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Sun Dec 2, 2012, 09:44 AM

America's Stunningly Overpriced Healthcare System In 2 Charts

http://www.businessinsider.com/healthcare-spending-as-a-share-of-gdp-2012-11

It's no secret that the U.S. spends a crippling amount of money on healthcare.
Here's some global perspective from Credit Suisse.
First is healthcare spending as a share of GDP. It's not hard to find the U.S.



But this next chart is a bit more damning. It shows that the branded drugs Americans get are available for around half price across Europe.


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Reply America's Stunningly Overpriced Healthcare System In 2 Charts (Original post)
xchrom Dec 2012 OP
leftstreet Dec 2012 #1
Agony Dec 2012 #2
xchrom Dec 2012 #7
Agony Dec 2012 #8
geckosfeet Dec 2012 #3
Mr. Blue Sky Dec 2012 #63
kenny blankenship Dec 2012 #85
Aerows Dec 2012 #4
PDJane Dec 2012 #22
Mr. Blue Sky Dec 2012 #62
hrmjustin Dec 2012 #66
TrueBlueinCO Dec 2012 #44
wilt the stilt Dec 2012 #46
MrModerate Dec 2012 #61
TrueBlueinCO Dec 2012 #67
dflprincess Dec 2012 #69
Occulus Dec 2012 #96
Agony Dec 2012 #5
99Forever Dec 2012 #6
SHRED Dec 2012 #9
SunSeeker Dec 2012 #11
robinlynne Dec 2012 #53
groundloop Dec 2012 #14
Mr. Blue Sky Dec 2012 #65
Mr. Blue Sky Dec 2012 #64
KansDem Dec 2012 #10
SunSeeker Dec 2012 #13
magical thyme Dec 2012 #26
Ilsa Dec 2012 #35
magical thyme Dec 2012 #52
blueamy66 Dec 2012 #86
magical thyme Dec 2012 #89
blueamy66 Dec 2012 #92
magical thyme Dec 2012 #98
blueamy66 Dec 2012 #99
SunSeeker Dec 2012 #41
magical thyme Dec 2012 #56
SunSeeker Dec 2012 #77
magical thyme Dec 2012 #91
SunSeeker Dec 2012 #93
magical thyme Dec 2012 #97
brokechris Dec 2012 #43
magical thyme Dec 2012 #58
brokechris Dec 2012 #82
Maven Dec 2012 #48
magical thyme Dec 2012 #57
mountain grammy Dec 2012 #83
magical thyme Dec 2012 #90
SunSeeker Dec 2012 #94
mountain grammy Dec 2012 #95
cilla4progress Dec 2012 #12
SunSeeker Dec 2012 #15
pangaia Dec 2012 #28
robinlynne Dec 2012 #54
Selatius Dec 2012 #70
SunSeeker Dec 2012 #73
abelenkpe Dec 2012 #16
DFW Dec 2012 #17
think Dec 2012 #34
DFW Dec 2012 #47
FarCenter Dec 2012 #18
jumptheshadow Dec 2012 #19
burnsei sensei Dec 2012 #20
liberal N proud Dec 2012 #21
DallasNE Dec 2012 #23
BlueJazz Dec 2012 #31
jsr Dec 2012 #24
Jakes Progress Dec 2012 #25
patrice Dec 2012 #37
BlueStreak Dec 2012 #27
jsr Dec 2012 #42
BlueStreak Dec 2012 #51
Mr. Blue Sky Dec 2012 #68
BlueStreak Dec 2012 #71
Mr. Blue Sky Dec 2012 #72
BlueJazz Dec 2012 #29
dkf Dec 2012 #30
patrice Dec 2012 #36
tularetom Dec 2012 #32
PDJane Dec 2012 #33
patrice Dec 2012 #39
patrice Dec 2012 #40
antigop Dec 2012 #49
Dustlawyer Dec 2012 #38
Posteritatis Dec 2012 #45
McCamy Taylor Dec 2012 #81
Cleita Dec 2012 #50
bvar22 Dec 2012 #55
Egalitarian Thug Dec 2012 #59
Duppers Dec 2012 #60
jamtoday Dec 2012 #74
hunter Dec 2012 #75
cantbeserious Dec 2012 #76
kenny blankenship Dec 2012 #87
Overseas Dec 2012 #78
lib2DaBone Dec 2012 #79
McCamy Taylor Dec 2012 #80
tomp Dec 2012 #84
Uncle Joe Dec 2012 #88

Response to xchrom (Original post)

Sun Dec 2, 2012, 09:52 AM

1. DURec

Disgusting

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Response to xchrom (Original post)

Sun Dec 2, 2012, 09:58 AM

2. thanks for the charts, Princess Spice!

