So why is everyone ignoring the out of control prices physicians, hospitals, and pharmacists charge?

[nikibatts]

Why are people and Congress afraid to hold the medical profession more accountable for the ever-profit-seeking medical profession. The links between the medical profession and pharmaceutical companies, the investment and ties to the medical device companies, the links to Wall Street, and the conflict of interest investments by thousands in the medical profession are prime for investigation and exposure. No one is dealing with the real problems of our medical system but focusing on how bad the government is for wanting to give medical care to poor people.

[nikibatts]

1. Remember, the biomedical research that results in new drugs, new medical devices, and

new medical treatments is all paid for largely from your tax dollars. Then you pay again by unreasonable medical treatment and service costs.

The military industrial complex has nothing on the organized, privatized medical profession.

[Sunlei]

2. everyone complains about the Corporations price gouging profits. Worse Congress in History thanks

to Republicans, the Corporations are 'legally people', bestest friends forever.

[Demsrule86]

3. A separate issue which can be discussed later...now our job is to save

the ACA and millions of lives.

[Boxerfan]

4. Hello-I am a 2000lb maggot leach monster-The insurance industry

Thou art barking upeth the wrong willow sir...

[Initech]

5. I would also bet the marketing and advertising industry has something to do with the high costs.

I wonder how much cheaper shit would be if companies didn't have to advertise their product 24/7?

[mythology]

22. Pharma companies spend a relatively small percentage on consumer ads

They spend far more on advertising to doctors directly.

And even with that Pfizer turned a mere 42% profit in 2013 for example.

[CountAllVotes]

33. Recently I was invited to a fancy dinner

Sponsor was BIOGEN, the maker of a drug that costs upwards of $15K a month.

I was at a meeting and not a person in attendance, myself included, cared to go to this fancy B.S. "dinner".

I'd have taken a check for the $100/plate though!

Gross isn't it? indeed!!

[Kimchijeon]

63. Yes, indeed.

[demmiblue]

6. This argument, blaming doctors, sounds very familiar. Very familiar, indeed.

[nikibatts]

18. Blame. You mean they share no responsibility? Why refuse to treat people on Medicaid or Medicare?

They get paid. They just don't get gouge people.

[BCBacon]

57. You do understand how prices are determined right?

Supply vs demand... If prices are going up, it can only be because demand is increasing relative to supply, or supply is decreasing relative to demand. People don't just "set" prices. If they did, your doctor would be charging you a million dollars a visit.

[dixiegrrrrl]

7. EXACTLY!!!!

Good on you..hardly anyone is talking about that.

Mr. Dixie had a molar pulled.
A dead molar, it had had a crown but then the tooth broke.
$175.00.

5 minutes in the chair.
$35.00 a minute
$2,1000 an hour.
In our teeny town..which, unfortunately has little competition for dentists.



We could keep Medicare and Soc. Sec. for decades if health care was openly and competitvely priced, and price fixing was monitored.

Never see a protest sign about that, eh?

[easttexaslefty]

11. This

[Paka]

24. I had a similar situation with my back molar.

Here in Thailand, I paid 500 baht (~$15.00) to get it pulled.

[metalbot]

55. Once in Bangkok I had some chest pains

Walked into Bumrungrad, asked to see a cardiologist. Was in front of one in 10 minutes, who drew blood, said I wasn't having a heart attack, and suggested a stress test. Ten minutes later, I get a stress test done, review results with doctor, then an ultrasound of the heart. Total time, about 2 hours. Total cost? $168

This was about 10 years ago, so it's probably gone up a bit, but I'd expect it would still be very affordable.

[discntnt_irny_srcsm]

8. Buried in the what providers charge is...

...the cost they pay for malpractice insurance. Add the doc's time and more to pay his office staff who work justifying to the med insurance co why they should pay for a treatment. Med insurance takes those costs adds some costs of their own plus a REASONABLE PROFIT.

I remember 25 years ago. I went to a doc's office on the corner a block away. There were 2 docs and 1 woman as office staff. They would give you a detailed receipt, as detailed as you needed but they didn't deal with insurance. You went to your company's HR, benefits or personnel office to get the forms. You filled them out yourself. You mailed them and got a check back in 3-4 weeks. Office visits at that guy were $22 - $40. That's not the copay, that's whole bill.

