alarming cost

Health care cost in the US is very alarming affecting families and sometimes forces them to file for bankruptcy. There is constant change in new technology and its updates, increase in insurance (premiums) and cost of outpatient care. The new machines and technology are very useful even though sometimes costly; they are used for prevention, diagnoses for diseases, for treatment, research and for cure. These machines used in the hospitals and clinics undergo the problem of wear and tear. It takes up on the health care cost for mostly maintenance and for the re-use of these machines. The cost of high insurance premium also gives rise to uninsured families in the US for example. It causes less doctor’s visits because they are not able to afford it. Sometimes would decrease the number of people who are able to receive prevention and early detection of certain diseases in tend increases the number of tests that need to be done after missing the early stages of some preventable diseases. There are some aspect of increasing cost in the US health system, such as bills processing and most of the administrative work. Instead of making all sort of documents for a particular patient and by also sending so much cash on papers, supplies, labor and some inventories. The health care industry must find a way to go paperless and recycle for example, Insurance companies must re-think on how to reduce premiums for most people who are able to afford insurance care, think more for the people than to make profit. New technology can be used by making affordable machines to serve the same purpose or even better. It right to put in place good policies to reduce the alarming increase in health care so that all will be able to afford and enjoy what it really means to have access to care.

Quantity over Quality Health Care

Quality care is receiving the medical attention patients deserve. Doctors are doctors for a reason. If doctors only cared about money, and not people’s health, they should have been businessmen. Primary care is the start to quality care, but most doctors just want to fit in as many patients as possible- more patients more money, but not more care. Primary care doctors should spend more than five minutes with their patients and provide a comprehensive exam. If patients can examine themselves, which soon patients must resort to because doctors aren’t caring for them, they wouldn’t go to a doctor and wouldn’t have to pay for it with their time and money. Most people without insurance suffer because of America’s profit driven system. I believe people who have quality care paid for quality care. This means, people who are not capable of paying such high fees suffer from low-mid income as well as poor health and health care, which include the majority of our population.

I think America spends enough on health care, but most of that is wasted to pay for expenses that don’t involve caring for one’s health. Since when did patients have to suffer from overtesting, medical errors, high administrative costs, hospital inefficiencies and other unnecessary areas? The only person that benefits from overtesting is the doctor, at the patients’ expense! The only thing the patients get out of their visit is an unnecessarily high bill. It is not the patients’ fault that doctors and hospitals cannot maintain their offices. It is also not the patients’ fault that doctors goofed. Hospitals are meant to be clean and doctors are meant to keep it clean. If doctors can ask the patients about their history, patients should be able to ask doctors about their own history, mainly about “did they wash their hands.” So why should patients have to suffer their consequences? It is the doctors that should suffer from their malpractice and their unnecessary costs, not the patients. If they spent half their energy to improve on their administration and inefficiencies as they do on improving their profit margin, patients can maybe receive what they are paying for- quality care.

Medicine as a Band-Aid

Spending more money does not equal better health - this is clearly true in the US. On the supply side of health care there is obviously a long list of unnecessary waste ranging from defensive medicine, administrative costs, malpractice insurance and lawsuits, doctors not washing their hands enough, etc. But this isn't the whole picture.

The demand side of the equation needs just as much reform. I was pretty shocked after reading this article in the NY Times "Big Food vs Big Insurance": http://www.nytimes.com/2009/09/10/opinion/10pollan.html?_r=1&adxnnl=1&emc=eta1&adxnnlx=1253081165-y35BhkGbk5zqTRcphZywfg. I'm just pasting in the text because the author is much more eloquent!

"To listen to President Obama’s speech on Wednesday night, or to just about anyone else in the health care debate, you would think that the biggest problem with health care in America is the system itself — perverse incentives, inefficiencies, unnecessary tests and procedures, lack of competition, and greed.

No one disputes that the $2.3 trillion we devote to the health care industry is often spent unwisely, but the fact that the United States spends twice as much per person as most European countries on health care can be substantially explained, as a study released last month says, by our being fatter. Even the most efficient health care system that the administration could hope to devise would still confront a rising tide of chronic disease linked to diet.

