So -- Why does healthcare cost so damn much? (warning: novel-length post)

[g8terh8ter_eric]

not sure i get your point. it cost money to go to school. are you arguing doctors should get less training? their training his higher. it's highly competitive to get said training. therefore they are paid well. supply and demand at it's best.

So, your saying it's money over the caring for people for them, right??

 

[JayVols]

I just paid a couple thousand for a prenatal test that could have been done 4 weeks later at 1/4 the price (and covered by insurance without issue) because we felt we needed to do it. Still arguing a bit with the insurance co on it but if I end up paying out of pocket then I truly won't care one bit



I don't think they have a case. I don't believe something already in common use will be allowed to become an exclusize right to the company. The FDA did what needed to be done in this case (and set a nice precedent)

I hope you are right.

Edit: congrats on your new child (if I read that correctly)
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[utvolpj]

To ignore the main point and focus on a detail, I don't think a C-section is three times likely to result in the infant's death. There might be three times as many deaths in C-section deliveries, but that doesn't necessarily mean the surgery caused it or that the baby would have survived a natural birth.

I didn't understand that part either. I get that more are opting for a c-section now (can't understand why that's acceptable) but is the US not better at handling these types of cases? What is the criteria when deciding a baby died at birth vs when one is considered viable but dies later in life?

 

[utvolpj]

I hope you are right.

Edit: congrats on your new child (if I read that correctly)
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thanks he's not here yet but it is exciting. Looks like he may ruin the bama game this year

 

[droski]

So, your saying it's money over the caring for people for them, right??

what? i'm saying if you want the best doctors in the world you have to pay them well. i.e. there is a reason why they are paid so well. they deserve it. does it matter whether they are doing it for money or being good people as long as you have the best care? i certainly couldn't care less.

 

[g8terh8ter_eric]

people saying that med school costs a bunch of money is not the same as saying hospitals take that into account when they set salaries. You're just making the claim without any proof whatsoever. Hard for others to prove something doesn't exist

And your making a claim it doesn't exist, without any proof yourself. I maybe assuming something, but that doesn't make it wrong, I'm just trying to think about it logically. It only makes sense that they do this. Costs start at the most fundamental levels, and most of the time it starts with what the person knows, not what the debt they owe. Yet, in the industry we are talking about, if they don't offer an incentive to offset the high education price, you obviously wouldn't have many doctors. So, we aren't just paying for what the person knows, but we are paying their medical school bills, and I don't necessarily have a problem with helping people pay their bills through their services, but when it comes to me not being able to pay my bills because it costs so damn much for them just to practice the ability to care for me, that becomes a very elementary problem for the patients and the docs. There is a reason that some people will roll the dice with no insurance, and that raises the costs even more, but that's a whole other discussion.

 

[BigPapaVol]

I'm not disputing Big Pharma and the hospitals, but the hospitals hire these docs at inflated rates, so the market rate jumps up every year, just like education costs. Hmmmmmm.

Those who hire docs pay as little as they can. The fact that others can and will pay a high number means that the floor is higher than most ceilings.

Students are willing to strap on the debt because they know the market rates prior to attending. If those rates drop, fewer will go. Less demand = lower quality.
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[Weezy]

do you realize how much debt people have when they come out of med school? you can be the most charity filled person on the planet and still not want to take on that debt to become a doctor if it pays poorly.

It takes a lot of balls to take on that debt. I looked at that decision and chose engineering, mostly because I didn't feel comfortable with the debt in comparison to another field that required none and paid well.

 

[g8terh8ter_eric]

Those who hire docs pay as little as they can. The fact that others can and will pay a high number means that the floor is higher than most ceilings.

Students are willing to strap on the debt because they know the market rates prior to attending. If those rates drop, fewer will go. Less demand = lower quality.
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So, basically steadily climbing educational rates, are a big factor in a lot of the economic issues in this country?? In certain areas, at least.

 

[g8terh8ter_eric]

It takes a lot of balls to take on that debt. I looked at that decision and chose engineering, mostly because I didn't feel comfortable with the debt in comparison to another field that required none and paid well.

So, basically you went another career path, and still get paid well and don't have the debt crushing you, versus getting paid well and having Sally Mae as a permanent guest in your home??

