What makes up the bulk of health care cost increases?

We all lament that health care costs keep rising, seemingly without limit.

But where do the cost rises come from? Who keeps raising the rent?

I think once we get a handle on what area the rising costs are coming from, we will have a better handle on what to do to keep costs in check.

I honestly don't know. That's why I'm asking.

thats where most of our money for health care goes and the areas that are likely to be restricted to contain costs and insure broader coverage for people in the years in between.

It's awful before a family comes to the realization that grandma won't pull through this time. Very touchy subject.

Newborns, we're getting better at it all the time, saving littler and littler ones.

The ratios of how many newborns we save might be going up - and among the premie crowd, we are doing better and better.

But each year, more babies are born in poor health. Jaundice, a condition that touched none of the babies I watched being born back in the seventies, is now considered "normal" Up to seventy per cent of all newborns now have this condition.

Oh well. What is important to a society?

I think we should be asking - Which is more important: Having Glade plug ins keeping the air smelling nice, with benzene and formaldehye spreading through the air and into the body of a pregnant woman, or healthy babies?

Unnecessary services being rendered, and an archaic excuse for a records and followup system, and on and on and on...

preventative treatments and diagnosis until the problem became critical.

All of these factors, and more, tell us it's time for comprehensive and systemic overhaul.

prescription drug benefit Part "D" is, that even though I refused to participate in the travesty, my drugs, which I pay cash for, have almost doubled in price. I do get a small benefit from my co-pay insurance, but they aren't shouldering the full burden of the startling increases. Since Medicare couldn't bargain for prices, the big PhRMA companies can charge anything they want. The increase in prices gets passed on to everyone, even those who don't get Medicare or Part "D". If we allow the for profit health care industry to write the benefit package for universal health care, like they were able to do for the prescription fiasco, the results will be something similar.

and staffing has been cut to dangerous levels so don't look there. Docs are having to see twice as many patients to make the same money they did 10 years ago, so don't look there. Executive salaries throughout the system have grown a lot, so that might be a better place to look.

However, you might look at the ridiculous duplication of services and expensive technologies within separate markets so that all hospitals can be all things to all people instead of sensibly specializing.

Huge ticket items like MRI scanners have been duplicated in even smaller markets like this one in NM, an insane expense that could have been avoided in a rational system.

Another issue besides sucking profit out of the system is the exponential growth of bureaucracy, again redundant and necessary to deal with the often Byzantine paperwork from competing systems. Insurance companies are devoting more and more overhead to staffs whose job it is to devise ways to keep sick people off the rolls and avoid giving care for people on the rolls who get sick.

The cost of healthcare is skyrocketing for a multitude of reasons, but they all come back to the insurance industry, phony competition, and sky high administrative costs.

The thing I don't understand about large-ticket items like MRIs is why they're still large-ticket items.

MRIs aren't especially new, advances in technology have led to miniaturization of control electronics, the control and visualization software is essentially off-the-shelf, and there are scads of them, more so each year. So why do they still cost so much? Shouldn't an increased supply of them, plus increased efficiencies in production, mean that the cost should come down? I know the magnets are the most expensive component of MRIs but does the cost of producing magnets go up each year enought to more than offset all the other market forces that should be driving costs down?

But it's not just MRIs. I recently had to have my BiPAP machine repaired. The deal with the insurance was that they would pay for either the repair or a new machine, whichever was less. The repairs came to over $1,000 which means to replace that >5 year old machine with a comparable new machine would have cost at least $1,100. Why does a machine that is essentially a blower, some valves, control electronics and embedded software still cost so much?

It doesn't make any sense to me and indeed some devices have come down significantly in price even while becoming much more advanced in features. For instance, ten years ago a simple pulse oximeter would have easily cost nearly $1,000 but now I can get one as good, if not much better, for around $200. $100 on eBay. Why doesn't similar price deflation apply across the board?

and, unlike flat screen TV sets, it's made here in the USA.

The miniature pulse-ox has come down in price because it is an assembly line item now. Lots of health care professionals are now carrying them on keychains and in pockets, meaning there is a much larger market for them.

They were very expensive at the beginning because they were huge.

Like I said in my reply to cosmik, I understand they're not mass-produced consumer items. I'm just a little perplexed that they haven't come down quite a bit in price because of advances in technology and greater sales. On the other hand, like cosmik said about liability coverage for home med equipment sellers/repairers, I can see where MRI manufacturers would need outrageous amounts of insurance. After all, every single time their machines are used somebody's life or well-being is on the line and one mistake could mean that tumor or brain lesion is missed or, worse, something shows which really isn't there and people have unnecessary surgeries.

And then I suppose there's the potential for a mishap like with that one CAT scan machine (I think it was a CAT scan machine) a few years back. There was a software bug that caused it to suddenly go to full power and giving a woman severe radiation burns.

