Somebody help me with the healthcare math
 

Today I saw a news note that pegged the cost of universal health care for Americans at 32 TRILLION dollars over ten years.

Wait just a minute. It seems to me that you could give every person on the planet a heart transplant for 32 TRILLION dollars and still have money leftover.

Truthfully, I don't expect anyone here to give me the stats on this. And I'm not fishing for political opinions. However, I don't understand how healthcare costs are figured, with or without insurance and all its bureaucracy.

While on vacation last week, DH and I had occasion to visit an Urgent Care clinic. The doc was not "in network" and so he charged his office rate for the consultation plus an antibiotic injection, a pain pill and prescription, and a sling for the injured shoulder. The whole thing came to under $200--which I considered fair and reasonable for the treatment received--received promptly and cordially at that. (An x-ray followed at an imaging center, which was "paid for" by Medicare Advantage.)

Coming back to the current audience, I think we have a responsibility to promote HEALTH, not healthcare. Low-carbohydrate ways of eating seem, on the basis of much evidence, to reduce the medications now prescribed for many common conditions from high blood pressure to diabetes--conditions which often result in heart disease and other high-cost disabilities.

Pharmaceutical companies are continually crying about the cost of developing NEW medicines. Are they better? Are they worth it? What about surgical interventions (for failing organs?) and hospital stays? What about end-of-life care?

In short, what is contributing most to that 32 TRILLION dollar price tag?

I wish I knew.

Meanwhile, take good care of yourself. You may not be able to afford NOT to.

We have a lot of profit-seeking layers between us and actual medical care. Don't get me started on insurance company horror stories.

True, and the cost increases of medical care over the past 10-15 years boggle the mind. One major contributor that I've read about recently is the acquisition and merger actions taken by large hospital and medical groups that has consolidated the market into fewer but larger entities providing health care. They can easily control the market with less competition, and during this time of mergers and acquisitions, costs of medical treatments have risen dramatically. While health insurance is a mess, the rising billing totals from these large medical enterprises is setting the market rate that insurers must honor. Meanwhile, these large conglomerates have the advantage of their actions being camouflaged due to the ongoing and polarized debate about healthcare insurance.

just the math... no opinion about the appropriateness of universal health care...

32 trillion is 32 followed by 12 zeros.

According to Worldometer.com, as of about 3 minutes ago, the current population of the U.S. is 329,890,310.

Pulling up my computer calculator and dividing $32,000,000,000 by 329,890,310 people gives $97,001.94/person... but that is for a ten year period.

So, dividing by ten results in $9,700 per person per year. Looks like a lot for those of us who are reasonably healthy... but a pittance for those who are not so healthy.

Like you, when people start throwing big numbers around, I like to break the numbers down into per person numbers or per day numbers or SOMETHING that I can wrap my head around.

It would help to understand the meaning of this number if I/we knew what gets included and what get excluded in the cost of healthcare.

Thank you, Bevangel, for the calculations. That per person/per year figure gives me something more thinkable to think about.

"Insurance" clearly aims to spread around the impossible costs of today's treatments for big events like cancer. I'm not opposed to that kind of "sharing."

So...what it may come down to (for me) is deciding on the best way to address the costs from the provider side. Too many layers? Profit-driven corporate medical entities? Inflated pharmaceutical prices? What is the proper government agency (if any) to address issues that affect the entire population?

Thanks everyone for helping with a little clarity.

So...take care of your health. Advocate for what works. Vote for people who think like you do.

My SIL was treated for free in Germany, while visiting her husband who is a subcontactor for U.S. military.That was about 30 years ago. They are ciming up on 3 years in Germany again. When contract ends, they have 60 days to pack and return home.

My point is I suspect too many middlemen, unnecessary treatments, and other factors play into our rediculous costs.
I too am for Health. I cant afford my copays now so I rarely go to a doctor. Save that money so my kids can go.

Long ago met a family that never saw a doctor. Dad was organist at local church..... no insurance.

Makes me think somewhere our medical i surance has gone awry and costs are artificially high.

I first read this as "...a lot of profit-seeking lawyers between us and actual medical care." Still a true statement, lol. No offense meant to any lawyers here...my daughter is one. But medical malpractice abuse has greatly increased medical costs.

And I couldnt get the medical treatment I needed without a lawyer.....workman comp is #//^&. So went without the treatment I deserved. Had an mri to prove the damage.

Wow that is a lot - As a comparison in Aus, healthcare costs are around $7400 ($5,059 USD) a year. However, our public healthcare system is free for everyone, unlike in the US where you co pay and buy insurance.

As a non US citizen I do think the malpractice mentality in the US probably has a roll to play? Along with the way pharmaceuticals are privately priced?

Both are major factors.