That’s why our success in bringing health care costs under control ultimately depends on whether Washington can summon the political will to take on and reform a second, even more powerful industry: the food industry.

According to the Centers for Disease Control and Prevention, three-quarters of health care spending now goes to treat “preventable chronic diseases.” Not all of these diseases are linked to diet — there’s smoking, for instance — but many, if not most, of them are.

We’re spending $147 billion to treat obesity, $116 billion to treat diabetes, and hundreds of billions more to treat cardiovascular disease and the many types of cancer that have been linked to the so-called Western diet. One recent study estimated that 30 percent of the increase in health care spending over the past 20 years could be attributed to the soaring rate of obesity, a condition that now accounts for nearly a tenth of all spending on health care....

Cheap food is going to be popular as long as the social and environmental costs of that food are charged to the future. There’s lots of money to be made selling fast food and then treating the diseases that fast food causes."

The American way of eating has become the elephant in the room in the debate over health care.

Also check out this related article: "Getting Real about the High Price of Cheap Food" http://www.time.com/time/health/article/0,8599,1917458-2,00.html

"But cheap food is not free food, and corn comes with hidden costs. The crop is heavily fertilized — both with chemicals like nitrogen and with subsidies from Washington. Over the past decade, the Federal Government has poured more than $50 billion into the corn industry, keeping prices for the crop — at least until corn ethanol skewed the market — artificially low. That's why McDonald's can sell you a Big Mac, fries and a Coke for around $5 — a bargain, given that the meal contains nearly 1,200 calories, more than half the daily recommended requirement for adults. "Taxpayer subsidies basically underwrite cheap grain, and that's what the factory-farming system for meat is entirely dependent on," says Gurian-Sherman."

Obesity accounts for 10% of all health care spending?!? 30% of the rise in costs over the past 2 decades? But the US government has spent $50 billion in the past 10 years subsidizing corn (and indirectly fast food)? I think we need to re-evaluate our contradictory policies, examine their long-term and indirect impacts, and be consistent in our objectives. Obesity (and health behavior) is clearly the elephant in the room but merely blaming overweight individuals is not the solution. Prevention isn't just about getting a MMR vaccine or about a yearly physical but is about changing our lifestyles, which could and should be encouraged through public policy. For example, requiring restaurants to post nutrition facts visibly on their menus, or company bonuses for maintaining a healthy weight, etc. We could also tax gasoline and improve our public transporation...gas is about $8-9 per gallon and many more people bike/use public transit. Also, we need to give the health care industry financial incentives to prevent chronic diseases. Otherwise, costs will continue to escalate, whether we reform health care or not. Chronic disease is no longer synonymous with old age either - young adults and even teens and children are increasingly being diagnosed with diabetes, hypertension, etc. In my field (Gerontology) there is some speculation that the current cohort of children may be the first generation to have a shorter life expectancy than their parents. Ironically, as technology improves, we are able to keep the sickest alive which lowers population health but simultaneously raises costs. But if we can change the incentives, "suddenly, every can of soda or Happy Meal or chicken nugget on a school lunch menu will look like a threat to future profits." (Michael Pollan)

Lastly, here's a link to an article about T.R. Reid's new book (the guy from the Frontline video) "Healing of America" :
http://www.nytimes.com/2009/09/15/health/15book.html?ref=health
And an interview with him on NPR:
http://www.npr.org/templates/story/story.php?storyId=112172939

Sorry for the ridiculously long post! But I'm in Texas this week so you won't have to hear me blabbering on and on in class:)

Moving to Taiwan?!?

Hey everyone---

So...I think we are definitely spending enough money, maybe even a little too much. Or perhaps our money is just not being divided into the right places? I think that the US needs to take a step back and realize what are our priorities in this country?? Health care and education should be on top! (Thats another issue though-) So...I think that we need to focus on primary health care for all, especially those who are unemployed and uninsured at the moment-and I also think that if other countries, Taiwan for example...can look at all the wrongs and rights other countire have made with health care systems, and form their own...WHY CANT WE?!?!?! ....I think that its a culture thing pretty much-and we are too selfish and money hungry in this country to learn from others-we have to be "better than everyone else" or something like that...but HAHA are we really at this point?? I THINK NOT. haha...

