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Quote:Define "normal".


What are they visiting for?


As in an average person.


Let's say a 35 year old man has a sore chest on goes to his doctor to see what's up. How much is that?
Quote:Depends on what the visit is for, a physical is about $200.00.


What would the minimum be, without a physical?
Quote:Which regulations and which barriers to entry? Can you provide examples?


Sure, Florida has a Certificate of Need requirement where someone who wants to build a hospital has to have the State's approval to do so. This restricts supply and increases costs.


Certain outpatient services may not be performed without the oversight of a physician. This restricts supply.


Insurance companies cannot sell across state lines meaning they must replicate administrative functions in every state where they do business. This increases cost.


Dozens of these situations exist, all related to overregulation.
Quote:As in an average person.


Let's say a 35 year old man has a sore chest on goes to his doctor to see what's up. How much is that?


Medicare, which creates the foundation of all fee schedules, pays about $70 for an acute visit of midling severity.
Quote:What would the minimum be, without a physical?


A physical is a visit, so its a good baseline for cost.
Quote:Sure, Florida has a Certificate of Need requirement where someone who wants to build a hospital has to have the State's approval to do so. This restricts supply and increases costs.


Certain outpatient services may not be performed without the oversight of a physician. This restricts supply.


Insurance companies cannot sell across state lines meaning they must replicate administrative functions in every state where they do business. This increases cost.


Dozens of these situations exist, all related to overregulation.
 

1) You assume the state government is the only barrier to entry. It may simply not make financial sense to build a hospital. There may be no demand for one. 

 

2) Not sure why you wouldn't want the oversight of a physician. They are your primary healthcare provider. 

 

3) There is a good reason they don't sell across state lines. Insurers would cherry pick where they provided business, potentially to the states with the healthiest populations. This would create a race to the bottom as insurers would get to choose both their regulator and their risk pool. 

Quote:What are her alternatives? Maybe you can point to a link where she can buy affordable healthcare insurance that will cover her drugs. 

 

Off topic: Are you always such an [BAD WORD REMOVED] hole? I'm sure you blame her for having whatever condition she has that requires her to take the drugs. 
 

Plain and simple, I have no alternatives. Obviously if I did, I would use them. My health insurance situation is way too complicated to explain here.

 

Yes, FSG is always an AH - especially with me. Being on my ignore lists probably saves him from getting warnings.

Quote:How much does it cost for a normal person to visit their doctor?
 

A psychologist told me at one of my appointments with her because everyone has problems, I am as normal as anyone else. So there is no answer to that question because, well, everybody is normal.
Quote:Plain and simple, I have no alternatives. Obviously if I did, I would use them. My health insurance situation is way too complicated to explain here.


Yes, FSG is always an AH - especially with me. Being on my ignore lists probably saves him from getting warnings.


Ah?


As in Ah-Ha? Great 80's band
Quote:Why don't you explain it to us. I'd like to hear your answer.


Cough cough cop out cough
Quote:Based on your definition, unless you have the means to finance the total cost of an injury or disease you cannot get health care without health insurance. So arguing over your semantics is quite literally an absolute waste of time.


Somehow even with such low expectations you still manage to disappoint me....
It's a complex issue for sure. I think the problem is largely in the cost of the healthcare itself. $1000 for an aspirin ect ect. I think a large portion of why the costs are out of control is that we use insurance to pay for everything. Insurance as a concept, is supposed to be to cover the unexpected and things that would be too expensive to budget for but by spreading the risk over a large pool of people, it becomes manageable. When insurance pays for everything, it distorts the prices of things. Instead of making a choice about whether you have x or y done, you get everything done because the insurance is paying, so there is no natural price control set by limits on the demand, that causes prices to explode. 

 

Why is more expensive for my family members to use their insurance to get some medications than to just pay $4 out of pocket and not use the insurance? See, that seems like a scam to me? What price is it really when the insurance pays?

 

If you look at some things that insurance does not cover, that you pay out of pocket for, those prices often come down a lot. Take LASIK, that used to thousands and thousands of dollars, now you can get that done for about 300 dollars an eye in many places. 

 

I don't have all the answers to this mess but I think many people need insurance that covers what they actually need and not what they don't. I'm a pretty young guy and in good health, I don't need the same plan as a 55 year old with hypertension and diabetes. I just need a plan that covers me if I get cancer or something. I don't need every bell and whistle, every hangnail covered by my insurance. If we stopped using insurance to cover trivial crap like that, the prices on that trivial stuff should come down a lot. 

 

Tort reform would also make a lot of sense. I wonder how much of the cost of medicine is there simply because of frivolous law suits and people who got care but could not pay the bill or illegals who don't belong here in the first place. 

Quote:1) You assume the state government is the only barrier to entry. It may simply not make financial sense to build a hospital. There may be no demand for one. 

 

2) Not sure why you wouldn't want the oversight of a physician. They are your primary healthcare provider. 

 

3) There is a good reason they don't sell across state lines. Insurers would cherry pick where they provided business, potentially to the states with the healthiest populations. This would create a race to the bottom as insurers would get to choose both their regulator and their risk pool. 
 

Oversight of a physician sounds GREAT!!!  But then when you look closer, when you mandate that a service has to be provided by the guy with 500k in student loans that went to school for 7 years before doing 5 years of residency you understand why it exponentially increases the cost of getting a routine prescription updated. 

 

Also the greatest mitigating factor for cost is consumer choice.  The current system allows certain state markets to have a single option for service.  That's the death nil for consumers.  Allowing competition across state lines increases the available competition and thus the quality of the product for the consumer.  If you want to have common sense basic regulations then that's fine, but creating 50 artificial monopolies isn't going to help anyone. 
Samjag, I do not necessarily disagree with you, but your point totally ignores the fact that expected medical expenses includes drugs for conditions that patients had most or all of their lives. I can only use my own situation as an example, so please don't think I am being selfish. Millions of Americans are in the same boat.

