Hospital's Computer System Always Marks Up Costs Automatically, Leaked Records Show (msn.com) 224
"Ridiculous, seemingly arbitrary price markups are a defining characteristic of the $4-trillion U.S. healthcare system — and a key reason Americans pay more for treatment than anyone else in the world," writes a business columnist for the Los Angeles Times.
"But to see price hikes of as much as 675% being imposed in real time, automatically, by a hospital's computer system still takes your breath away."
Long-time Slashdot reader fahrbot-bot quotes their report: I got to view this for myself after a former operating-room nurse at Scripps Memorial Hospital in Encinitas shared with me screenshots of the facility's electronic health record system.... What they show are price hikes ranging from 575% to 675% being automatically generated by the hospital's software. The eye-popping increases are so routine, apparently, the software even displays the formula it uses to convert reasonable medical costs to billed amounts that are much, much higher. For example, one screenshot is for sutures — that is, medical thread, a.k.a. stitches. Scripps' system put the basic "cost per unit" at $19.30. But the system said the "computed charge per unit" was $149.58. This is how much the patient and his or her insurer would be billed.
The system helpfully included a formula for reaching this amount: "$149.58 = $19.30 + ($19.30 x 675%)."
You read that right. Scripps' automated system took the actual cost of sutures, imposed an apparently preset 675% markup and produced a billed amount that was orders of magnitude higher than the true price. This is separate from any additional charges for the doctor, anesthesiologist, X-rays or hospital facilities.
Call it institutionalized price gouging. And it's apparently widespread because the same or similar software is used by other hospitals nationwide, including UCLA, and around the world... Healthcare providers routinely ignore the actual cost of treatment when calculating bills and instead cook up nonsensical figures to push reimbursement from insurers higher. For the millions of people without health insurance, those sky-high prices are what they're stuck with (although most hospitals, including Scripps, typically will offer discounts in such circumstances).
"But to see price hikes of as much as 675% being imposed in real time, automatically, by a hospital's computer system still takes your breath away."
Long-time Slashdot reader fahrbot-bot quotes their report: I got to view this for myself after a former operating-room nurse at Scripps Memorial Hospital in Encinitas shared with me screenshots of the facility's electronic health record system.... What they show are price hikes ranging from 575% to 675% being automatically generated by the hospital's software. The eye-popping increases are so routine, apparently, the software even displays the formula it uses to convert reasonable medical costs to billed amounts that are much, much higher. For example, one screenshot is for sutures — that is, medical thread, a.k.a. stitches. Scripps' system put the basic "cost per unit" at $19.30. But the system said the "computed charge per unit" was $149.58. This is how much the patient and his or her insurer would be billed.
The system helpfully included a formula for reaching this amount: "$149.58 = $19.30 + ($19.30 x 675%)."
You read that right. Scripps' automated system took the actual cost of sutures, imposed an apparently preset 675% markup and produced a billed amount that was orders of magnitude higher than the true price. This is separate from any additional charges for the doctor, anesthesiologist, X-rays or hospital facilities.
Call it institutionalized price gouging. And it's apparently widespread because the same or similar software is used by other hospitals nationwide, including UCLA, and around the world... Healthcare providers routinely ignore the actual cost of treatment when calculating bills and instead cook up nonsensical figures to push reimbursement from insurers higher. For the millions of people without health insurance, those sky-high prices are what they're stuck with (although most hospitals, including Scripps, typically will offer discounts in such circumstances).
The last time I went to the hospital... (Score:4)
They told me if I wanted to wait ANOTHER 2-4 hours, they could give it to me. I declined.
They STILL charged me for it.
Re: The last time I went to the hospital... (Score:4, Interesting)
That's our for profit Healthcare system for you. They talk about caring for people but it's only the green those at the top really care about. The people running these hospitals claim they are struggling and have to give free Healthcare to some. But the amount of money they get is insane. Nearly all employees working in the Healthcare system make from a good living wage (nurses,, billing people,, etc) to a very high wealthy income like the Dr's, surgeons and don't forget the board members running the system and fleecing those who need healthcare.
