Health care, The elephant in the room.

[Naomi]

OOPS

[LifeHiscost]

Quote:

The surgeon is paid 75.00 an hour for 8 hours work.

My husband made more painting and didn't need the intensive training a heart transplant surgeon does

I paid the mechanic that fixed our auto that same amount per hour which was half the amount a dealer charges for the same work. We're talking about people who need to make a living and some are more concerned about the patient (or auto as the case may be) than they are for the welfare of the pocket needing to be picked for the trip to the Bahamas this year instead of Europe. What do we expect from a broken world system? And the sad thing is that it's not going to get any better.

" For where your treasure is, there will your heart be also."Luke 12:34 AMP

And besides, here's what money means there.

" “Ho! Every one who thirsts, come to the waters; And you who have no money come, buy and eat. Come, buy wine and milk Without money and without cost."

Isaiah 55:2 NASB

God cares!

[Stan]

I saw one Emergency Room MD, called Casualty Officers, crack open a chest and do internal cardiac massage it what seems like 15 seconds, but it may have been a couple of minutes. just snip snip in the right places then and the heart could be removed, that is far from an 8 hour procedure to remove a heart.

Or perhaps my statement was understood as the $$$ do the transplant to the recipient. From what I understood, it was to remove a heart upon death.

[Bravus]

Except that that calculation was incorrect, based on an incorrect premise. The particular operation takes around 4 hours on average, meaning the surgeon earns about $112 per hour.

By way of comparison, it's possible that this number is the actual salary of the surgeon, whereas the $4500 quoted in the US includes the surgeon's overheads including insurances: the comparison may not be as simple and direct as it looks, as a number of people have noted.

Anecdotal evidence of individual stories aside, though, the statistics show that Canada spends less on healthcare for outcomes that are the same in many cases, worse in some cases and better in some cases.

The litigious society in the US no doubt has much to do with it, and so does the for-profit nature of the system.

It's not what doctors get paid that's the main issue, it's what a whole heap more administrators get paid - and what shareholders get paid.

[Stan]

The removal of a heart, and prepare for transplant takes 4 hours? The payment seems low in that case.

[bonnie]

Troubling scernario, Naomi. Those of us with HSA accounts face the same annual increases. There certainly were/are decent solutions available in the free market, but were not utilized by the liberal left in their imposition of Obamacare. Tort reform and the removal of state boundaries for insurance would have been a long step towards fixing the high cost of health care in America.

G

Interesting

Malpractice a Tiny Percentage of Health Care Costs

One of the principal myths surrounding medical malpractice is its effect on overall health care costs. Medical malpractice is actually a tiny percentage of health care costs, in part because medical malpractice claims are far less frequent than many people believe.

In 2004, the CBO calculated malpractice costs amounted to “less than 2 percent of overall health care spending. Thus, even a reduction of 25 percent to 30 percent in malpractice costs would lower health care costs by only about 0.4 percent to 0.5 percent, and the likely effect on health insurance premiums would be comparably small.” i

Five years later, the CBO revisited the issue of medical negligence costs. This time, they attempted to account for the indirect costs of medical negligence, mainly the idea that doctors order extra tests to avoid liability. Again, the CBO found that tort reform would only save 0.5 percent of all health care costs.ii

Other authorities have also found that the direct costs associated with medical negligence are a tiny fraction of health care costs. According to the National Association of Insurance Commissioners (NAIC), the total amount of money spent defending claims and compensating victims of medical negligence in 2010 was $5.8 billion, or just 0.3 percent of the $2.6 trillion spent on health care in the U.S. that same year.iii

i Limiting Tort Liability for Medical Malpractice, Congressional Budget Office, January 8, 2004; for the purposes of the chart, Personal Health Care Expenditures is taken from the Centers of Medicare and Medicaid Services and is $1.88 trillion (http://www.cms.hhs.gov/NationalHealthExpendData/downloads/tables.pdf - tables 1 & 2), and total spent on medical malpractice insurance is Tillinghast Towers Perrin (2008 Update on U.S. Tort Cost Trends, Tillinghast Towers Perrin, 2008); The CBO has reaffirmed its earlier findings that tort reform does not lower health care costs. In 2008, the agency found that “the effect [of tort limits] would be relatively small— less than 0.5 percent of total health care spending.”- Budget Options Volume 1 Health Care, Congressional Budget Office, December 2008.

ii Bernard Black, Charles Silver, David A. Hyman, and William M. Sage, Stability, Not Crisis: Medical Malpractice Claim Outcomes in Texas, 1988-2002, Journal of Empirical Legal Studies, 2005.

iii Personal Health Care Expenditures taken from the Centers of Medicare and Medicaid Services and is $2.6 Trillion. Total spent on paying and defending medical malpractice claims from National Association of Insurance Commissioners (Profitability By Line By State 2010, National Association of Insurance Commissioners (NAIC), 2011), and is $5.8 Billion. Percentages may not round up due to both rounding and the fact that CMS does not regard medical negligence costs as health care costs.