Also, quality health care should mean that everyone has access to medical treatments, primary care, etc...no matter your socioeconomic status, race, anything! The way I see it is...ok so suppose right now...mostly the wealthy get the best treatments right? Well...suppose the "poor or middle class" people walk around carrying some disease--even the uninsured/unemployed--and they cant do anything about it because of lack of medical care...wellllll...this could affect all the OTHER people living around them..which could spread...and eventually lead to the "wealthy " people-are they aware of this!?!?

We're spending enough

It seems that both articles had a fairly negative view of the financial part of our health system. The Washington Post article used the example of cardiovascular disease as a case study in medical care to follow how our advances are increasing the costs. Over time, these costs will come down, as the technology for creating stents becomes cheaper and as the various drugs come off patent (Plavix, Zetia, etc).

It seems that these questions always come down to a cost benefit analysis. Unfortunately for planning purposes, the benefits are measured in other units than dollars. Is the cost of a slightly more expensive drug worth the 0.5% decrease in mortality? Who makes those decisions? Right now, the market makes it. And the people will pay. We don't want to let people die, even those in pain with little or no chance of recovery. Some of the most expensive, least likely to work treatments are for those patients with little chance of recovery, and we are trying to eke out a few more months. There needs to be some regulation of those decisions, cost benefit analysis and decision trees. We need to make it easier for patients to decline the more invasive options, and easier for doctors to take the less invasive approach when deciding between two treatment options.

There is an adage in medicine "When you hear hoofbeats, think horses, not zebras" which is to say that common things are common. However, we are all trained to make sure that its not a zebra, because there is always a case of "you should have known, but you missed it". This does come down to defensive medicine, which is related to malpractice, but not only malpractice. Its looking into a patients eyes and knowing that they are just the same as your sister, your father, your daughter or your son, and wanting to make sure that you are doing what is best for them. Public health pushes us to think of the big picture, how trends affect medical care and which treatments are the best for the most people, but we as individuals don't like statistics. We play the lottery because we think "I know that for most people, that is true, but what if this one is different". I don't think that mentality is going to change.

As for the idea that happy health care is good health care, I agree for different reasons than other people have stated. Happy people are less likely to sue. People happy with their health care are less likely to seek care elsewhere and have repeat tests. Multiple studies have shown that in cases of medical errors, the best course of action for the practitioner is to admit the mistake, be forthcoming and express remorse. Saying you're sorry isn't the same as admitting guilt. The idea being to develop that relationship with the patient and keep them happy.

There are always little things we can do to keep costs down: like the ideas of choosing lighter colored rooftops and keeping your tires filled to combat climate change, the idea of increasing handwashing and decreasing nosocomial infections and medical errors is incredibly important. Some of the mechanisms in place to make those things happen may not be the most efficient/cost effective (hmmmm....JCAHO requirements), but are certainly a step in the right direction. Free vaccines and health care maintenance/preventative screenings are also a key step in the right direction, and I was happy to hear Obama talk about it.

The NY Times article listed "Not following doctors orders" as one of the main costs, but didn't address it in the body of the text. I assume this means patients not following recommendations. I have no idea how they came up with that number, but I think it would be more if it included public health initiatives. If only it was easy to quit smoking, lose weight, get more exercise, cut fat intake, use condoms, wash our hands.....