 

[utvolpj]

And your making a claim it doesn't exist, without any proof yourself. I maybe assuming something, but that doesn't make it wrong, I'm just trying to think about it logically.

you made the claim. Now either back it up or quit citing it as fact

It only makes sense that they do this. Costs start at the most fundamental levels, and most of the time it starts with what the person knows, not what the debt they owe. Yet, in the industry we are talking about, if they don't offer an incentive to offset the high education price, you obviously wouldn't have many doctors. So, we aren't just paying for what the person knows, but we are paying their medical school bills, and I don't necessarily have a problem with helping people pay their bills through their services, but when it comes to me not being able to pay my bills because it costs so damn much for them just to practice the ability to care for me, that becomes a very elementary problem for the patients and the docs. There is a reason that some people will roll the dice with no insurance, and that raises the costs even more, but that's a whole other discussion.

thing is you have yet to acknowledge their higher level of education or skills in your argument but instead focus on money. They are better prepared for their job than most people coming out of school. Their job requires them to deal with issues that affect lives and they are paid accordingly.

So, we aren't just paying for what the person knows, but we are paying their medical school bills,

if you deal with anyone who has outstanding student loans then you're doing the same. This is not limited to doctors and I have never had an interview where I had to disclose how much I still owed on my education

 

[BigPapaVol]

So, basically steadily climbing educational rates, are a big factor in a lot of the economic issues in this country??

Who said that?

Rates outstripping inflation by a mile reflect government loan program idiocy, but that pricing isn't core to our problems. Our main problem is runaway govt spending in the name of buying votes.
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[JayVols]

thanks he's not here yet but it is exciting. Looks like he may ruin the bama game this year

Would be well worth it. I planned my girls to be born mid-June during summer vacation. 1st on the 19th the 2nd on the 29th. Not bad timing if I do say so myself.
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[g8terh8ter_eric]

1. you made the claim. Now either back it up or quit citing it as fact



2. thing is you have yet to acknowledge their higher level of education or skills in your argument but instead focus on money. They are better prepared for their job than most people coming out of school. Their job requires them to deal with issues that affect lives and they are paid accordingly.



3. if you deal with anyone who has outstanding student loans then you're doing the same. This is not limited to doctors and I have never had an interview where I had to disclose how much I still owed on my education

1. I never cited it as fact, I am assuming here, and no one seems to be able to prove my assumption wrong. No big deal.

2. They obviously have a higher skill set PJ, I've never argued that, but if there focus is more on Ben Franklin and their staggering student debt, then the patients suffer, and the quality of care is less. That's why a lot of newer docs fail.

3. I know people who haven't taken a college class in their life, studied really hard, and taken certifications that equate to a specific amount of time in the classroom, without the debt incurred. Some people are obviously more cautious with education and it's cost than others. So, should those people who got their certs get paid less because they didn't take English 201 in college??

 

[g8terh8ter_eric]

Who said that?

Rates outstripping inflation by a mile reflect government loan program idiocy, but that pricing isn't core to our problems. Our main problem is runaway govt spending in the name of buying votes.
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Don't disagree a bit, and there are many other underlying issues as well.

 

[utvolpj]

1. I never cited it as fact, I am assuming here, and no one seems to be able to prove my assumption wrong. No big deal.

2. They obviously have a higher skill set PJ, I've never argued that, but if there focus is more on Ben Franklin and their staggering student debt, then the patients suffer, and the quality of care is less. That's why a lot of newer docs fail.

3. I know people who haven't taken a college class in their life, studied really hard, and taken certifications that equate to a specific amount of time in the classroom, without the debt incurred. Some people are obviously more cautious with education and it's cost than others. So, should those people who got their certs get paid less because they didn't take English 201 in college??

1. You've presented it as one of your main arguments with nothing to back it up then asked people to prove you wrong. Doesn't work that way

2. Where has it been claimed they care about the money more than a patient? People mentioned money and you went down the path that that must be their only goal. Even if it is they are more skilled and can command the pay at that level. Happens in all sorts of businesses

3. Becoming a doctor isn't like getting your A+ cert. The rest is just ridiculous

 

[droski]

1. I never cited it as fact, I am assuming here, and no one seems to be able to prove my assumption wrong. No big deal.

2. They obviously have a higher skill set PJ, I've never argued that, but if there focus is more on Ben Franklin and their staggering student debt, then the patients suffer, and the quality of care is less. That's why a lot of newer docs fail.

3. I know people who haven't taken a college class in their life, studied really hard, and taken certifications that equate to a specific amount of time in the classroom, without the debt incurred. Some people are obviously more cautious with education and it's cost than others. So, should those people who got their certs get paid less because they didn't take English 201 in college??

2. why is the quality of care less?

3. yes people with higher educations generally get paid more and should get paid more. why? because by getting an elite education they are signaling to the market that they are a high performer. it's a way of weeding out the losers. is it perfect? no. but that doesn't mean it doesn't work.