Non-profit != Non-ripoff (Score:4, Insightful)
At 675% markup, someone is definitely profiting. Televangelists are also "non-profit" but somehow manage to fleece millions from their followers.
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Only the uninsured pay this. Insurance companies get a 90%-95% discount on the price.
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In theory the uninsured aren't supposed to pay that. There's a whole set of rules [communitycatalyst.org] protecting them. There are times when somebody has an insurer that has terrible negotiators, and their co-pay is higher than an uninsured person who qualifies.
You only get screwed if you're too high-income to qualify, the hospital is for-profit, or you send them the money without contacting them.
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That might have been true at one time, but that's definitely not true now. I had a procedure a couple years ago, and the 'insured' price came back as something crazy... like over $1k for a visit that took 20 mins. And this was supposedly a 'discount' on the full price of $3k.... So I called the hospital to see what was up with the charge and why it was so outrageous, and after a bunch of back and forth, they told me that if I didn't go through my insurance for the procedure, I could instead pay the 'uninsur
Re: Non-profit != Non-ripoff (Score:3)
That's not the way it works for me, and I'm in the hospital a lot. Basically the hospital has three values for each line item: ICD code (basically what's wrong with you), CPT code (basically what they did for it), and the amount they're charging for it.
Insurance company responds, for each line item, basically this: Oh ok that's nice, but I'm only paying you about a tenth of what you asked for, and you can only directly bill the patient an amount much smaller than that (typically the copay or coinsurance.) O
Re: The last time I went to the hospital... (Score:2)
Yeah so are mega churches. Just because they file taxes that way doesn't make it true. They are simply using loop holes.
Re:The last time I went to the hospital... (Score:4, Interesting)
They STILL charged me for it.
So sue them. Which leads to the actual cause of this. There's a whole load of costs around US medicine which relate to lawsuits and insurance. If you have private insurance companies, then those private insurance companies have to make profits. If you have lawyers then someone needs to pay for their Aston Martins and Martinis. If your senior heart surgeon spends a couple of weeks of the year operating, a month or so on holiday and the rest of the year fighting litigation then, obviously, she needs big charges in those few working weeks to keep her in the kind of apartment that she expects to have by the beach whilst also covering her liability insurance.
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I got ivermectin at my hospital. They sent me home with it instead of admitting me. I felt a lot better the next day and recovered from being nearly unable to breathe in a matter of days.
Status: Tropical parasites cured.
There, fixed that for you.
Re: Ivermectin saved my life (Score:2)
Joke all you want about Ivermectin, but remember one thing: Sexually transmitted diseases of equestrian origin have greatly reduced among Republicans this year.
The only excuse... (Score:3)
The only remote statement on a possible excuse is if the $19.30 is the hospital's material cost (what THEY pay). The markup is to intend to cover costs (employee time, use of space, use of related lesser-cost products, etc., and, of course, profit margin). This is how a lot of the food industry works, you take your food cost and multiply it by whatever factor is needed to cover overheads and still get a profit margin. It just makes it easier to come up with a 'fair' price.
That said, our entire medical industry--especially costs--is completely fucking broken.
the food industry does have the cook bill you (Score:2)
the food industry does have the cook bill you on top of the bill you get and out side of the USA tipping is not really an thing and they don't pay some workers $2.13/hr
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Except they will also bill separately for the use of the room. The doctor or PA will charge separately as well.
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The reason is because all health insurances demand 50-80% cuts in the asking prices, so they need to add stupid fat margins on the base price to be able to give those arbitrary rebates to the unnecessary middle men.
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More like over 90% discount.
Price caps are neccessary (Score:4, Insightful)
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The US does have price-caps for common procedures and medicines (or rather, individual insurers do, including medicare/medicaid).
This kind of price weirdness comes from multiple levels of back-and-forth, over decades, with insurers and hospitals trying to get as much as possible from each other, bending the rules in unintended ways.
Couldn't use the original link? (Score:3)
This story comes from the LA Times [latimes.com] and was written by David Lazarus.
Why use a source which scraped the original article, on top of which, it's from Microsoft?