Dan Shaer

The articles are generally straight forward and reiterating information we already know. EVERYTHING contributes to the high costs and huge bill of health care ($2.2 trillion). It's a matter of what aspects are the most costly, what can be reduced, and what is considered a waste. The CNNmoney.com article (the "critics" one) claims that up to $88 billion is wasted on ineffective use of technology. The Washington Post article claims that we get what we pay for, better health care through better technology. I do agree that the more breakthroughs and improvements we have in our technology, the better treatments and preventions will be, thus less health problems eventually. I also believe in the concept of "you get what you pay for". However, I do think that there is some wasteful expenditures on unnecessary "technology". I still think that money should be spent on technology (I am a strong supporter of advanced technology), but on more beneficial ones.
As President Obama said in his address to congress last Wednesday, "We've estimated that most of this plan can be paid for by finding savings within the existing health care system — a system that is currently full of waste and abuse. Right now, too much of the hard-earned savings and tax dollars we spend on health care doesn't make us healthier."
Why do MRI scanners cost significantly less in Japan than they do here in the U.S.? The Japanese pay $98 for an MRI scan. In the U.S. they pay around $1200 (these figures are from last week's blog articles). The government should regulate such costs.
As a future doctor I'm sure that I would like to keep my practice up on technology if that technology improves treatments as well as makes my work more efficient. For example, in dentistry there is new technology that takes a 3D digital impression of a patient's teeth and creates an accurate wax impression in the lab using a special wax printer. This replaces the old fashioned alginate impressions (the nasty-tasting slimy material) which are much more prone to errors, are time consuming, and are uncomfortable for the patient. The costs may be higher but the results are priceless. This is the kind of technology that I consider legitimate spending.

Technology advances in everything--EXCEPT OUR OWN HEALTHCARE IT SYSTEMS? WHAT?

After reading the two articles, my sentiments about our healthcare system falls somewhere inbetween the supporters and the opponents. While I do agree that we have to cut down many of our budget costs, I do not agree with Dr. Garson's take in the CNN article. He said, "But any money that is spent on a patient that doesn't improve the outcome is a waste." My concern is how can improving outcome truly be measured when it comes to long-term impact? It is really hard to make value judgments to what improves outcome, especially when it comes to preventative care.

Quality care to me means patients feeling happy about their experiences when they see their doctor or when they stay in the hospital. Quality care doesn't necessarily just mean improving outcome because someone can come out of a hospital feelilng better physically, but they might not be happy emotionally or fiscally even, which may negatively affect their health (and outcome) later on. However, I do agree that we need to cut costs.

The main problem with our healthcare system is its inefficiency in terms of a poor infrastructure and high administrative costs. How can we be spending so much on certain technologies (like treating heart attacks), while forgetting to apply that same technology to our IT systems? Why can't we apply that technology right now on standardizing insurance claim forms? Why can't we apply that technology towards making it mandatory to have electronic health records and drug entry? We have that technology, and we need to spend some money now to save later. By computerizing everything, it allows us to save money on mistakes of ordering extra tests and such.

Put in ≠ Get out (Kelly Leech)

The article, “It’s the Prices, Stupid: Why the United States is so Different from other Countries” by Anderson, Reinhardt, Hussey and Petrosyan, basically explains why the U.S. is spending more on its health care, but not providing higher quality health care in comparison to other developed countries.

The reasons why health care is too expensive are:
1)The inputs are more expensive (salaries, technology, drugs)
2)The system is more inefficient (fragmentation, higher administrative costs, private not public financed)

The reasons why the health care isn’t better quality are:
1)Supply of health care professionals isn’t higher
2)Hospital stays and capacities are less

Although U.S. does have more access to advanced medical technology there is no evidence proving the necessity of this technology in certain health care treatments and procedures (unnecessary costs again!).

So basically, “United States spends more on health care than any of the other OECD countries spend, without providing more services than the other countries do” (Anderson, Reinhardt, Hussey and Petrosyan).

I like this question because it’s a comprehensive critique of the U.S. health care system. Sometimes the debate just proves that U.S. spends too much, but by providing an explanation in relative terms (with other developed countries) why these costs are worrisome (because services aren’t better quality) strengthens the argument for universal coverage.

Quality health care to me is full access to health care – primary and specialty (if deemed necessary by professionals) with no regard to preexisting conditions, socioeconomic status or geographic location. Since the health care system left as a free market cannot provide quality health care, government must intervene to ensure it does. The professional alongside with the government should serve and provide health care for the individual as their human right.

