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Scott Shepherd
05-21-2009, 3:57 PM
My father just had major back surgery. Just got the first bill. $28,000 for "supplies" for the Operating Room. Surgery was 3 hours.

That's supplies, not surgeons or any other people.

Exactly HOW can you have the nerve to submit something like that and still sleep at night? I know I couldn't.

Unbelievable to me. If it were me, people would be in jail for this type of behavior (sorry, I'm sure that will offend someone, but it's how I feel). I'm sure there are probably another $75,000 worth of bills to come in because they squeeze every possible penny out of it.

David G Baker
05-21-2009, 4:04 PM
Kind of lets us know why medical insurance is so high. Take a wild guess at the cost of an Aspirin in a hospital, costs more than I paid for my first car.
$75,000 is probably a conservative figure.

Dustin Lane
05-21-2009, 4:09 PM
It cost $80+ not long ago to 'administer' 650mg of tylenol in the ER. Hospital cost for 650mg of tylenol is less than a penny. Its unbelievable.

curtis rosche
05-21-2009, 5:05 PM
ill tell u what the cost of cutting my finger off and 9 stitches was as soon as i see the bill

Brent Leonard
05-21-2009, 5:29 PM
It's not the lawsuits. Sorry but you've been misled.

With a wife who has/does administrated, negotiated and handled the contracting phase in the buisness of medicine for a number of years, holds a Phd and has been recognized as a top person in her field of expertise,

I can tell you,

lawsuits are small potatoes to the cost associated with running medical facilities, regardless of what your brand politics tells you....

Hopsitals and such are EXPENSIVE to run.

Jerome Hanby
05-21-2009, 5:31 PM
Assuming that other states are in a similar situation as Alabama, you have prices like that because of Medical Insurance. The insurance companies do NOT pay those prices, they have their own schedule of prices for various and sundries. Those prices only come into play for the uninsured (and I imagine the hospital's accountants at tax time to show the difference in the "normal" cost and what the insurance payed as a loss).

It's all pretty shady from my view point and the fix is the same as for most of our problems.

XXXXXXXXXXXXXXXXXXXXXX




Kind of lets us know why medical insurance is so high. Take a wild guess at the cost of an Aspirin in a hospital, costs more than I paid for my first car.
$75,000 is probably a conservative figure.

glenn bradley
05-21-2009, 5:45 PM
Hopsitals and such are EXPENSIVE to run.

Now that your source is well qualified, how about a hint as to why hospitals are expensive to run. Does their electricity cost more than than the injection molding company down the street? Do their janitors make more than the outsourced folks? :D

I am being a bit silly here and understand that the costs are probably significant. You can't just jury rig an outlet strip nailed to the wall when you need more power in an operating room and the regulations alone have to be a chore to comply with. All kidding aside I would be interested to hear from someone in the know as to what a few of the specifics are on the big dollar items.

Joe Hardesty
05-21-2009, 5:50 PM
Hopsitals and such are EXPENSIVE to run.

Oil exploration is expensive too, so I guess Exxon must really be struggling financially.

Hospitals have a captive market. When you are seriously ill, nobody asks "what's this gonna cost?" And most people with health insurance don't care anyway.

Hospitals are by no means an innocent part of the equation.

Greg Cole
05-21-2009, 6:00 PM
ill tell u what the cost of cutting my finger off and 9 stitches was as soon as i see the bill
I lost (errrr cut off) a bit of the end of my left pinky almost 2 years ago. I waitied in the ER waiting room for 3 hours (with the pinky tip bone cut and all the meat about 1/3 the way down the nail all gone too).
45 minutes in the ER, 3 stitches to pull the flesh over the exposed bone, one vicodin and out the door. $3800.00.
And with no meat on the pinky tip and all scar tissue covering the end of the bone, I certainly know it when I tap that finger tip on anything but a keyboard.:rolleyes:
My biggest beef with the health care industries is the insurance companies.

Ken Fitzgerald
05-21-2009, 6:03 PM
Oil companies don't have a "captive market"?:confused:

Clifford Mescher
05-21-2009, 6:15 PM
I had a vision of riding down the street looking for the cheapest hospital price.:rolleyes: :)Clifford

Tim Morton
05-21-2009, 6:44 PM
My wife had Jaw surgery recently....it was an all day procedure with 3 nights in the hospital and the bill was over 50grand....our out of pocket was $200.

T

Jerry Bruette
05-21-2009, 6:50 PM
I just purchased some medical equipment from a company that advertised the price on their website for $102. I asked if they could bill my insurance..mistake. They billed the insurance for $780. Insurance company says that because the company is contracted with them they can bill any amount they want, but will only be paid the amount they contracted for.
That amount comes to $209, after I pay my deductable it'll cost me $107 more than the prices advertised on their website.:eek: How does all this add up:confused:

I'm guessing plan "B" will be to purchase 209 forever stamps and send them $1 every month for 209 months and see if they like being messed with.

You ever wonder why hospitals and insurance home office buildings are so posh and over the hill???

