Thread: How to bring health care costs down?

I recently noticed that the United States spends more money per capita on health care than any other nation, and we get less for our money relatively speaking. Health Care Spending

I was just wondering if anyone had any bright ideas as to how to bring costs down?

- Programs to hire/train more doctors/nurses.

-Stop treating patients for problems they don't have, such as mandatory additional testing, refering patients to specialists simply for a second opinion, etc...

- Stop over prescribing medicines such as chronic pain killers, anti-depressants, etc...

- Upfront billing, no more $500 line items for medication when the only medicine received was ibuprofen, $1000 for 10 minutes with doctor Schmuckatelli, etc...

- Stop allowing the uninsured to pass off the costs to the taxpayer through ER visits or tax deductions.

- We could also throw tomatoes at President Obama until some of the people in the mental health ward develop a sense of humor and decide to start getting better.

Any other thoughts, ideas, concerns, suggestions, complaints, assumptions, or jokes?

Make people pay for their own health care.

The end. Problem solved. Next.

We have three health care systems in the US, private insurance, single payer and government run.
Government run has the lowest costs, and the results are equal or better than private insurance, which is the most expensive, single payer Medicare falls in the middle.

So how much do you want to save?

Wow, it's amazing how you just say that the more socialized a system is, the better. Time to go to Cuba, everyone! For the best healthcare on the planet! Who's with me?

Originally Posted by .3dontVoteParty

I recently noticed that the United States spends more money per capita on health care than any other nation, and we get less for our money relatively speaking. Health Care Spending

I was just wondering if anyone had any bright ideas as to how to bring costs down?

In framing the question (in the bit I've bolded), you've suggested the answer: relentlessly pursue greater value (health outcomes achieved per dollar spent) in the health care system.

Now, you could write entire books on how to do that but the gist of it would be to improve incentives (primarily by changing the ways we pay for care) and improve the way we deliver care. We can take lessons from pockets of innovation around the country that delivery high-quality care while keeping costs in check to get a better handle on how, specifically, we achieve that latter goal. Some of the short answers to that would be: use data, rely on evidence-based care, and focus on the processes underlying care delivery.

Originally Posted by .3dontVoteParty

I recently noticed that the United States spends more money per capita on health care than any other nation, and we get less for our money relatively speaking. Health Care Spending

I was just wondering if anyone had any bright ideas as to how to bring costs down?

- Programs to hire/train more doctors/nurses.

Those programs are expensive.

-Stop treating patients for problems they don't have, such as mandatory additional testing, refering patients to specialists simply for a second opinion, etc...

A lot of these are done by doctors to prevent being sued for accidentally missing something a patient feels they shouldnt have missed. Doctors are very paranoid about being sued for malpractice because those kinds of lawsuits can be very expensive and damaging to their professional reputation. It's the same reason surgeons will refuse to operate on certain patients; the risk of death is too great for the patient which brings down that surgeon's "stats", lower stats means institutions wont hire or keep you on.

- Stop over prescribing medicines such as chronic pain killers, anti-depressants, etc...

The high costs associated with this have a number of different reasons, many of which link back to the pharmaceutical industry and a public that wants to just take pills for everything.

- Upfront billing, no more $500 line items for medication when the only medicine received was ibuprofen, $1000 for 10 minutes with doctor Schmuckatelli, etc...

Not working in the medical billing sector, I couldn't address this.

- Stop allowing the uninsured to pass off the costs to the taxpayer through ER visits or tax deductions.

There is only one way to do that and many Americans froth at the mouth if you suggest it.

Any other thoughts, ideas, concerns, suggestions, complaints, assumptions, or jokes?

Universal healthcare.

That is THE single best way to bring our healthcare industry under control. Virtually every other first-world nation on the face of the Earth has some form of universal healthcare and they have lower cost of healtcare per capita and a better healthcare system than we do.

There is no getting around this, universal healthcare is an absolute requirement for the 21st century in America and I have yet to see a convincing argument against the idea.

Greenbeard, you suggested use data, rely on evidence-based care, and a focus on the processes underlying care delivery, in addition to looking to the areas in the country that have been successful in bringing costs down.