What can we do?

In my opinion, quality health care means that a person, despite their socioeconomic status, could go seek medical treatment when needed. Unless a health care system is accounting for all inhabitants of a country, no matter their ability to pay a bill, then the system is inefficient and quite risky. I often ask myself: what would happen if all of a sudden some horrible epidemic hit the county of Los Angeles. With so many uninsured individuals, how would the system react, what would hospitals do, and how would these community members pay for treatment? It is quite a scary and overwhelming thought. It has become very clear to me that the U.S health care system is in need of a solution. What that solution is exactly, I am uncertain.

Reading through the two articles, I found that they both gave very different arguments. I completely agree that the U.S has made phenomenal progress in the treatment of issues such as heart attacks, cancer, HIV, and many others. When HIV first arose, there were not any antiviral drugs that prolonged the life span of those affected. But now so much has changed and so much progress has been made. Those who have HIV sometimes live full and long lives because of the new technology and medicine that exists. I believe that the article written by David Brown therefore makes an excellent point- these improvements would not be possible if it was not for greater monetary investments. HOWEVER, I believe that the prices of health care in America are in desperate need of regulation. The Pricewaterhouse Cooper data presented in the CNN article was so depressing! 1.2 trillion dollars of overspending due to defensive medicine and over testing, ineffective use of technology, hospital readmission, high administration costs, processing claims, medical errors, ignoring doctor's orders, unnecessary ER visits, and hospital acquired infections! That is outrageous! There definitely is a call for reform, but I still do not know how to go about reform. My question is similar to what many of you asked: How do we cut waste without affecting quality of care? And if other countries could accomplish this task, America should theoretically and practically be able to as well, right?

Where is the money going?

I have often wondered about malpractice in the US. One of the articles mentioned that doctors spend roughly 3% on medical malpractice insurance, but I wonder where else does this hit the patients? I understand physicians practicing defensive medicine, and think its stupid that so many extra tests, over prescribed drugs, and other unnecessary procedures go into covering the doctors from our sometimes litigation happy population. Does the cost of malpractice help to drive up the cost of procedures as well?

Secondly, what about health administration is so expensive? Do we need a better system that requires less paperwork, and relies more on technology? How can we fix this system so it is less wasteful. Why are we the patients paying for a system that seems rather ineffective.

I am all for advances in technology, and believe that sometimes even the smallest decrease in the chance of mortality makes a new treatment or procedure worthwhile. I do wonder however why medical technology does not seem to follow the trend of other technology. When the iphone first came out it was over 500 dollars, but as time has gone on the radio constantly advertises specials as AT&T tries to move this technology. Another student mention this as well, but they seemed to believe that over time this would happen. With cell phones and other technology the markdown seems to happen within months, how long are we willing to wait for this to happen with medical technology. Do we need a system that helps to drive down these prices, or does the government need to help regulate costs like they do in other countries.

To me good healthcare is available and affordable to all. There is a focus on prevention rather then treatment, and high quality care is available without unnecessary burden on the population. Let change the current system. Many changes to make the current system less wasteful could probably begin before an overall healthcare system reform. We can't afford to be this wasteful, and still not receive the level of medical care that other countries who pay far less then the US population do.

Your money vs. Your health

It is truly ridiculous that we are draining away more than $1.2 trillion each year in health care; yet we are not nearly close to being the healthiest nation in the world. I totally agree with “any money that is spent on a patient that does not improve the outcome is a waste” by Garson from the CNN article. Reducing the cost of the health care can be advantageous for patients, but budget cutting in the health care providers, medical technology and pharmaceuticals may not be too beneficial for the patient in return.

