Most people are not aware that Medicare payments to MD’s vary depending on what state or even city you live in for the same service. Medicare payments to a MD are not based on what the MD charges. Many insurance companies like to base their fee schedule on Medicare rates because those rates are sometimes slightly raised but because most times they are lowered. The major HMO’s in this state do not pay a cap or stipend for each patient. It’s based on a contracted rate when a patient is seen. Plus in our state, the physician must pay gross receipts tax (ours is 7%) on all income that is not under contract. Thank you Bill Richardson.

w/o vote accountability/verification, what’s the point?

blackbox voting must be stopp’d.

Many of us wonder why medications are so expensive, but what we don’t keep in mind is that the cost of research and development and testing of new treatments cost millions of dollars, and that expense has to be leveraged out. And while Americans living in border towns trumpet the benefits of buying cheaper drugs in Canada, they don’t know that someone has to pay for their discounted drugs, and right now, that’s us here in the US. It’s a vicious cycle of sorts…everyone wants access to the latest and best drugs, but those drugs only come after many years of very expensive trials, and no one wants to pay for it.

I imagine the overhead alone has got to be at least 20-25% of the total cost for providing medical care. Anyone else think this is an interesting subject?

Stockholders are demanding more return on their investment and, to increase stock performance, firms have been downsizing and raiding the healthcare piggybank. They have also demanded that companies require their staffers to pay more for their benefits or institute a tiered system with different payment levels depending on the wellness of the covered employees.

We’re getting fatter and lazier as a nation with no end in sight. Schools are getting rid of phys ed and recess and children are more sedentary than at any other time in history. Foods are fattening and the hormones in meats are fattening up our children and ourselve (like the livestock they were designed to chubb-up).

Entire city operating budgets will be taken up by healthcare premiums for active and retired city workers and their families. I think it’s the city of Madison or Milwaukee that will spend its entire budget on healthcare costs in the next 5 years–with no money left ot keep the lights on.

With all of this being the case, what systematic changes will the government, industry and individuals need to make?

Unfortunately, rising health care costs made it difficult for the average American to continue to pay for their out-of-pocket fees for indemnity coverage. So, people turned to HMO’s and managed care as a solution for affordable coverage.

This changed healthcare dynamics in this country and several factors that have and will continue to contribute to rising health care costs. These include:

New technology in medical procedures, testing and treatment such as MRI, Chemotherapy and new medications which continue to drive up the cost of health care. Additionally, access to medical information is becoming vital to the future of healthcare requiring many providers to upgrade their computer systems to assure rapid and secure access to patient information.

State and Federal Regulations, Benefit Mandates and Litigation are adding to the costs of administration for both medical plans and providers. Another contributor is the growing number of legal cases regarding medical treatment and outcomes, which increase malpractice rates and medical review.

Our aging population is also adding to medical demands as baby-boomers join the ranks of seniors and increase their needs for treatment and care. The growing number of patients with conditions such as heart disease, cancer and diabetes have helped to drive the development of more effective forms of treatment, but at a greater cost.

One of the biggest is: Americans Want More
Social expectations continue to rise and the demand for more technology and advanced medical treatment also drives the cost of medical care.

Pharmaceutical companies and direct to consumer advertising drive consumer demands for the latest medical options. This contributes to the cost of care,but not always to the effectiveness of these treatments or the quality of care that is needed to balance today’s healthcare environment.

So over the past 25 years, health care costs have continued to rise, along with the American consumer demand for both the latest and most advanced technology.

Unfortunately, as these cost trends for products and services have continued to rise, consumers have been shielded from the actual costs of health care. As with many HMO plans the member never sees a bill, so they have no idea what the real charges were for their treatment.

Surprisingly, health care is one area where consumer tolerance for cost increases, regardless of the value of the service provided in comparison to other products and services, has gone down:

Service 1982 1992 2002 2007

Bread $0.65 $0.85 $1.10 $1.20
Gas $.91 $1.05 $1.55 $2.95
CarWash $5.99 $10.99 $15.00 $18.00
Milk $2.19 $2.85 $3.99 $4.50
Coffee $0.50 $1.00 $3.50 $4.15
Dr. apt $3.00 $5.00 $10.00 $20.00

With the introduction of the HMO copay in the early 80′s consumers began to expect to pay a lower out of pocket cost for their healthcare services with greater expectations for covered services.

I find it surprizing that in America today, no one bats an eye to paying $20 for 4 cups of coffee, a car wash or 2 movie tickets. But many people seem to think it is unfair to pay $20 for a physician visit or surgical procedure!

Before we can change the healthcare system in this country, we will need to address consumer expectations and the continuing trends that impact health care costs.

I think the more important question is:

How can we ensure that every American has access to health care?

Right now emergency rooms are being used as primary health care, when that is not only more expensive, but by the time someone is going to the emergency room whatever is wrong may already be beyond help.

Most Americans don’t even have access to preventive tests because they do not have insurance.

For example, simple preventive tests so as a mammogram or a colonoscopy (which would detect breast cancer and colorectal cancer, respectively). By the time most people have these tests done, it is too late and the cancer is in the later stages of the disease.

If all Americans had access to these and other preventive tests, ultimately, the price of health care would go down. People wouldn’t need to be receiving expensive treatments and surgeries for diseases or other problems that could have been prevented by a test.

We need to make health care accessible to all Americans. Rich, poor, black, white…it shouldn’t matter. Unfortunately, within our current health care system, those do factor into a person’s access to health care.

Most people cannot afford health care. Especially if someone is unable to or not working. Health care is expensive.

The current system needs to be reformed if we ever have any hope to stop people from dying needlessly.