WOW!

more details?

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Response to Agony (Reply #2)

Sun Dec 2, 2012, 10:08 AM

7. oh sure

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Response to xchrom (Reply #7)

Sun Dec 2, 2012, 10:32 AM

8. Wait.. I was asking for more details on the Healthcare Cost charts...

What were you thinking?

Ha Ha Ha you're so vain

Cheers!
Agony

I am going to send your charts to my dickwad representative and/or bring copies of them to the next town hall meeting he has when he brings his usual debt charts.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 09:59 AM

3. Notice that many countries are in a band right through the 8-12% region.

I think that most of these countries - Canada, UK, Ireland, France, Germany, Denmark, Finland, Sweden, even Greece and Spain have some kind of nationalized health care. The US with it's antiquated and badly outdated extortionist system of health care remains an outlier.

And the x axis is GDP per capita which kind of normalizes population against GDP and collapses the axis.

on edit: The drug cost chart is an example of the extortion practiced by the health care industry. We pay double the cost for drugs in the US - why? To subsidize drugs around the world? I don't think so. I think it is because most other countries protect themselves against price gouging and highway thievery in their health care programs by REGULATION. Something that has been demonized as anti-business socialism by conservatives and industry in the US.

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Response to geckosfeet (Reply #3)

Sun Dec 2, 2012, 08:57 PM

63. We pay double because drug companies lobbied congress for a rule that says

drug companies must never be reimbursed by CMS for more than the average price of the US marketplace instead of the worldwide marketplace.

Drug companies cut sweetheart deals with other countries because those countries bully the drug companies by threatening to invalidate patents. The drug companies give cut-rate pricing and then "make it up" by jacking up the price in the U.S. Stop this by changing the rule and it will bring down drug costs dramatically. Congress should instruct CMS to never reimburse more than the average price in the worldwide market place.

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Response to geckosfeet (Reply #3)

Mon Dec 3, 2012, 09:32 AM

85. Notice also that the other outlier country, Switzerland

with the highest costs in the world outside the US, has the individual mandate. But the Swiss are fortunate in that insurance companies that want to participate in the health care market in Switzerland have to offer basic insurance policies at no profit. You don't have to buy a basic non-profit plan specifically, or a for-profit plan, but you have to pick one, and they have to make basic non-profit plans available. There will be no such restriction on US insurance companies with RobamneyCare, but there will be a mandate on you.

Shows you what your rulers really think of you. They looked at the worst system in the western world (we didn't have a system prior to the passage of RobamneyCare) and deliberately designed a system derived from it, but an order of magnitude even worse.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 10:01 AM

4. Because our lax regulatory laws

let them get away with it. We subsidize the rest of the world's health care.

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Response to Aerows (Reply #4)

Sun Dec 2, 2012, 11:38 AM

22. Actually, no you don't subsidize the rest of the world.

The truth is that the US is the only country in the world that allows them to extort what they can get. All other countries except the US have laws that control the price of drugs. Research is done around the world, most of it in universities. Most 'new' US drugs are one-offs; next generation drugs based on someone else's research.

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Response to PDJane (Reply #22)

Sun Dec 2, 2012, 08:46 PM

62. Congress instructed the CMS to never reimburse drug costs more than the average price

of the US marketplace. All congress has to do is change the rule... congress should instruct CMS to never reimburse more than the average price in the worldwide market place. Drug companies cut sweetheart deals with other countries because those countries bully the drug companies by threatening to invalidate patents. The drug companies give cut-rate pricing and then make it up by jacking up the price in the U.S. Stop this by changing the rule and it will bring down drug costs dramatically.

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Response to Mr. Blue Sky (Reply #62)

Sun Dec 2, 2012, 09:09 PM

66. Welcome to DU!

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Response to Aerows (Reply #4)

Sun Dec 2, 2012, 01:01 PM

44. Truth

 

We subsidize drug R&D, which is why they are so much cheaper in other countries.

We also subsidize defense across the globe, which allows European social democracy to exist. Without the US paying for worldwide defense, they would never be able to afford it.

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Response to TrueBlueinCO (Reply #44)

Sun Dec 2, 2012, 01:42 PM

46. FYI- many countries do research

My niece went to France to do her internship in Bio- medical. France is very advanced. Sanofi- Aventis is a french company.and the U.S. gov't does a lot of the research.

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Response to TrueBlueinCO (Reply #44)

Sun Dec 2, 2012, 08:23 PM

61. And the US is defending Europe from whom? n/t

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Response to MrModerate (Reply #61)

Sun Dec 2, 2012, 09:15 PM

67. The US military protects a peaceful world

 

for everyone, including Europe.