Progress isn't a plus.

[ismnotwasm]

12. You should check out ZDoggMD

And his health care 3.0 philosophy. The guy makes a lot of funny videos, but he's devoted to the concept of an evolving way of delivering healthcare, that is patient based, provider friendly and cost-effective.

[discntnt_irny_srcsm]

14. Bookmarking

Thanks

[taught_me_patience]

30. My wife's malpractice is 7k/yr

Which is approx 1% of fee for service revenue. A minor cost.

[discntnt_irny_srcsm]

40. My younger daughter's obstetrician's was $6k...

...per month in 1989. Single practice, just him; the bill for care and delivery was $3000. Our part was 20%.

[tosh]

9. Please don't

conflate PHARMACISTS with pharmaceutical companies.

[WillowTree]

38. Thank you! Most pharmacists aren't getting anything like rich.

[progressoid]

10. Physicians? Not so much.

[Nictuku]

13. I've been wondering that for years.

[yeoman6987]

17. They up the amount to get the pathetic amount the government reimburses

Nobody pays the sticker price. Who cares what they charge? Doctors don't get near that from refunds. Plus would you like to wait months for payments on jobs you did today?

[nikibatts]

20. It is not a pathetic amount that the government reimburses. Their price is just too damn high in a

lot of instances. I worked with and for two GPs who were able to treat lower income people with great quality care at much lower prices than other physicians in the same neighborhood. They made very healthy livelihoods without gouging sick poor people.

[Kingofalldems]

39. I have seen what yeoman6987 stated on a couple right wing sites.

The ultra right Heritage Foundation is one.

http://www.heritage.org/health-care-reform/report/obamacare-impact-doctors

[Eliot Rosewater]

27. So you are a physician.

[Kingofalldems]

37. Hmmm. Got a link on that, yeoman6987?

[LanternWaste]

54. I'm not surprised you're unable to see more than two, extreme possibilities.

I'm not surprised you're unable to see more than two, extreme possibilities. Your bias appears to demand you discount the practical middle, and is most consistent in its narrative.

[truebluegreen]

60. "Nobody pays the sticker price."

Nobody except the uninsured. Well, they don't pay either, they just go bankrupt so technically you are right.

[coco22]

15. Because they are on the payroll too..

they know they invest in these companies and they know where the money is but, we are penalized for the least little things..

[CousinIT]

16. CONgress gets BIG BUCKS from Big Pharma, Big Insurance, Physician Lobby

That's why. They're dancing for the ones who bought 'em.

[ileus]

19. We need to demand total governmental control over the medical industry.

We need to set hospital, clinic, and dr office staffing numbers and salary levels for all medical positions. Next we take over every medical device manufacture and set their pay scale, and product pricing.

[hughee99]

21. Yes. When we tell everyone in the profession what they'll make, where they'll work, and how much

they'll charge, and then tell all of their suppliers the same thing, we'll have a first class medical system in no time.

Kids who want an obscenely expensive education that they'll never be able to pay off will flock to the medical field.

[Motownman78]

29. Than do what the Merchant Marine Academy did

Make 60K a year fresh out of college (paid for by the government btw), but you have to serve 4 to six years.

[taught_me_patience]

31. Too bad that's completely unamerican

you know... the forcing people into labor in order to pursue their profession...

[Motownman78]

34. I know right

But the American system has failed. Something better needs to be done.

[TheFrenchRazor]

42. isn't that the way the military works? serious question. health care is a national security issue.

in my opinion.

[SaschaHM]

36. Not to mention the fact that Democrats/Liberals won't always control the government.

I bet Trump and the Republicans would love to mold the healthcare industry in their image.

[hughee99]

41. Yes, always something to consider when talking

About giving the government this kind of authority.

[SidDithers]

23. Welcome to DU...

Sid

[Sgent]

25. Insurance companies do negotiate

the fees for providers (in most cases), so there is a cap on what they can charge if they accept insurance.

