Honored Social Butterfly


Message 1 of 4


It does cost a lot of money for healthcare - no doubt, no matter where.  Our system is also complicated the way we price every little thing, or every service.  It is also pricey because we have a system of insurance coverage (public or private) that pass along cost that do not meet the total price.  That is known as price shifting.  It is also pricey because we perform so many services that have no value or don't produce the good outcome that is desired;  sometimes dupicated services like your own example.


Other countries manage their system of actual healthcare and manage the amount and the payment of services.  They manage their medical infrastructure and the healthcare personel needed by area.  This isn't just for single payer systems either - even those countries which have private insurance regulate these things to keep their cost under control.  They manage the prices of their pharmaceuticals by paying for what is the best for the price; leaving off some of them.


As the article that I used to start this thread indicates they use budgets - global budgets to also help to control cost.  A Global Healthcare Budget is a hard limit on health care spending for the coming year, and then providers and payers negotiate prices for individual services based on that budget cap.


The example you gave of your own situation is a good example of how things could definitely work better to get better care / better outcome at a cheaper price but for other people and situations it might not be so simple or acceptable to them.


All I know is that we cannot just look to demanding a reduced price from whomever without making other changes - My doubts are whether or not WE would like these changes even if they produce lower cost, better outcomes.  When I say WE - I am talking about all of us - pharma, hospitals, doctors and other providers and most of all US - you and me.   


It could be that government might have to pay more for Medicaid beneficiaries to get and keep the providers they need for services.  That is one place right now in some states where we have cost shift.


It could be that original Medicare beneficiaries may have to instigate "gatekeepers" - a primary care provider which the beneficiary picks to manage their care including a required referral to specialist.


It could mean that doctors could no longer form alliances for care especially if shared funds are involve - even though alliances work effectively in certain types of plans like Accountable Care Organizations.


It could mean that treatments that have not been proven for whatever wouldn't be included in Medicare.


It could mean that whatever type of patient advocates groups be scrutinized as to their main funding source and see if it is to our healthcare cost benefit.


To me, price controls through negotiations are the easiest of all to fix - Pay for the best at the best price available  for whatever.





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Honored Social Butterfly


Message 2 of 4

Gail please!!!!!!!  how many times in my numerous posts in which I have said that we need a National health care system I have said that the first thing that needs to happen is the price control of the meds.
But you know as well as I know, that, is not going tohappen. Ir didn't even happen when we did Obamacare. 
And now do you really believe that anything will be done about the price of meds. REally?|
We are now the farthest that I have seen to really deal with our health care in the US. I have no faith that anything will happen in regards to thisissue. and with this Administration?  never

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Social Butterfly


Message 3 of 4

@GailL1 I so appreciate your post! From the first time I heard "Affordable Care Act" (ACA; "Obamacare") I thought this was to rein in health care costs! Why is a hospital room $2500+, why is an X-ray $500?


I went to "emergicare" clinic with EXTREME pain after fall running upstairs; they charged $1800 plus xrays plus scrip (I didn't fill); then the sent me on to hospital for "casting". Even with xrays, hospital needed their own (another $2000) then casting plus re-visit/re-xray, then re-visit/re-xray...


I so wish AFFORDABLE CARE meant affordable care...


Not sure why it can't be reined in, but do know it is why I don't go for health care and have not no matter the insurer. I cannot and will not pay their way.


Thanks, again.

Phil Harris, actor and showman, to John Fogerty of CCR: “If I’d known I’d live this long, I’d have taken better care of myself.”
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Message 4 of 4

So what, in your opinion, happens to the quality/quantity/number of provider of our health care system if we develop price controls as they do in other countries? Think we can turn things around by price controls in various forms - pretty much on ALL providers ?


VOX 12/17/2019 - A CT scan costs $1,100 in the US — and $140 in Holland 


Why are US health care prices so high?


That’s the million-dollar question, and it doesn’t have one simple answer.


The US is still the wealthiest country in the world. It’s home to the world’s leading biopharmaceutical industry. It tends to have the most cutting-edge treatments. All this contributes to higher prices here than elsewhere. But one big and unavoidable culprit is the lack of price regulation.


Insurers there (in many [most] other countries) use global budgets, also common in single-payer systems, to pay providers, capping the amount they’re willing to pay per year to cover all of the services their customers need. It’s a hard limit on health care spending for the coming year, and then providers and payers negotiate prices for individual services based on that budget cap.


Because of America’s high prices, there is a $3.5 trillion industry invested in the status quo. Cutting prices, whether through global budgets or price setting or other rules, means cutting income for health care providers. So those cuts have proven extraordinarily difficult in American politics. Even a clear perversity — like the surprise medical bills patients can face for out-of-network care — is hard to fix because it would cut payments to providers.


~ more at the above link ~







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