Why does Health Care cost so much?

[_MeDotOrg]

Medicare pays $20.83 for a chest X-ray. The same X-ray costs a private party $283 at a Houston Hospital.

Why? According to the Hospital:

"The issues related to health care finance are complex for patients, health care providers, payers and government entities alike … MD Anderson’s clinical billing and collection practices are similar to those of other major hospitals and academic medical centers.”

In other words, "F___ you."

...All part of a very interesting article about the cost of health care in the U.S. Recommended.

http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/print/

[_Gadianton]

Pretty scary. If I ever come down with something and odds are it's the end, the first thing I'm going to do is call a lawyer and figure out the best strategy for avoiding a financial hit to my family. A half century ago people died, today, dying is unthinkable. The box office flop Repo Men is a dead hit on the various social realities that lead to high medical costs, I recommend it for the serious student of the subject.

The $20.83 could reflect a volume discount, it could reflect a "free consultation" knowing the distribution of future procedures, but it's obviously part of a more complex packaged deal where the hospital has determined the cost to give up treating a similar patient in the risk-free packaged deal for that service. It seems like the risk-free deal is part of the problem, but it's not exclusively the problem either. Insurance in general doesn't work like it's supposed to in theory. The cost of fixing a ding on your car door at a collision center is laughable.

[_EAllusion]

My experience is usually the exact opposite. When a home health provider/clinic/hospital charges a service to medicare, they jack up the fee in comparison to what you could get if you just paid out of pocket.

[_Doctor CamNC4Me]

I know this sounds overly simple, but it's because of this:

It takes a lot of resources to educate someone properly in the healthcare field, and we all pay for it one way or another.

If healthcare were as simple as making a hamburger it'd be cheap.

It's not.

It's very complicated, and requires employees who are smarter, more driven, and more disciplined than your average worker.

If you want cheap healthcare move to a crappy place in the world, accept whatever BS the local medicine man or woman says, and wish for the best.

That's it in a nutshell.

- Doc

[_ajax18]

It amazes me how many people would let an unlicensed physician do LASIK surgery on them out the back of a van just because it was cheaper. The toughest thing for me to understand my first year of practice was people who preferred to see 20/40 rather than 20/20 just because they were too cheap to buy a pair of toric contact lenses. But in a way that's how it should be. The patient should be making the decision whether it's worth it to him or not, not the government.

[_RockSlider]

I just finished up chemo 9 treatments ... the cost is mostly in the drugs - $130,800. 6 weeks of radition was around $90,000, two surgeries was around $120,000 ... one more surgery to go expect about $90,000 based on the last two.

I was lucky and had very good coverage, with me having to only pony up with several thousand dollars.

Not sure what others do, just die I suppose

[_beastie]

I once heard an interview of David Goldhill whose idea was to have universal, single-payer catastrophic care, but otherwise, get rid of insurance altogether and just have consumers pay for regular care. His theory was that would enable free market forces to drive prices down. (that's a summary based on my memory, and it's an oversimplification - the last page of his article contains the hard details) But with the current monopolies in most communities, it might be difficult to drive the prices down. Of course, if people stopped going to the doctor as much that might do it, but then there's a real cost to health.

Here's his article:
http://www.theatlantic.com/magazine/arc ... er/307617/

[_lulu]

Medicare pays $20.83 for a chest X-ray. The same X-ray costs a private party $283 at a Houston Hospital.

Why? According to the Hospital:

"The issues related to health care finance are complex for patients, health care providers, payers and government entities alike … MD Anderson’s clinical billing and collection practices are similar to those of other major hospitals and academic medical centers.”

In other words, "F___ you."

...All part of a very interesting article about the cost of health care in the U.S. Recommended.

http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/print/

I think OP's point is why is there such a large differential between self pay and Medicare re-embursement. What's the True cost accounting?

[_EAllusion]

Not that long ago, a colleague of mine was attempting to get Medicare to cover the cost of a hospital bed for a client. The cost to MA was ~$2500. Medicare refused payment, which is fairly common. (If you aren't used to dealing with the Medicare system, I promise you it blows.) But, this was a medical necessity, so we looked to private pay. At the same vendor, they charged $1100 for the same product out of pocket. I still don't know how that isn't fraud, but apparently it's on the legal up and up.

[_EAllusion]

Health insurance is weird in that it is expected to cover all routine costs. Usually the idea behind insurance is spreading the risk of a catastrophic event over a group of people to lower the cost of paying for a catastrophic event should it happen. Can you imagine if car insurance covered all routine repairs and maintenance? Or if home owner's insurance covered all home upkeep? Abstracting people from routine costs makes them inefficient shoppers.

Regarding the expense of health insurance, I don't think it's in the education of doctors, nurses, and so on. Rather, it's in the intellectual property derived from research. And the fundamental problem is that demand for health care is fairly inelastic. A long, healthy life is a prime desire as it's needed to facilitate most other desires. People will pay through the nose to prolong a healthy life. And the leading edge of technology is often a superior, though extravagantly expensive, means to do just that.