What Is the Importance of Cost Containment in Health Care.?

Question by myelinman18: What is the importance of cost containment in health care.?
Being an obvious election hot button, why is the cost of health care going up, given it was static in the 50’s-70’s.

Best answer:

Answer by heyteach
Cost containment is BEST done by the providers themselves in a free market, COMPETITIVE environment, which we only have pockets of in the US at this time. Where we have it, we have ACCESSIBLE, AFFORDABLE care, which is the rational man’s goal.
A doctor owned and run hospital that sees everyone gets care, no matter what happens to the bottom line.

http://www.simplecare.com/ a doctor-driven group where reasonable rates are charged.

Note you can go to a walk-in clinic at Wal-Mart or CVS or the like in many cities and get many of the most typical reasons for seeing a doc addressed for under $ 100.

The price of LASIK has DROPPED dramatically over a decade. Plastic surgery is CHEAP. Compare a major procedure like a tummy tuck with the bill an uninsured patient will get for a medically necessary appendectomy WITHOUT complications.

Another factor contributing to higher costs NOW as opposed to 30 or more years ago is the EXPLOSION in what we CAN do and treat. There is simply so much more–new meds that extend life, transplants, ADULT stem cell treatments that work, etc. And this innovation CAN continue if we don’t allow politicians to screw it up for everyone.

However, the BULK of the cost of healthcare is, primarily governmental bad choices and the HANDFUL of large insurers who DOMINATE health care. (Sorry to repeat myself, but it’s true):

A FEW examples of how the government drives up costs:

the laundry list of nonsense states require in order to allow a plan to be sold in their state. There is NO good reason for this. If someone wants a “barebones” plan and the company is solvent, let it be offered, instead of stupidly DEMANDING that chiropractic care be offered, or something else that some people won’t want.

When we have government programs (and we have SEVERAL: Medicare, Medicaid, SCHIP, IHS, VA, as well as other programs that allow more income than Medicare, but that’s the concept), ALL should do everything possible to reduce costs. Example: the VA logically allows for negotiated prescription med prices, Medicare is prohibited. End result: far more expense for the taxpayer and the patient. ALSO those on Medicare a decade ago who had an HMO version typically got drug coverage that is BETTER than the current idiocy of the “donut hole” that they’ve all apparently converted to now. Thanks, Uncle Sam.

Freebies for “charity hospitals.” Fact is the bulk of hospitals have this designation and are tax-exempt. The idea was that they’d give back the equivalent of their tax pass to the public they are supposed to serve. Fact: the majority fail to do so. See CAGW–Citizens Against GovernmentWaste–also check out specifially IL AG’s Madigan’s attempt to get them to get on board with that.

AWP BS–AWP is the “Average Wholesale Price” of drugs. It’s a fictional story designed to bump up government payment to drug companies.

ERISA shield–most folks with insurance still get it through work. ERISA has been misapplied by the courts and folks with insurance that way can be denied treatment their plan SHOULD cover with impunity. IF they damage the patient, all they can be out in court is what the treatment that was denied would cost. IF they can win the “drag it out” lottery and the patient dies, they can’t even be fined! Read Jamie Cort’s book “HMOs: Making a Killing.”

See the testimony of Meidinger re: the routine bad accounting principles where they get GIFTS that other businesses and certainly PEOPLE would pay tax on and don’t: http://www.ftc.gov/reports/healthcare/04…

Also government routinely tries to balance their Medicare Ponzi scheme on the backs of doctors–who are stopping taking this bogus system:
“That dark cloud lurking over the shoulder of every Massachusetts physician is Medicare. If Congress does not act, doctors’ payments from Medicare will be cut by about 5 percent annually, beginning next year through 2012, creating a financial hailstorm that would wreak havoc with already strained practices.

Cumulatively, the proposed cuts represent a 31 percent reduction in Medicare reimbursement. If the cuts are adjusted for practice-cost inflation, the American Medical Association says Medicare payment rates to physicians in 2013 would be less than half of what they were in 1991.”
The media who refuse to report these facts wouldn’t take that kind of pay cut OR any pay cut.

