Why is healthcare so expensive?

All sectors in American business are now controlled by a handful of Big players who can conspire to set prices given the lack of competition.

Don't blame the victims

PA/NP are actually MORE likely to order things such as MRIs or subspecialty referrals. Data confirms this.

Don't have to look much further than the good old letsrun to see people complaining about why the doctor won't give them antibiotics or do a chest xray for their cough, or refer them to an endocrinologist for "hormone levels" or an MRI for their hip pain. So don't discount the tendency of US consumers to expect and demand the very best in health care. THIS drives testing, subspecialty referrals, admissions to hospitals for "observation", referrals to ERs for noncardiac chest pain "to be sure".

We have the highest rates of both obesity and poverty in the world--guess what this will get worse.

Administrative costs are equal to physician pay as percentages of health care expenditure--both 8%

https://www.theguardian.com/us-news/2018/mar/13/us-healthcare-costs-causes-drug-prices-salaries

Elvin wrote:

Lack of ownership wrote:

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.

In what developed country is the government the single owner of the healthcare industry?

Japan, England, France, Canada, Sweden,

Hell. Name one "developed" country other than the USA that does not have govt provided healthcare for essential services.

Look it up wrote:

Elvin wrote:

In what developed country is the government the single owner of the healthcare industry?

Japan, England, France, Canada, Sweden,

Hell. Name one "developed" country other than the USA that does not have govt provided healthcare for essential services.

I don't believe you are correct about the government owning the entire healthcare industry in these countries. Single payer does not equal single owner. I am 100% sure that private hospitals exist in France.

Look it up wrote:

Elvin wrote:

In what developed country is the government the single owner of the healthcare industry?

Japan, England, France, Canada, Sweden,

Hell. Name one "developed" country other than the USA that does not have govt provided healthcare for essential services.

But hey, it's "free".

Look it up wrote:

Name one "developed" country other than the USA that does not have govt provided healthcare for essential services.

Also, LOL at the moving goalposts. Government needs to be the single owner of all things healthcare suddenly becomes government is a provider of essential healthcare services. I'm discussing the original claim, not your new one. You realize that the government is a provider of essential healthcare services in the US, right?

Here's a question. Why is the same or better healthcare so reasonable and affordable in other places? I live in Spain where I pay 100% out of pocket for my private health insurance. Absolutely full coverage, no deductible no copay. Costs me a little over 500€ per YEAR.

I lived in Germany 3 years. Had a little "worse" coverage, about a 1000€ deductible, but still very reasonable at full coverage for around 1200€ a YEAR.

An anecdote. When I first moved to Germany, before I had residency permit, before I had health insurance. I was hit by a car on my bicycle. Mostly unhurt, but they strapped me to a gurney and ambulanced me to the hospital anyway just in case. Siren on, blowing through traffic lights, the whole deal. I sat around in a wheelchair, got some x-rays, they washed up my cuts, it was determined the offending driver's insurance would pay for my visit (my german was poor and I was in a quite small city). So I was released same day, finished my bicycle trip, etc. Months later long after this had all been concluded through a lawyer and I was reimbursed for my bicycle repairs and a little PT, I receive bills at my US address from the hospital. Bills for the Xrays, bills for the ambulance ride, etc. I asked my german lawyer what to do, he said forget it, it's all been sorted already. Point of this whole story: know what the bills came to? For zero insurance pay-it-out-of-pocket costs for an ambulance ride and several xrays in hospital in Germany? It was like 250€.

What's an ambulance ride in the USA cost? And then next question after that: Why?

A few reasons why wrote:

It’s no mystery. I’ll tell you why...

-Big pharma constantly developing new expensive drugs with marginal benefit (FDA to blame as well)

-People unwilling to accept death even when terminally ill . Live their last days in an ICU on a ventilator for $20k/day instead of peacefully at home

-doctors doing too many unnecessary tests and procedures

-doctors unwilling/unable to remove life support.

-Average person is fat and unhealthy and unwilling to take any personal responsibility for their health.

-healthcare administrators being paid enormous salaries for basically doing nothing. Similarly, ‘overhead costs’ which provide no real value to patients

I pretty much covered everything. .

Except: That is the way republicans like it.

iflyboats wrote:

None of the reasons given in the original post are valid.

Your entire post is invalid.

The way republicans like it wrote:

A few reasons why wrote:

It’s no mystery. I’ll tell you why...