Depending on the doctor's specialty, each physician's malpractice insurance can currently cost between $50,000 and $200,000 annually. But just to CYA with the malpractice insurance companies, they'd better order every test and procedure even remotely related to any symptoms the patient exhibits, as well as a slew of recommended standard tests and procedures (immunizations, colonoscopies, mammograms, PSA, etc) for every single patient, and the list changes and grows as the patient ages.

Pharmaceuticals are also a big part of it, but it's not just that the drug companies are coming out with new meds all the time, with the high cost of research, testing, FDA approval, and advertising them on TV and in magazines. That's why the patient's insurance company has medications it will pay for set up in tiers, which depends primarily on how much they cost, but also on whether there's a similar lower cost medication available. They want you to start at the lowest tier, trying the lowest cost med first (generics). If those don't work, then you can start trying the next cost level (preferred brand name meds). If an ONLY if those don't work, then the highest priced, newest meds (non-preferred brand name meds).

Both of the malpractice and pharmaceutical factors are also intertwined in increased costs - Lab values which were once considered to be well within in the normal range are now being treated with drugs (so more cost per patient), because the standards of treatment have changed so much, requiring patients to be treated for lab values that were at one time considered to be in a perfectly normal range, because if a dr doesn't treat a patient who has BP higher than 120/70 or cholesterol over 200, and that patient happens to have a stroke or heart attack, then they could be subject to a malpractice suit.

People sue because it's the ONLY way they can take care of their family member with a serious deficit.

Drug research is publicly financed but they don't like anyone to know that. They push statin drugs that run $800-1200 a month for every single person past the age of forty. They do an expensive stent procedure even in cases where research shows it does no good. Diabetes care alone cost $245 billion in 2012.

Doctors and hospitals get paid for everything they do. They like to do a lot of things.

DH takes statins, and his are only a couple of bucks/month - but they're generic, which of course is what the insurance companies prefer you use. The last time DH said something about it, the price for a 3 month supply was around $7. This was one case where the no-insurance price was actually cheaper than if he had used his insurance for the generic. (What they might cost in side effects, or additional drugs to control side effects is another matter, but something DH doesn't want to hear about, since he's convinced he NEEDS his statins)



If he couldn't have tolerated the generics, or if they didn't lower his cholesterol "enough" :rolleyes:, then they could put him on one of the newer brand name versions that supposedly causes fewer side effects, or are better at lowering cholesterol. There are also long acting statins, and statins combined with other CAD drugs. Those of course would be far more expensive.

DH is on Medicare and after a hellish year, the Advantage is finally working the way it is supposed to. We no longer get large and mysterious bills we're expected to pay. This might be a short-term situation because we're in open enrollment: not since the slave labor factories of the Third Reich has so much been demanded and so little given in return.

People think I exaggerate my loathing of health insurance companies. Well, these people are lucky: they've never come down with anything particularly expensive or poorly understood and thus, deniable.

I suspected a rare genetic disorder. This can't even be tested for in a lab, it's too complicated. It needs an expert diagnostician, so naturally my health insurance company doesn't have any in-network. Fair enough, so I asked for permission to find one. They encouraged me! They told me to do it!

In fact, they harassed me with thrice-weekly calls where they left no message and it was only an 800 number. So it was an ordeal to call them back and find out what they wanted, which was a chirpy, "We just wanted to know how you were doing!" "On the brink of death", was my answer. "Just like last time. Don't help me." But they kept doing it.

Finally I found a center with the specialization credentials required, four hours drive away. In my state of health, I would need a day off work and two nights in a motel because the evaluation took six hours. That's on me, that's okay, I did it.

I was right. I did have it. And they refused to pay the $2,000 bill. Because: "it's genetic, there's nothing that can be done." Well, there are things that can be done, but it's not drugs or surgery, so they chirpily informed me that I shouldn't have gotten it in the first place.

I was lucky in that my company has a Health Savings Account and I could use that to pay it. I could have filed an appeal with the state (at least my state has that) but the thought of more phone calls and paperwork when they had already pushed me into a worse state with their lack of help was too overwhelming.

I'm slowly getting better because at least now I know what was causing all my mysterious symptoms; the source of the stress that was triggering the auto-immune disorder; and what changes I needed to make in my life in order to have one, moving forward.

But it's no thanks to the "health" insurance companies. If any of you pray for health, you might as well add in the line, "please let my illness be recognized as one and paid for" because if you are an outlier in this game, they will let you dangle.

WereBear, your story is appalling. What's with THAT??? It sounds like "So die already." I suppose that's the unspoken answer for many people with difficult--or even not so difficult--health issues. Not acceptable!

Thanks for writing it up for us. At least we feel less alone. And, in my case, extremely lucky. I have no complaints about my Advantage plan because...I have no complaints. That's complacent of me, but how would I know??

The "idea" of insurance is something we're all accustomed to. In most states, you MUST have insurance in order to drive a car. Household insurance of various kinds provides a security blanket. People who can afford it purchase life insurance to protect their families.

Why is health care so complicated?