Insurers bad faith is quite common. Examples include:

Linda Peeno, MD comes clean about how insurers deny claims to save money, NOT to follow the policy agreement:

more bad faith, esp. with United Health Care:

attempted end runs to make sure they get their excessive demands met by now using flat out predatory lending practices:

I could go on–I’ve studied these things for some time now. On the bright side, the current system could be VASTLY improved with some sensible changes, including:

price transparency–no reason why prices can’t be posted up front and before the fact. Many expenses are NOT for emergencies and people should be able to shop around and make an INFORMED financial decision, which they are DENIED now, though this is the ONLY industry in which that is allowed. (If you’re a car repair shop and you don’t follow the law on estimates, not only are you SOL you may not be able to get ONE CENT for work done. You don’t see them laughing at the law much in those states on car repair.)

EVERYONE should be required for all non-emergency procedures, to give the patient the bottom line bill. The insurer should be legally required to pay what he says he will BARRING fraud. Any LIKELY procedures should be simarly costed out and locked in. Example: angiogram? Good chance you’ll need an angioplasty and the cardiologist might want to do it there and then. Have him do the medical informed consent AND have the bill costed out for JUST the angiogram AND the angioplasty IF needed–takes a lot of pressure off everyone as well. No reason for anyone to object. We all know if a patient codes on the table, there will be additional charges, but that doesn’t happen often and as it is a medical emergency, you have to treat it.

Oh and “compassionate entry” is costing us a LOT. The Border Patrol is told specifically to let in illegals who are sick for care they know the taxpayer will have to pay for:
“Dickson emphasizes that not all the free care is going to illegal aliens passing through on their way to other states. About half goes to Mexicans who use the Copper Queen as their personal emergency-care facility. In effect, the hospital, which performs general surgery, has become the trauma center for that stretch of northern Mexico. If an ambulance pulls up to the border-crossing point near Bisbee and announces “compassionate entry,” the border patrol waves it through, and the Copper Queen is compelled to treat the patient. It is one more program that Congress mandates but does not pay for. “If you make me treat someone,” says Dickson, “then you need to pay me. You can’t have unfunded mandates in a small hospital.” Although the Medicare drug act that passed last year provides for modest payments to hospitals that treat illegal aliens, Dickson says there is a catch that the U.S. government has yet to figure out. “How do I document an undocumented alien? How am I going to prove I rendered that care? They have no Social Security number, no driver’s license.'”

Frankly, more can be said, but if you’re interested in a PLAN that makes sense (we need to do something with the huge sums we spend on the government programs we ALREADY have millions enrolled in), then here it is and it’s being ignored by the pols because there’s nothing in it for them apparently. (I found this months ago and sent a good summary and link to the FREE PDF and the federal level ones ignore the hell out of it.) Check it out and see what you think: no increased individual taxes, no mandates for employers, but a funding solution that solves another problem in the system:

Oh and that plan would work because when you get something close to a free market, it DOES work:

Check out LASIK prices over a decade–did they go up 120% like Medicare premiums did (1998: $ 43.80, 2008 $ 96.40) or did they drop like a rock? Why did they drop–few third-party payers involved.

Ditto plastic surgery–look at the cost of a “tummy tuck” which is MAJOR abdominal surgery and compare with a MEDICALLY NECESSARY uncomplicated appendectomy if you’re uninsured. The appy will bankrupt you in many cases.

Walk-in clinics (Wal-Mart, CVS, grocery stores) be seen in a short time and treated for around $ 100–from sprains to upper respiratory infections, strep throat, etc.


The key is it is DOCTOR OWNED and DOCTOR RUN.

So we CAN deal with the situation, but it MUST be done via the FREE MARKET, NOT more government and giving insurers a free rein. They caused the problems.

There IS a sensible plan that does NOT force patients on it with fear of fines; does NOT impose the costs on employers; does NOT raise our taxes; and DOES resolve another abuse of the taxpayer in its funding, provides for preventative care (moral and economical), and would prevent bankruptcies (more than half are caused by medical bills and most of those folks have insurance). Check it out:

Know better? Leave your own answer in the comments!



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