Liability

[SteveM]

A friend of mine worked for a manufacturer that had an unwritten policy that you NEVER put into any communication or documentation that an engineering change was going to lower the cost of production, because then a lawyer would have you over a barrel saying "this evil company killed my client's husband because they wanted to save one penny on the cost of making that widget".

Steve

[SteveHGraham]

Part of it is. In many cases they go way overboard on diagnostics if there is ANY chance of a complication, and that IS due to lawyers (and associated litigation happy culture).

That's overly complimentary to people who make money from medicine. You seem to be suggesting lawyers are the only cause of unnecessary charges. Martin Shkreli wasn't thinking about lawyers when he jacked up the price of his AIDS medication by 5000%. It had nothing to do with lawsuits. He just likes money. According to the Harvard School of Public Health, defensive medicine only accounts for about 2.4% of healthcare costs.

The doctor who gave me a $250 x-ray was just as worried about lawsuits as the thief who prescribed a $5000 MRI I didn't need, but somehow he was happy to charge 95% less. And he knew I was a lawyer!

I had another stone years later, and my doctor gave me a cheap ultrasound in his office. If lawyers were the whole explanation for high medical bills, the doctor who gave me the x-ray would have backed up his friends at the hospital.

Doctors and hospital executives love money just as much as everyone else does, and they use tort lawyers as an excuse to overcharge. If other industries were like medicine, a box of pancake mix would cost twenty dollars "because of lawyers." Lots of dangerous products are still reasonably priced, in spite of lawsuits.

One of my college roommates worked at a hospital as an undergrad, before becoming a radiologist. He said he listened to the doctors on the elevators. His comment? "The young doctors talk about medicine. The old ones just talk about money."

No one goes to school for 25 consecutive years and racks up huge student loans purely out of love for humanity.

I would love to see real tort reform, but medicine in the US would still cost too much.

[SteveHGraham]

It's really amazing that people criticize lawyers for medical costs, which is fair, yet rarely complain about the doctors who actually set the prices.

When my doctor charged $675 for a 15-minute strep throat test, there was no excessive treatment that could be called "defensive" or blamed on lawyers. They stuck a swab down my throat, told me I was fine, and sent me a huge bill.

[SteveM]

I had to pay for a checkup out of pocket (long story). Did it at a walk-in clinic. Talked to them over the phone before I went and told them that I had to pay out of pocket. They told me that it would cost $80.

Exam gets done, go to pay and the woman behind the counter says "that will be $450". The other woman comes over and tells the first that she will take care of it and has me pay the $80.

Turns out the cost under insurance is $450 and OOP is $80.

Part of that is the fact that when they bill the insurance company $450, the insurance company won't pay the whole thing anyway. Another part is that due to the way insurance works now (it's not insurance, it's really a prepaid health plan), the patient does not have enough skin in the game and could care less what the price is.

Think about it - if you have a $10 copay for drugs, would you go to the pharmacy down the street where the price for the drug is $100, or go a mile away to one where it is $50?

Steve

[warmstrong1955]

It also pays to shop.

Blood test at local hospital, nothing fancy, routine test stuff: $1300.00
Same identical blood test, at a lab a few miles away: $110.00

Bill

[Harold_V]

An observation from an uneducated individual (me).
Health care costs started to spiral out of control when health insurance became commonplace. When a faceless entity pays the bill, it's much easier to overcharge, as individuals don't pay the price (that's the theory, anyway, which is erroneous).
Greed, on behalf of virtually all entities involved, are responsible for high medical costs. Here, in the USA, it has become fashionable to rake in as much money as one can, all without putting forth any effort. Many wear, as a badge of honor, the fact that they "earn" (a tern I use loosely) money far beyond the value of effort expended.

We've lost our way, and it's not likely to be found again. Great nations in history have all fallen due to that problem.

"Could care less"? Don't you mean Couldn't care less? Could care less implies one is concerned, but could be less concerned.

Harold

[SteveHGraham]

An observation from an uneducated individual (me).
Health care costs started to spiral out of control when health insurance became commonplace. When a faceless entity pays the bill, it's much easier to overcharge, as individuals don't pay the price (that's the theory, anyway, which is erroneous).

That's exactly right. It's just like college tuition. We started guaranteeing student loans, and now tuition is insanely high.

[warmstrong1955]

An observation from an uneducated individual (me).
Health care costs started to spiral out of control when health insurance became commonplace. When a faceless entity pays the bill, it's much easier to overcharge, as individuals don't pay the price (that's the theory, anyway, which is erroneous).

That's exactly right. It's just like college tuition. We started guaranteeing student loans, and now tuition is insanely high.

Agreed 100%.
How many people check the pricing on anything they get done by a doctor? A test, an x-ray...anything?
Go in, whoever and whatever entity it is, will Xerox your insurance card, and you get 'er done. Cost? No clue. Not a concern. You don't pay for it. Insurance does. Quite simply....you don't care....it's out of sight....out of mind.
That changed a few years ago, for me anyway. I treat healthcare, of any kind, just as I do buying an end-mill or tool.
Bill

[BadDog]

Part of it is.

That's overly complimentary to people who make money from medicine. You seem to be suggesting lawyers are the only cause of unnecessary charges. .

Not at all, that's why I said "part of it is". There is plenty of greed and blame to go around.

[Harold_V]

How many people check the pricing on anything they get done by a doctor? A test, an x-ray...anything?

In support of the notion that it's easy to charge a faceless entity, I offer the following.
Many, many years ago, my mother had a staph infection, manifested as a horrible carbuncle on her chin. She was hospitalized (in isolation) while it was treated. Because of the severity of the infection, the hospital requested permission from my mother to photograph the resulting carbuncle, which she permitted.
When she was discharged from the hospital, on her bill appeared a rather hefty charge for the resulting photograph, which in no way was related to her care or treatment. It was for the benefit of the hospital. I do not recall the outcome, but my mother was then employed by Mountain Bell, who provided good health insurance. I expect the bill was paid. We all paid, in the way of higher and higher premiums.

If that experience had been mine, where I had authority to challenge the totally unreasonable charge, you can bet your last buck, I'd have been in their face. There shouldn't have been a charge at all.

Harold

[SteveM]

An observation from an uneducated individual (me).
Health care costs started to spiral out of control when health insurance became commonplace.

My dad was a dentist. He said that when an elderly person or someone you know could not afford a procedure, you would cut them a break. He said that when you had to look that person in the eye and tell them what it was going to cost, it was different than billing the insurance company (who wasn't going to pay the full bill anyway).

Twice, my dad took a used car as payment for services (reminds me of the line from MASH when Hawkeye said "Some of my patients pay me in chickens"). That Spitfire was a lot of fun.

Another aspect of the current insurance situation is that when a doctor has to spend two hours of an eight-hour day on the phone arguing with the insurance company, he has to make up that lost revenue.

That's exactly right. It's just like college tuition. We started guaranteeing student loans, and now tuition is insanely high.

Someone did an interesting analysis of inflation, and instead of looking at the price that something costs, they looked at how many hours you had to work to buy it. Virtually EVERYTHING was less expensive. For what a stereo from Radio Shack cost in the 1970s in terms of hours, you could today buy an entire home theater system.

Only three things showed inflation: healthcare, college tuition and cars. In the first two, a third party picks up much of the the cost, and in the third, government regulations have mandated various emission and safety equipment, driving up the costs (I am not arguing for or against those requirements, just saying that that is why the costs are up).

Steve