Jerry

John Schreiber
05-21-2009, 7:00 PM
It seems to me that the health care industry thinks differently than other industries. They watch some costs like a hawk and cut at every opportunity, but in other areas huge purchases and payouts are made which don't seem to be based on any financial sense.

I'll acknowledge that the issue is much more complex than I know, but I don't understand why costs in the USA are twice that of other countries and we don't have better outcomes.

Greg Cuetara
05-21-2009, 7:02 PM
Actually quite a bit of the pricing is based upon medicare and medicade rates. The feds undercut the hospitals quite a bit therefore the hospitals up their rates so that they and go back to the feds and say there is such a huge difference they need to up the medicare rates and pay the hospitals more. Basically the hospitals are trying to dicker with medicare so they start high and hope to get something in between what they are asking and what they collecting now.

If you have insurance the insurance co. has their contracted rates based upon the demand in the area and the hospital you go to. In my area it might be 1200 for a cat scan but if you go to boston the contracted rate might be 300 becuase there is more competition and more scanning machines. If the hospital won't take the 300 the insurance sends their patient to the next hospital 1 mile down the road.

Then there are those that dont' have a job and can't pay anything so the hospital pays the bills or bills the gov't. The people who get screwed are those who either pay cash or those who have medicore insurance and have to pay a lot out of pocket.

It would be nice for everyone to just pay the contracted rates or for the hospitals to charge what they really want. It is a game the hospitals play to see how much the insurance will pay and what the insurance will cover. It might cost a penny for tylenol but how many of those tylenol does the hospital have to give away for free....someone has to pay for it.

Quite frankly we have the best health care in the world. If you don't think so why does EVERYONE in the world come here to have major surgeries or even minor surgeries. Why does every country in the world send their citizens here to study medicine....we must be doing something right. It is complicated but when every other countries medical system has failed again we must be doing something right. It might cost more in the US but you can have your surgery and don't have to wait for 6 months to see a doctor or wait years for the surgery that will take away pain.

When your son or daughter or family member is sick you can run right in and most of the time see the doctor that same day or the next day. Is that true anywhere else in the world?

Clifford Mescher
05-21-2009, 7:26 PM
It seems to me that the health care industry thinks differently than other industries. They watch some costs like a hawk and cut at every opportunity, but in other areas huge purchases and payouts are made which don't seem to be based on any financial sense.

I'll acknowledge that the issue is much more complex than I know, but I don't understand why costs in the USA are twice that of other countries and we don't have better outcomes.
:rolleyes: Your kidding, right? The rich and famous around the globe can go to any place they want. I bet 9 out of 10 come to the USA. Clifford.

Scott Shepherd
05-21-2009, 7:29 PM
I don't dispute the cost of running a hospital is expensive. We haven't even gotten to those charges yet. We're on the "Supplies". $28,000 for "Supplies".

I just want to know what "Supplies" cost $28,000 for 3 hours.

John Schreiber
05-21-2009, 7:33 PM
. . . Quite frankly we have the best health care in the world. If you don't think so why does EVERYONE in the world come here to have major surgeries or even minor surgeries. Why does every country in the world send their citizens here to study medicine....we must be doing something right. It is complicated but when every other countries medical system has failed again we must be doing something right. It might cost more in the US but you can have your surgery and don't have to wait for 6 months to see a doctor or wait years for the surgery that will take away pain.

When your son or daughter or family member is sick you can run right in and most of the time see the doctor that same day or the next day. Is that true anywhere else in the world?
It's hard to respond to this without getting into issues which will be considered political, so I'll tread carefully.

Everyone doesn't come here to get their medical work done. The USA does not have a monopoly on great doctors. Some wealthy people come from developing countries to the USA to get work done, but they also go to other industrialized countries.

Other countries medical systems have not failed that I know of.

Most medical systems in the world allow you to see a doc on the same day you want to. I can't say no one ever waited six months for an operation, but every story I've heard checked out was not based on a real example.

In the USA our infant mortality rates are higher and lifespan is lower because many people do not have access to preventive care.

And, twice as much comes out of our pockets to pay for it. And, monitoring medical bills and explanations of benefits takes me a couple of hours a month to keep everyone from taking advantage of me or each other.

Moderator - Sorry if this is considered political. Delete the relevant posts if you feel the need.

John Schreiber
05-21-2009, 7:35 PM
:rolleyes: Your kidding, right? The rich and famous around the globe can go to any place they want. I bet 9 out of 10 come to the USA. Clifford.
Do some research before you put your money up. Otherwise, I'll take it.

Scott Shepherd
05-21-2009, 8:04 PM
Don't mess up my non-political thread here guys, I just want to know what $28,000 worth of supplies look like.

Scott Donley
05-21-2009, 8:28 PM
This maybe ? :D

Brent Leonard
05-21-2009, 8:31 PM
Now that your source is well qualified, how about a hint as to why hospitals are expensive to run. Does their electricity cost more than than the injection molding company down the street? Do their janitors make more than the outsourced folks? :D

I am being a bit silly here and understand that the costs are probably significant. You can't just jury rig an outlet strip nailed to the wall when you need more power in an operating room and the regulations alone have to be a chore to comply with. All kidding aside I would be interested to hear from someone in the know as to what a few of the specifics are on the big dollar items.