That said, providers in the US have to pay 200k+ for medical school and loans, plus whatever undergrad, malpractice that can range from 10-150k (or more), licensing costs and CE that probably cost ~5k / yr. All that and they have (for a GP) 7 years less of a working life than a college grad.

[Eliot Rosewater]

28. Resolve all of that with universal healthcare and little to no

school costs if higher education is tuition free.

But then the physicians will have to agree to accept what we pay them, in the cases of some specialists it will be less, in the case of GP it might be more.

Then of course, since we were not born yesterday, ALL hospitals are non profit, like VA. You can have for profit ones for rich people who want private rooms.

Malpractice insurance at this point could be regulated more than it is now making it less costly, but NOT until we have single payer.

[JudyM]

43. Malpractice insurance is an enormous cash cow for the insurance industries. They charge far, far

more than they need to cover a reasonable margin. And they lie about it, both about their profit margin/"need" and the rationale, pushing the blame onto lawyers. It's a huge load of BS.

[Sgent]

46. In my former state the major

insurer is a mutual company owned by doctors. OB/GYN's were paying 300,000k for 1m of coverage, and that was on a claims made (not the better occurrence) basis.

Most of them got out of OB except private pay patients, and sent / saw all their Medicaid / Medicare patients to the local community health center which is protected by the federal tort claims act.

[politicaljunkie41910]

26. Probably because most people don't pay the trumped up charges on their hospital bills.

Although built into most people's hospital bills at a regular hospital is a cost for the uninsured who utilize emergency services and don't pay their bills. I belong to Kaiser Permanente (a Health Maintenance Organization- HMO). I pay a small co-pay for doctor visits and office visits. My community has no Kaiser Hospital in our area in the event of an emergency. But we have private hospitals in our area. I have had three emergencies in the past two years. Two due to Atrial Fibrillation, caused by my heart beating out of control. (The second trip turned out to be due to an anxiety attack brought on from a caffeine rush, (a false alarm) and I panicked due to my being home alone and the closeness in time since my first diagnosis of A-Fib. Turned out that I had just celebrated my Cardiologist visit giving me the all clear the day before and decided to celebrate with my first hot cup of black coffee since my original episode of A-Fib, since no one said I couldn't when I was discharged. Turns out that caffeine overstimulated my heart since I hadn't had any since before my A-Fib episode). Hey when you have a heart problem, they tell you, when in doubt call 911.

Kaiser has contracts with our local hospitals to treat their patients in the event of an emergency, and those costs are pre-negotiated. Kaiser paid all my out-of-area-network bills except for my $50 copay for a hospital admittance. The amount that they paid amounted to just about 45% of the actual amount billed. Kaiser paid 100% of my ambulance bill which was $1600 for an approximately 10 mile. Our city contracts for ambulance services, so I guess Kaiser cannot negotiate those costs down any further.

I also took a two year assignment in Northern Virginia (NoVA) with the Federal Government and there were no Kaiser Hospitals. (My home is in Southern California.) NoVA had Kaiser medical facilities that provide medical services during the week during normal business hours but no emergency or urgent care after hours and on weekends. One Sunday I awoke with a bladder or kidney infection and was experiencing pain. I also was going out of town with my job that week so I needed to know what was wrong. I called the phone number on the back of my Kaiser for out of the area services and the lady who answered asked me for my current location, and within minutes told me what hospitals were available in my area that were part of their out-of-area-network services. Turns out all of the area hospitals were part of their network so I could take my choice, so I just went to the closest one, which happened to be a very nice hospital. I have belonged to Kaiser Permanente my entire life, except for the 5 years I spent in the military. I would recommend them to anyone. I never have to worry about being able to obtain medical services anywhere in the US and I know that no matter how bad the shape I'm in, I'll never have to worry about a hospital bill bankrupting me.

[taught_me_patience]

32. Exactly... many providers charge 10x what insurance pays for a procedure

That's the benefit of having insurance even if you have high deductables... you're not stuck with the insane "retail" prices the providers charge.

[TheDebbieDee]

35. SINGLE-PAYER would solve those problems...

But doctors, medical supply and pharmaceutical prices and fees would have to be regulated/price controlled AND THEY DON'T WANT THAT!