[Bravus]

That's fascinating stuff, bonnie, thanks for sharing it. Definitely good to put aside myths.

I wonder what *does* lead to the cost disparities, then? Maybe it is just that (a) private means the shareholders need their cut and ( private means many operators, each with their administrators, rather than one?

Only guesses on my part, really.

[bonnie]

That's fascinating stuff, bonnie, thanks for sharing it. Definitely good to put aside myths.

I wonder what *does* lead to the cost disparities, then? Maybe it is just that (a) private means the shareholders need their cut and ( private means many operators, each with their administrators, rather than one?

Only guesses on my part, really.

Part of it I think is are almost immediate availability of services.

My husband is scheduled for cataract surgery in three weeks.He had been previously diagnosed with cataracts Because of issues that could complicate any surgery he needs more than the run of the mill surgeon. We did not need a referral and had an appt within a week with the surgeon of our choice.From there he was scheduled for surgery with the second surgery 2 weeks later.

The following is something I would not care to have to put up with to defray costs

The reality of cataract surgery in Australia: wait 12 – 18 months or pay-up

Thursday, 03 December 2009 12:04

“Thousands of elderly people in Australia must choose between spending months with virtually no vision or coughing up thousands of dollars to foot the bill of cataract surgery in the private system. This is utterly unacceptable” said Charmaine Crowe, CPSA Policy Coordinator.

When I needed knee and hip replacement mine was arranged just as quickly.

No matter how we try to find that free lunch,it just isn't so.

When my cousin had to bring her husband to the states,she was already paying for their government provided care.

Regardless of the quality of care,he would have died because it would have been to late.

She broke it down for me and what she paid for medical care in increased taxes was more than what we paid for private insurance.In addition paying for the very lawyers that would fight her in court if the occasion had come to that.

For her contribution to provided medical care her husband was put on a waiting list.

There will always be a cost for services on demand.

[Stan]

FWIW A lot of the cataract surgery, and laser stuff was from an adventist ophthalmologist in Canada Dr Gimble.

[CoAspen]

Quote:

The litigious society in the US no doubt has much to do with it, and so does the for-profit nature of the system.

Yes and yes.

I have a friend who was a surgeon, leave private practice because of the cost of litigation and the insurance required. I work in a 'for profit' system. It is very profitable!

[Planey]

The reality of cataract surgery in Australia: wait 12 – 18 months or pay-up

Thursday, 03 December 2009 12:04

“Thousands of elderly people in Australia must choose between spending months with virtually no vision or coughing up thousands of dollars to foot the bill of cataract surgery in the private system. This is utterly unacceptable” said Charmaine Crowe, CPSA Policy Coordinator.

This was not my experience at all.

I have had two cataract operations, about 12 months apart (right eye, then left eye)

Did not have to wait 12-18 months, nor did I have to pay thousands of dollars.

Must be a different Australia.

Graeme

[Gerr]

I don't know how the analyst arrived at his figures, but I personally believe that the cost of malpractice suits is understated. The medical decisions of most physicians I knew were influenced by the threat of a malpractice suit. The cost of high tech tests are astronomical. No doctor would ever want to go to court and be asked why such and such a test was not done.

Malpractice Insurance alone makes a big hit.

High Cost States

While Nevada malpractice insurance rates are between middle to high in comparison with all other states, doctors of many types in Nevada--including general internists, pediatricians and general practice doctors--earn a higher average salary than doctors in any other state. In 2009, one of the highest rates of insurance in Nevada is for OB/GYNs, who may pay between $85,000 for malpractice liability insurance per year up to $142,000 per year for a premium plan by a prominent insurance company. Although the average annual salary for such doctors was around $180,000 in 2009, malpractice insurance can still be a huge financial burden.

Florida has some of the highest rates of liability insurance. Moreover, the deviation between low and high averages varies in Florida more widely than in almost any other state. For instance, a doctor in internal medicine in Florida could expect to pay in excess of $56,000 per year for insurance as of 2009, in contrast with Minnesota's $4,000. General surgeons paid in between $90,000 per year and $175,000 per year or more. OB/GYNs once again could expect the highest rates, with liability coverage ranging from $100,000 to $200,000 per year.

