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Wednesday, December 21, 2016

The Reason Our Healthcare Is So Outrageously Expensive

We're just not very bright.  We put companies and corporations and profit and profits ahead of people and people's needs.

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Sevesteen said...

It isn't that we are for profit--it is the combination of for profit with laws that limit competition. If a business sees an opportunity to build a new hospital or clinic, chances are they have to convince a government board to issue a certificate of need--and chances are the existing hospitals will have seats on that board. This has even gone as far as private doctors or clinics being banned from buying equipment with their own money. Imagine if Walmart got to block competing stores.

The real money is running a for profit business that the government supports or mandates--Like Epi-pens. Off patent, schools are required to stock them, government refuses to certify competitors...and the manufacturer has family in federal government involved in this rule making. Where consumers have choice and pay for things themselves costs are under much better control--elective cosmetic surgery, laser eye surgery, even glasses benefit by not being included in the traditional rules of US health care. Look at the prices from Zenni Optical, they charge a fraction of what my first pair of glasses in the 70's cost...and take about the same time to arrive.

Mo Rage said...

It is precisely because we tie health to profit and profits that we have the most outrageously expensive health care in the world and also the reason, of course, that so many of us can't afford it. We are, again, the only nation, the only fools to do so. And this is what it is getting us and what it has gotten us. Until we disconnect health from profit, we will never have affordable care. And I doubt we can, as a people, imagine this. I honestly doubt we have the ability to imagine doing this--doing what the rest of the world has done and what they do--disconnecting health and health care from profit.

We aren't that bright.

If we don't do this, too, if we don't finally, one day, detach health and health care from profit, costs will continue to soar, fewer and fewer will be able to afford it and more and more will die. Our mortality rates will continue to worsen. We already have the most expensive and least effective health care, as a nation, as a people, than the other top 17 industrialized nations.

Once again, U.S. has most expensive, least effective health care

Hug that Capitalism all you like. This is what it's getting us.

Sevesteen said...

Who bells the cat?

Can doctors make a profit? If doctors aren't able to profit from their education, won't many of the good ones do something else instead? The linked article says we already have a shortage of primary care physicians, how do we fix that without allowing profit? Or do you only mean corporate profit?

According to The Motley Fool (first hit when I Googled) the average new drug costs 2.87 BILLION to develop and approve. Why would anyone spend that kind of money if they can't expect to get a significant return?

What about cosmetic and elective surgery--Is profit allowed for breast implants or Lasik? If not, how do we allocate these?

If not allowing profit makes sense for medical care, why doesn't it makes sense for food? After all, people need food even more than medical care, and food can reduce the need for medical intervention. (To be clear, I don't favor eliminating profit from food)

Our current system only frees corporations to make profits. It is missing the competition that would keep these profits in check, usually through some government system to protect patients. In a free market there would be a balance--much like food. Not perfect, but better than alternatives.

Mo Rage said...

You're such an American.

No one is talking about doctors not making a good living. You need to research health care in other nations. Other nations do quite well, thanks very much, again, not tying health care to profit. Their is no expectation for doctors to be wildly, fabulously wealthy in other nations. They make a good living, sure, but they don't go into it to be, as I said, wildly wealthy as they do here in the US.

But doctors and what they make aren't the issue. They're not the big issue.

The big issue with our health care is that corporations, the insurance companies and pharmaceuticals and others all expect to reap huge profits, year after year, and increase those profits, again, year after year.

Too many Americans can't imagine, don't have the imagination to see how we could do this and what we could do to have our health care system work reasonably.

Even though it's being done in other nations, all over the world.

You need to see this. All of it.

Comparing International Health Care Systems

You won't but you should.

Sevesteen said...

I think Blogger ate my last comment, if both show up please only approve one.

I can't think of anyone who deserves to be fabulously wealthy more than a really good doctor. If we take steps to limit doctor's wealth to acceptable levels, some of those capable of being the best will be the best engineers or stockbrokers instead.

Likewise, if we limit the profit of big pharma to "acceptable" levels, people will invest in safer industries. Lifesaving drugs deserve big profit more than smartphones or whatever the latest Apple gadget is. Without the profits from the US market, a lot of the billions on drug research will be invested somewhere else instead. Solutions would be to look at less regulation instead--let terminal patients at least use unapproved drugs, or even better limit the FDA to making sure that Big Pharma tells the whole truth about their drugs, and let doctors and patients decide what's a safe level of risk for a cold, or cancer cure.

Should profit be allowed on food? If so, why should that be different than health care?

Mo Rage said...

Spoken like an American. Like a true American.

I don't mean that as a put-down, more as just fact. As I said earlier, the entire world does this, that is, disconnects health care from profit but so many Americans can't imagine doing just that. It's why we're trapped in this system. That and the fact that the already-wealthy and corporations like it this way and benefit greatly from it so they keep funneling "campaign contributions" to our government legislators so they can keep the huge amounts of money shoveling and funneling their way.

Meanwhile, the CEOs are making literally millions of dollars and millions upon millions of our fellow Americans can't afford health care.

Our system is the most obscene, immoral, bloated, disgusting health care system in the world.

Bar none.

Sevesteen said...

Food is more important than health care. Do you think profit should be allowed on sales of food? If so, how is that different than health care?

Mo Rage said...

You don't understand.

It isn't profit, period, of any kind with health care.

It's huge, obscene, outrageously large and completely uncalled for profit and profits.

Of course the farmer must have a profit for raising and selling his food. But he doesn't charge $38,000 for, say, a grapefruit.

See today's post for yet one more example.

Sevesteen said...

I understand that profits in health care should not be left unchecked. I understand that this should be done through competition, not another set of restrictions to replace the previous restrictions that didn't work. We don't have a free market health care system, yet you still use it as an example of free market failure.

The problem isn't profits, the problem is monopolies enforced by government. Imagine what would happen if you needed a certificate of need to open a new grocery store and the Kroger corporation was on the board that issued them. What if not only the food's safety was regulated but also packaging and producing methods--and each company had to individually and expensively test their method for each type of food, even if it was exactly the same as a competitor's? What if you could get the federal government to mandate that schools serve the type of grapefruit that only you matter how much you charge? (This is what the makers of Epipen did)

We need to eliminate many of the rules that hinder competition. Instead of setting a price or profit margin for Epipens and other off-patent drugs, eliminate barriers to competitors and encourage competition.

Mo Rage said...

There are $38,000 vials.

There are $3000 tubes of ointment, for pity's sake.

There are $800 bags of saline solution---salt water--hospitals charge patients.

The problem is profits.

The problem is obscene, unchecked profits by these huge corporations that don't give a damn if you or I get better.

Sevesteen said...

We aren't arguing about the problem--I agree that those costs are a problem. But we've got those costs in spite of regulation, or often because of regulation. Kroger doesn't usually get to ban other grocery stores. The government doesn't usually determine what a grocery must sell, or what prices they must sell at--but the prices are up front.

We could and should encourage the same for medical care. Clinics and hospitals should be regulated for safety and honesty, not for "need". (My town doesn't "need" nearly as many food options...but I'm glad they are there) Encourage up front pricing that's the same for everyone. Don't force hospitals to eat the cost of indigent care, do that through tax funding. Don't force clinics to provide every possible service. Stop strangling innovation.

And we could work towards all of this in parallel with other efforts to control costs. Regulations always have unintended consequences--putting government in charge of medical profits is certain to harm at least some aspects of medical care. Instead of finding a scapegoat again, we need to look deeper at solutions less likely to cause harm.