Bitter Pill: Why Medical Bills Are Killing Us

[Count 'Bility]

When we had our 2nd kid, my wife refused everything they wanted to give us. Diapers, medicines, etc, everything. We brought our own meals. We questioned every bit of medication they tried to give to determine if it was some over the counter crap that I could get for here at walmart. Both stays were paid 100% out of pocket (for reasons I will not get into) and we saved over 800 dollars on the 2nd visit by doing this way. It was recommended by a farmer couple that we know that has done it with 3 of their 4 kids for the sake of saving money. If you dont question and snoop every little thing or pill that they give and take an itemized list of everything they use, they will bend you over the bed come bill time. We wouldnt even take the water mug they wanted to give her. I brought one from home.

 

That's great, and in a situation like having a child, you can reasonably do that. But what about when you have a heart attack? You are in no condition to make such decisions...

True, and, I understand that. I was just using it to point out how much extra money is charged for such stuff.

[Junior]

As long as we keep paying it, they'll keep charging it.

 

Health care really isn't one of those things you can just decide to not use.

All we need is a law forcing healthcare to have a price list. Its a very simple solution, that actually would force the free market on to healthcare. A hospital that was showing that they would charge several dollars for an aspirin would very quickly no longer have people selecting that hospital.

 

Price caps on life saving drugs would help. As would tort reform, so doctors don't feel compelled to order unnecessary tests just to cover their asses in the event of a lawsuit.

Knowing openly what drugs cost would drive down prices. No one would buy 'Fancy New Drug X' if 'Good Ole Tried and True Drug B' was a fraction of the cost. Antibiotics come to mind, for a lot of stuff a 30 year old one will get the job done for most people on comon infections, but they get prescribed the new one that costs several hundred times the cost. Most people would pick B or X in that situation.

 

Tests make hospitals and clinics money, that is one reason why they order unnecessary ones. I'm hesitant to call for what many want as 'tort reform' as it is often angled to protecting profits, not just eliminate idiotic lawsuits. There are many cases where a lawsuit is more than justified.

 

Agreed, and the tests making hospitals obscene amounts of money is addressed in the article I linked. The general cry of tort reform is appealing, and I think important to discuss. We don't want to make it impossible for someone to file a lawsuit, but I think penalties for baseless lawsuits would be one place to start. Besides, if a doctor's actions were so egregious that it requires a multi-million dollar lawsuit, don't you think that is something that should be addressed through criminal investigations?

[sd'sker]

Agreed, and the tests making hospitals obscene amounts of money is addressed in the article I linked. The general cry of tort reform is appealing, and I think important to discuss. We don't want to make it impossible for someone to file a lawsuit, but I think penalties for baseless lawsuits would be one place to start. Besides, if a doctor's actions were so egregious that it requires a multi-million dollar lawsuit, don't you think that is something that should be addressed through criminal investigations?

but what would happen with any tort reform is a cap on punitive damages, which is a bad idea and unfair to the victims.

[carlfense]

Agreed, and the tests making hospitals obscene amounts of money is addressed in the article I linked. The general cry of tort reform is appealing, and I think important to discuss. We don't want to make it impossible for someone to file a lawsuit, but I think penalties for baseless lawsuits would be one place to start.

What do you have in mind?

 

Besides, if a doctor's actions were so egregious that it requires a multi-million dollar lawsuit, don't you think that is something that should be addressed through criminal investigations?

Generally there are not criminal statutes on point. The focus should be on compensating the injured party.

[Junior]

Agreed, and the tests making hospitals obscene amounts of money is addressed in the article I linked. The general cry of tort reform is appealing, and I think important to discuss. We don't want to make it impossible for someone to file a lawsuit, but I think penalties for baseless lawsuits would be one place to start.

What do you have in mind?

 

Besides, if a doctor's actions were so egregious that it requires a multi-million dollar lawsuit, don't you think that is something that should be addressed through criminal investigations?

Generally there are not criminal statutes on point. The focus should be on compensating the injured party.

 

To your first question, I'm not sure. I'm not going to pretend to know the answer, but I think it should be discussed. The general stance on the left shouldn't be that tort reform is off of the table. Like the article mentioned, I think establishing "reasonable care" guidelines, so that as long as a doctor has met these standards of care for a patient, they are not open to liability.

 

To your second point, I disagree. The focus should be in removing the offending doctor from practice, if it was that bad. But the punitive damages do little.

