Why is healthcare so expensive?

The mean salary of a doctor in the United States is $294,000/year according to a Medscape Report.

Most docs are overpaid. This inflates costs. Most of family medicine can be done by a PA.

You're missing one glaring issue. The overhead costs related to regulations imposed by CMS. Hospitals have to staff in the 100's to accommodate what is required to be paid for providing services to people on medicare and medicaid.

When you speak of overhead costs, yes there are high administrative salaries but they pale in comparison to what they would be making if they weren't in a non-profit so it's not as much of an impact as it is made out to be.

It's a business. They make as much as they can.

Why do you pay doctors so much? We pay much less and still enough doctors. Actually many procedures could be done without one

Not Jamin wrote:

The mean salary of a doctor in the United States is $294,000/year according to a Medscape Report.

Physician compensation accounts for something like 8% of total healthcare expenditure. If every doctor started working for free today, we'd still have the most expensive healthcare system in the world per capita. How, then, can the fact you quote be responsible for the high cost of healthcare in the US?

None of the reasons given in the original post are valid. It’s particularly evil to say that people are wrong to want to extend their lives as long as possible—this is the whole point of medical care. As long as individuals are financially responsible for their own healthcare, no one has the right nor the ability so say what medical care someone else should should receive. If someone wants to spend $20K a day of his own money (either through cash or private insurance) to stay alive, he has every right to do so.

The real reasons healthcare is so expensive are:

-80 years of tax incentives designed to manipulate consumer behavior to make them pay for medical care with insurance rather than cash.

-Regulations restricting the trade of medical products and services. These mainly take the forms of FDA drug regulation and professional licensure. While rationalized on the grounds that they are necessary to “protect the public health” (a quick glance at which will show that they don’t work), their real purpose is to insulate trade groups, like government-licensed doctors and drug companies selling FDA-approved medicines, from competition.

In short, the government, driven by the irrationality and ignorance of the anti-capitalist left, is the cause of our healthcare problems.

Lack of a true free market when it comes to medication. Like in Mexico, the meds are a fraction of the cost.

We should automate everything. Replace doctors, PAs, and nurses with robots. That would make things cheaper.

I would add:

1) States mandating that insurance policies cover more and more things like acupuncture. Even if I never use those services, I am paying the premiums for those who do. Plus the insurance companies have to negotiate with the providers and that negotiation has costs.

2) Unnecessary restrictions on new clinics or facilities

3) Let's loosen up licensing. Allow nurse practitioners to do more. Same with PAs.

Overpaid docs wrote:

Most docs are overpaid. This inflates costs. Most of family medicine can be done by a PA.

So what do you think a doc should be paid? I mean if they are overpaid, you must have a number in mind.

I agree that NPs and PAs should be able to do more.

When you look at the doc pay is that net or gross? Does that include malpractice premiums? For some specialties they are crazy high.

Health Care Finance Person wrote:

You're missing one glaring issue. The overhead costs related to regulations imposed by CMS. Hospitals have to staff in the 100's to accommodate what is required to be paid for providing services to people on medicare and medicaid.

When you speak of overhead costs, yes there are high administrative salaries but they pale in comparison to what they would be making if they weren't in a non-profit so it's not as much of an impact as it is made out to be.

Also in terms of hospitals, those with ERs have to treat everyone who comes in. If a homeless guy comes in and cannot pay, that cost of treatment has to be picked up elsewhere. (ER visits are incredibly expensive!)

Not Jamin wrote:

We should automate everything. Replace doctors, PAs, and nurses with robots. That would make things cheaper.

The track record on AI in healthcare is not good. It may help in radiology, but in other areas it has not been good.

Bro, you cannot be serious. Nobody languishing in the ICU is footing that bill. Taxpayers (for Medicare/Medicaid patients), hospitals and other people with health insurance are paying for that. If they want to pay fine, but no one can afford that unless they're exceeding wealthy (likely over 10 million in savings). To claim ICU stays aren't a major driver of costs...don't even know what to say.

Lol @ the rest of your post. Unless you're prepared to pry Medicare away the cold dead hands of seniors, good luck. Even the most hardcore conservative won't dare tough Medicar.

Health insurance CEO's are incentivized to rip off the consumers. In 2015 the CEO's... just the CEO's made $2 billion dollars in compensation. See: https://www.axios.com/the-sky-high-pay-of-health-care-ceos-1513303956-d5b874a8-b4a0-4e74-9087-353a2ef1ba83.html

iflyboats wrote:

None of the reasons given in the original post are valid. It’s particularly evil to say that people are wrong to want to extend their lives as long as possible—this is the whole point of medical care. As long as individuals are financially responsible for their own healthcare, no one has the right nor the ability so say what medical care someone else should should receive. If someone wants to spend $20K a day of his own money (either through cash or private insurance) to stay alive, he has every right to do so.

Well if it is through private insurance that raises the cost for everyone else. Remember we are putting our premiums into a pot. That money is invested (and at times it has been done so poorly) and all that money is used to pay claims.

One idea I have liked (and it sounds cold) is to allow insurance companies to approach those with late stage diseases and make an offer. Basically let's say their data shows that you have 6 months to live and that the cost of keeping you alive for those 6 months is $100K. Without treatment you live 3 months. We will give you $80K in cash right now to forego treatments.

Now some people will pass. You hear stories of people wanting to stay alive for something like a kid's graduation or marriage or birth of a grandchild, etc. I might say give me the money! If I am well enough maybe I take a trip with my kids or give them the money to pay for college. Maybe I go to Vegas and spend it on hookers and blow.

In that scenario with the government being the one to pay, does someone in government get to decide when I can no longer get healthcare?

Luv2Run wrote:

Not Jamin wrote:

We should automate everything. Replace doctors, PAs, and nurses with robots. That would make things cheaper.

The track record on AI in healthcare is not good. It may help in radiology, but in other areas it has not been good.

Economics 101: decrease the demand, the price will go down.

PAs are good at treating colds and a run of the mill sinus infection (which don't need medical care anyway).

Beyond that, seeing a general PA is useless and if you have a real problem you'll have to see a doctor anyway. Actually causes costs to go up when you are seeing two practitioners for different visits.

I work in an ER - PA/NPs are great when they're heavily supervised by us and probably save us some money. However can't tell you how many patients were referred by their PA/NP general practitioner to the ER because they didn't know what to do with them (typically from an urgent care), usually unneccesarily.

Business 101: someone has to have ownership.

If you ask a doctor they will pin the problem on insurance companies and the government, while still collecting their excellent pay. If you ask insurance companies they will blame the government, the drug industry, doctors and hospitals, while still making excellent profits. The drug industry blames high research costs and excessive government regulation, while spending billions on advertising. Ask the government and you’ll get every conflicting answer and solution possible, and we keep electing them, paying taxes, and just living with the problem. All those in the medical arena with the exception of patients, are doing very well. They have no reason to see anything change. There needs to be one owner (government) and and wipe out all the money wasting non-medical actions that cost so much. Every other developed country has figured this out.