Obamacare: lower than expected premium rates.

[DGM]

Thousands of dollars for products that cost cents to make. Supplying to the medical field has been lucrative for years because if it is medical, you can add a couple of zeros to the price and it'll get paid. That is the area where change has to take place and where the gouging is going on.

I'm interested.

Are you in favor of abolishing the USDA, FDA and the requirements it takes to get a drug certified for use in the US?

 

[RandFan]

That CBO estimate shows the cost going from about $0 to about $160 billion from 2013 to 2016. It's true that it does say:

I'm just a little skeptical. True there are some provisions (like the tax penalty for not getting insurance) that will act to reduce the deficit, but do they really total more than $160 billion?

Have you figured out yet why America pays more than any other nation for health care? If there is any reason to be skeptical of a premise it's that.

 

[Ausmerican]

How does the US lifestyle compare when you use it to compare healthcare cost? Do we live a healthier lifestyle? How about obesity statistics?

Want to go there?

It depends what you want to base obesity statistics on.
Sadly for the most part the term is determined by using the BMI, a totally outdated and inaccurate measure. BMI is only a measure of height vs weight and recognizes no difference between a 240 pound 6 footer that is 5% body fat and the rest lean muscle and a 240 pound 6 footer that is 45% body fat. According to BMI measurements Arnold was morbidly obese when he was Mr Olympia.
Also the requirements for a lap-band surgery were lowered last year to a 30 BMI. At 5'9" and 225lbs I would easily qualify for a lap-band under the current requirements, despite the fact that I have a 34" waist.
Sadly, most of the people getting bariatric surgery these days do so not because they need it but because they see it as a quick easy alternative to diet and exercise.
It isn't.
And many of those same people are going to run up more costs afterwards when they are back in the hospital for revisions, reversals and various other problems.
Obesity statistics are therefore highly misleading. Do we have a lot of overweight people in this country? Absolutely. But we also have a lot of very fit, muscular people in this country as well.

 

[Ausmerican]

I'm interested.

Are you in favor of abolishing the USDA, FDA and the requirements it takes to get a drug certified for use in the US?

I can't for the life of me see what your question has to do with my earlier comment and no I am not in favor of that. I would rather see an additional branch of these departments charged with watch-dogging price gouging.

You are still talking about drugs like the gouging is going on at the high end of drug supply. You were already shown how much a patient is charged for a bag or saline solution compared to the actual cost. The pills I was referring to that are charged so highly for were Motrin and aspirin, not specialized anti-virals or cancer drugs.
You think they are still recouping the R&D costs for Motrin? Or aspirin?
A plastic splint in a hospital can easily cost you in the hundreds.

The gouging is endemic and covers everything from cheap disposables to simple OTC meds up to the top end. There is often actually LESS gouging on the high end items simply because they start out that high to begin with.

 

[maxpower1227]

How does the US lifestyle compare when you use it to compare healthcare cost? Do we live a healthier lifestyle? How about obesity statistics?

Want to go there?

Sure, was there a sudden increase in obesity that correlates in time with the time during which our health care costs started to skyrocket?

 

[WildCat]

It's amazing how people can make this argument. My son for the first time will be able to afford health insurance.

Can he afford the hospital bill?

 

[DGM]

The gouging is endemic and covers everything from cheap disposables to simple OTC meds up to the top end. There is often actually LESS gouging on the high end items simply because they start out that high to begin with.

OK. Show me how to fix this without cutting the wages of all involved across the board? You're not claiming that it's just the greedy pharmaceutical companies?

Tell me, what are the regulations each step along the process has to go through to safely get that saline to the hospital while complying to regulations? Toss it in the mail?

Don't forget post use disposal, you can't just toss that in the trash.

 

[maxpower1227]

Tell me, what are the regulations each step along the process has to go through to safely get that saline to the hospital while complying to regulations? Toss it in the mail?

Yes, I imagine that's about all it takes to get a supply of saline to a hospital. Why would it require any tremendous amount of special handling, let alone enough to increase the cost by an order of magnitude or more?

You are stretching quite a bit here. $7 for an alcohol prep pad that you can buy in bulk for less than a penny a piece. That's a 70,000% markup. There's a 36x markup for diabetes testing strips. 480x markup on niacin pills. A box of gauze pads will cost you $77. For ****'s sake, read the article, and quit trying to excuse obvious price gouging.

 

[DGM]

Sure, was there a sudden increase in obesity that correlates in time with the time during which our health care costs started to skyrocket?

Tip of the iceberg.

The regulation governing anything medical and the liability for anyone that deals with it. We really need more government involvement.

 

[WildCat]

Yes, I imagine that's about all it takes to get a supply of saline to a hospital. Why would it require any tremendous amount of special handling, let alone enough to increase the cost by an order of magnitude or more?

You are stretching quite a bit here. $7 for an alcohol prep pad that you can buy in bulk for less than a penny a piece. That's a 70,000% markup. There's a 36x markup for diabetes testing strips. 480x markup on niacin pills. A box of gauze pads will cost you $77. For ****'s sake, read the article, and quit trying to excuse obvious price gouging.

The hospital charges that because they have to pay the doctors and nurses and administrators and lots of other workers.

 

[DGM]

Yes, I imagine that's about all it takes to get a supply of saline to a hospital. Why would it require any tremendous amount of special handling, let alone enough to increase the cost by an order of magnitude or more?