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This story comes from the LA Times [latimes.com] and was written by David Lazarus.
Why use a source which scraped the original article, on top of which, it's from Microsoft?
Note: I did provide the original LA Times article as the reference link when I submitted this [slashdot.org]. Don't know why it wasn't used. in TFS.
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Good to know. I came across this article when it was online a week ago and shrugged. The more I've learned about the medical industry the less stuff like this surprises me. Adam explained why this occurs [youtube.com].
I have also seen postings from people saying they had a bill of XXXX dollars and asked for an itemized list of services, and lo and behold their bill was reduced to XX dollars. It's getting more difficult to figure out who is worse, car dealers or hospitals.
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Thanks for that link, I enjoyed Adam Ruins Everything [wikipedia.org] when it ran on truTV ...
We pay more because of private insurance (Score:5, Interesting)
We know exactly how to get the cost of healthcare under control and it's single-payer healthcare. What most call Medicare for all. Anything else is just a Band-Aid on a gushing wound. I suppose it's better than nothing but it's not going to solve the problem and it's not going to get you access to healthcare as you age.
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many doctors refuse to take more than a minimum number of Medicaid patients, because Medicaid pays so much less than regular insurance
This is true but not for the reasons you might think. The AMA (American Medical Association) is really a guild or a union. It controls the number of doctors who are allowed to be trained and to practice. This artificially allows doctors extra pricing power in the market that they should not have. Ever wonder why the place where you buy your tires seems more organized than the doctor's office? Because it is. When you don't have competition, you have poor performance. And while I'm sure many doctors ar
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The average US hospital billing department is staffed by more people than doctors. So a single payer system would at least help get rid of an entire department of people who do nothing but bill insurance companies.
A doctor's office often has a FTE (full time equivalent) person who does nothing but deal with insurance companies, so that's another person of overhead who's not treating anyone, just dealing with billing. It's a full time job for a private doctor's office. And a whole department at a hospital st
One last thing (Score:2)
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I'm glad you can't edit comments on this site. It would be far too easy to pull bait-and-switch after getting a post upvoted, especially if you waited until the end of the edit period to minimize the chances anyone will notice while their mod points are still revocable.
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It would be possible to allow editing, but then wipe out any up moderations.
Re: There are a wide variety of studies (Score:2, Insightful)
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I agree that single-payer is probably needed because of where you're starting from, and the huge difficulty you'd have in getting insurers to behave, but I'm always struck by the fact that there are plenty of examples of both tax-funded single-payer and regulated multi-payer systems that work well. In the latter camp, for example, is France, Germany, Belgium, the Netherlands, Israel. In the former is the UK, Spain, Denmark, Norway, Italy.
That's basically Medicare for all (Score:2)
Also if you dig into those hybrid systems the ones that work so heavily regulate the private aspects of it that it might as well be single-payer entirely. Sort of how you can have a "private" power grid. And if you
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I dunno, I've studied this subject professionally for many years, and I think the differences between single-payor and multi-payor are pretty significant in terms of the mechanics of the system, the incentives, etc. Just strikes me that it might be easier to move to a quasi-Dutch model than a quasi-British one.
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I think the medical insurance companies are in on this scam. First of all, these kinds of astronomical bills scare people into never wanting to go without medical insurance. Second, it allows the insurance companies to apply pressure to hospitals that are not in network because they know that most people would never be able to pay these rates. The result is either to go along with the insurance companies or face debt collection and bankruptcy.
If medical bills were reasonable, then a lot fewer people woul
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We know exactly how to get the cost of healthcare under control and it's single-payer healthcare. What most call Medicare for all
Medicare does the same thing. Doing "Medicare for All" (which seems like an acceptable solution to me) wouldn't solve this problem.
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Think its time (Score:3)
That the government stepped in and started regulating prices yet? The competition model doesn't seem to be working.
Re: Think its time (Score:4, Insightful)
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You have to be very careful letting private healthcare deliver services on behalf of the government though. What tends to happen is the private companies want guaranteed profits, and eventually some corrupt politician gives it to them. The public hospital isn't allowed to compete for those services anymore, they are forced to outsource even if they can do it cheaper.
