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mike m
Trad climber
black hills
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Dec 13, 2011 - 06:22pm PT
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Everryone says it is too expensive but nobody wants to get around to saying who is going to get paid less.
Who is it:
Doctors
Nurses
Medical Corporations
Insurance Companies
Hospitals
Nobody seems able to tell the above they are going to get less even though a good chunck of the rest of the country has had to deal with less.
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climbski2
Mountain climber
Anchorage AK, Reno NV
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Dec 13, 2011 - 06:52pm PT
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Large corporate conglomerate hospitals.
Private insurance should die for all the people they killed.
Big pharma companies.
Lawyers.
After the dust settles from that lets see what needs adjustment.
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Brandon-
climber
The Granite State.
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Dec 13, 2011 - 07:24pm PT
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I sure wish I could afford health insurance.
I got sepsis in Costa Rica and almost died. I went to the hospital in Palmar and was treated. Life saved. Bill, $20.
I cut my finger and needed five stitches here in NH. They stitched me up. Bill, $1400.
I'm priced out of health insurance and hate it.
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tolman_paul
Trad climber
Anchorage, AK
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Dec 13, 2011 - 07:31pm PT
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It's gotten crazy expensive. A friend who's had his own construction company for years and can't afford health insurance flew to Costa Rica to have shoulder surgery. Airfre, hotel, surgery et al was ~1/4 the cost of having it done locally.
I'm all for having great doctors and top healthcare, but somehow the costs have gotten out of wack. My doc ordered up some extra bloodwork last time I had my physical, $1000 just for bloodwork??
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ms55401
Trad climber
minneapolis, mn
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Dec 13, 2011 - 08:00pm PT
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health costs in this country are insane. There's no way it costs $300 for a nurse to take stitches (actually staples, which are far cheaper and easier to remove than stitches) from my head, but that's what I got billed for. Five minutes of staple-removing.
I'm lucky to be insured, but I still had to fork over $100 for that bullsh#t.
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TWP
Trad climber
Mancos, CO
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Dec 13, 2011 - 08:01pm PT
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From personal experience I have resolved that my "health insurance" will be a plane ticket to Thailand or India if I need serious medical attention.
In a small provincial town of 15,000 in Thailand (Pak Chong) my wife developed a serious urinary tract infection in 2007. High fever, delirium. Her previously diagnosed urinary tract infection recurred, though supposed treated and cured in the US prior to our departure.
We went to the local hospital, accompanied by a sympathetic Thai "Good Samaritan" (a Buddhist of course) who could translate for us.
Within 15 minutes after arrival at midnight at the emergency room, ALL the following had occurred:
1. We were admitted to the hospital;
2. Wife saw two primary care physicians who;
3. Correctly diagnosed her condition and;
4. Began administration of IV fluids and an appropriate prescription drugs;
5. Wife was resting in her own bed in the hospital.
Wife spent 36 hours in the hospital until discharge.
Prior to admission and during the 36 hours she stayed in the hospital, we were never asked a single question on these subject (or to show a sign crap of paper);
1. our identity, nationality or immigration status in the country;
2. existence of insurance coverage;
3. our ability to pay for services.
Likewise, we were not asked to pay anything until her discharge.
At discharge, I received a simple and completely comprehensible bill covering ALL the following:
1. Emergency room admission;
2. Hospital admission;
3. Hospital room charges;
4. All doctor fees;
5. All diagnostic tests;
6. All drugs given;
7. AND a supply for the next week of prescription medication.
Total bill = LESS THAN $US 300.
Did I mention we don't speak Thai and no one (even the doctors) spoke English?
On discharge, I told staff I would take my wife to a hotel using a taxi so we didn't need to use the ambulance they offered. They then indicated the ambulance would take us to our hotel FOR FREE.
Is anyone intrigued by this tale?
If so, I'll continue with the rest of the story concerning followup care at two different hospitals over the next three weeks as we both traveled the countryside and my wife enjoyed a complete recovery. It continues in the same vein, but with other amazing demonstrations of the absurdities of modern medical care.
P.S. Fat Trad. You lackey running dog for all things conservation-red-neck and all-American, what do you think of this tale? My guess? You'll call me a liar.
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Gimp
Trad climber
Grand Junction
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Dec 13, 2011 - 08:02pm PT
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Been to Chile, great country and great skiing.