Pax Americana benefits Europe and every other country, and only we pay for it.

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Response to TrueBlueinCO (Reply #67)

Sun Dec 2, 2012, 09:53 PM

69. It doesn't hurt that most other countries do not have a for-profit middle man

controlling who gets access to care.

If there were no Stephen Hemsley skimming millions out the system, and no shareholders and no insurance agents/brokers getting their cuts our costs would not be so high.

For that matter, we wouldn't be spending so much on "defense" if someone wasn't making a ton of money off it.

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Response to TrueBlueinCO (Reply #67)

Tue Dec 4, 2012, 11:34 PM

96. Ladies and gentlemen, please welcome Mr. Paul Wolfowitz

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Response to xchrom (Original post)

Sun Dec 2, 2012, 10:01 AM

5. I'm going to point this out to my "representative" who keeps blathering on

about the cost of Medicare. As he renews his G N tax pledge...

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Response to xchrom (Original post)

Sun Dec 2, 2012, 10:04 AM

6. What is this thing you call...

... healthcare?

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Response to xchrom (Original post)

Sun Dec 2, 2012, 10:38 AM

9. Our high drug prices...


...help subsidize other country's lower prices.

The grip these vultures have on our government is obscene.

--

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Response to SHRED (Reply #9)

Sun Dec 2, 2012, 10:57 AM

11. Our high drug prices subsidize plutocrats. nt

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Response to SunSeeker (Reply #11)

Sun Dec 2, 2012, 05:46 PM

53. Thank-you.

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Response to SHRED (Reply #9)

Sun Dec 2, 2012, 11:04 AM

14. How do our high prices subsidize other countries lower prices?

I could believe that to some extent if R&D for new drugs was done only in the US, but I don't believe that's the case.

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Response to groundloop (Reply #14)

Sun Dec 2, 2012, 09:02 PM

65. Congress instructed the CMS to never reimburse drug costs more than the average price

of the US marketplace. All congress has to do is change the rule... congress should instruct CMS to never reimburse more than the average price in the worldwide market place. Drug companies cut sweetheart deals with other countries because those countries bully the drug companies by threatening to invalidate patents. The drug companies give cut-rate pricing and then make it up by jacking up the price in the U.S. Stop this by changing the rule and it will bring down drug costs dramatically.

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Response to SHRED (Reply #9)

Sun Dec 2, 2012, 09:01 PM

64. Our high drug prices are because drug companies lobbied congress for a rule that says

drug companies must never be reimbursed by CMS for more than the average price of the US marketplace instead of the worldwide marketplace.

Drug companies cut sweetheart deals with other countries because those countries bully the drug companies by threatening to invalidate patents. The drug companies give cut-rate pricing and then "make it up" by jacking up the price in the U.S. Stop this by changing the rule and it will bring down drug costs dramatically. Congress should instruct CMS to never reimburse more than the average price in the worldwide market place.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 10:53 AM

10. America, the Patsy

Maybe we should call ourselves "Americhumps"

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Response to KansDem (Reply #10)

Sun Dec 2, 2012, 11:02 AM

13. Naaah. $90 for an aspirin in the ER is the American way because.....freedom.

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Response to SunSeeker (Reply #13)

Sun Dec 2, 2012, 11:49 AM

26. if all you need is an aspirin

then why the hell are you in the ER?

Seriously, I see way too many people in our ER who have normal, everyday, over-the-counter ailments. Way too many drama queens.

I'm not saying that nobody who comes into our ER doesn't belong there. But I'm sorry to say the vast majority do not belong in an ER.

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Response to magical thyme (Reply #26)

Sun Dec 2, 2012, 12:16 PM

35. Exactly. They belong at the doctor's office.

But even highly insured patients sometimes end up in the ER. My MIL was living with her granddaughter. The MIL got a post-op infection starting. The granddaughter took her to the ER first instead of calling the dr to see if they would see her in the office first before an ER visit. (Some infections require more than antibiotics, I know.)

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Response to Ilsa (Reply #35)

Sun Dec 2, 2012, 05:41 PM

52. depends on the symptoms...if it appears systemic

say, spiking a high fever, then we can run tests at the ER that they can't run at the doctor's office, and get the results faster.

We had a patient recently with a post-op infection. The symptoms were such that they ran blood cultures. If the infection had gotten into the bloodstream, we'd be able to pick it up within hours and although it will take some time to identify the pathogen and sensitivity, at least we can let the doctors know they're looking at bacteremia or possible septicemia.