When setting it up, you need to be very careful to have something like a constitution that forbids that kind of thing and which is extremely di
Which insurance then knocks down ... (Score:3)
Who of them do you think is most likely in it for the explicit purpose of making money?
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You're thinking of capitalism. One of the defining features of a free market is that no individual or group controls enough of the market to be able to affect prices.
And yes, that pretty much means that a free market is as much a fantasy as communism. Never been genuinely attempted at scale, because if you did there would be no way for the the rich and powerful to make obscene profits.
"Discounts" (Score:2)
although most hospitals, including Scripps, typically will offer discounts in such circumstances
How generous - providing a "discount" of a predatory price-gouge. Many hospitals [npr.org] will resort to suing or wage garnishment to "recover" these outrageous costs.
What is the root cause? (Score:5, Insightful)
What is the root cause for this?
It's most likely overbilling because of expected haggling from the insurance providers.
They get a bill, and then they "negotiate" it for months and months at a time until the account exec gets the expected discount from the hospital (to meet his monthly quota) and look good in front of his other coworkers who are doing the same.
They probably get a 50% discount of that $150 bill for a $20 item. If they charged $20, the account exec would most likely still demand a 50% discount, because he probably uses a software that won't let it approve a payment if he hasn't haggled enough.
I heard that, in the US if you pay cash, no insurance, with most hospitals you'll get a crazy amount off, like 90% or so. But I have no idea if it's true. The article seems to suggest it.
Re:What is the root cause? (Score:4, Informative)
The insurance system has become it's own little market, and anyone on the outside gets screwed in all aspects. If you have insurance great, otherwise you better be so poor that they can't collect their billings - otherwise you will be poor for the next time.
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>What is the root cause for this?
The US government. The government insists that it gets a discount on all services, so hospitals simply mark everything up so that they can get marked down. There's too many services in the health care market to negotiate each one, so it's typically just a certain percentage discount off the chargemaster price that gets negotiated each year. If the government catches you selling services at a lower price to the uninsured, then they will say that's the actual price and dema
Capitalism working as intended (Score:2)
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Re: Capitalism working as intended (Score:2)
Afraid for what awaits the UK... (Score:2)
The NHS in the UK, despite being desperately underfunded, on its knees during the pandemic etc., seems to be being eaten away by stealth.
If it carries on like this, we will end up with a two-tier health system like the USA.
Tier 1, no money: Start praying
Tier 2, some money: Pray you don't need it
I had a recent experience with private Health Care in the UK and it wasn't reassuring.
I get medical aid as part of my company employment package.
I'd been pestered for about a year with constant emails, to get my "360
Makes me glad to live in a Socialist hellhole... (Score:5, Insightful)
where at least healthcare is free and you don't have to worry about how much treatment costs. Or whether or not it's covered by insurance. Or whether you have insurance. Still, I believe health care can be quite good in the US, as long as you can afford it.
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Other countries get healthcare which is as-good or better, but spend less for it. For-profit healthcare will always exclude people who don't have money because there's no profit in it. If not for laws requiring (emergency) care to be provided, it wouldn't be. You'd literally have people dying on the hospital steps because they were refused entry.
Healthcare is one area where a monopsony is a good thing.
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It's free at point of use, i.e. most developed countries have universal healthcare paid for by taxes & people receive treatment according to need rather than ability to pay. Nobody talks about insurance or billing or money when you go to hospital or to see your doctor. They're just there to diagnose & treat you.
I remember showing a dental receptionist the price of dental treatments on the UK's NHS. She couldn't believe the prices & insisted that they must be wrong or that they weren't the full c
Be angry at (Score:2)
In a sensible, regulated system... (Score:4, Insightful)
That is the charge master price just like sicker p (Score:2)
That is the charge master price just like sicker price at the car dealer
Ever Worked for a Defense Contractor? (Score:5, Interesting)
That markup is actually called "Burdened Cost". The cost of the "thing" isn't just the cost of buying it, but also the costs of the time spent selecting and ordering it, transferring and auditing the payment for it, receiving and stocking it, distributing it to be close at hand, frequently checking the expiration date, and so on.