Unfortunately, like any BIG problem, it's not something I could write up on this forum in any easy structure nor could I even pretend to have the knowledge to do so. I'm sure the issue has been explored in MASSIVE research studies, write ups and of course, get 5 experts on the subject in the room and you'll get 7 opinions.

The numero uno thing my wife tends to tell me......
Costs come from several sources, all free to charge what they want for their "product". Pharmaceticals are a major cost factor in the industry, putting a major strain on final costs.

The other issue seems to be Doctors who create partnerships, create a "specialty" clinic and take the high profit work away from the hospitals.
Example:
A team of orthopedic doctors put together a large sports medicine clinic, doing a variety of orthopedic surgeries and other things. Those procedures are HIGH profit procedures which the hopitals perform to support the low profit or even negative profit areas such as the ER. Now that the hospital don't have the high profit buisness to pay for the ER, what happens? Noninsured and those who use the ER as their primary means of medical treatment is a killer on ER financials. The ortho Doc's only take the cream, leaving the crap to the hospitals. Hospitals must charge more to compensate.

I don't pretend to be an expert, only what I know from my wife. Not to mention, she has her opinion too. My wife typically laughs at those who say lawsuits are the problem. Insurance is expensive (what insurance isn't?) and should be examined as an issue, but is not THE problem.

Karl Brogger
05-21-2009, 9:40 PM
ill tell u what the cost of cutting my finger off and 9 stitches was as soon as i see the bill

I couldn't tell you what cutting a finger off costs, but last time I had stitches it cost me just over $700 for 6 stitches in a thumb. I've got a buddy who's a vetenarian who'll said he'll stitch me up for beer from now on.:cool:






I swear I posted in this thread already, but I guess I just read it...

Brian Brown
05-21-2009, 9:54 PM
"I had a vision of riding down the street looking for the cheapest hospital price."

That's funny, I don't care who you are. That's funny!

mike holden
05-21-2009, 10:10 PM
Scott,
Consider that at a minimum, the entire operating room needs to be sterilized for the next use. Considering that there may be bodily fluids exposed, the cleaning crew needs to wear hazmat equipment that cannot be reused - tyvek jumpsuits, hoods, masks, gloves, etc. The cleaning equipment, towels, mop heads, etc are also onetime use - bodily fluids again. This is the ancillary cost to the AIDS problem. At a guess, a good $10,000 is just in this clean up.
There are other supplies that are placed in an operating room that are there for emergencies, but once exposed, cannot be reused. Then there are the gowns, gloves, caps, eye guards, footies, etc. for people involved in the operation itself. More one-time use items.
The more I think about it, 23,000 actually sounds about right.

My gall bladder removal and bile duct rebuild cost over $250,000 and counting. Just the hospital has billed, the doctors bills are yet to come.

Mike

Mark Norman
05-21-2009, 10:19 PM
A few years back I gashed my hand while doing some sheet metal stud walls. After waiting at the emergency for a couple hours I went home and sewed it up myself four sutures for a 1-1/4" cut that was near 1/2" deep in my palm.

Sedative/painkiller: about $6.00 (12 pack and a shot of whiskey)
Needle and thread: free out of my sewing kit.
gauze and rubbing alcohol: another ~$6.00

It healed up quite nice.

I have always pulled my own sutures out over the years.

Doug Shepard
05-21-2009, 10:42 PM
Roughly 20 years ago while showering I notice what I assume are some sort of swollen gland issues in the groin right at the crease with the legs. So I head for the doctor that week, who informs me that I'm the lucky recipient of two minor early stage hernias then refers me to a surgeon. Crud. I had medical insurance but no disability leave insurance. So no work - no income. The surgeon informs me that I'll be off work 6 weeks after each surgery and that they only do one side at a time. Once the first is healed, the other side would get done. Yikes - 12 weeks with no income. About that time I run into a cousin who mentions he got back from Toronto about a week ago. Then mentions he went there for a hernia operation. After prodding him for more details and why he needed to go to Toronto for something he could get done here, I like what I hear and start checking into whether I can get mine done there too. I'd be there for a week and walk out with both done and they gave me the cost - $1200 USD for the entire weeks stay, surgery, and all fees. My insurance company was falling over themselves approving the operation there. I found out later that I would have been close to 5 figures for just the first one if done here. Something definitely needs fixin with the medical industry here in the US.

Edit:
Just in case anybody needs it
http://www.shouldice.com/

Ken Fitzgerald
05-21-2009, 11:22 PM
Do some research before you put your money up. Otherwise, I'll take it.


John,

How about giving us the source of the information you claim to have.

Ken Fitzgerald
05-21-2009, 11:26 PM
The medical system, the government Medicare and Medicaid system are a lot more complex than most people realize.


Example:

For certain diagnostic procedures, the Medicare reimbursement value doesn't even pay for the expense the hospital incurrs when they perform the procedure.

Now hospitals have 3 choices that I can see:

1. Refuse to take any Medicare patients that might need the procedure

2. Refuse to perform the procedure on Medicare patients

3. Perform the procedure on the Medicare patient and markup the price on everybody else that have insurance or a lot cash so that they don't lose money.