Would recommend reading "Lawyer Barons: What their contingency fees really cost America". Explains a lot of our excessive costs.
Very difficult read but packed with information everyone should be exposed to.
Steve
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Brandon-
climber
The Granite State.
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Dec 13, 2011 - 08:06pm PT
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I'll listen to the rest of that story TWP.
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bluering
Trad climber
Santa Clara, CA
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Dec 13, 2011 - 08:24pm PT
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You people are crazy.
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Paul Martzen
Trad climber
Fresno
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Dec 13, 2011 - 09:10pm PT
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According to the Consumer reports link above the major increase in prices has been from doctors and hospitals. If their profits were not extremely high then there would be no economic incentive to sue them. There would be no point in suing them if you couldn't get a lot of money out of them. According the the CU link, liability costs add about 2% to the total costs.
On the other hand if we are willing to keep paying doctors and hospitals more and more, then they would be crazy to not demand more and more.
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Ezra Ellis
Trad climber
WA, & NC & Idaho
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Dec 13, 2011 - 09:33pm PT
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From inside the system I can say this.
1. The prices are stupid.
2. Many of my classmates graduated with $300,000.00 in debt, and were living like paupers.
3. A basic health care system run by the Gov, kinda like an expanded medicare would probably be superior to what we have, in terms of resource utilization.
4. Even meidcare is insane on alot of stuff.
5. The medicare drug benifit passed by the repubs, was a waste of money, time and was actually written by the pharmaceutical companies lobyists. total cost of medicare part D (drug benifit)= 789 billion
6. Litigation fears add many hidden costs, such as unnecessary CT scans at $1,000 a pop, way more then 2%.
7. Even a nurse here makes $55-60K a year, which is double what a doc makes in the third world.
8. Canadian docs can make $300,000 a year, I know one who does.
I certainly don't have all the answers, but those are some insight from my perspective.
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Chaz
Trad climber
greater Boss Angeles area
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Dec 13, 2011 - 09:37pm PT
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If it's free, there'll be a line.
A long line.
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Fritz
Trad climber
Choss Creek, ID
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Dec 13, 2011 - 09:43pm PT
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Ezra! Thanks for your insider information!
I’ll agree that the U.S. has great health care: for those that can afford it.
I had two Basal-Cell skin cancers removed in Nov. & Dec. in an “outpatient procedure,” plus biopsies on 4 “possible cancers.”
The care was great and everything is good.
Let’s get it straight! This is damn-near cosmetic surgery: since Basel-cell cancers kill slowly, and statistically, only a tiny fraction of those afflicted die from the cancer.
I have Blue-Cross “high-deductable” health insurance.
I’m in about $3,500.00 and Blue Cross is finally kicking in.
What do you think it would cost for “out-patient” surgery in Chile? $500.00?? or less??
Only a fool (or a conservative-tool) would assert that medical instruments are not sterilized, and the quality of care for out-patient procedures is lower: in the rest of the world.
Anyone defending our current health-care system is a: health-insurance shill, conservative-tool, or is smoking way too much dope-----or all three.
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Chaz
Trad climber
greater Boss Angeles area
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Dec 13, 2011 - 09:47pm PT
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Everything Made In America is more expensive than the same thing done in a foriegn country. That's why we import so much sh#t, because it's cheaper - and worth the trouble - to do the work overseas.
I don't know why medical work would be any different.
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micronut
Trad climber
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Dec 13, 2011 - 09:50pm PT
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Jim,
Glad to hear your tooth is feelin better for now. I have some pretty strong and fairly substantiated opinions on medicine and dentistry in the US and other countries. ive traveled and lectured and practiced in many countries. Be careful down there getting anything done by a dentist. I fix stuff often done by "awesome state of the art" dentists and oral sugeons in Chile, Brazil, Argentina and Mexico. lots of folks get really messed up down there trying to save money and they dont know it for a while. There are some good doctors down there, but honestly, the training is often way sub par. If you have any questions, I mean it, email me and shoot me an xray. I'd be glad to be a resource.
Climb hard and enjoy the trip.
Scott
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micronut
Trad climber
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Dec 13, 2011 - 10:06pm PT
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I'm not sure what the above comment means, but the Democratic party doesnt seem to really know what the answer to Donini's post is, so its not real wise in my opinion to try and blame this on the Republicans. if you think you'll like socialized medicine, wait for Obamacare to kick in, then get reeeeeaaal sick. You may change your mind.
