Have you ever had a doctor tell you something along the lines of "You don't need this procedure, but the insurance company is going to cover it so why don't we just check anyway, we're just being safe!"
Not really. With the massive deductibles and coinsurance payments these days the conversation is often the opposite. "Doctor, how much is it gonna cost?" (doctor has no clue, she doesn't do billing). "Sounds expensive, what's the risk if we don't do it?" (doctor is wasting her time solving financial problems for the patient instead of health problems).
This sort of behavior, this wasteful behavior that is filled with greed (on the side of the doctor) and carelessness from the patient is what causes a large amount of waste in the healthcare sector.
You need to switch doctors
. Most of those I've dealt with were passionate about their job, helpful to the extreme, if somewhat limited by the time they can afford to spend with the patient.
That's not to say there is no fraud, particularly in the prevalent pay-per-procedure model. I just don't think that adding monetary negotiation to the doctor-patient conversation is going to change much. It would probably reduce cost somewhat (you can skip MRI but you'll need to get X-ray done and have that appendicitis cut out no matter what) and would increase health problems (already happening with people skipping unaffordable doctor's visits and medications and ending up in emergency rooms).
I don't know if this is an issue all around America, though I know where I live the Hospital around me is allowed to veto development of a new hospital in the area if they'd like to. I don't understand the rationale behind a decision like this, though all it is doing is allowing a Hospital to avoid competition which is vital to our market.
I don't know your specific situation but adding more hospitals just for the sake of competition can backfire. One hospital that is 80% full replaced by two hospitals at 40% would probably result in fixed costs driving up the total cost of care and eventually one of them ending up bankrupt. Good for capitalism, sucks for health.
Healthcare demand is generally quite inelastic even when paying out of pocket. I think market-driven fixes are doomed to fail. There is a good reason why most of the developed world solved that problem the way they did. The US will probably experiment for a few more decades at the cost of trillions of dollars and millions of preventable health issues, and still end up with a single-payer system. If not at the federal level then at least in some states.
When I spoke I did not mean every single doctor, or every single patient was like that. I meant that their are doctors that are in it for the $ at the end of the day, some portion of people are like that in every profession.
Patients that are on some sort of healthcare plan that doesn't charge them (Medicare, Other gov plans, Work plans, etc) and simply has a deductible for the entire visit are going to be abused by those doctors that are just going to bill the insurance for more than they must. It's a rite of passage in the Healthcare industry.
In regard to Hospitals being able to veto the development of other hospitals. I think yes, this might be better for costs of the hospitals -- as a large hospital company is going to be able to negotiate better prices and (maybe) pass these cost savings onto consumers. The issue in my mind is that this stifles innovation and competition, as the Hospital that is already present doesn't have to change as they know no one is going to be able to take over their business. They're safe, and can just keep the status quo going.
The problem with US healthcare: It's singular focus is profit.
There a MANY examples of very effective and cost efficient universal healthcare, there are literally ZERO examples of successful purely for profit healthcare systems, but hey lets not let actual real world examples affect our thinking!
As Suchmoon mentioned this is really not difficult and literally the entire rest of the develop world moved on from this half a fucking century ago LOL. Yup a few more more decades, a few more trillion dollars, a lowering level of healthcare and lowering age expectancy and eventually the US will figure out not EVERYTHING needs to be purely profit driven!
Now to start to fucking haggle with a doctor or to shop around for something like surgery FUCK that shit OMG, can my doctor focus on fixing my problems and not selling me his cheap ass services, fuck me sideways, I don't want some hack cheap cunt slicing me open with cut rate shit so he can do it cheaper...
I think that the customer seperation from the cost is a problem, it causes people to be lazy and to disregard the different prices that different companies are charging. The medical industry should be like every other industry in that regard, where you shop around for prices and see what's the best thing to work with. I'm not saying go to the cheapest doctor in town, but I don't think it would kill people to actually take some responsibility with their money instead of just using the first service (like they've always done) because of convenience.
I may go ahead and either make a post on this thread or an entirely new thread with the costs of illegal immigration, we'll see!