When I worked as an engineer at a Major Defense Contractor, we were always astounded at how our project cost estimates got so many zeros tagged on in the process of becoming a bid and proposal. Then, by the end of the project, to see how close those huge estimates actually were, sometimes scarily close to having us lose money on the contract.
One time, a project had a commercial spin-off we desperately wanted to pursue, so we did a round of cost estimates to cover development, marketing, initial production and roll-out. And then all those zeros appeared once again, and we thought the whole idea was dead. A few of us dug into everything that went into adding those zeros. A vast part of it was simply communication: Creating truck loads of documentation, preparing and presenting status updates, responding to feedback. Another part was the cost of meeting military standards for quality and testing. Yet another part was designing and building the system to last at least 20 years, often 40 or 50. So many sources of zeros!
Then, of course, everyone billing their hours directly to the project had to cover 100% of the indirect costs: We had to support HR, the mortgage on the building, the service staff, the utility bills, and so on. You get the idea. Our project work estimates were given a "Burdened Rate" that generally exceeded my salary by a factor or 2 or 3.
The "burden" was basically the result of the accounting process by which all the above were identified, estimated and included in the bid and proposal. To get our product to a commercial market, we'd need to operate under a commercial accounting process. We literally had to form a separate company as a "wholly-owned subsidiary" to get far enough away from the military work to be allowed to charge our time differently. We had to move to a separate building, a local rented space. We had to become a startup, with our parent company supplying seed capital.
The world of commercial medicine is FAR WORSE than military contracting! In fact, military medicine can often provide similar services at substantially reduced costs, at least to active military members (families, reservists and retirees live in a weird blended system).
Yes, a 600% medical product burden factor may seem extreme, but it should not be all that surprising (other than it being higher than military markups). Consider one major difference: Every single thing a patient will encounter, be it a suture, pills, nurses, doctors, lab testing, everything, needs to be covered by massive amounts of malpractice and product liability insurance. We're all human, everyone makes mistakes, but when it comes to medicine, those affected by such mistakes must be "made whole".
Is the cost of addressing mistakes something that should be eliminated? So far, the universal answer is an emphatic "No!". In fact, most would say the present system doesn't do enough in this area. Meaning these costs seem set to continue to rise.
Another surprisingly large cost is "coding", ensuring a treatment is precisely identified to ensure insurance and Medicare will correctly cover it. Last I heard, there are over 45,000 codes that have been defined. My own ongoing asthma treatment has over 1000 different codes associated with it. This coding data is critically important, as it is used not just to get paid, but is also used to review and determine the efficacy and use of every single product and treatment at both the level of the individual patient and at the level of decades of data for millions of patients.
Thorough medical documentation is critically important, and every attempt to reduce its cost has also reduced its benefits. We're now at the p
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Why does no other country seem to have this problem? If it were merely this matter of logistics that you make it out to be, surely this would be a universal problem. It would be impossible for anyone to achieve lower costs, not just a country burdened by a system whose very incentives are aligned against the best and most efficient treatment of patients.
I don't think you're wrong, per se. I think there's a lot of very interesting stuff in here. Tort costs do seem to be a burden on the system, but certainly
Understand the meaning of Free Market Efficiency (Score:2)
Free market is efficient in maximizing profits. If informed consumers are voting with their dollars, and they could because there are multiple merchants hoping to sell, Free market will be efficient in delivering goods and services at the
Universal healthcare... (Score:2)
Do people care about words anymore? (Score:3)
It is not even _an_ order of magnitude higher.
Yes, of course it is still ridiculous, but times 7.65 is _not_ "orders of magnitude higher"
DPC Comparison (Score:2)
Just picking a random direct primary care physician off this map [dpcare.org], looks like stitching (the cost of both the stitches and the procedure) could have a marginal cost only $35 [wecaremedoffice.com] in the US.
The difference? No insurance company in the middle, and no hospital overhead.