Michael Weber
05-21-2009, 11:37 PM
A serious topic but I always get a laugh out of what my Insurance pays opposed to what the Doctor/Hospital/Clinic bills. Often it's 1/2 or less of the original amount. Recently had a little fall resulting in lot of broken cheek bones/jaw/cracked sinus. One of the bills I got was for 143.00, evidently for lab work. Insurance allowed amount was $11.21!!! My responsibility after provider payment was $2.26. An extreme example perhaps but every time I see something like that I'm grateful I have great medical insurance. Feel sorry for the uninsured who are on the hook for the whole amount. At least those that can/do pay. I agree something is badly out of whack with our medical system. I understand that medical tourism is a growing industry. Thats where a person has an expensive procedure done in a foreign country because it's so much cheaper. Lots of countries getting in on it. Especially in the elective surgery area where insurance won't pay anything.

Mike Henderson
05-22-2009, 1:05 AM
Medical billing is one of my pet peeves. If you don't have insurance or Medicare, you pay the highest amount. It's worth it to get insurance, even if all the insurance company does is turn around and bill you for the amount they paid, plus a service charge.

This is a problem for people who lost their jobs and their insurance. They have a medical emergency and they get billed significantly more than anyone with insurance would pay. It's like being hit twice.

In my opinion, there should be one charge for a procedure no matter who pays - the individual, private insurance or Medicare.

Mike

John Schreiber
05-22-2009, 1:06 AM
John,

How about giving us the source of the information you claim to have.
Ken,

I was responding to an earlier statement that:

The rich and famous around the globe can go to any place they want. I bet 9 out of 10 come to the USA. Clifford.I have studied a bit about health care (and have worked in a related industry) and it's true that some rich and famous people have come to the USA for medical services. In the 1970s and 80s, there were a lot, but there is now no strong tilt towards people coming to the USA for treatments. In fact, one of the biggest growth areas in the world for health care is India. People are traveling from around the world and from the USA to India to have medical work done.

I don't have a source which says X out of 10 rich and famous people people come to the USA, but I'm sure I could win a bet that it's not 9. If someone else has a different source, I'd love to see it and if it's legit, I'll pay up. (I'm not a gambler. I am speaking figuratively in response to an "I bet" statement. For this question though, it would not be a gamble.)

James Jaragosky
05-22-2009, 1:21 AM
Now that your source is well qualified, how about a hint as to why hospitals are expensive to run. Does their electricity cost more than than the injection molding company down the street? Do their janitors make more than the outsourced folks? :D

I am being a bit silly here and understand that the costs are probably significant. You can't just jury rig an outlet strip nailed to the wall when you need more power in an operating room and the regulations alone have to be a chore to comply with. All kidding aside I would be interested to hear from someone in the know as to what a few of the specifics are on the big dollar items.

Because they are required by law to at least admit and administer minimum care to anyone who enters the emergency room. So many people with no health care use emergency rooms as their primary care center. And someone has to cover the cost of the non payers.
Thats one reason, another is outlandish bills by doctors.
In 1996 I had cancer surgery to remove a tumor in my saliva gland. To just have a stand by surgeon in the hospital in case the primary surgeon had problems cost $5000 and he never scrubbed up.:eek:

Matt Meiser
05-22-2009, 8:54 AM
I don't know how it is everywhere, but hospitals aren't exactly rolling in money here and many are operating at significant losses. Our local hospital has been operating at a very signifcant loss and burning through their endowment rapidly for the past several years. Now they just came out and said that the lastest Medicare cuts will probably cost them $400,000 a year and their unpaid bills are skyrocketing. I pretty much expect they will file for bankruptcy or be taken over by one of the big hospital systems in the region within the next couple years. For some reason I don't see the economy improving in our region any time soon.

It costs a lot of money to pay all those people high-5 and 6 figure salaries, good benefits, utilities, supplies, etc. 24 hours a day 365 days a year. Then they need to go out and buy a new multi-million dollar MRI machine, CT Scanner, surgical robot, building improvements etc. every few years because we demand that they have the latest and greatest of everything when we or our loved ones need care. We demand every last measure, no matter how low the chances for success or how high the cost are to prolong someone's life for an extra week or month. We want the latest drug that prevents hangnails in nearly 50% of people who take it. We expect a good outcome in every situation (and aren't afraid to sue everyone involved when there's not.) We expect everyone to get care whether they can pay or not.

Then we forget all that and complain about the costs of health care and health insurance and put all the blame on the industry.

Glenn Clabo
05-22-2009, 9:18 AM
For those who continue based thier words on feelings...and quote stories...here are some facts to think about.

For those who like to think that people flock to the US for healthcare...why would they if they had a choice...
The U.S. is 33 percent worse than the best country on mortality from conditions amenable to health care Ė that is, deaths that could have been prevented with timely and effective care.
The infant mortality rate in the U.S. is 7.0 deaths per 1,000 live births, compared with 2.7 in the top three countries.
Recent studies show that only a little more one-half (54.9 percent) of adult patients receive recommended care. The level of performance is similar whether it is for chronic, acute, or preventive care and across all spectrums of medical care -- screening, diagnosis, treatment, and follow-up.