The unnecessary tests and procedures that doctors order to protect themselves against malpractice suits is an absolute waste of money and time of the patient. However, the worst part is when patients are exposed to harmful side effects such as x-ray radiation and the over-use of prescription drugs from the unnecessary testing. In this case, patients are not only wasting their money and time but in fact, are getting worse outcomes in terms of quality of health care. The article also said that doctors order defensive medicine simply out of greed. Clearly, a balance between malpractice issues and cost of the health care is needed. President Obama also briefly mentioned that he wants the Dept of Health to work with states to reduce malpractice suits in his recent proposal on last Wednesday. The defensive medicine drives the cost of health care up to $ 210 billion every year; therefore we do need some kind of policy or regulation to prevent a larger amount of money directly going to the drain from the defensive medicine.

Because emergency room medical care is more expensive than routine medical care, we must reduce the number of non-emergencies seen. Most of the users of ER are poor and uninsured people; hence the high price of ER could have been avoided with much lower investments in the primary care unless they need immediately treatments. Here, we need to emphasize more on access of health care. The goal of recent health care reform is to cover all people in U.S. Obama's plan will allow them to treat people with preventative care which is much cheaper and will reduce overall number of emergency room visits. On the other side, if we are to insure 47 million more people, don’t we need more money to cover all of them?

We are spending almost 1/3 of our health care expenditures in administration costs. I believe that the EHR will help save billions in health care costs through improving efficiency and reducing the number of unnecessary medical documents. It definitely would be faster, more legible, and most importantly, advantageous in minimizing the cost of administration and increasing investment on areas actually efficient such as primary care.

The definition of quality in the health care can be varied by individuals; it may deal with the satisfaction of patients and better health outcome. But I strongly believe that access must be the first step toward achieving the quality of health care system.

$1,000,000,000,000.00 = 0

The CNNMoney article showed that $1.2 trillion are dumped into the health care toilet each year. It’s hard to grasp how much a trillion dollars actually is, but written out, that’s $1,000,000,000,000.00. A lot of wasted zero’s. Disgusting. It seems as though everyone is trying to find the culprit of our health care debt pointing at physicians, hospitals, and insurance companies, while we fail to see that we are the spark that ignites much of America’s waste.

The biggest factor that contributes to this excess comes from overtesting, or “defensive medicine.” Our doctors are practicing “defensive medicine” because of offensive patients. Doctors are watching out for their own tails and jobs. This is understandable considering patients willingness to sue at the first hint of human error. I’m curious as to how much money is paid out due to malpractice awards every year? How much of this can we pin to the list of health care waste? A cap to malpractice awards seems reasonable and timely.

We are also at fault for wanting the newest, best, and most expensive health care products and procedures. Examples include: Going to the ER for strep throat, buying $1200 TPA vs. $300 streptokinase, and purchasing the $800 metal stent vs. the $2200 stent. We are “getting what [we] pay for” since we are asking for the best.

I realize that I didn’t cover all of the factors contributing to health care waste, but it still seems that we are the instigators to many of them. The CNNMoney article gave some of Obama’s reform ideas for these factors, and on the surface they look like they will help. But, I am skeptical, yet hopeful. Solution can only be seen after results.

So, in conclusion, is health care a right? Yes. I believe everyone who needs help should receive it. So then, the question becomes what quality health care should everyone receive? The best quality health care or just good quality health care? I think Americans, individually want the best health care for themselves, but this would only deepen our health care debt and fuel our waste. We need to tighten our loose pockets and let out some air from our egotistical minds and consider the idea of community. Let’s go to a general practitioner for minor illnesses! Lets buy streptokinase and the cheaper metal stent! Then, good health care for all!!

How are we not spending too much on healthcare?!?!

One of the main opinions that I keep hearing in repetition is that the US has good health care and that is why our country's annual medical bill is so expensive. Unfortunately, that is a falsehood spoken with a strong bias. We do not have a good health care system or everyone would be covered. If a private citizen can afford to pay for health care or they are given it by an employer then, yes, the coverage usually is very good. However, there is a large percentage of our citizens who do not get those benefits.

What really stood out to me between the two articles is that even though but writers are taking different opinions on whether the US spends too much on healthcare or not, they still were able to make a fairly long and overlapping laundry list of wasteful spending contributors in our health care system.

