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Old 06-29-2017, 8:03pm   #1
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Default Thoughts on healthcare/insurance costs

So a lot of blame goes around on the subjects of healthcare costs and health insurance costs, but a lot of the issues are party-agnostic. Below are some of my thoughts.

Thought #1
Due to technological progress, we are dealing with the "now that we can, we should" effect. (Sorry, I don't have a better name yet). In short it goes like this (disclaimer, dollar values are not to scale):

Old days
"I broke my hand."
"Well that sucks. My concern as your friend is free. Give yourself 'the stranger' for a couple of weeks."

"I broke my hand."
"Here's a splint. I'm a doctor, so that's $100"

Still later:
"I broke my hand."
"It may be fractured. Here's a splint and painkillers. $150"

Still later:
"I broke my hand."
"Let's X-Ray. Image is murky, but it may be fractured. Here's a splint and painkillers. $500"

Still later: "I broke my hand."
"Let's X-Ray. Hmmm...results are murky. We need an MRI. Okay, MRI says it's fractured. Here's a splint and painkillers. $2,000"

Outcome in every case: Hand hurts, can't use it for a while, some lingering pain. Meanwhile, over time, the cost goes up because we try harder using more and more expensive technologies without significantly improving outcomes. Obviously this isn't true in every case, and there are examples where technology has made treatment as a whole cheaper. But keep in mind that grave illnesses tend to be expensive to treat whereas dying is (or can be) free. But we as a species aren't very good at limiting our use of medical technologies when they aren't likely to improve outcomes.

Thought #2:
The impact of the obesity epidemic. People eating way too much, gaining weight, and then having multiple primary and secondary health problems which are expensive to treat or correct. This includes cancers, diabetes, joint problems/replacements, etc. If you're on insurance, even before Obamacare, then you're paying for the crappy life decisions of others. To be fair: while obesity is the big one, there is also drug addiction and other avoidable states of health.

Thought #3:
Lastly, and in this case somewhat party-dependent, is the fact that "health insurance" today isn't insurance. It's a maintenance plan coupled with insurance. Maintenance plans, by definition, are always a bad deal whereas insurance plans, by definition, are a bad deal for most, but not for those who truly need them. If we were to limit insurance to accidents (car/motorcycle/aircraft wrecks, workplace mishaps, etc.) and unexpected or unpreventable health issues, it would be much cheaper for everyone while still protecting those who most need protecting.
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Old 08-21-2017, 8:38am   #2
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When a hospital purchases or leases an expensive piece of equipment, it costs lots of money to have it and have trained technicians to operate it. Certainly some of these machines, like an MRI can work miracles in diagnostics and treatment choices. So, of course, any patient would want the machine to be available when applicable.

But the hospital sees it as a cost/profit center. They are going to use it and create billable time whenever they can. This of course creates lots of unnecessary expense. And the problem is the insurance companies have just laid down and paid the bills. For them it doesn't matter, they just pass the cost on to the consumer. Except now we are at a breaking point.

My neighbor died recently. He had a heart attack getting out of his car at the grocery store. He was 74 years old and hadn't seen a doctor in years, even though he was covered by VA. He was helicoptered to a cardiac hospital over 50 miles away where they performed a four-way bypass, then the next day another follow-up surgery due to infection problems. Next day another surgery due to circulation problems in his leg where the donor artery came from.

Next day he died from kidney failure. I'm amazed they didn't put him on dialysis so they could make some money with that machine. I estimate the VA will have to cough up a mid-six figure sum that accomplished nothing but to make the last few days of this man's life a painful hell.

How I wish he had had his heart attack at home where he lived alone and died peacefully in his own bed.

Welcome to the world of modern medicine.
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