I know the system isnt perfect, there has to be a better way to take care of more people more efficiently. But I am glad I practice here so I can afford quality care in the ethic I believe to be best for my community and my patients. Its nasty when government or ins companies start telling doctors how to practice.
If you like the Democrat style obamacare idea. Picture going to the DMV.....but you are sitting there with a brain bleed or a kidney stone. Just a thought....
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TWP
Trad climber
Mancos, CO
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Dec 13, 2011 - 10:30pm PT
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Continuing from my prior post, here's the rest of the story.
Wife and I continued our travels in Thailand so by the time we needed to repeat the urine test to determine if the infection was beaten, we were 400 kilometers from Pak Chong. Now we were in a well-known city in northern Thailand: Chiang Mai.
So, we showed up about 1 PM at the Chiang Mai Hospital nearest to the inner city. The first floor of the hospital consisted of one very large reception room with various departments of the hospital around the perimeter. We walked up to the Information desk (signed in English) and said, "We want a urine test" and were pointed to the "Laboratory" department, with obvious sign and located adjacent the large "reception" area. We walked up to the Laboratory and made our request; wife received the sample container and went to the bathroom and returned the sample. We were told the test result would be available in one hour and cost $US 3.
In one hour, a diagnostician handed us the test results (in English) which showed wife still had the infection. The diagnostician told us the result and recommended she see a doctor. She pointed out the sign for the department where we could see an internist.
Stating our request to see a doctor at this department, we waited ten minutes and saw the internist, a real-life M.D. He recommended a change in the prescription with another followup urine test in another week, but next time with a specific test of the sensitivy of any remaining infection to a range of pharmaceuticals. Cost of the doctor visit: $US 6. We took the prescription to the "Pharmacy" - yet another department one could visit from the hospital's reception area. We waited ten minutes, paid $20, and left with another course of antibiotics.
We continued our travels and next checked out the hospital in Chiang Rai, a small city in extreme northern Thailand.
Same routine. Show up; take to information; state your need (another urine test, but this time with drug sensitivity screening). We got the test results within 1.5 hours of arrival (still some infection present) and saw another doctor. Using the sensitivity screening, the best antibiotic was chosen for the next round. Costs were the same as before.
The third urine test yielded a clean bill of health.
The prescription antibiotics we were given in Thailand were "state of the art" - to wit: identical to those a physician in the U.S. would have prescribed. The standard of care was identical/equal to the U.S. standard of care.
So why was the cost less than 10%?
The answer is not "lawyers," "lawsuits" or the other conservative drivel. In fact, the answer(s) is/are multiple and complex. But they start with our insane aversion to "socialized medicine." In fact, the best served U.S. population in terms of health care are, you guessed it, Congressman and the military. The Veterans Administration, Fat Trad, is providing "socialized" medicine to our military - and doing a good job. Why shouldn't the taxpayer be given access to health care "as good as" the servicemen we employ to maintain our Empire? Like to hear a straight answer to that one from the GOP. (This is a slight exaggeration of my position. I don't recommend all Americans get care as good as our servicemen. I do advocate ALL Americans (taxpayers and servicemen alike) be given access to the SAME LEVEL of medical care — at whatever level we as a society decide we can afford for EVERYONE. And if the 1% considers that level of care inadequate for their preciousness, THEN they can pay out of their pocket for whatever the "boutique care" they desire.
The above-recommendation is not OBAMACARE. That effort was a political compromise that produced a Frankenstein.
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rottingjohnny
Sport climber
mammoth lakes ca
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Dec 13, 2011 - 10:46pm PT
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MS55401...try charging a doctor $300.00 for 5 minutes work and he will scream bloody murder...How many doctors do you know that still think they are poor college students living off of mom and dad but are making $700.00 an hour...? RJ
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Fritz
Trad climber
Choss Creek, ID
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Dec 13, 2011 - 11:05pm PT
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Chaz: Re your post up-thread:
Everything Made In America is more expensive than the same thing done in a foriegn country. That's why we import so much sh#t, because it's cheaper - and worth the trouble - to do the work overseas.
I don't know why medical work would be any different.
Santiago Chile is very similar to an European City. Per this chart of cost of living: their cost of living is not that much below Los Angeles.