Unfortunately, a lot of these contributors are part of our broken fragmented circle of health in this country. For example, David Brown of the Washington Post said that this year we will spend approximately $93 billion on the treatment of coronary heart disease. He states that this is worth the money to treat this many people. However, wouldn't it be more effective to stage primary care interventions encouraging people to change their diets and exercise routines, etc. Wouldn't it save billions in the long run to fund prevention instead of just throwing expensive surgeries and medications at the problem?

Also, in Parija Kavilanz's article from CNNMoney.com, it is stated that a few of the overspending problems come from ERs being used as primary care clinics and hospital readmittance because of patients being discharged too early. Both of these problems could be solved with a better insurance and healthcare system. The lack of insurance or insurance coverage is determining whether these people get to see primary care physicians or if they can stay long enough to heal in the hospital!

Between the two authors I noted them both saying that contributors to our overspending were: inappropriate care, defensive medicine and over testing, high administration costs, inflated prices, fraud, processing claims, ignoring doctor's orders, ineffective use of technology, hospital readmission, medical errors, unnecessary ER visits, and hospital acquired infections. In my opinion, no matter how you feel about our healthcare spending, I can not see how someone could look at the list of contributors and say we are not spending too much. I definitely think we are.

not medicine, but prices are killing the patients

Though the United States does offer a wide gamete of advanced and specialty medical services, this does not necessitate offering “quality health services.” If the blog is asking whether the US health care system delivers quality health services, a person must address what “quality health services” include. The US Health Care system (USHCS) offers top-notch medical procedures and offers them without a patient waitlist. In addition the system is well advanced with innovative medical technologies. The USHCS does not offer these services at prices which are practical; these prices continue to increase at exorbitant rates. Both articles alluded to this, particularly” Health care's big money wasters” published on CNN.com. In this article PricewaterhouseCooper’s Health Research Institute gave many startling statistics on how much money is spent each year on unnecessary tests, early hospital discharge leading to quick remittance, administrative costs due to insurance claim forms, and patients receiving grand amounts of primary care in the ER each year. The second article expounded upon the USHCS over-spending. “You Get What You Pay For” article mentioned the inflating rates of health care costs in the United States and explained in addition to unnecessary tests, many unnecessary procedures are performed for patients. The USHCS also chooses to administer expensive medications without sufficient evidence of their medical benefit.
The USHCS offers great, comprehensive health care but it does not offer it at affordable rates for the population. This is a big area where the health care system could use some reform. We have discussed in the past how the USHCS is run much like a business in this country where insurance companies make large yearly profits and people are dropped from coverage on minor, ambiguous claims. For being a business, it would never make the Forbes 500 with as much money that is wasted or lost in the system.
In my opinion, quality health care would be more affordable, not with exuberant prices or administering procedures which are unproven in their effectiveness for the price tag associated. This system overall is not bad, it does offer good medical care, just the prices are killing the patients.

Reasonable cost or complete waste??

Through the articles, I think the cost of nowadays medical care has increase year by year, and drug companies, hospitals and most health care related business companies are all profit orientation. New medical treatments do cost a lot of money, but I don’t think that’s the excuse for spend too much money on health care or medical related cost. Even the new drugs and new treatments seem to do the really good job, but if there is a better health prevention program and education provide to everyone, maybe the number of most health behavior related disease cases have the chance to drop. The waste problems could be improved by many ways, for instance, the U.S. doctors rely too much on the medical-tech tests, sometimes, the simple health assessment and physical examination can determine the patient’s condition; and there should be a family doctor clinics or a primary care center for every county or city, and that should reduce the cost for patients use the ER as a clinic. The electronic health records and other new technologies can also help to reduce the waste of resources and costs. The waste problems could be solved. I think the priority problem is that “Is the health care reform are necessary to everyone?”

The ideal quality health care to me is like everyone can have access to all kinds of health care, and there’s no waste of the unnecessary medical cost. The government should have the national health insurance program for everyone and I don’t mind if there is a little extra co-payment adds to my medical bill. People would not sacrifice their rights to health care or medical treatments just because the medical bills are too much or the insurance coverage don’t cover the payments. I think everyone should have the equal rights to health care.

