
What makes the US health care system so expensive – Inpatient Care - Anon84
http://theincidentaleconomist.com/wordpress/what-makes-the-us-health-care-system-so-expensive-%e2%80%93-inpatient-care/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+TheIncidentalEconomist+%28The+Incidental+Economist+%28Posts%29%29
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tomwalker
Its the bureaucracy that amazes me (as a European quack).

When I was in LA, I was amazed that small hospitals have teams of individuals
dealing with insurance forms with many specialising in just one company.

I hope that America can lead the way in reforming healthcare and I think that
an entrepreneurial group will shake things up. It will work out better for
patients in the long run.

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protomyth
The entrepreneurial spirit isn't very welcome in health care. In fact, in some
areas of the country you cannot open a new hospital with the permission of the
existing hospitals. Expect medical devices to get more expensive with some of
the provisions of the new health care bill.

I still think the US missed the boat by not properly looking at input costs
and risks in the health care system.

    
    
      It is far too expensive to certify a drug or device.  Even with all the testing, the company is going to get sued.
      Medical training costs a lot of money - spend some of the Government money on scholarships for high GPA students
      Do a flood style insurance by the government for cases of over $100K
      Allow real medical saving accounts that can be inherited

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carbocation
An interesting read, in which I learned that Americans spend far fewer days in
the hospital than others, but our costs per day are ~2x average, and we
receive 25% more procedures than others. I wonder how much of this is waste
due to either profit motives or fear, versus how much is due pioneering new
procedures that will gain widespread usage a few years down the road
elsewhere. (That's intended to be a sincere question.)

One sentence struck me as odd, confusing me as to what the author was trying
to demonstrate:

> "In fact, the increased numbers of percutaneous coronary interventions, knee
> replacements, coronary bypasses, and cardiac catheterizations alone accounts
> for an extra $21 billion in additional inpatient costs."

Percutaneous coronary interventions are life-saving procedures. It's a bit odd
to see them lumped in with diagnostic caths and knee replacements. I would
like to see _at least_ X PCIs, where X is the number of myocardial infarctions
that occur each year.

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illumen
It's quite complex to compare countries. Especially when other social programs
can reduce hospital visits dramatically. For example: reducing alcohol related
violence, lower gun shot /knife wounds, housing people reducing homeless
hospital visits, lower obesity reducing many problems, sexual disease
education reducing STI/STD, easy contraception availability, better sexual
education, free medical care meaning people go earlier to get help reducing
the cost down the line... the list just goes on and on.

Countries with better social services can often save money on medical care
down the line.

So just comparing medical costs is silly. You need to take into account other
social, and education programs too.

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lefstathiou
After years of covering the healthcare industry I would argue it is actually
an easy answer: people have been too far removed from the actual cost of
healthcare. Nobody knows who and how their healthcare is paid for which is why
one night in an emergency room can cost $15,000, completely defying all the
laws of supply and demand. Without getting into pricing theory, a general rule
of thumb is that if you provide a service that is unaffordable even to the
rich (so 99.9% of society), market forces will put downward pressure on your
pricing. This doesnt happen in healthcare because everyone but the individual
pays for it (it either comes from your work, your insurance company,
subsidized by someone else or the government).

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theBobMcCormick
Intuitively that seems to make sense, but how does that account for almost
every first world country _except_ the US? In countries like Canada, the UK,
etc. healthcare costs don't seem to be nearly as out of control as they are in
the US, yet I would expect that patients in countries with socialized health
insurance (like Canada), or socialized health care (like the UK) would be even
_farther_ removed from the actual cost of healthcare than their US
counterparts. Why are their healthcare costs not dramatically more out of
control than costs in the US?

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known
Is it a good idea for Gov to provide free diagnosis? And patients will pay
hospitals for treatment.