[mitch96]

44. Because we let them...

If we all had the balls to elect real politicians that would fight for us, this would not be an issue.
AND we don't have the best medical care in the world but have the most expensive health care.
Greed and profit motivation are at the center of it all.. This is from what I saw after working in hospitals for over 40 years...
Don't get me started...
m

[Docreed2003]

45. It always makes me a little irate when the discussions of physicians salary comes up...

At the end of the day, the number of physicians trying to milk the system to maximize their profits pales in comparison to those of us who want nothing more than to provide quality care for our patients. The topic of physicians salaries should not be equated to "physicians are gouging the system and making too much money." Reimbursement rates vary greatly for region to region and even state to state. When I lived in RI, I was "reimbursed" significantly less for major operations than physicians just across the border in MA. Those rates are set by the government, not physicians.

I spent the majority of my 20's training to do my job. I entered medical school at 21 and finished training at 30. From the time I started residency until I finished five years later, I worked 80-100 hrs or more a week, just to gain the experience needed for my craft. Today, work hours are more restricted in residency and while this is a benefit in many ways, residents are graduating with less experience and less confidence in their craft, thus many are seeking even further specialty training just to gain comfort in their field. Eventually, training is going to be longer in order to continue putting out well trained physicians.

In rural areas, hospitals are forced to pay their providers much higher than market value just to recruit and retain physicians.

Primary care physicians are often forced to work longer hours for less pay and they are on the front lines of our field, caring for the most patients

Regulations and requirements like electronic medical records have been a huge financial burden to most practices and to older physicians, many who aren't tech savvy are forced to hire "scribes" to do their electronic paperwork and records upkeep.

Medical malpractice is outrageous, especially for those of us in specialty surgical fields, but it's part of the price of doing business.

Yes, the pharmaceutical industry is out of control. Yes, the medical equipment and device companies are out of control. But we need both for further advances in the field of medicine!

Finally, as I said at the outset, I understand and agree that a small minority of doctors do misue the system to attempt to maximize their personal profits, but that's not the majority. We're just doing our best to care for our patients in the best way that we can.

[ismnotwasm]

47. Thank you

I work at a teaching hospital as an RN and most providers work their asses off, so the point of not seeing their families. To the point of NOT recommending youth to go into medicine. People are not understanding bundling reimbursement for procedures and surgeries--they are not understanding coding and costs, or how hospitals eat costs and operate at a loss.There is a coming provider shortage--although that anticipated the successes of the ACA, if there are less insured, perhaps there will actually be enough providers To go around. That is NOT the case with any successful universal healthcare program. We simply wouldn't have enough of anyone in the medical field.

These kinds of attitudes are not helping.

[nikibatts]

49. Then please do some research on the number of physicians invested in Pharmaceutical companies and

medical device companies. Learn about licensing and patents in the medical profession. Certainly not ALL physicians are involved in this but the ones who are set the parameters for the rest of them.

Truth hurts.

[jrthin]

56. The AMA lobbied hard

To prevent universal health care. Further, why do they have a cap of the number of doctors for medical school? Fewer doctors higher charges.

[ismnotwasm]

59. Oh for Gods sake

Let's put it this way. They're not all out to "get" you you. Nobody is saying there aren't shitty or unethical Docs. Ask YOURSELF this--Why are more and more providers specializing and not getting into primary care? Why are there more and more providers saying they if they had it to do over again, they'd pick a different career? Why are NPs stepping up into PCP roles more and more? Have they "sold out" as well?

Yes Investing in pharmaceutical companies is a thing, and so is giving underserved free samples or what basically amounts to free care to those populations

'Parameters" what the hell are you even talking about? Truth hurts--what the fuck is that supposed mean?

Let's me guess--you love naturopathic medicine.

[nikibatts]

61. Let me guess. You are a highly invested physician or family member of one?

[ismnotwasm]

62. Fuck no

I'm a RN in a hospital that takes in more than its share of underserved and uninsured human beings.

[Tom the Mechanic]

48. Prices are high because the law is written that way,on purpose

Jan 11, 2017
115th Congress, 1st Session,

Amendment #178

Would have allowed cheaper drugs from Canada.