For those who think we don't spend enough...
Health care spending is 4.3 times the amount spent on national defense.
In 2008, the United States will spend 17 percent of its gross domestic product (GDP) on health care. It is projected that the percentage will reach 20 percent by 2017.
Although nearly 46 million Americans are uninsured, the United States spends more on health care than other industrialized nations, and those countries provide health insurance to all their citizens.
Health care spending accounted for 10.9 percent of the GDP in Switzerland, 10.7 percent in Germany, 9.7 percent in Canada and 9.5 percent in France, according to the Organization for Economic Cooperation and Development.
A new survey shows that more than 25 percent said that housing problems resulted from medical debt, including the inability to make rent or mortgage payments and the development of bad credit ratings.

For those who think that a national (not socialized medicine) insurance plan is not affordable...
About 1.5 million families lose their homes to foreclosure every year due to unaffordable medical costs.
Retiring elderly couples will need $250,000 in savings just to pay for the most basic medical coverage. Many experts believe that this figure is conservative and that $300,000 may be a more realistic number.

All the above are facts backed by data...not just some political side spouting off about what they don't know anything about.

I lived on both sides of this...I went a 1/4 million $$$ in debt trying to keep my wife alive....and it didn't work. Now one half of my friends and my wife are in the healthcare world. It not as easy as some would make you think.

Glenn Clabo
05-22-2009, 9:24 AM
Cliff..
I can't dispute your bet with facts but I can say what I think. I think the rich and famous come here because they can.
Now for the facts...that's not the problem...the problem is simply that the US does not have the best outcomes...it has the most expensive and available to rich people...which is VERY different than the best.

Jeffrey Makiel
05-22-2009, 10:37 AM
Nicely stated Glenn.

As far as an earlier comment that stated that litigation is not a factor, the physicians in my home state say different. About 3 years ago, physicians demonstrated at the state house for litigation reform. That's right, physicians themselves were protesting, not hippies. It was a big event according to local news. Their point was that the legal system could not distinguish between a 'bad outcome' and 'negligence'. Just being sued and winning is a big cost.

In my home state, the hardest hit physicians are neuro-surgeons, orthopedic surgeons and obstetricians. As a result, these disciplines are difficult to retain.

I understand that there is also a trend for physicians to directly work for the hospitals to help shelter themselves from the administrative burdens and high malpractive insurance thus allowing them to focus on medicine.

Litigation certainly seems to have an impact in New Jersey. It may not be the primary cause of the cost issue, but it certainly seems to contribute to the problem.

-Jeff :)

Clifford Mescher
05-22-2009, 10:49 AM
I have not been on top of this thread but I see my "bet" caused some feathers to be ruffled in certain circles. My "bet" was just a rhetorical type statement that wasn't seeking a response.
I admit that the system is far from perfect. What I was trying to say is: do we not have some of the best doctors in the world practicing in the USA? Do we not have some of the best research facilities in the USA? Do we not have some of the best teaching hospitals in the USA?
All I was saying is that these resources are available to people around the world who have the funds. Is it fair? I don't know. This is a capitalistic society (so far) and it probably is in need of alot of tweaking.
That being said, is it fair that people use the emergency room as a prime care facility? Somebody has to pay for all these people who actually receive free health care at the expense of the whole. The hospitals must compensate the difference somehow. Like Matt mentioned above, we expect the best for our loved ones, and equipment and medicine cost money.
In the future, I hope, all of this will get ironed out somehow. I only hope that the solution does not retard the incentives and standards that a capital system generates. Everybody wants the world to be perfect and have everybody healthy. To that, we all agree. Clifford.

John Schreiber
05-22-2009, 10:54 AM
James,

I'm not arguing with you here. I'm just trying to understand why these things are the way they are.

Because they are required by law to at least admit and administer minimum care to anyone who enters the emergency room. So many people with no health care use emergency rooms as their primary care center. And someone has to cover the cost of the non payers.
We know this, but our system is still set up so that emergency room care is the only source of care for a huge number of people. With the huge cost of seeing a doctor through an ER, why don't we have alternatives for people to get primary care. Also, these people have no access whatsoever to preventive care. The system we have adds costs, makes it hard to see a doctor in an emergency and doesn't provide quality care.

Thats one reason, another is outlandish bills by doctors. In 1996 I had cancer surgery to remove a tumor in my saliva gland. To just have a stand by surgeon in the hospital in case the primary surgeon had problems cost $5000 and he never scrubbed up.:eek:
Who made that requirement that there be another surgeon on standby? There was already a 2nd doctor there as an anesthesiologist and many technicians already in the room. I assume this was a scheduled surgery, couldn't a standby surgeon also be on standby for other surgeons, if not, why not? What else was the standby being paid to do while he was paid $5,000 to wait around? Did the 2nd doctor really need to be a surgeon or could it have been the ER doc who was already in the building? We let two pilots making a lot less than doctors fly 400+ people around the world in totally unpredictable conditions, does having two docs really make sense?

