I'm rather irrated this morning. I took my son to the dematologist Thursday for acne problem.

He was prescribed 3 medications.
1 medication was anti-biodics
1 medication was a cream
1 medication was a face wash.

Total amount billed to insurance ?

$1087.00 + Dr. visit (we never saw) $400 billed.

The appointment was 30 minutes.

IS THERE A PROBLEM WITH OUR HEALTH CARE ?

Let me climb up on my soapbox...

Given the markup % the amount of money changing hands is pretty significant. OF COURSE THERE'S MASSIVE PROBLEMS WITH OUR HEALTHCARE!!!

First thought is that its great you guys have health insurance. How many families could afford that kind of care without insurance?

Understand that Doctors are rewarded on a piecemeal basis. The more tests, procedures, etc. they submit, the more they get paid. How well your Son responds has no bearing on it at all. Did he really need all those treatments? Maybe...probably? Who knows for sure?

The Doc will argue his malpractice insurance (MI) is so expensive (and it is) that he has to charge this much to make ends meet. MI rates are the highest in the US by a wide margin.

Most of the other Western, Industrialized countries who provide health care for all their citizens have significantly lower rates for MI. In many of those countries, Doctors can't recall the last time they were sued for anything.

Docs also have massive debt coming out of College and Med School they justifies their rates. In most of the other coutnries that offer a form of Universal or Socialized
health care, most Docs education is paid for by the Gov't. Its viewed as an investment. Often, the local Gov't will chip in for the Docs working in their areas as another incentive.

US healthcare is the most expensive in the world and we aren't even close to the top in terms of outcomes or access. 37th best overall in the world is a crime for the United States...

Hey, but let's not change healthcare too much. Let's nibble at the edges with tort reform and cross state line talk...

Almost forgot, Insurance Companies in those countries are not allowed to generate a profit on basic health insurance policies. Yes, on supplemental policies for things like plastic surgery or health club memberships, but not basic, nuts & bolts healthcare.

The CEO of United Health Care made 342 Million over a five year period with a high water mark of $124.8M in 2005 alone.

Grrrrr....

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Bill in Dayton

[This message has been edited by Bill in Dayton (edited 11-23-2009).]

[This message has been edited by Bill in Dayton (edited 11-23-2009).]

I can honestly say it is shock to my wife and I. We have what is suppose to be excellent coverage through Aetna.

This would've cost between US$4 and US$6 (registration fee)in Taiwan.

Regards

Taike

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Bo pen nyang.

One of my co-workers said that part of the money is for research and development.

BTW.. we paid $105 co-pays for the 3 medications. Should be $1600 pimple

Some is, but not nearly what you'd think...

Read these for a nice short explanation on how it works:
http://mdcarroll.com/2009/10/25/explaining-research-drug-company-expenditures-part-1/
http://mdcarroll.com/2009/10/26/explaining-research-%E2%80%93-drug-company-expenditures-part-2/


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Bill in Dayton

When I asked the walgreen associate about generic versions they said they automatically give generic if available. The one med, had 7% benzoil peroxide, the walgreen version had 10% and more expensive than the co-pay.

It may be a harsher formula than the one your Doc prescribed...

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Bill in Dayton

Guys, the abuses in the medical and health insurance industries are beyond belief.

I am still taking care of my father-in-law, a late stage Alzheimer's patient. Recently, he went into the hospital for the 9th time this year for dehydration (basically caused by neglect at the VA). I typically don't get a copy of the Medicare bill at all. What I get is a Blue Cross detail telling me who pays what. That means, for anyone with just Medicare, it's basically a liscense to steal.

On this invoice, there were charges for Physical and speach theraphy. He's 93 years old and hasn't been able to walk and talk for over 5 years. As of the 4th day of his stay, the place hadn't found the lost papers sent from the VA. They new NOTHING about him...they were not giving him mechanical soft food and messing up on every level possible. The bills for the theraphy he didn't need were over $800.00. The total bill at full price wasa $19,000.00. The insurance negotiated price was closer to $8,000.00.

I don't want to even get started at the physical, mental and financial abuse rampant in the Nursing Home industry.

It's a national tragedy.


Dan, I hope the $1,600.00 pimple healed.


Russ

This from what they bill themselves as one of the nations top 100 heart hospitals.

So if the government would actually get involved in finding answers to those problems, rather than finding ways to pay for it themselves, we might actually get somewhere. If that guy hadn't got his hundreds of millions, and got $50000 a year instead, and all the cost savings were spread among all of the healthcare bills over those years, how much less would the pimple have cost?

What is the relative cost for food, a house, in Taiwan? I mean, if the pimple had cost $60, it's still 1000% higher than it would have been in Taiwan.