In the US, "health insurance" isn't really insurance, but a membership into a weird negotiated payment plan.
This is absolutely criminal (Score:2)
My experience with US hospitals (recently) (Score:2)
Then the bill came.
Ok, actually, it came in June. The original bill was > $12,000.00. It had been "negotiated" by insurance down to about
I wonderâ¦.. (Score:2)
How many sutures they have to buy and how many they have to throw away due to expiration dates. This was a problem with N95 masks last year. Testing indicates that the straps decay and lose their elasticity making them useless for their purpose.
$7 = $96 (Score:2)
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There was never a $9,000 hammer -- That's an urban legend. You can learn more about it here: https://www.govexec.com/federa... [govexec.com]
Do you have a *specific* reason to believe that the markup comes from government regulations and government requirements and government corruption?
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Not $9K, but the price of a non-sparking, non-magnetic special purpose berylium hammer is quite breath taking.
Re:"Ridiculous, seemingly arbitrary (Score:5, Informative)
Unsurprisingly, you seem completely unaware that people from around the world are reading this. Some of them live in countries such as the UK, and thus have direct experience that shows your statements for the pathetic lies they are. Healthcare costs as a % of GDP in the UK are about 10%; in the US, it's 18%. Our service is state-funded and regulated out the wazoo, and a *really expensive* suture in the UK costs £4.65 -- less than a third of the basic, unmarked-up, cost of a suture in the hospital in the article, and less than 5% of the cost of the marked-up suture.
https://www.nice.org.uk/news/n... [nice.org.uk]
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Re: "Ridiculous, seemingly arbitrary (Score:4, Informative)
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better health outcomes
To be fair, much of those better outcomes are due to healthier lifestyles and different demographics rather than better medical care.
Re: "Ridiculous, seemingly arbitrary (Score:4, Informative)
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Healthier lifestyle is somewhat arguable. Brits drink a lot more, but they also walk a lot more, so they're in-shape. But drunk. Whether skinny drunk is healthier than sober fatty depends on how drunk and how fat.
"Different demographics" is just wrong. The only demographic factor that has a significant effect on health costs is age, and they have fewer kids so they're a couple years older.
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The only demographic factor that has a significant effect on health costs ...
We weren't discussing costs. We were discussing outcomes.
Many demographic factors affect outcomes. One of those is the longevity of different ethnicities.
Ethnic Asians live nearly four years longer than ethnic Africans. This is mostly independent of lifestyle or income and appears to be mostly genetic.
Britain has more Asians than America and fewer Africans.
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The UK rate you gave is not obesity, it's obesity plus overweight. Obesity alone is 28%. The other 36% are merely "overweight." We're skinnier than them, but they're catching up.
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By what measure? UK has 100% coverage of the population and better health outcomes
The UK system is better when you look at the entire population but the USA likely does have superior health care
if you only look at those people with quality private health insurance or are willing to pay out of pocket.
Wait times are significantly lower and you have much better access to cutting edge treatment options.
The USA also leads in medical research and bringing new drugs and treatments to market.
The UK and many other countries benefit from the excessive money the USA spends on medical advances.
The p
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If your health system is run by people who know medicine increased wait times have nothing to do with actual health outcomes. "Cutting edge treatment" options in the US tends to be stuff that some Doctor thought "hey this should work," but has not proven it yet. As for the new drugs developed, have you looked at the list? It's pretty much entirely "This drug is just like that other drug, except it costs 500% more, and is less likely to stop your boner."
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Not only is this not true, even the healthcare outcomes for the RICHEST Americans often lag behind the quality of care for AVERAGE people in other countries.
https://pubmed.ncbi.nlm.nih.go... [nih.gov]
There is virtually no metric by which American healthcare is better than the care of other countries, particularly ones in Scandinavia and Western Europe. The only thing it's good at is enriching insurance company executives.
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And of course the main reason why this is the case is that the US has much weaker primary care than other developed countries. Shiny hospitals are expensive and have lots of economic power in the US, but if you want a population to stay healthy and well, they need cradle-to-grave family doctor services that act as effective care navigators and gatekeepers.