[carlfense]

To your first question, I'm not sure. I'm not going to pretend to know the answer, but I think it should be discussed. The general stance on the left shouldn't be that tort reform is off of the table. Like the article mentioned, I think establishing "reasonable care" guidelines, so that as long as a doctor has met these standards of care for a patient, they are not open to liability.

I'm fine with tort reform being on the table so long as it isn't just financially insulating doctors to the detriment of their patients. It's good to remember that the reason why malpractice insurance is so expensive isn't because of greedy patients . . . but rather because malpractice is shockingly common.

 

 

Besides, if a doctor's actions were so egregious that it requires a multi-million dollar lawsuit, don't you think that is something that should be addressed through criminal investigations?

Generally there are not criminal statutes on point. The focus should be on compensating the injured party.

To your second point, I disagree. The focus should be in removing the offending doctor from practice, if it was that bad. But the punitive damages do little.

First, we'd need to write some criminal laws to address this because they don't exist. Second, it's still more in the realm of negligence/malpractice than it is in criminal law. Finally, you don't need a criminal conviction to pull a doctor's license to practice medicine.

[Junior]

Besides, if a doctor's actions were so egregious that it requires a multi-million dollar lawsuit, don't you think that is something that should be addressed through criminal investigations?

Generally there are not criminal statutes on point. The focus should be on compensating the injured party.

To your second point, I disagree. The focus should be in removing the offending doctor from practice, if it was that bad. But the punitive damages do little.

First, we'd need to write some criminal laws to address this because they don't exist. Second, it's still more in the realm of negligence/malpractice than it is in criminal law. Finally, you don't need a criminal conviction to pull a doctor's license to practice medicine.

 

Agreed, my stance is just that if a doctor's negligence is so egregious as to warrant $100 million in punitive damages, then I'm guessing he probably needs to have his license pulled and spend time in jail. Just kind of what I'm thinking here. Not saying I'm right... just my $0.02.

[Junior]

Thanks for posting it Junior. This article (and the follow up from Yglesias) has been a hot topic at the hospital.

 

Here's another good read from a few years ago by Atul Gwande:

http://www.newyorker...fa_fact_gawande

 

Interesting article. Sure suggests that tort reform isn't the answer...

[rawhide]

I've been in the medical field albeit (nursing) since '96. Have seen both sides of the spectrum, treatment and patient both. I don't think the hospital in Texas is your normal hospital. It sure isn't like any I've worked at in So Cal. Of course, I never worked at Cedar Sinai or UCLA or USC medical center either.

 

But the amazing thing is hospitals can be money makers. All the doctors in the valley I live/work in purchased 2 hospitals locally and their medical group owns them. I no longer work at either place but from what I've heard things aren't exactly stellar but not as bad as some had predicted. But if this group of doctors invested to purchase these facilities there has to be money made or they wouldn't have done it.

 

Have yet to see if Obamacare has a positive or negative effect on their operations. Only time will tell since it isn't all up and running yet.

 

Malpractice and tort reform I'll leave to others; I pays my malpractice insurance annually so it isn't unreasonable.

[Junior]

http://www.nytimes.com/2013/03/04/opinion/krugman-mooching-off-medicare.html?partner=rss&emc=rss&_r=0

 

When it comes to conservatives with actual power, however, there’s an alternative, more cynical view of their motivations — namely, that it’s all about comforting the comfortable and afflicting the afflicted, about giving more to those who already have a lot. And if you want a strong piece of evidence in favor of that cynical view, look at the current state of play over Medicaid.

Some background: Medicaid, which provides health insurance to lower-income Americans, is a highly successful program that’s about to get bigger, because an expansion of Medicaid is one key piece of the Affordable Care Act, a k a Obamacare.

There is, however, a catch. Last year’s Supreme Court decision upholding Obamacare also opened a loophole thatlets states turn down the Medicaid expansion if they choose. And there has been a lot of tough talk from Republican governors about standing firm against the terrible, tyrannical notion of helping the uninsured.

Now, in the end most states will probably go along with the expansion because of the huge financial incentives: the federal government will pay the full cost of the expansion for the first three years, and the additional spending will benefit hospitals and doctors as well as patients. Still, some of the states grudgingly allowing the federal government to help their neediest citizens are placing a condition on this aid, insisting that it must be run through private insurance companies. And that tells you a lot about what conservative politicians really want.