Kind of funny talking about how much a pimple cost.. I am about to burst out laughing.. LOL ..

Locally produced food is much cheaper than imported food. Imported food can be very expensive as there's a smaller market for it (distributor's excuse).

Taiwan has enjoyed four years of rising house prices. Prices rose by 8.86% across Taiwan in the year to end-Q1 2008, according to the Sinyi House Price Index. Residential property in Taipei city increased in price by 7.06% over the year.

Sales of upscale properties worth more than NT$30 million per unit (US$922,500) jumped 70% in the year to November 2007, according to a report by Yungching Real Estate Agency, while sales of houses costing less than NT$6 million (US$184,500) dropped 10%.
Real estate agents have observed a noticeable increase in returning Taiwanese businesspeople buying houses or apartments, especially in Taipei.

At the bottom end of the market the complaint is that house prices have climbed beyond ordinary affordability levels. Indeed, Taiwan has the highest price/rent ratio in Asia, at 42:1, exceeding even the levels of Hong Kong, Singapore, and Bombay, India.

Regards

Taike

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Bo pen nyang.

I just did!

Taike

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Bo pen nyang.

My point was this. Medicare is going bankrupt. Social Security is going bankrupt. Government isn't fixing those problems, but adding universal healthcare is going to be a resounding success? I'm having a disconnect somewhere.

I guess the staggering cost of taking care of acne gives no impression of how screwed up the healthcare system is ?

If the insurance and drug compansy can adjust there prices by having competition, than maybe we would have more money to help pay for medicare and social security.

It's screwed up for sure, no argument there. I just think the way they're trying to go about fixing it is very very wrong and is going to create more problems down the road than it solves. Somehow we think just because we want it that the government has money to make it happen. It won't be long when our interest payments alone will be more costly than the 700 billion dollar stimulous program, annually. What then? We'll pay interest on our interest payments? There's a huge melt-down coming. Yeah, stocks went back up this year, but based on what? Based on funny money and still rising unemployment! That sure makes sense.

Both programs need some significant reforms, but this isn't anything new. The GOP controlled Congress & White House over the last 8 years achieved little on improving either.

Eliminating the huge waste that is Medicare Advantage is a great thing. It was never paid for and it never performed the way the private insurance companies claimed it would.

That's not a bad start to help medicare...

Social Security also needs reformed but thats not part of the HC reform efforts as of now. It will need to be addressed.

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Bill in Dayton

The proposed bills in both the House and the Senate are paid for. They actually drop the deficit by over 100 Billion in ten years. If we did nothing, that benefit would not be realized, actually...health care would add to the deficit, which everyone agrees is a bad thing.


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Bill in Dayton

Well then, if the government says it's already paid for, then we have nothing to worry about. No government program has ever cost more than they said it would. Nope, never. Oh wait, they all do. Kind of like unemployment going up and up, but look at all the jobs being saved and created. Just look at all the money we'll be saving by spending it. Guesss I'm just not as smart as some people.

[This message has been edited by FAEbGBD (edited 11-29-2009).]

True the Gov't has a pretty iffy track record at containing costs. Just look at our military expenditures, postal service and Amtrack...

That said, the Congressional Budget Office, Not the White House or the Congress says it will have this financial effect on the deficit. Also, MIT just released a study yesterday that suggests premiums should go down for most Americans' health care costs.

The CBO releases their preview on effect on premiums this week-it'll be interesting to see if their outlook jives with MIT's.

Who's suggesting we have nothing to worry about? This won't be the end of fixing healthcare by a looooong shot. There's not nearly enough in either Bill that addresses costs, so we'll all be back here in a year
working on this again. To address costs meaningfully, we'll need to get everybody in the boat and have some adult type discussion on how best to spend limited health care dollars. IMO, this Country isn't ready for that kind of conversation yet, so I don't see it happening anytime soon. Other Countries have figured this out, why not us? Sometime taxes aren't bad things. Taxes pay for any number of things society has deemed worth it, like Parks, Sewage & Water systems, Education, etc. I have great healthcare and would be willing to pay higher taxes so other Americans could have access to health care. I'd rather pay for them to go to the GP for a $20 co-pay on a check up than hundreds/thousands on an ER visit for a stupid head cold.

Unemployment is going up, but the rate of unemployment claims is slowing, which is better than if it wasn't. Employment is a lagging indicator in an economic recovery, so its one last things that will really improve.

These are all pretty complex issues. Smart people from both political parties haven't figured it all out yet.

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Bill in Dayton

[This message has been edited by Bill in Dayton (edited 11-29-2009).]