Luckily for me in this case, they only ordered one set of blood cultures and the nurse pulled all the specs off the IV setup. Lucky because I've had to draw very ill 6 year olds who were more stoic than this young adult, who, quite frankly, was a big, fat baby. Admittedly with no veins, but still, crying, begging, shaking, refusing, while his mommy sat there all upset at her poor widdle baby.

I was very, very nice, which I always am to patients, but inside I heaved a humongous sigh of relief when I got out of there scott free.

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Response to magical thyme (Reply #52)

Mon Dec 3, 2012, 09:55 AM

86. Wow.... Hope that I never have blood drawn

Last edited Mon Dec 3, 2012, 10:36 AM - Edit history (1)

in your ER.

"big fat widdle baby"? Maybe you should seek another profession.

JMHO

On edit: Just read some more of your
posts...methinks you have lost your a ability to empathize and are jaded and may need to find other work.

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Response to blueamy66 (Reply #86)

Tue Dec 4, 2012, 07:22 PM

89. I was very nice to him

but relieved I didn't have to actually try to draw him. He was crying and screaming "NO! NO!" when I gently probed his arm to look for a good vein. I had already let him know I wouldn't even try if I didn't find a really prominent, easy vein and promised I wouldn't make him a pin cushion. Good vein would mean a single quick try with smallest needle. No good vein, I wouldn't even try.

I can assure you that behind the scenes nobody would have had much sympathy for him. I have assisted with better behaved and more cooperative 2 year olds.

My empathy is vast with people who make the effort, but this kid was really acting more like a stuck baby than an adult having his arm gently probed for a possible vein.

I've drawn from 6 year olds who were seriously ill and very stoic after having to be drawn over and over. And I'll never forget the developmentally disabled little girl I assisted with. She was not an easy draw, but she kept her arm stock-still. Afterwards, her mother was in tears when she thanked me. So you can write what you want. Personally, meh. There are patients truly suffering who leave me in tears. Again, behind the scenes.

That said, there are other reasons you wouldn't want to be drawn in my hospital. One would be the pothead lab assistant who consistently mislabels tubes, when she doesn't leave them unlabeled somewhere. Another would be the alcoholic lead chemistry tech. Another would be the sexual harasser from the cleaning crew that a few lab assistants were encouraging, aiding and abetting by soliciting and providing him with personal information (about me). Except he finally got fired when another member of the cleaning crew alerted his manager to the fact that one night, in his determination to get my attention and set up a "date" he deliberately shoved me 4 times into my computer while I was sequentially attempt to run and result a pre-intubation critical arterial blood gas, a cord arterial and then venal blood gas for very sick neonate, a critically low potassium, and a critical post-intubation arterial blood gas. A fourth would be the porn addict they were protecting, except he became so brazen that they finally fired him. Not because ED specs were laying around un-resulted because he lost track of time while staring at female genitals on his computer screen, but because he had graduated to where he was doing it out in the open where any doctor or nurse running in from the ER might get an eyeful, which would cause trouble back at the lab chain headquarters.

And yes, I am getting out of the field. I have never worked in such an unprofessional environment as I am in at this hospital. And I've just been hired part time back to my old just in financial customer service. When I am one on one with a customer, I am able to deliver excellent customer service. I am very empathetic, but don't have a lot of tolerance for the occasional manipulators and cheaters, although I have my way of dealing with them so they 1. fail to get me to break rules for them and 2. are grateful or at least not angry by call's end. During my 1st (and last) tax season there, I won 2 quality awards and had 2 supervisor calls from customers raving about my service. Again, meh.

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Response to magical thyme (Reply #89)

Tue Dec 4, 2012, 07:59 PM

92. Good that u are getting out of the field

I just got a terminal diagnosis on my guy... Don't have much more to say, other than I should have drop kicked the 5'2" asshole doc that told me the news. What a sweetheart...learn how to talk to human beings docs...you are not God

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Response to blueamy66 (Reply #92)

Wed Dec 5, 2012, 06:36 PM

98. I'm so sorry....

I lost the love of my life to early onset alzheimers a couple years ago. Some doctors are great. Some, not so much.

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Response to magical thyme (Reply #98)

Thu Dec 6, 2012, 07:31 AM

99. Thank you

If I see him again, I'm gonna let him have it. I'm gonna let the neurologist have it too.

Don't they teach bedside manner anymore?

I am sorry for your loss. It just sucks.