Read more: The Average Cost for Medical Malpractice Insurance | eHow.com http://www.ehow.com/about_5514154_average-cost-medical-malpractice-insurance.html#ixzz2RrXIe7bC

ps

And, yes, the profit aspect in medicine is a huge factor. For example, a recent Time magazine article cited a couple spending something like $85,000.00 in 3 days at a cancer clinic in Texas.

[bonnie]

“Thousands of elderly people in Australia must choose between spending months with virtually no vision or coughing up thousands of dollars to foot the bill of cataract surgery in the private system. This is utterly unacceptable” said Charmaine Crowe, CPSA Policy Coordinator.

[bonnie]

I don't know how the analyst arrived at his figures, but I personally believe that the cost of malpractice suits is understated. The medical decisions of most physicians I knew were influenced by the threat of a malpractice suit. The cost of high tech tests are astronomical. No doctor would ever want to go to court and be asked why such and such a test was not done.

Malpractice Insurance alone makes a big hit.

High Cost States

While Nevada malpractice insurance rates are between middle to high in comparison with all other states, doctors of many types in Nevada--including general internists, pediatricians and general practice doctors--earn a higher average salary than doctors in any other state. In 2009, one of the highest rates of insurance in Nevada is for OB/GYNs, who may pay between $85,000 for malpractice liability insurance per year up to $142,000 per year for a premium plan by a prominent insurance company. Although the average annual salary for such doctors was around $180,000 in 2009, malpractice insurance can still be a huge financial burden.

Florida has some of the highest rates of liability insurance. Moreover, the deviation between low and high averages varies in Florida more widely than in almost any other state. For instance, a doctor in internal medicine in Florida could expect to pay in excess of $56,000 per year for insurance as of 2009, in contrast with Minnesota's $4,000. General surgeons paid in between $90,000 per year and $175,000 per year or more. OB/GYNs once again could expect the highest rates, with liability coverage ranging from $100,000 to $200,000 per year.

Read more: The Average Cost for Medical Malpractice Insurance | eHow.com http://www.ehow.com/about_5514154_average-cost-medical-malpractice-insurance.html#ixzz2RrXIe7bC

ps

And, yes, the profit aspect in medicine is a huge factor. For example, a recent Time magazine article cited a couple spending something like $85,000.00 in 3 days at a cancer clinic in Texas.

My husbands very intense testing for three days didn't reach

that amount but was very high. It did save his life.

Insurance rates vary considerably and if we could cross state lines to purchase insurance the cost would go down.The government in it's wisdom has seen fit not to allow that.

My two older brothers pay considerably more than I do because of it.

I provide products to the parents of special needs children.

Several are in that position because of mistakes that should never have happened and did so out of neglect and carelessness by medical personal.

If they would have had to run the risk of paying for the legal fees of the hospital/DR in the event of losing they could not have cared for their children.

Some of the settlements seem outrageous at first glance. The son of one of my clients is now 23. Has needed round the clock care from birth. Their "outrageous settlement" is now exhausted and they are left trying to find a way to keep their son at home. Other countries would not have awarded such a large amount and this young man would have been left to the state(taxpayer)

[phkrause]

Couldn't agree more Gerry. My wife you used to work in the medical field, as a RN, suppervisor, office manager, who had to pay the bills for the doctor she worked for, said the highest cost was for medical malpractice, period.

[Stan]

I have come across MD who retired at 60, just because the expenses were too high..

How sad is it to waste talent and time?

Best money is to sell insurance..

[joeb]

Stan,

You say don't make this about politics, yet the reason for the difference in cost between the US and Canadian examples and is the political philosophies of the two countries. Canada has socialistic medicine and the US is only starting down that road thanks to Obama.

My question is, how on earth can these difference in apparent cost to the individual be discussed while ignoring the reasons for the apparent differences?

[bonnie]

Couldn't agree more Gerry. My wife you used to work in the medical field, as a RN, suppervisor, office manager, who had to pay the bills for the doctor she worked for, said the highest cost was for medical malpractice, period.

” Finally, on average, doctors spend less on malpractice insurance – just 3.2 percent of their revenue – than they do on rent.

http://www.medmalfacts.com/facts-and-myths/

The report, State Trends in Premiums and Deductibles, 2003–2011: Eroding Protection and Rising Costs Underscore Need for Action, finds that total health insurance premiums now amount to 20 percent or more of annual median family incomes in 35 states, affecting 80 percent of the U.S. working-age population. States in the South and South-Central U.S. had the highest costs relative to household income—in West Virginia, New Mexico, South Carolina, and Texas, average total health insurance premiums amounted to more than 25 percent of median incomes.

http://www.commonwealthfund.org/News/News-Releases/2012/Dec/Employer-Health-Insurance-Premiums.aspx