Supported by Bernie Sanders.

Rejected.

All but one Republicans voted against it, as well as these Democrats.

CO - Michael Bennett
DE - Tom Carper
DE - Chris Coons
IN - Joe Donnelly
MT - Jon Tester
ND - Heidi Heitkamp
NJ - Cory Booker
NJ - Bob Menendez
NM - Martin Heinrich
PA - Bob Casey
VA - Mark Warner
WA - Maria Cantwell
WA - Patty Murray

The only thing stronger than corporate money is votes.
It will not change until we teach Dems to vote in the PRIMARIES.

[mitch96]

50. Thank you

Yes, doctors work their asses off and get paid well for it.. Down here in South Florida the lure of easy money is very tempting and rampant.. I've seen young doctors start off with good intentions and then, after being beaten up by the system just go after the money. " if I'm gonna get sued I might as well make a ton of money to pay for it".. More doctors and tort reform.
Supply and demand. More doctors would relieve the "shortage" and associated high cost.
When the affordable care act was being banged about the author T.R.Reid went around the world investigating health care in other countries. He used him self with a old shoulder injury. Many different remedies from expensive shoulder replacement in US to manipulation in India.. Very eye opening on how people use the system and how the system uses them..
https://www.amazon.com/Healing-America-Global-Better-Cheaper/dp/0143118218

m

[ecstatic]

51. Exactly. One night in the hospital would clear out many HSA accounts.

The problem is, I think most legislators, as well as most of the press corps, have never experienced life without insurance or even life on the individual insurance market. They have no need to look at bills to even see what's going on.

[JNelson6563]

52. Not to mention closer to home.

Take a look around. At least here in my burg...all the docs are RICH. Many others who work in med field in any way here make way more than most. It's a goldmine.

Sickening.

Edited to add: A medical staffing co that is located here schedules emergency docs. If they need to fill a hole in the schedule they can entice the doctor to give up their day off with up to $700 an hour.

[jrthin]

53. I agree. The night of the Russian Selection

My husband's friend, a doctor, texted him saying that this is a good day for doctors. A majority of doctors voted for this turd. For some doctors a half-million dollar boat isn't enough. One summer home isn't enough.

[ghostsinthemachine]

58. I have cancer

As we speak. A lot of tests, scopes, scans, feeding tube placement, port placement and care, chemo and radiation. etc.

Literally millions of dollars worth of doctoring. Oncologists (2), surgeons, GIs, etc. 2 appts everyday since January 1st. End of five weeks chemo and radiation. Then eight weeks rest, then a esophoectomy, then 4 more weeks of chemo. Millions spent.

The staff, all of them are superb. Patient care. In the hospital the staff the nurses and the technology is outstanding. In ICU, a full time highly trained nurse watches you... And the millions of dollars with of machinery keeping you alive and comfortable. At the doctor's, cancer center, there are a lot of staff to see you get the best care. The doctors are exceptional. All of these people need to be well paid. My surgeon? Cal, Harvard, U of Michigan education, with residency at Mass General. This guy should be rich. His staff are amazing, from reception to therapy post and pre surgery.....Everyone involved should be well paid, with great benefits, retirements etc.

Behind every doctor are ten people, mostly working for the doctor (or the corporation they own), all with specialty degrees and certifications. The machinery is so expensive too. Etc?
One thing though about the system. It is morabund with paper. Why can't all my records, labs, scans, results, diagnosis, medications, doctors etc, all be on a flash drive, So I, and the doctors can access this without filling out the same forms over and over, answering the same questions, not receiving results timely, lost reports, labs etc? Here it is, everything you need to know.

Another thing. I am very thankful that I am poor! This will cost me nothing. I know a lot of people that have lost everything or were burdened with huge costs related to their cancers, illnesses. Great insurance but still hundreds of thousands of dollars in bills.

[Kimchijeon]

64. Look at countries with single payer. The prices are negotiated with the govt, and are

reasonable. The real, main reason for the price bloat is simply the insurance industry run amok.

Just cut to the chase, the root of the problem, it's really the for-profit insurance industry. They're the ones fucking us over.