category means that people with those illnesses now survive. That's the good news. The bad news is the drugs and treatments are unbelievably expensive.

As is the research and development of those drugs and treatments so naturally there is the inevitable return on that investment, which includes the patents that give exclusive pricing to those companies that lasts for years.

4. The widespread practice of suing doctors and hospitals for anything and everything, with settlements amounting to millions and millions of dollars, has resulted in a defensive practice of medicine resulting in increased costs.

Add the costs of debt collection to those costs for those they can take legal actions against when they cannot pay for whatever reason. Most large businesses take this course of legal action, and pursue them aggressively to mitigate losses. I guess you never got sick, couldn't work, and found your wages or bank accounts garnished when you did get back to work. You could lose everything or filed for bankruptcy.

I don't think settling lawsuits instead of fighting them is a cost that should be passed onto consumers nor any other legal actions for wrongdoing, or bad decisions, nor used as an excuse since most of us have no clue about what's defensive medicine or what's a necessary and reasonable since medicine as advanced as we are s not a sure thing for good outcomes.

The bottom line is the fact that cost are rising much faster than wages and there are many why's as to the reasons for that. Just remember that it is another human that decides to jack up the price to cover those costs and make a few bucks in the process. That's the supply side capitalist way.

I guess we all want a way to pay that doesn't break the bank, but as you have found out you pay, or steal, or just don't buy what they are selling. See, you have a choice in the matter. Living longer isn't a right is it?

[talaniman]

Restrict the use of specialists to serious cases

Good luck with that law, since a physician here will never go along with it. Especially if the network they are in requires such a referral.

Restrict what medical insurance can cover

That's been tried, but what would you suggest not covering?

Regulate the price of drugs

You got my vote for that one.

Set limits in liability claims

Already done!