The manufacturer and the repair people who maintain that BiPAP have to carry large liability coverage because they frequently get sued by users who find some way to hurt themselves with it.

It is a common expense for medical manufacturers, refurbishers, and repair persons. (I was the latter. I never got sued, but more than one of my employers did get sued.)

An MRI typically costs over a million dollars and requires a special room to operate. To recoup your cost plus a reasonable return on investment, you have to charge a lot of money.

But on the brighter side, you can now get a reasonably accurate Blood Pressure machine at Walgreen's or CVS for about $50. The technology for Pulse Oximetery and BP took a hugh leap in the 90's when it all went digital. Now they are just "consumer electronics."

I had no clue about the liability coverage. How the frack do people hurt themselves with CPAP or BiPAP machines? Unless you buy the set up manual on eBay or something, it's not like consumers can change their pressure settings themselves. Oh, I know, where there's a will there's a stupid.

Or is the liability coverage because people who sell/service CPAP/BiPAP also sell home oxygen equipment and O2 cylinders? That I can see how people could easily get into trouble, especially if they have gas stoves or furnaces.

As far as MRIs, I understand how big and complex they are. And I do understand that they're not consumer items. I would have expected though by now they wouldn't be as expensive because of the reasons I outlined in my previous post.

Lowest I got paid as a RN was $4.50/hour in 1978. For what I do, the education, training, experience, responsibility, damn straight I want a bigger paycheck than $15/hr that I got 10 yrs ago. I am up to $25/hour now, and it is almost enough, considering where I work.

If I worked ICU/etc, I would want more since it is more intense, more immediate life threatening stuff going on, much much much more responsibility.

The other thing I want is to have a patient load that does NOT endanger the patients. One way to cut nursing costs is to cut a position, and share that nurse's patients between those of us remaining. Not a very good move, liability-wise.

I see the biggest increase coming from insurance companies that want to make more money while paying out less, and insurance companies that provide liability insurance for health care providers (again, want to make more, etc). Legalized extortion, legalized gambling. Insurance companies don't give a shit about any of us, they just want to make money

Enough to be happy.

When Frima Harrup, the syndicated columnist, wrote about the health care situation, she pointed to a hospital in Rhode Island that keeps asking its HMO providers to give it an extra 10% a year so that there will be better care for people at the hospital. Each year that request is denied.

The CEO of the HMO recieves a salary equal to the salaries of the 3300 employees at that hospital! Is that obscene or what?

I don't blame the MD's, it's the patients who demand it. Lets say it's a hot day, a guy is out working in the yard, does not drink any water (duh)gets dehydrated and dizzy. Wife freaks out and calls 911 (duh) ($$) instead of getting him cool and some water (no cost) Symptoms are dizziness, now he is ER. Ok. It could be a stroke, so CT ($$)scan and MRI ($$$) are done. Negative. Could be an arrythemia, get cardiology ($$), EKG ($), Echo ($), lab work ($)stays overnight ($$$) to monitor. Feels fine in the morning after some fluids and rest (which would be cheaper at the Holiday Inn) goes home. All that technology just wasted.
People have lost all common sense.

Both medical insurance and medical service companies are huge for-profit corporations with huge overhead in staff and buildings and a whole bunch of greedy stock holders who expect to constantly make higher dividends every years.

Back when health care was a cash transaction between a patient and a doctor who's office was in the back of his house only two people were ever involved, and only one of those people, the doctor, had to be paid. Now every doctor visit involves at least seventy two people, sixty four of whom are not even present at the doctor's office, but work on the ninth floor of the medical insurance company or the twenty third floor of the holding company that owns the medical services corporation that runs the medical center where your doctor, his three nurses, two receptionists, billing secretary, medical transcriptionist, appointments clerk, and beefy, muscular collections manager all hang out.

The problem is that the whole doctor thing is no longer about helping people, it's all about making a profit for investors, and all on the backs of sick people.

who go to the ER, or who just cannot pay. Hospitals have to take everyone and to cover the uninsured sick people, who wait until they are really sick to come to the ER - they have to raise charges for the rest of us.

My belief is that it is due to GREED. Primarily by insurance co's and big pharma.

"DR. DAVID HIMMELSTEIN: It's what we used to call national health insurance. So government collects the money for health care from taxes, you don't pay premiums, instead you pay taxes, and pays all the bills. Hospitals remain privately owned and operated. Doctors remain mostly in private practice. But their bills go to the government insurance program, just as they do today with Medicare, but we'd be able to streamline the payment system if we had only one payer instead of Medicare being one among many.

So a hospital would get paid like a fire department does today. You have one check a month that pays for the entire operation. And that means you can eliminate the huge billing apparatus of the hospitals and the doctors offices where we're employing many people to do our billing. And fighting with insurance companies. You save $400 billion a year that way..."

http://www.pbs.org/moyers/journal/05222009/transcript4.html