Look at the costs of healthcare in the USA. It is way high compared with other “First World” countries: that have made healthcare a governmental program.
No problems. You can still pay a premium for your “private healthcare.”
http://www.numbeo.com/cost-of-living/city_result.jsp?country=United+States&city=Los+Angeles%2C+CA
Do you live in Santiago? We need your help: Update information for Santiago, Chile!
Restaurants [Edit] Avg. Range
Meal, Inexpensive Restaurant 9.23 $ 7.00
12.00
Meal for 2, Mid-range Restaurant, Three-course 41.03 $ 23.69
60.00
Combo Meal at McDonalds or Similar 6.42 $ 6.00
7.40
Domestic Beer (0.5 liter draught) 2.29 $ 1.50
3.00
Imported Beer (0.33 liter bottle) 3.19 $ 1.50
4.00
Cappuccino (regular) 2.26 $ 1.50
3.40
Coke/Pepsi (0.33 liter bottle) 1.18 $ 1.00
2.00
Water (0.33 liter bottle) 0.98 $ 0.74
1.20
Markets [Edit] Avg.
Milk (regular), 1 liter 1.27 $ 1.07
1.50
Loaf of Fresh White Bread (500g) 1.11 $ 0.88
1.44
Eggs (12) 2.32 $ 1.50
3.00
Fresh Cheese (1kg) 10.02 $ 8.00
15.80
Chicken Breasts (Boneless, Skinless), (1kg) 6.89 $ 4.00
8.16
Apples (1kg) 1.11 $ 1.00
1.30
Oranges (1kg) 0.96 $ 0.80
1.06
Potato (1kg) 0.92 $ 0.70
1.28
Lettuce (1 head) 0.82 $ 0.50
1.06
Water (1.5 liter bottle) 1.11 $ 0.80
1.50
Bottle of Wine (Mid-Range) 6.65 $ 5.35
8.00
Domestic Beer (0.5 liter bottle) 1.09 $ 0.95
1.28
Imported Beer (0.33 liter bottle) 1.31 $ 1.00
1.50
Pack of Cigarettes (Marlboro) 3.69 $ 2.90
4.00
Do you live in Los Angeles, CA?
Restaurants Avg. Range
Meal, Inexpensive Restaurant 10.94 $ 7.00
20.00
Meal for 2, Mid-range Restaurant, Three-course 42.68 $ 28.00
60.00
Combo Meal at McDonalds or Similar 5.95 $ 5.00
7.00
Domestic Beer (0.5 liter draught) 3.22 $ 2.00
4.50
Imported Beer (0.33 liter bottle) 4.77 $ 3.00
6.00
Cappuccino (regular) 2.58 $ 1.99
3.75
Coke/Pepsi (0.33 liter bottle) 1.66 $ 1.00
2.00
Water (0.33 liter bottle) 1.38 $ 1.00
2.00
Markets [Edit] Avg.
Milk (regular), 1 liter 1.96 $ 0.79
3.00
Loaf of Fresh White Bread (500g) 2.79 $ 2.00
3.50
Eggs (12) 2.46 $ 1.99
3.00
Fresh Cheese (1kg) 7.79 $ 5.00
10.00
Chicken Breasts (Boneless, Skinless), (1kg) 7.76 $ 6.00
11.00
Apples (1kg) 2.04 $ 1.54
2.53
Oranges (1kg) 1.10 $
Potato (1kg) 1.13 $ 0.55
1.71
Lettuce (1 head) 1.14 $ 0.99
1.29
Water (1.5 liter bottle) 1.73 $ 1.25
2.50
Bottle of Wine (Mid-Range) 11.88 $ 9.00
15.00
Domestic Beer (0.5 liter bottle) 2.78 $ 1.25
5.00
Imported Beer (0.33 liter bottle) 4.26 $ 1.85
7.00
Pack of Cigarettes (Marlboro) 5.19 $ 4.00
6.00
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Fat Dad
Trad climber
Los Angeles, CA
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Dec 14, 2011 - 01:28am PT
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Fear of litigation is just spew from the insurance industry who are opposed to actually having to pay claims when MDs screw up which, yes folks, does happen. As has been well established, caps of damages would only reduce costs by c. 1 percent. The Harvard School of Public Health performed a study several years ago that concluded that only one out of every nine patients with legitimate malpractice claims ever file suit. If doctors want to get sued less, they shouldn't screw up in the first place.
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