 

[utvolpj]

Would be well worth it. I planned my girls to be born mid-June during summer vacation. 1st on the 19th the 2nd on the 29th. Not bad timing if I do say so myself.
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we tried to plan just didn't quite work out. I'll take him any day he wants to come though

 

[kptvol]

I didn't understand that part either. I get that more are opting for a c-section now (can't understand why that's acceptable) but is the US not better at handling these types of cases? What is the criteria when deciding a baby died at birth vs when one is considered viable but dies later in life?

In retrospect, I missed a golden opportunity to legitimately use the word "vaginal". I don't know that it's necessarily the patients opting for the surgery... I know in the US doctors are a lot more apt to head that route if there's a slight hiccup whereas in other countries they'll continue to push the vaginal route. Oh yes. I can't say if going the C-section is the right choice, but it's the frequent choice when there is a cause for the doctor to worry, even if it's just a minor concern. Thus, you'd expect to see better results from natural births, because most of those births have been deemed in the clear.

 

[kptvol]

3. I know people who haven't taken a college class in their life, studied really hard, and taken certifications that equate to a specific amount of time in the classroom, without the debt incurred. Some people are obviously more cautious with education and it's cost than others. So, should those people who got their certs get paid less because they didn't take English 201 in college??

If employers value that kind of education less than they do an education at a major university, then yes.

 

[IPorange]

I'm not disputing Big Pharma and the hospitals, but the hospitals hire these docs at inflated rates, so the market rate jumps up every year, just like education costs. Hmmmmmm.

I think a 30 year old pizza hut employee, of all people, would realize the true value of education.



Standing by for deletion by protective mods.
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[milohimself]

not "owning" the doctors but controlling the distribution of care through regulation seems pretty darn close. You are taking money from some to bring others to the same level. What kind of system is that exactly?

in the US the removal of gov't roadblocks and allowing a market would go a long way toward improving costs.

And how do you think HMO's work?

Doctors nationwide were crying "socialism!" when HMO's were expanded under Nixon.

 

[milohimself]

Risky sexual behavior was listed as an action associated with the highest causes of death, yet nothing on the list pertains to anything sexual, unless papiloma is a leader in fatal cancer.
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Sorry, that ended up from the "higher costs" list... More unwanted/unplanned babies -> more costs passed on to the rest of us.

The comparison of the stats was very misleading. The 1900 stats were essentially useless.

My issue with the whole thing was the final two sentences, which were shown as minor drawbacks and all but glossed over. In my mind, they are the issue. Doc quality will go south and innovation will undoubtedly head back to a crawl. Euros can go there because we won't.
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I absolutely think that doctors should be paid at market rates. Most other countries, doctors do tend to flock to where the money is. That's clear. If one wants to stay in Europe, they tend to go to Switzerland because that's where they tend to be paid the best. There, everybody is covered at a mandatory minimum level and operations have to be approved if paid for by deductible, but this can be circumvented by straight fee for service. It's not really all that different than how HMOs and managed care works. They also approve or disprove treatment and make use of "gatekeepers" in order to control costs.

Regarding physician incomes here, there is definitely a plus side to what they make. Folks in this thread have touched on one of the major reasons why they're able to demand what they make; the amount of debt they are steeped in coming out of medical school. If I'm not mistaken, med and law are the two areas of study which do not have loan and grant caps, or have higher caps. The other, which I touched on, is the overhead in equipment and hospitals that HMO's utilize. This of course is all intermixed with the fact that doctors here have among the best standards of living of any profession in the world; I'm fine with that, they have one of the toughest jobs on the planet.

law school and mba programs cost a lot as well. difference is that medical school is 3 times as long.

Yep. What's normal for these days for a new MD grad, $150k in debt?

thanks he's not here yet but it is exciting. Looks like he may ruin the bama game this year

Hopefully there will be a good game to ruin this year.

 

[milohimself]

Another interesting thread to this topic is how "market valves" ended up constituting the healthcare systems we have in place today, many of which came about during WWII and our brief period of a near command economy.

Employer-provided health coverage was started largely because of the wage freezes, so the market valve was for employers to offer fringe benefits. Even out of the relatively vast deregulation of the 50's, this system stuck.

The precursor to the HMO came about from Henry Kaiser providing on-site medical care for his shipbuilding yards on the west coast, but rather than using the traditional fee for service model, each employee contributed a small amount of his paycheck whether or not he got needed care. The builders didn't fall into financial ruin if they were injured on the job, and the on-site doctors could be guaranteed a salary. This initiative became permanent and turned into Kaiser Permanente.

 

[justingroves]

I noticed you listed it in the order or money then people. Was that on accident, or just your true thoughts on why people go to med school??

True thoughts.

You don't put yourself through that kind of hell to make 30 bucks an hour.