4 Shocking Facts about US Healthcare

[Galraedia]

[ErikJ]

1. And DONT forget about the $1000 toothbrush

http://opinionator.blogs.nytimes.com/2013/08/13/the-cure-for-the-1000-toothbrush/?_php=true&_type=blogs&_r=0

The Cure for the $1,000 Toothbrush
By TINA ROSENBERG

Here is a basic fact of health care in the United States: Doctors and hospitals know what they charge, but patients don’t know what they pay. As in any market, when one side has no information, that side loses: price secrecy is a major reason medical bills are so high. In my previous column, I wrote about the effect of this lack of transparency on the bills patients pay out of pocket.

We know about these bills, which hit us directly. What most people don’t know, because the costs are hidden, is that the same imbalance exists with insurance. The employers and employees who buy health coverage have delegated vigilance over health care costs to insurers — but insurers, for the most part, have gone AWOL.

Consider the story of Texas811, a company with about 200 employees based in Dallas. (They mark utility lines so people don’t damage them when they dig.)

In January 2010, the company was enrolled in a Blue Cross P.P.O., or preferred provider organization. That month, Blue Cross told Texas811 that it was planning to raise the company’s premiums by 75 percent. That was extreme. But health insurance premiums are rising three times as fast as wages, doubling since 2002. “We freaked out,” said Lee Marrs, the company’s president. They negotiated. Blue Cross agreed to lower the increase to 68 percent. “At that point it was go out of business, drop health coverage, or try something new,” Marrs said......................................................

[antigop]

2. what bullpucky.

Yeah. If I'm on the floor writhing in pain, I'm supposed to go shopping for who has the cheapest price on appendectomies that day.

Yeah, maybe I should look for coupons, too.

[Dustlawyer]

3. I disagree with one part of this post.

In medical mal-practice cases, the Plaintiff must show that his/her doctor breached the standard of care. Doctors can make mistakes that do not breach this standard, example is where doctor accidentally cuts a vein close to where he/she is supposed to be operating. It is just a risk of the surgery. Where a reasonable and prudent doctor (the standard which varies state to state) would not have done, or would have done a certain thing, and your doctor goes against that standard, there may be some liability/responsibility.
States have enacted Tort Reform to make med-mal cases very hard to prove. The damages paid on all med-mal cases still amount to 1% or less of the total health care costs pie chart. His argument on the high costs of med-mal cases is the same one the U.S. chamber of Commerce makes because the medical profession and their insurance companies want to push the costs to the consumers and not pay for their mistakes.
In Texas if you are a child, retired person, or a house wife/husband who has a med-mal claim you will find it very difficult to find an attorney to take your case. The damage caps in place for the "frivolous" cases mean that the total amount that can be recovered from your doctor is $250,000 plus your medical bills. The attorney must post a bond to be paid if it is found to be a frivolous case. The attorney must have a report from a doctor stating that there was a breach in the standard of care and exactly what that breach was. Even if the attorney recovers the full amount, $250,000, by the time he/she pays the expert and other expenses, subtracts the attorney's fees, the victim is left with little to nothing. The risk financial risk is born by the attorney who will have a client who is unhappy even with the best result, therefore, they are not inclined to take the case. This was the desired situation for the insurance companies and the medical profession in the 1st place. They have already done this with Workman's Compensation in many states where they make it so the attorney cannot make money taking the cases. The victims have to do it themselves and usually get run over.
Doctors know what tests they really need and they know what the standard of care is. The extra tests because of litigious people and lawyers is a smokescreen to deflect the anger at the extra money being made by bogus testing. If you do not want a check and balance to medical care, do away with med-mal cases and let the doctors do what they want. It is almost to that point here in Texas and in many other states. You won't know unless it happens to you or someone you love. But it won't happen to you, it only happens to other people, right!

[Quixote1818]

4. Nicely stated. nt