I know we've got docs on this board, and I don't want to insult them or anyone else, (I sure want to be on their good side when I need care) I just don't understand why costs are so high.

Rod Sheridan
05-22-2009, 11:06 AM
Glenn, the US now has a golden opportunity to learn from the healthcare plans in use in other western countries. You have the opportunity to take the best features from each model, and combine them, or modify them to provide a system that would be the best fit for yourself.

None of the other systems are perfect of course, however as you have factually stated, Americans spend more on healthcare, with worse results than any other western nation.

Good luck on the process............Regards, Rod.

John Schreiber
05-22-2009, 11:08 AM
Scott,
Consider that at a minimum, the entire operating room needs to be sterilized for the next use. Considering that there may be bodily fluids exposed, the cleaning crew needs to wear hazmat equipment that cannot be reused - tyvek jumpsuits, hoods, masks, gloves, etc. The cleaning equipment, towels, mop heads, etc are also onetime use - bodily fluids again. This is the ancillary cost to the AIDS problem. At a guess, a good $10,000 is just in this clean up.
There are other supplies that are placed in an operating room that are there for emergencies, but once exposed, cannot be reused. Then there are the gowns, gloves, caps, eye guards, footies, etc. for people involved in the operation itself. More one-time use items.
The more I think about it, 23,000 actually sounds about right.

My gall bladder removal and bile duct rebuild cost over $250,000 and counting. Just the hospital has billed, the doctors bills are yet to come.

Mike
This directly relates to what Scott was first asking about.

My brother in law had the job of cleaning up after surgeries when he was in high school and college. He was paid a little over minimum wage and he did most of his work in a Tyvek suit. Surgical sterilization is not brain surgery :):eek:. He did most of his work with a (single use) mop and (single use) towels. Somebody else actually dealt with the surgical supplies. The equipment in an OR is designed for easy cleaning and easy sterilization. Surgery is messy, but it's not like you have to clean between the ceiling tiles with a toothbrush after each procedure.

If equipment or supplies are placed in a room and it can't be reused, why not. It can be placed in a sealed container and opened if needed. That's what I've seen when I've been in ORs.

Part of my experience with super high medical costs is like this.

If I buy something at a hardware store, it costs $1.00.
If I buy it at a marine chandlery it costs $10.00.
If I buy it from an aircraft parts supplier it costs $100.00.
I suspect if I buy it from a medical supplier it costs $1,000.00.
Some of that relates to a higher quality better tested product, but there's also a huge amount of charging what the market will bare.

I can't get to $23,000 in a reasonable way for supplies even when counting for overhead, and especially when overhead is counted in other places too.

Curt Harms
05-22-2009, 11:24 AM
Nicely stated Glenn.

As far as an earlier comment that stated that litigation is not a factor, the physicians in my home state say different. About 3 years ago, physicians demonstrated at the state house for litigation reform. That's right, physicians themselves were protesting, not hippies. It was a big event according to local news. Their point was that the legal system could not distinguish between a 'bad outcome' and 'negligence'. Just being sued and winning is a big cost.

In my home state, the hardest hit physicians are neuro-surgeons, orthopedic surgeons and obstetricians. As a result, these disciplines are difficult to retain.

I understand that there is also a trend for physicians to directly work for the hospitals to help shelter themselves from the administrative burdens and high malpractive insurance thus allowing them to focus on medicine.

Litigation certainly seems to have an impact in New Jersey. It may not be the primary cause of the cost issue, but it certainly seems to contribute to the problem.

-Jeff :)

A number of smaller hospitals closed their trauma centers because most of the neurosurgeons were either retiring or moving to less litigious areas and the hospital has to have a neurosurgeon on call to be a trauma center. The ones remaining had to charge a bunch just to cover malpractice insurance. I don't have firsthand knowlege but a widely bandied-about number was about $160,000/year for a neurosurgeon's malpractice insurance. Ob/Gyn has similar problems. Talking about other countries' medical care systems. It'd be interesting to know the ratio of doctors to personal injury-malpractice lawyers in those countries. I suspect some of the apparently outrageous costs cited in previous threads are a result of sucessful suits contending " you, hospital, were negligent because you didn't do ____. Insurance and hospital administrators take note of this outcome and make sure they do ____ so that they too don't get sued, no matter the cost/benefit ratio of that action. Nothin' comes for nothin' so they have to charge for doing ____. Hence $28,000 for supplies.

I don't question the need for a tort system to keep industries and providers honest. I just wonder if it's not tilted too far in favor of "injured" parties and too lucrative. 'course I may be full of it:o.

Pat Germain
05-22-2009, 12:22 PM
When it comes to healthcare and infant mortality rates, the numbers in the US are significantly skewed due to the huge number of immigrants, both legal and otherwise, who come to the country.

For example, Norway probably has some of the most impressive numbers when it comes to health care and infant mortility. But if Norway had tens of thousands of people crossing the border from a third world country every year, their infant mortality rates and other numbers would be close to the US; or worse.

When a pregnant woman runs across the border and shows up in a US ER only minutes from delivery, there's a lot more risk. That woman likely had no prenatal care, took no vitamins, had a poor diet, and lived in perilous conditions. Although she may have been in the US only a matter of hours, if her baby dies, it's a part of US infant mortality rates.