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Response to magical thyme (Reply #26)

Sun Dec 2, 2012, 12:42 PM

41. They're in the ER because they don't have health insurance.

If they had health insurance, they'd take their flu and cold issues to their family doctor's office. Instead, the only place that will take them is the ER (because ERs are prohibited by law from turning away the indigent). There, they will see you for "free" (assuming you're judgment proof). If we had universal health coverage, the ER would be just that, an Emergency Room. And our healthcare costs would go down big time, to be in line with other countries, especially if we could negotiate with Big Pharma on drug prices.

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Response to SunSeeker (Reply #41)

Sun Dec 2, 2012, 05:56 PM

56. if all they need is an aspirin, it's not even a doctor issue

Seriously, sniffles and colds are best treated at home with bed rest and plenty of fluids. Second best with over the counter symptom relief if you need to work through it.

Flu shots are cheap and readily available.

And it's not automatically people without insurance. Most people here have some kind of coverage, including Mainecare if they're not insured.

You go to a hospital or to the doctor's office and you are exposing yourself to every bug everybody who has been in there is carrying, and exposing them to your bugs.

People in this country are waaaaaay too dependent on going to the doctor for every minor freakin' issue. They need to learn to take care of themselves with an appropriate diet, appropriate exercise and sufficient rest.

That also means using common sense and being aware of changes in your region's environment. We recently had a mother and son in with bloody stool. The doctor was testing for c-dif. Mother stopped by the lab to ask questions and while chatting, told us she'd been camping with her son and giving him survivalist training. I asked if they'd drunk from a stream as part of his "training." "Oh, yeah!" she nodded, smiling and enthusiastic. Lab partner and I looked at each other and blurted out "Giardia" in unison. It's now endemic here.

If they catch a cold, treat it at home. Doctor's offices are for treating things that aren't resolving at home, not running up bills for every headache, sniffly nose or 24 hour stomach bug.

Not to mention the rash of young, female syncope victims we had one night.

The ED treats each one as if it's a life threatening emergency because that's more revenue. It's also, ultimately, a huge cost on society.

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Response to magical thyme (Reply #56)

Sun Dec 2, 2012, 11:41 PM

77. They wouldn't go to the ER if they thought all they needed was an aspirin.

But they have no access to a family doctor who can tell them whether their symptoms warrant an ER trip. Fever and a stomach ache could be a flu or salmonella poisoning. You apparently have medical training, but most people don't, and don't know the difference.

And people don't get flu shots unless they have health insurance. It cost $25. Think about it. That is dinner for a family of four. A poor family will choose dinner. And not every flu is prevented by a floor shot.

What may sound minor, even to a doctor, like my painful left armpit, can be major, like it was in my case. Fortunately, I had insurance. Even then, I had to insist on the ultrasound that revealed cancer-positive lymph nodes...my doctor wanted to me to first try taking Ibuprofin for a month. Glad I didn't listen and try to "treat it at home" like you suggest.

You sound like you work in an ER. And you sound burned out. I know it is a horrifically hard job. But please remember, it's not the people who are the enemy. It's the system and the plutocrats it supports.

Every who walks in that ER prays for your empathy.

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Response to SunSeeker (Reply #77)

Tue Dec 4, 2012, 07:34 PM

91. I'm curious as to where you provide health care

that you know so much about the patients visiting my ER.

Because that's not what I see there.

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Response to magical thyme (Reply #91)

Tue Dec 4, 2012, 08:19 PM

93. I don't provide health care. I'm on the receiving end.

And I've been to over half a dozen ERs around the Los Angeles area, most often to Long Beach Memorial Medical Center.

I don't know about your ER, but Long Beach and Harbor/UCLA ERs have 8 to 12 hour waits unless you are in the middle of a heart attack or spouting a geyser out an artery.

No one goes to wait 8 hours under miserable conditions for something they think is minor or can be taken care of with an aspirin. People go to the ER because they're scared about whatever health condition they're suffering from. You may think it's stupid, but it is serious to them. They're not doing it to piss you off. They go there for your help, or at a minimum, reassurance. And if they had somewhere else they could go, they would.

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Response to SunSeeker (Reply #93)

Wed Dec 5, 2012, 06:28 PM

97. I know you don't provide healthcare, and I know you are on the receiving end.

and I'm sorry that your life has required so many trips to the ER.

I am on the opposite coast in a tiny rural hospital. Your wait will not be 8-12 hours for care here. Lab orders are typically entered within 45-60 minutes of your presenting at registration. If you are a chest pain, your troponin, CMP and CBC results will be reported within 60 minutes of your presenting with chest pain.

We have patients abusing the system here. I know this for a fact because sometimes they have confessed to me and other times I have seen the looks on spouse's faces and seen them mouth apologies. And when a series of 20-something, giggling young women present with dizziness and fainting, and everything tests out normal, you pretty much know they are malingering. And yes, along with trying to order us around when we try to draw them, they are openly giggling about what they think they are getting away with.