-Big pharma constantly developing new expensive drugs with marginal benefit (FDA to blame as well)

-People unwilling to accept death even when terminally ill . Live their last days in an ICU on a ventilator for $20k/day instead of peacefully at home

-doctors doing too many unnecessary tests and procedures

-doctors unwilling/unable to remove life support.

-Average person is fat and unhealthy and unwilling to take any personal responsibility for their health.

-healthcare administrators being paid enormous salaries for basically doing nothing. Similarly, ‘overhead costs’ which provide no real value to patients

I pretty much covered everything. .

Except: That is the way the corporations who control republicans and democrats like it.

fixed it.

Don't be fooled, they are both controlled by the same puppet masters.

Here's one reason why wrote:

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

They are exactly the same medications, but branded differently. Special branding is required by the U.S. to make sure that the same, but, cheaper drugs are not allowed in the U.S. The allows drug makers to sell the exact same thing for a lot more money to Americans.

The complete article (JAMA)

https://jamanetwork.com/journals/jama/article-abstract/2674671

the upshot is that guess what it costs more here cause prices are higher

Conclusions and Relevance The United States spent approximately twice as much as other high-income countries on medical care, yet utilization rates in the United States were largely similar to those in other nations. Prices of labor and goods, including pharmaceuticals, and administrative costs appeared to be the major drivers of the difference in overall cost between the United States and other high-income countries. As patients, physicians, policy makers, and legislators actively debate the future of the US health system, data such as these are needed to inform policy decisions.

Because it's the one thing people will pay anything for.

Ask a billionaire dying of cancer if he'd forego all his money IF he would wake up cancer free in the morning. The market has no top end.

I left wrote:

What's an ambulance ride in the USA cost? And then next question after that: Why?

A lot of money. Why? Because the provider intentionally over-bills it because they know the insurance company will only reimburse a certain percentage. People post ridiculous medical bills online all the time but the truth is that it's just some hospital or other provider trying to recoup the actual cost when they know someone's insurance company will only pick up 20% on certain services.

same meds wrote:

Here's one reason why wrote:

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

They are exactly the same medications, but branded differently. Special branding is required by the U.S. to make sure that the same, but, cheaper drugs are not allowed in the U.S. The allows drug makers to sell the exact same thing for a lot more money to Americans.

Why does the US have these rules?

1. Patents. Give people legal monopolies on drugs and medical devices and the costs will be astronomical. Get rid of patents and you will have more innovation and cheaper products. Without patent protection, the value shifts from the innovation to the innovators and innovations are free to all to improve instead of being locked away in a legally protected monopoly.

2. Private insurance. In the US, four people go to the doctor with a broken arm. One person has a big insurer that negotiates a good rate. He pays $3,000.00 to get treated. Another person has a smaller insurer that does not have the leverage to negotiate a good rate. He pays $6,000. Another person has no insurance or has his insurance claim denied because it happened on the job and worker's comp denies it for another reason (happens way too much in the US). He is charge $12,000. And then the last person has medicare and is charged $1,500.00.

In a sane world, the provider knows that he can treat X number of broken arms every month and needs to make $Y for each broken arm in order to sustain his business. In the single payer world, the providers negotiate one time to get a rate set and always get paid that rate. In the private insurance world, the provider never knows exactly how much they will get because it depends on who walks through the door with what insurance, no insurance or government benefit. The provider in the private insurance world negotiates to charge as much as he can because he has no idea how much he is going to actually get paid.

3. Public Health. We should actually be seeing health care costs come down significantly as cancer rates from smoking have dropped dramatically over the years. But the obesity crisis has wiped out those savings and added crushing costs from long term chronic diseases like diabetes and heart disease.

Elvin wrote:

Look it up wrote:

Japan, England, France, Canada, Sweden,

Hell. Name one "developed" country other than the USA that does not have govt provided healthcare for essential services.

I don't believe you are correct about the government owning the entire healthcare industry in these countries. Single payer does not equal single owner. I am 100% sure that private hospitals exist in France.

Yes. Private health care is available but essential services are covered by he government. As I stated earlier. Never said that the government "owned the entire healthcare industry."

Why the need to lie?

Posting corporate propaganda are you?

Try taking away the government provided healthcare in any nation and you will see

Overpaid docs wrote:

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

Most family medicine is done by PA's and Nurse Practitioners.

I think for the most part on an individual level health care providers try to be somewhat accommodating with patients regarding costs.