[BigRedBuster]

When we had our 2nd kid, my wife refused everything they wanted to give us. Diapers, medicines, etc, everything. We brought our own meals. We questioned every bit of medication they tried to give to determine if it was some over the counter crap that I could get for here at walmart. Both stays were paid 100% out of pocket (for reasons I will not get into) and we saved over 800 dollars on the 2nd visit by doing this way. It was recommended by a farmer couple that we know that has done it with 3 of their 4 kids for the sake of saving money. If you dont question and snoop every little thing or pill that they give and take an itemized list of everything they use, they will bend you over the bed come bill time. We wouldnt even take the water mug they wanted to give her. I brought one from home.

 

 

I haven't read the articles or the links in this thread. I am going to because it looks like good information.

 

However, this post caught my eye. I love this. This is what every consumer of health care should be doing until the industry proves we can trust them to be reasonable on what they charge.

Which brings me to a thread that I started a while back on our health care and what Obamacare is forcing us to do over the next few years. Right now we have a $5000 deductible mostly because a few years ago, we flat out couldn't afford the lower deductible that we had. Going to the $5000 deductible has forced our employees to be better consumers. After all, a large part of it is coming out of their pockets.

 

NOW...Obamacare is forcing us to have a lower deductible. This goes AGAINST forcing the public to be better consumers and forcing the health care system to be accountable.

 

Thanks to everyone for the links above. I'll get to them eventually.

[Junior]

When we had our 2nd kid, my wife refused everything they wanted to give us. Diapers, medicines, etc, everything. We brought our own meals. We questioned every bit of medication they tried to give to determine if it was some over the counter crap that I could get for here at walmart. Both stays were paid 100% out of pocket (for reasons I will not get into) and we saved over 800 dollars on the 2nd visit by doing this way. It was recommended by a farmer couple that we know that has done it with 3 of their 4 kids for the sake of saving money. If you dont question and snoop every little thing or pill that they give and take an itemized list of everything they use, they will bend you over the bed come bill time. We wouldnt even take the water mug they wanted to give her. I brought one from home.

 

 

I haven't read the articles or the links in this thread. I am going to because it looks like good information.

 

However, this post caught my eye. I love this. This is what every consumer of health care should be doing until the industry proves we can trust them to be reasonable on what they charge.

Which brings me to a thread that I started a while back on our health care and what Obamacare is forcing us to do over the next few years. Right now we have a $5000 deductible mostly because a few years ago, we flat out couldn't afford the lower deductible that we had. Going to the $5000 deductible has forced our employees to be better consumers. After all, a large part of it is coming out of their pockets.

 

NOW...Obamacare is forcing us to have a lower deductible. This goes AGAINST forcing the public to be better consumers and forcing the health care system to be accountable.

 

Thanks to everyone for the links above. I'll get to them eventually.

 

The corrollary to this, is that if we went to a single payer Medicare system for ALL citizens, then hospitals wouldn't be able to charge at 300% markup on lab tests, because Medicare won't pay it. It would cause a tightening of the belt on the side of hospitals, who are quite clearly ordering unnecessary tests to jack up the costs against people with good insurance (and those without any insurance).

[NUance]

Medical care in America is just plain crappy. The care isn't *that* good. And the costs are outrageous. This is coming from someone who spent a LOT of time with a dying person going in/out of hospitals for two years.

 

For my own care I wish I could find a good, independent nurse practitioner to go to. And just pay her/him cash, at reasonable rates. (I'd rather have an independent doctor practicing out of a small clinic with reasonable rates. But this is a mythical creature.)

[carlfense]

For my own care I wish I could find a good, independent nurse practitioner to go to. And just pay her/him cash, at reasonable rates. (I'd rather have an independent doctor practicing out of a small clinic with reasonable rates. But this is a mythical creature.)

I wouldn't wish that . . .

[NUance]

For my own care I wish I could find a good, independent nurse practitioner to go to. And just pay her/him cash, at reasonable rates. (I'd rather have an independent doctor practicing out of a small clinic with reasonable rates. But this is a mythical creature.)

I wouldn't wish that . . .

That'd work for me. Since I'm fairly healthy. A nurse practitioner could take my pulse, measure my weight and handle any stitches, sprains, or minor injuries I've had during the course of my life. And I wouldn't have to pay $1500 to get a Band-Aid. (Which is what it cost when we took my kid to the emergency room with a minor cut on his forehead a few months back.)