We have an abysmal lab system that is spreading along the coast, managed by coercion and threats and the lowest pay in the state. We have a university based training system where they continue to blatantly lie to incoming students about job prospects and HR people who blatantly lie about the starting salary.

It is one of the most unprofessionally managed operations I have ever had the misfortune to work at, in 40 years of working.

Mercifully, I have found an exit and started back part time at my old job last week. I know the score there, and as soon as a full time operation opens and my salary there permits, I will leave the hospital environment for good.

I expect this non profit hospital to continue to decline, as they have been taken off the state's preferred vendor list for being too expensive.

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Response to magical thyme (Reply #26)

Sun Dec 2, 2012, 12:53 PM

43. my brother has medicare

and he goes to the ER every time he sneezes. Doesn't want to have to make an appointment and then wait for the Dr. to see him. We live in a pretty quiet area and if he just heads over to the ER he is usually seen within 2 hours. Some people do abuse the system.

in the two years that I have lived near him--he has gone more than a dozen times. And it has only been a serious event once (pneumonia) and even that could have been handled better outside the ER.

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Response to brokechris (Reply #43)

Sun Dec 2, 2012, 06:25 PM

58. We call them frequent flyers

and know their names when we see them. I see people that come in monthly or even weekly with the same set of symptoms. We run the same tests over and over and the results are always normal.

We get a *lot* of that. I've also seen young people feeling us out for a new set of symptoms to come in with.

There is abuse among some elderly and a frightening amount of ER abuse by young people. Hence my reference to the drama queens.

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Response to magical thyme (Reply #58)

Mon Dec 3, 2012, 05:15 AM

82. you must be one of the lovely health professionals

they are always so nice to him! even when I am gritting my teeth and so embarrassed even to be seen with him.

Thank you for doing your jobs with kindness and professionalism.

There is abuse of the ERs though--but since you can't turn anyone away--I don't see how to fix it. I wish the ER could just say--that isn't serious--wait and call your Dr in the morning...

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Response to magical thyme (Reply #26)

Sun Dec 2, 2012, 02:29 PM

48. I just went to the ER in intense pain from a kidney stone.

I'd never had one before so I couldn't be sure what the pain was. So I went to the ER at around midnight.

I was there for a total of around 4.5 hours. In that time I received an IV, blood tests, saline drip, one CT scan, one brief physician consult, and...some ibuprofen and FloMax.

For those services and medications, without even staying one night, the hospital billed my insurance company $18,000 and change.

$18,000.

Now, maybe some people are going to the ER when they shouldn't. Maybe. But a better question is, where do these numbers hospitals are charging come from???

My CT scan alone was billed at over $12,000 when the average cost of a CT scan in California is a little over $2,000.

Now of course, I'm insured, so my insurance company "negotiated" the total cost down to 7,800 or so. Which makes it even more apparent that the raw number the hospital charged was completely fictional. Had I been uninsured, the hospital would have tried to collect 18 grand from me, without ever having to substantiate that number. That is ABSURD and it is CRIMINAL.

If you're looking for someone to blame, don't blame the person who needs care. Blame the institution that thrusts "financial responsibility" forms in patients' faces while they are in pain and then makes up huge numbers to charge them for minor medical services and basic drugs.

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Response to Maven (Reply #48)

Sun Dec 2, 2012, 06:17 PM

57. I didn't blame people who need care.

I blamed people who should be in self-care.

I've never had a kidney stone, but from what I understand that's not some minor pain that will resolve with aspirin.

My point is that there is blame to go around. I see a *lot* of people who abuse our healthcare system. Sometimes we do actually get sick or injured people, like the post-op infection I mentioned above. But I see way too many people coming in with minor ailments that could and should be treated at home.

My understanding is that the hospital where I work always charges insurance companies more because they lose money on every Medicare patient and every charity patient. Plus the state owes them several millions dollars in back charges. We service a lot of Medicare patients and charity patients.

Now the state has responded by taking us off the "preferred vendor" list, so we're losing patients to the larger hospital an hour to our south that doesn't service a large Medicare community. The response has been to cut people at the bottom. Fewer people on the cleaning staff. They walked the experienced registration person out the door and replaced her with the semi-retired per diem who makes a million mistakes and a cheaper newby. And fight with the outsourced lab over every penny, so fewer people in the lab. My hours have been cut to the point where I started back at my old job last week and will hopefully transition to there full time and leave the shit hospital job for good.