It All Comes Down to $$

The two articles had very interesting yet different approaches to health care spending in the U.S. I do agree that new technologies that make a significant impact on improving diseases is quite costly and at the same time worth it. Just as technology becomes more affordable with computers, cell phones, etc. I feel that over time, treatments for conditions like heart attacks will also be reduced in price. As long as there is competition in the market, companies will produce cheaper and more efficient technologies. Other countries also treat the same conditions that we do and they are not always in a deficit from it.

It is quite astonishing to realize the amount of money wasted in health care from the estimates that Pricewaterhouse Cooper provided. I can not believe that $420 billion is spent on defensive medicine and insurance claims alone. Though this is a huge inefficiency, I wonder what the U.S. could even set in place to significantly reduce this amount without re-structuring our entire health care system.

In a related issue of costs from Obama's speech (http://www.huffingtonpost.com/2009/09/09/obama-health-care-speech_n_281265.html), he speaks of how reducing inefficiency in Medicare and other aspects will help fund for his new $900 billion plan. He also said that if health care's rising costs are cut by just .10% (less than 1%) that it would save $4 trillion in the long run. I'm not sure how long the 'long run' is exactly, but that is an absolutely astonishing figure.

So all in all, these talks of reducing costs seem to relate to either cutting the quality of health care for patients or reducing waste. I doubt that we would want to reduce treatments for life saving technology no matter how expensive the best care is. So how do we exactly go about cutting waste??

Technology = Friend Not Enemy

In my opinion, quality health care is simply the ability to fix whatever healthcare problems arise within both an individual person and in a population and the ability to prevent those problems from occurring. Unfortunately, we are at the point where the U.S. is simply wasting money on unnecessary technological advances with very little return on the investment. At this point, it’s the economic problem of diminishing returns.

The situation reminded me of a quote used by Obadiah Stane in Iron Man to describe the lack of technology in the Middle East, “Technology has always been the Achilles heel in this region.” The only problem is that we are the exact opposite; as a society, we are always obsessed with the fastest, loudest and biggest technologies, regardless if they are medical or electrical. Consequently, we are always willing to pay top dollar for that tiniest fraction of improvement just so we can say we have the best or are better than our neighbor.

This train of thought is costing the country billions of dollars wasted unnecessarily. There needs to be a regulation system put in to place whether by the government, providers or insurance companies to control the excessive use of some technologies. In addition, we need to learn to embrace technology, similar to what Taiwan and Japan did, with the usage of smart cards to carry information and computers to control claims and billing. Through this, we can significantly cut administrative costs like those two countries did.

Unfortunately, in order to make the changes needed to save money, we are going to need to pay sacrifices through both cutting our health care expenditures and paying extra for the set up of new technologies. I’m not sure how many people are willing to make those sacrifices yet.

Discounted medicine

I don't think you can put a price on health...whatever it takes to stay alive, you know? But $2.2 trillion is excessive to the point that it's ridiculous. I am not against spending as much as possible to keep a human being healthy, but I do believe that there is a way to attain health efficiently and in a way that is financially responsible. We have a lot of other issues in this country besides healthcare...not enough teachers in schools, for example, which could really use a monetary boost. Pouring more into healthcare only means that we are taking money away from other arenas.

I always thought it was amazing just how many acquired illness are from hospital infections. Dr. Atul Gawande has an entire section in his book "Better" about washing hands. Doctors and nurses only wash their hands one-third to one-half as often as they're actually supposed do. And this accounts for something like 2 million cases of acquired hospital infections...of which some 90,000 die. There's an entire procedure for how to properly wash your hands. I don't think any doctor or nurse completely adheres to it--not because they don't care, but when you see patient after patient after patient day in and day out, it's easy to forget or slip up.

It seems logical to not over-spend on anything, but when it comes to healthcare, there's almost this mentality like "how can you put a discount on health?" But just because the price of something is low, doesn't mean that it's of poor quality.

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