You are stretching quite a bit here. $7 for an alcohol prep pad that you can buy in bulk for less than a penny a piece. That's a 70,000% markup. There's a 36x markup for diabetes testing strips. 480x markup on niacin pills. A box of gauze pads will cost you $77. For ****'s sake, read the article, and quit trying to excuse obvious price gouging.

No problem. When a shipment shows up contaminated, you'd accept "how the hell should I know how that happened. Sorry your Mom died".

 

[maxpower1227]

The hospital charges that because they have to pay the doctors and nurses and administrators and lots of other workers.

Don't forget the 7-figure executive salaries and the staggering amount of money they spend on lobbying Congress.

 

[maxpower1227]

It's pretty amazing the lengths conservatives in this country will go to to defend and protect excessive corporate profits. This is why we can't have nice things, like a decent universal health care system that every other modern nation manages to provide for their citizens.

 

[Ausmerican]

OK. Show me how to fix this without cutting the wages of all involved across the board? You're not claiming that it's just the greedy pharmaceutical companies?

Tell me, what are the regulations each step along the process has to go through to safely get that saline to the hospital while complying to regulations? Toss it in the mail?

Don't forget post use disposal, you can't just toss that in the trash.

You cant just toss saline solution in the trash? It is water with a little salt in it, you can pour it down the drain.
And yes it gets delivered normally, not by mail but only because of the quantity. It is not a drug.
Do you imagine that everything that gets delivered to a hospital is delivered by guys in Steri-suits using special sterile transports or something? Even surgical equipment that needs to be sterile is delivered by those great surgery specialists, UPS and FedEx. They simply put the product inside a sterile package inside a non sterile package.

And again this has nothing to do with just pharmaceutical companies, much of the inflated prices are on things like slings and splints and screws and a multitude of things that come from common everyday manufacturers.
And as for cutting wages across the board, many clinical staff in hospitals have seen stagnant wages for years now. The money isn't going there.
The huge amount of non clinical staff in administration that are getting their raises every year as well as annual bonuses larger than some nurses annual pay would be a good place to start cutting.

 

[Ausmerican]

No problem. When a shipment shows up contaminated, you'd accept "how the hell should I know how that happened. Sorry your Mom died".

Yeah, because when a package shows up opened or damaged the hospital just uses it anyway. It isn't like they have any quality control programs in place or anything.

 

[maxpower1227]

You cant just toss saline solution in the trash? It is water with a little salt in it, you can pour it down the drain.
And yes it gets delivered normally, not by mail but only because of the quantity. It is not a drug.
Do you imagine that everything that gets delivered to a hospital is delivered by guys in Steri-suits using special sterile transports or something? Even surgical equipment that needs to be sterile is delivered by those great surgery specialists, UPS and FedEx. They simply put the product inside a sterile package inside a non sterile package..

Thank you. You handled that post much better than I did. I was just so stunned by the sheer idiocy of suggesting that price gouging on freaking salt water was due to some special shipping requirements.

 

[Ausmerican]

The hospital charges that because they have to pay the doctors and nurses and administrators and lots of other workers.

Almost every department in every hospital has to justify their man hours against their productivity hours. Generally if it drops below 100% someone is getting sent home to flex out some time and make up the shortfall.
Except of course for administration. Not that it would matter if they went home since they are salaried anyway.
Also most doctors don't work for hospitals anymore, they work for a physicians group that contracts with various hospitals.

 

[Ausmerican]

Thank you. You handled that post much better than I did. I was just so stunned by the sheer idiocy of suggesting that price gouging on freaking salt water was due to some special shipping requirements.

De nada. I sat there blinking and re-reading it a few times too.

 

[Delvo]

The POTUS speech I would love to see, the one where he says "you pay a lot because you need a lot. You ignore your health then expect this not to bite you in the ass."

Ignoring our own health is exactly what people are forced to do by high prices.

You're saying the "need" or "demand" is much greater in the USA than in other countries with practically the same health standards but lower costs. Why? I've seen the old "Americans are fat" stereotype thrown around, but the actual numbers for that claim were never anywhere near as severe as the stereotype, even before the USA got bumped to second place behind a country with significantly lower health care costs, and even then, the timing was wrong because the growth in people's size didn't relate to the growth in costs.

Yes, I imagine that's about all it takes to get a supply of saline to a hospital. Why would it require any tremendous amount of special handling, let alone enough to increase the cost by an order of magnitude or more?

No more need for imagining: I've worked in a hospital storage area. It was no different from working in either of a couple of other storage rooms or warehouses I've worked at. Supplies (including saline bags) came in in cardboard boxes on trucks. We unloaded the trucks and put the boxes on shelves. We took items off of the shelves and delivered them to various departments throughout the hospital, sometimes using an obscure piece of technology known as a "cart". We often brought garbage back down with us and threw it in garbage dumpsters.

There's no place that the idea that there's anything special to this to legitimize prices (and somehow only in the USA, not other comparable countries) could possibly have come from, other than purely making it up. That was a truly desperate move.

 

[RandFan]

Once the govt mandates that people cannot be turned away and hospitals can charge whatever they want to cover their shortfall then you have a problem.

Personally I'm not happy with the ACA. I'd rather have UHC but it's a move in the right direction.