Utilizing data a little better would of course mean getting everyone's medical records to become digitized, which would require a lot of labor-hours and a lot of money, but I agree, the more data we can collect in regards to an individual's health, the better, then it would be up to the doctor to make the best use of that.

The processes which underlay the delivery of care I would guess are the prescription process, the referral process, and the decision process. Decisions are the responsibility of the patient, ultimately no medical care can be forced on an individual, although this fact frequently escapes many patients who are warned that if they don't go along with treatment they will get sicker. An example is someone with an abnormal liver test result who goes in for months of expensive testing only to find out there is nothing that can be done and to eat healthy and exercise more. There is no solution to this other than more education for patients and doctors in regards to the effectiveness of treatments, and of course this would tie into using evidence, rather than policy, to dictate what medical care is to be provided.

To look for pockets of innovation we need look no farther than the Federal Employees Health Plan, which is comparable to any of the best private insurance plans offering many different plans at competitive prices. Of course this plan costs money, but overall I think individuals pay less on it than if they continue to go through the ER, charitable contributions, or tax-deductions.

And Goober, sir, I'd like to save a lot, but single payer is sort of a misnomer isn't it since it is mostly paid for by taxpayers which is the opposite of single payer, it's like, everyone pays...

Originally Posted by C-B-M

Wow, it's amazing how you just say that the more socialized a system is, the better. Time to go to Cuba, everyone! For the best healthcare on the planet! Who's with me?

For the buck, we don't come close to Cuba, they spend 10% of what we do, and the results are fairly close.

Or do you consider it wise to spend a lot more, and get roughly the same quality product?

Originally Posted by .3dontVoteParty

...
And Goober, sir, I'd like to save a lot, but single payer is sort of a misnomer isn't it since it is mostly paid for by taxpayers which is the opposite of single payer, it's like, everyone pays...

Single payer reduces overhead.
Instead of different forms, different rules and different coverage for each insurance provider. You get one set of rules, one set of forms, one payer for all services.
This saves around 20% of the cost of health care.
You know what we pay for health care? You know what 20% of that is?

3 words:

Market
Based
Reforms:

3) Promote choice and competition through insurance market reforms. Today’s health insurance markets are less competitive and increasingly dysfunctional, especially for those who have a change in coverage or move in and out of coverage. These churning effects result in patchwork health care coverage that fails to ensure continuity of care or portability of coverage.

In moving toward a more consumer-based system, insurance market reforms should focus on creating the right incentives to deliver better value to the consumer. Consumers should have greater choices, and plans and providers should be able to offer coverage and services that meet the needs and demands of the consumer without excessive government interference. Moreover, insurance market reforms should help to stabilize health insurance, promote individual ownership, and facilitate greater portability of coverage.

Congress should focus on removing market barriers to interstate purchase of health insurance, addressing access issues for the hard-to-insure, and making pooling arrangements more effective. Congress could also build on existing law to improve opportunities for those who currently own their health insurance to switch plans without penalty or fear of losing their coverage. Today, health insurance regulations provide protections for those who move from employer-based coverage to individual coverage or from one employer plan to another. However, similar protections do not apply to individuals wishing to switch from one individual plan to another individual plan. Such a simple reform would promote stability, portability, and personal ownership.

4) State-based reforms. States play a critical role in health care reform. States regulate the small group and individual insurance markets, establish benefit requirements, and administer the Medicaid program. These core functions directly impact the availability and affordability of health insurance. Significant variations exist among the states, not only in geography and demographics, but also in how their health insurance markets and medical delivery systems are organized and financed. Therefore, federal health care reform should include a strong state component that provides additional federal flexibility so that states can better tailor reforms to fit the needs of their citizens.

States should get started right away. There is no need to wait for Washington. State policymakers should begin by assessing their own health insurance challenges related to insurance markets and their Medicaid programs. State lawmakers should look for ways to scale back costly regulations and mandates that drive up premiums and discourage healthy consumers from entering the market. On Medicaid, states should maximize existing authority to better engage enrollees in their health care decisions. At the same time, state policymakers should pursue innovative ways to advance a consumer-based marketplace at the state level. Good state experimentation can help to identify future federal changes necessary to achieve full reform.

Read the rest here: Restarting Health Care Reform: A New Agenda