I also blame certain doctors. There is one who automatically orders both a CRP and an ESR on his patients. They are different tests that measure essentially the same thing: nonspecific inflammation. There is no reason to order both tests, but he orders both anyway. That is enormously wasteful. Order the CRP and get a more specific result, sooner. Leave the ESR for outpatients that are having their arthritis monitored.

And there has been one doctor, and now there is another, who order a ridiculous number of blood cultures. Double sets of blood cultures on practically everyone who walks in the door. Again, wasteful. There are only rare circumstances when a blood infection should be suspected, and given the time it takes to get results, there is plenty of time to rule out systemic infection without going to that cost. But we see those doctors names on the roster and roll our eyes because we know we're going to be drawing a double set of blood freakin' cultures all night.

I've seen patients in ICU who were clearly within hours of death, with hands and arms black and vein-less as they're circulation shuts down. But we're still ordered to wake them up at 5am for routine chemistry so they can monitor everything to the bitter end. They belong in hospice, or at least allowed to die peacefully, without some poor, overtired, overworked tech sticking them over and over trying to find a functioning vein somewhere.

Our so-called healthcare system is, imho, sadistic. I've already decided I'd rather somebody just shot me then take me into *any* hospital that uses my lab chain. It's that bad.

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Response to magical thyme (Reply #57)

Mon Dec 3, 2012, 09:16 AM

83. I quit the Med Tech profession 20 years ago. Sad to see it hasn't changed.

Probably gotten worse, with more tests to over order!

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Response to mountain grammy (Reply #83)

Tue Dec 4, 2012, 07:32 PM

90. I'm leaving as soon as I can

I don't know how it was back then, but at the small, rural hospitals it is really, really shocking behind the scenes.

We have a do nothing/know nothing lab manager who manages by bullying and covert threats. She makes a point of letting new hires know that she is married to a high powered lawyer and has the good lab assistants terrified of being fired because the lab chain owns almost every lab within commuting distance. Most of the good lab assistants are either gone or burned out or have wrecked backs from 13-14 hour shifts.

We have a pothead among our lab assistants who keeps her job by being a snitch for the lab manager. I can't tell you how many tubes she's mislabeled. The worst was the night she mislabeled and mis-ordered what was supposed to be a stat for a young man with a pulmonary embolism. I was the lucky tech who got the irate call from the doctor looking for results. Took an hour just to find the tube...

We have an alcoholic lead chemistry tech who came to work tipsy every day for weeks after her daughter was walked out of admin.

We had a porn addict tech that they protected for a year before finally firing him.

I've rarely seen such poor morale or piss-poor performance in any work environment. I just got hired back part time at the job I was doing while in school. As soon as I can make a living at it, I'm gone from the hospital environment for good. Shame to waste the education, and sad that I'm now saddled with a lifetime of debt for it, but I'd rather be dead than stay in that hellhole!

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Response to magical thyme (Reply #90)

Tue Dec 4, 2012, 08:27 PM

94. Wow. Where is this hospital so people know not to go there?

I am glad you are moving on to doing something you like. I think it is best for all concerned.

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Response to magical thyme (Reply #90)

Tue Dec 4, 2012, 11:29 PM

95. The horror stories abound in the medical professions

never regretted getting out of it, but did make some lifetime friends.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 11:01 AM

12. I'd like to see spending related to outcomes ...

I think I know the answer.

It's like they want us to die!

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Response to xchrom (Original post)

Sun Dec 2, 2012, 11:05 AM

15. The no-negotiation clause in Bush's Medicare Part D explains a lot of that second chart.

Republican treason explains the rest.

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Response to SunSeeker (Reply #15)

Sun Dec 2, 2012, 11:51 AM

28. Right on the money, so to speak. !!

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Response to SunSeeker (Reply #15)

Sun Dec 2, 2012, 05:48 PM

54. Didn't Obama also put in Obama care a clause where the US govt may NOT negotiate lower drug prices?

As I recall, that is why the pharmaceutical corps so loved the AMA.

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Response to robinlynne (Reply #54)

Sun Dec 2, 2012, 10:03 PM

70. The deal was never on the books per se. It was more of a backroom deal, but well documented.

The pharmaceutical companies supported the Affordable Care Act because Obama got from them a voluntary cost cutting measure totaling 100 billion over the next ten years, or 10 billion in savings per year on prescription drug prices.

100 billion was ultimately better than nothing from them.

Also, if the health insurance reform bill included a provision repealing Medicare Part D's prohibition against negotiating drug prices, Obama would have to face the powerful lobbying arm of the pharmaceutical companies. Fighting the powerful health insurance corporations is enough of a battle without also pissing off the pharmaceuticals as well.