 

I have epilepsy. Treatment is two drugs - one twice a day, the other once a day. Both drugs are unaffordable despite being on the formulary for my health insurance plan. The only way to get them is free from the manufacturers. Luckily I qualified for that, but why should it be necessary when the drug are covered? Mom said the problem was she "fell into the doughnut hole." Although the doughnut hole is still legal I felt like I was scammed because the insurance companies Mom talked to gave her misinformation when she was shopping for a cheaper plan.

 

She also told me the price difference for regular vs. extended release forms of the same drug is ridiculously high. If I could take the regular version of my drugs, they would be dirt cheap. But I medically require an extended release prescription - otherwise I would get seizures before it was time to take my next dose. What an ACA replacement bill needs (I accept the fact there will be one) is a mandate to make all forms of a drug the same price - or at least a low cap on the price difference - so people don't see medication costs soar out of control just by getting new prescriptions.

Quote:Samjag, I do not necessarily disagree with you, but your point totally ignores the fact that expected medical expenses includes drugs for conditions that patients had most or all of their lives. I can only use my own situation as an example, so please don't think I am being selfish. Millions of Americans are in the same boat.

 

I have epilepsy. Treatment is two drugs - one twice a day, the other once a day. Both drugs are unaffordable despite being on the formulary for my health insurance plan. The only way to get them is free from the manufacturers. Luckily I qualified for that, but why should it be necessary when the drug are covered? Mom said the problem was she "fell into the doughnut hole." Although the doughnut hole is still legal I felt like I was scammed because the insurance companies Mom talked to gave her misinformation when she was shopping for a cheaper plan.

 

She also told me the price difference for regular vs. extended release forms of the same drug is ridiculously high. If I could take the regular version of my drugs, they would be dirt cheap. But I medically require an extended release prescription - otherwise I would get seizures before it was time to take my next dose. What an ACA replacement bill needs (I accept the fact there will be one) is a mandate to make all forms of a drug the same price - or at least a low cap on the price difference - so people don't see medication costs soar out of control just by getting new prescriptions.


The Donut Hole only applied to those with Part D coverage, only amounted to about $1,000 out of pocket for the year, and was closed in 2013.
Take a break from money excuses. and he law's ripple-down effect. The OP's question is about how we should fix it, not what wrong seven years ago. I suggested one. Now it is someone else's turn.

Quote:I get that. She was speaking on her own behalf and not that of others. FYI...ACCESS to healthcare should be looked at as a right. Making you and I pay for it outside our individual requirements via government should not.

Why does the original post read as if someone's homework assignment is due by 11:59 Sunday?
 

Good stuff. Nope, no assignments due, I just have read a few books on the subject, and talked with folks, and wanted to get feedback from people on the board about their thoughts. I wanted to see if we could get past some of the sniping that goes on in other threads and drill down on some details with real information rather than just buzzwords. As I said originally, I want to sit out the first day or two as far as advancing my thoughts and try not to set the tone too much based on my opinions (as if I had such powers of persuasion :no: ).
Quote:I think we need to look at existing models that work. The Australian model works, German model works, Canadian model works. We also need to address why the United States has lower health outcomes compared to other industrialized countries yet we spend the most on healthcare. We need to talk about preventative care vs reactive care. We need to address the Obesity epidemic in this country. Lot of things to look at.
I agree that comparing different countries' systems is a good area to explore, although B2hibry indicates there might be limitations(will try to get more info on that). 
Quote:I think we need to look at existing models that work. The Australian model works, German model works, Canadian model works. We also need to address why the United States has lower health outcomes compared to other industrialized countries yet we spend the most on healthcare. We need to talk about preventative care vs reactive care. We need to address the Obesity epidemic
in this country. Lot of things to look at.
This goes alot deeper than just the 'healthcare' system. High fructose corn syrup replacing sugar and the rapid increased of processed food being one thing. Also the increased proliferation of GMO's allowing our grains to be saturated with 'Roundup' which is screwing with our gut bacteria is a thing also.

 

And thats ignoring the impact of companies like McDonalds. You could eat 'not healthy' food at home (if you made from scratch) and I bet most morbidly obese would lose weight just from reducing the side effects of an industrial food system. In fact, Obesity has almost nothing to do with our actual health system and everything to do with our culture. I can tell a patient till I am blue in the face that he shouldn't eat processed foods or goto McDonalds and they will agree with me. But then they do it anyway cause they are addicted.

 

A lot of people don't like fruits and veggies here, so they get replacements. Full of preservatives and other nonsense from being processed for shelf life that everyone knows is not good for them. Half the country doesn't really cook or eat at home. Women focus on careers and don't know how to cook, and most men never knew. Thats a factor too. Just messed up from all kinds of angle. You can't fix it with legislation IMO. 
Quote:None of the systems mentioned is ideal due to different countries economic factors. Personally I believe preventative care needs to be a priority. I also believe big pharma needs to be reeled in. I'm also of the opinion that people will generally take care of themselves if incentivised. Does that come in the form of lower copay or monthly payment? Not sure. Lastly, you tend to take better care of items that your hard earned money pays for. A pay-out-of-pocket HSA may be a good direction for that. Not to mention your money stays put and earns interest if it is not used. Either way, take big pharma and government out of the mix as much as possible and get away from one size fits all approach.
Not sure what you mean by your first sentence. Can you clarify? I agree about preventative care, and along with big pharma I might add over-prescription as a potential reason for high costs. 
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