Similarly, when an injured or sick person suddenly shows up in an ER in an advanced state of distress, helping that individiual is going to be very difficult.

It's a sad, tragic situation. But those are the facts. Thus, when you see the numbers related to healthcare in the US, it's really not appropriate to compare them with countries who have almost no new immigrants.

Covering the costs for treating such patients is extremely expensive and must be covered somehow. Hospitals get money from the federal government. But the difference is covered by people who have insurance and can pay. The allowed costs for common procedures are typically negotiated with the government for Medicare and with insurance companies. Thus, simple supplies and medicines have huge markups.

The solutions to these problems get into politics, so I won't go there.

Darius Ferlas
05-22-2009, 12:55 PM
Quite frankly we have the best health care in the world.
Ranked 37 in the World (http://www.photius.com/rankings/healthranks.html) by WHO in 2000.
Other rankings (http://www.nytimes.com/2007/08/12/opinion/12sun1.html) don't place the US health care system as # 1 either. I was even surprised that the US has the highest rate of deaths resulting from malpractice and medical errors.



If you don't think so why does EVERYONE in the world come here to have major surgeries or even minor surgeries.
That's a myth. More and more Americans travel abroad for medical treatments. It's cheaper and the quality is second to none. Most people outside the US simply cannot afford to come to the US to pay for what some get at home for free.


Why does every country in the world send their citizens here to study medicine....we must be doing something right.
The US medical education is surely superb, but Americans got to study medicine abroad too. In fact I know personally at least two American doctors with credentials from Poland. No, they are not Poles, or even descendants of Poles. They went to study there.

American medical schools excell in leading edge research. Your "run of the mill" medicine (heart surgeries, transplants etc) are not rocket science anymore. Not to mention that many leading edge procedures were not even pioneered in the US.



When your son or daughter or family member is sick you can run right in and most of the time see the doctor that same day or the next day. Is that true anywhere else in the world?
In some parts of the world it is actually better.

My daughter got sick during a trip to Paris. We called the doctor. He was in our apartment within 45 minutes. Accompanied by a nurse. He happened to have had the required medication with him. Since we are not French citizens we had to pay FF100 which was about $25 in mid 1990's.

Some of us, unfortunately, loose a finger working with our tools, and as someone wrote, a small pinkie surgery will run you around $3800. Not in France, Germany, UK, Sweden, Norway... well, you get the idea.

It was also sad to see the American seniors on "prescription drugs tours" in Canada. They paid on average 70 to 90% less in Canada then in the US for exactly the same medication, manufactured by the same factory and packaged in the same bottles, boxes etc.

As someone said before, they charge what they can. It's whatever the market will bear.

Again, American medical science is great and certainly leads the world in its many aspects, but medical science is not the same as medical care. The latter in the US is considered a business, while in other countries it is considered as a security issue since the nation's health as important as maintaining defense forces, public roads etc.

glenn bradley
05-22-2009, 3:26 PM
Unfortunately, like any BIG problem, it's not something I could write up on this forum in any easy structure nor could I even pretend to have the knowledge to do so.

No worries. Good info none the less, thanks.

Andy Bardowell
05-22-2009, 4:35 PM
Curious, but understandable, who is there to say no you can’t do that.

At some point in the future, who knows how far away my friends you’ll stop listening to the lobbyists and adopt a universal health care system. I know some will respond back with outrage citing all manner of reasons why you’ll never adopt such a system but you will.

You have to understand that it is not in the best interests of the insurance companies who horde massive premium payments from you and then when you make a claim will seek any opportunity to renege or the hospitals, or the surgeons or anyone on the periphery who try and usually get their gouge in as well so you will always be bombarded by their lobbyists their mouth pieces and congressional strong arm tactics. Americans as we all know have traditionally been very opposed to taxing (from revolutionary times) and any talk at all of adding taxes in any way is by nature abhorrent and so folks you are susceptive to the standard cry of we simply can’t afford it!

Granted our system isn’t perfect, we’ve lost many good surgeons and nurses to you guys but if my dad needs surgery and he’s had a lot I don’t even think about it, costs aren’t even a consideration. The standard rhetoric in the states is “oh the waiting lists!”, “oh the care is sub-standard!”, blah, blah, blah, BS, our doctors are trained to the highest standards of the British system, in fact if an American MD comes here he’d have to re-qualify, and as to waiting lists they exist yes for some things but not to the ridiculous scare tactic extent that the fear mongers would have you believe.

Come on, I’m willing to bet that the majority of Americans would like a system where you wouldn’t have to worry if your child fell ill and had to spend months in hospital, where you don’t have to worry about your parents going bankrupt because of a surgery, their home their savings everything they’ve worked for their whole lives gone!

$75,000, brutal man! I’ll get off my soap box now, that’s my rant for the day.

Andy Bardowell
05-22-2009, 4:41 PM
It's hard to respond to this without getting into issues which will be considered political, so I'll tread carefully.