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Haha x1000 no. In no way, shape or form.
The US trails on affordability, efficiency, equity, and outcomes.
https://www.commonwealthfund.o... [commonwealthfund.org]
Re: "Ridiculous, seemingly arbitrary (Score:2)
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price markups" the markups are the distortions in the cost accounting caused by excessive government regulations
Horseshit. Countries with the heaviest regulations on healthcare are the ones that lead to the lowest costs of care for a comparable outcome.
There's nothing in the regulations that drive this cost up. Each individual suture isn't numerically numbered like in your $9000 hammer example.
Your example of hidden costs happen in every government, yet excessive costs of healthcare only happen in America.
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The U.S. has some of the best
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This has more to do with the constant battle to get insurance companies to pay more. In other words, it's not government.
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You make it sound like the battle is against insurers, rather than led by them.
Prices go up because of collusion between the insurance companies and providers - *both* see a direct benefit from increased medical costs.
Remember, the insurance company isn't paying your medical bills *you* are, in the form of insurance payments that pay for your demographics expected medical costs, plus a legally limited percentage for profit and overhead. The higher your medical bills, the more dollars that percentage transl
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True. The insurance companies aren't exactly sad to make the pie bigger (at our expense) so they can keep more.
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yes, that's right. slimy corrupt government.
As opposed to those operating in industry who are paragons of honesty and truthiness.
as is often the case, the reason for those excessive regulations is precisely because companies are so often unethical and dishonest that you need a 100 pages of regulations to try and prevent them from doing that.
the "excessive" regulations are one side of the problem. but of even more importance is the fact that no one is convicted and thrown into prison for violating those "ex
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Not necessarily. The government can force the hospitals to charge them below the costs of goods and services, and then foster the costs onto the insurance holders by forcing the hospitals to make up the costs.
If you suddenly take away the subsidies of the private insurance, you lose that "efficiency." Suddenly, you are paying the forced price, and you get situations they have in every other country in the world with a pure socialized health care system, with it always being under funded.
Re: "Ridiculous, seemingly arbitrary (Score:4, Informative)
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In the UK we pay 1/3 what US citizens pay
Sure, but the UK's NHS was designed to be cost-effective and built that way from the ground up.
The US has an enormous bloated, inefficient healthcare system designed from the ground up to maximize profit.
Converting the American system into something like the NHS would be like trying to stuff a whale into a goldfish bowl.
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>Converting the American system into something like the NHS would be like trying to stuff a whale into a goldfish bowl.
So... lots of fresh meat for more efficient providers to feed on? What's the problem?
Massive inefficient industries are *supposed* to collapse - that's one of the selling points of "free market" capitalism. Their specialized assets can then be bought up for pennies on the dollar by those willing to actually try to do better. If we're going to pretend we have such a market, and that it
Re: "Ridiculous, seemingly arbitrary (Score:5, Insightful)
The American healthcare system is 20% of the economy. It is the most powerful special interest group that has ever existed in the history of the world. It is not going to fade away without a fight.
22 million Americans work in the healthcare industry. Slimming America's system down to the efficiency of the NHS would eliminate half of those jobs. What politician is going to alienate 20% of the electorate?
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>It is the most powerful special interest group
Absolutely - but that's a discussion of how likely it is to happen, not how difficult or unpleasant the actual doing of it would be if we decided to.
>22 million Americans work ...20% of the electorate
How are you getting that 20%? There's 331 million Americans, 22M is only 6.6%. Still not a number to ignore - but most of those are themselves deeply unhappy with the way things are now. Nobody likes dealing with penny-pinching insurance companies, nor
Re: "Ridiculous, seemingly arbitrary (Score:2, Informative)
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It used to be. The problem is that the conservatives/neo-liberals got their hands on it and defunded the shit out of it and now it's limping along. Canada has a similar problem where reining in costs is always the concern, rather than quality of outcome or patient comfort.
Our waiting lists aren't terrible and critical care is handled well enough, but our biggest issue is that we're neighbours to the USA, so as long as our system works better than theirs, it's easy to deflect criticism and put off investment