Everyone doesn't come here to get their medical work done. The USA does not have a monopoly on great doctors. Some wealthy people come from developing countries to the USA to get work done, but they also go to other industrialized countries.

Other countries medical systems have not failed that I know of.

Most medical systems in the world allow you to see a doc on the same day you want to. I can't say no one ever waited six months for an operation, but every story I've heard checked out was not based on a real example.

In the USA our infant mortality rates are higher and lifespan is lower because many people do not have access to preventive care.

And, twice as much comes out of our pockets to pay for it. And, monitoring medical bills and explanations of benefits takes me a couple of hours a month to keep everyone from taking advantage of me or each other.

Moderator - Sorry if this is considered political. Delete the relevant posts if you feel the need.

Just to lighten up a bit don't you mean thread carefully!

Jerome Hanby
05-22-2009, 5:14 PM
Painting all health insurance companies with that brush is certainly ridiculous and in many, if not most cases libelous.As far as your arguments go, if you earn enough to have anything worth losing and don't have health insurance, then maybe it's time for a little Darwinism.

By all means, lets nationalize everything, and give no one any incentive to be exceptional, no reason to do research, no reason to excel. Maybe we can spend more time watching hockey and eating doughnuts. If the British standards of medicine rival the British standards of dentistry, then maybe that's not the best point to try to make.



Curious, but understandable, who is there to say no you canít do that.

At some point in the future, who knows how far away my friends youíll stop listening to the lobbyists and adopt a universal health care system. I know some will respond back with outrage citing all manner of reasons why youíll never adopt such a system but you will.

You have to understand that it is not in the best interests of the insurance companies who horde massive premium payments from you and then when you make a claim will seek any opportunity to renege or the hospitals, or the surgeons or anyone on the periphery who try and usually get their gouge in as well so you will always be bombarded by their lobbyists their mouth pieces and congressional strong arm tactics. Americans as we all know have traditionally been very opposed to taxing (from revolutionary times) and any talk at all of adding taxes in any way is by nature abhorrent and so folks you are susceptive to the standard cry of we simply canít afford it!

Granted our system isnít perfect, weíve lost many good surgeons and nurses to you guys but if my dad needs surgery and heís had a lot I donít even think about it, costs arenít even a consideration. The standard rhetoric in the states is ďoh the waiting lists!Ē, ďoh the care is sub-standard!Ē, blah, blah, blah, BS, our doctors are trained to the highest standards of the British system, in fact if an American MD comes here heíd have to re-qualify, and as to waiting lists they exist yes for some things but not to the ridiculous scare tactic extent that the fear mongers would have you believe.

Come on, Iím willing to bet that the majority of Americans would like a system where you wouldnít have to worry if your child fell ill and had to spend months in hospital, where you donít have to worry about your parents going bankrupt because of a surgery, their home their savings everything theyíve worked for their whole lives gone!

$75,000, brutal man! Iíll get off my soap box now, thatís my rant for the day.

Andy Bardowell
05-22-2009, 6:17 PM
I'm sorry you feel that way Jerome but I understand it is the majority opinion.

Glenn Clabo
05-22-2009, 6:48 PM
Jerome
So...you believe that 46 million people without health insurance haven't evolved? Interesting comment to make about your fellow human being that could simply be too sick...or without work...or with employers that are too cheap.

Stop listening to the spew of falsehoods and know that one of the leaders in new healthcare/medical procedures is ..... Canada. One of the worlds best medical schools...where many doctors and nurses would kill to go to...yup it's Mcgill in....Canada. From insulin...to pasterization...to some of the biggest breakthoughs in Alzheimer’s care. You know that country that some people keep saying has a "socialist system". (Which by the way is also false. They simple insist that everyone has insurance.) How will that "give no one any incentive to be exceptional, no reason to do research, no reason to excel"? Maybe they have proven that trying to make healthcare available to everyone at a reasonable cost is the incentive...not greed?

And by the way...one of the things they perscribe in Sweden after surgery...beer! Now that's healthcare!

Oh ya...the comment about the British dentistry made me think I just heard someone say....ya but your mother wears army boots.

David G Baker
05-22-2009, 6:53 PM
Did anyone watch the Michael Moore documentary on comparing different medical practices in England, Canada and the United States? If what he presented was true we have a long way to go in the USA. Moore does not install in me a tremendous amount of confidence in his style journalism but he did stimulate my imagination.

John Schreiber
05-22-2009, 6:59 PM
. . . By all means, lets nationalize everything, and give no one any incentive to be exceptional, no reason to do research, no reason to excel. . . .
It doesn't have to be all or nothing.

I'm optimistic enough to think that we can take advantage of the fact that we are the last industrialized country to provide universal health care and we can learn from what everyone else has done. We can cut costs overall, but still probably pay more than anyone else does and have the best system in the world.

If my optimism doesn't pan out, at least we can have a better system than we do now. I really hope it gets rid of the hassle of monitoring the bills coming from the hospitals and the explanations of benefits and figuring out what I'm really supposed to pay. To say nothing of how a system serves the weakest among us.

Glenn Clabo
05-22-2009, 9:00 PM
Okay...I'm closing this thread. Let's go back to our regularliy scheduled program.