This reason likely explains why Obama went to cut a deal with the drug companies. By cutting a deal with the drug companies, he could simply concentrate on battling on one front against the health insurance companies without having to open up a second front against the drug companies. A two-front war was probably something Obama couldn't handle.

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Response to robinlynne (Reply #54)

Sun Dec 2, 2012, 10:27 PM

73. Obama tried to insert a negotiation provision, but the Republicans blocked it.

As a candidate, Barack Obama promised to repeal the prohibition on Medicare negotiating directly with drug companies over prices for Medicare recipients. But he was not able to do it. I guess the administration had to pick its battles. The priority was getting people covered, which was struggle enough. To declare war on Big Pharma would have sunk the ACA. Remember, Obama had a veto-proof majority in the Senate for only about two months (24 Congressional working days) during his first two years in office.

Sen. Al Franken introduced a bill that would repeal the ban on negotiations, but it too stalled in the Senate Finance Committee.

The administration included as part of its fiscal year 2013 budget a narrower proposal allowing Medicare to negotiate prescription drug prices in the same manner as the Department of Veterans Affairs. It would allow Medicare beneficiaries who are also covered by the income-based Medicaid to receive the same rebates that Medicaid receives for brand name and generic drugs.

But this, too, seems unlikely to happen given Republicans' death grip on Congress.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 11:10 AM

16. K&R

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Response to xchrom (Original post)

Sun Dec 2, 2012, 11:10 AM

17. This is no secret to the White House

I got to tell this to Obama face to face last July and got a follow up email from the WH.

They know they can't change it over night, but they are quite aware of the situation. I had two operations with 3 day stays in a hospital in 2011, one in Germany and one back home in Dallas. The bill for Dallas was for $35000 and the Bill for Germans was for $11,500. Same degree of care all araound, same difficulty of operation, etc etc.

I laid it out for him in a meeting I had and it was noted, as Obama was specifically looking for ways to reduce health care costs without reducing the level of care.

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Response to DFW (Reply #17)

Sun Dec 2, 2012, 12:14 PM

34. Very cool. Thank you for your efforts & sharing this. /nt

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Response to think (Reply #34)

Sun Dec 2, 2012, 01:52 PM

47. When he brought the subject up (reducing health care costs),

I told him my story, and it was noted as I said.

Here's the original thread from last summer: http://www.democraticunderground.com/125170848

Now that there's no more presidential election to worry about, I'm a little more comfortable about talking about some of the details of the meeting, although there was some discussion on budget tactics that I won't yet talk about, as Obama and the Congressional Democrats still need every card they still have up their sleeve.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 11:18 AM

18. Drug industry sales are around $300 B/year or about 2% of GDP, so they are not the only problem

Way too many health facilities and too much employment in the health industry.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 11:31 AM

19. Not only is it expensive, it is stunningly incompetent...

...A billing specialist at a recent meeting of cancer patients and their caregivers told us how many medical bills are incorrect. Her organization processes and reconciles invoices for cancer patients.

According to her, 90 PERCENT of the bills that come in are wrong.

The system is broken. It needs to be fixed.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 11:31 AM

20. 45,000 people die annually

as a result of our health care system and reliance on private insurance.
Health care for profit is the reason our system is so expensive.
Drugs for profit, a legitimate-on-paper analogue of the criminal drug industry if ever there was one, costs lives.
If you favor human misery, then do nothing.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 11:38 AM

21. The best health care money can buy

We are bing soaked but all our congress can talk about is cutting the benefits that help people pay for this highway robbery.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 11:42 AM

23. Recently I Replaced The Sponge Air Filter On My CPAP

This sponge is roughly 1 1/2" x 3/4" x 1/3"; very small in other words. The cost to manufacture this filter is likely less than a dime. The bill to Medicare: $23.

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Response to DallasNE (Reply #23)

Sun Dec 2, 2012, 12:00 PM

31. That seems about right. (if you changed your inches to feet)

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Response to xchrom (Original post)

Sun Dec 2, 2012, 11:48 AM

24. And one more:

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Response to xchrom (Original post)

Sun Dec 2, 2012, 11:48 AM

25. Somebody has to pay for the campaign donations.

Looks like we pay for pharma and corpmed lobbyists.

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Response to Jakes Progress (Reply #25)

Sun Dec 2, 2012, 12:19 PM

37. "we pay for pharma and corpmed lobbyists" and their pet Risk Managers employed by "health"

"care" systems.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 11:51 AM

27. One simple change makes Medicare solvent for the next 75 years

Simply let Medicare negotiate drug prices.

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Response to BlueStreak (Reply #27)

Sun Dec 2, 2012, 12:51 PM

42. That would be so un–American

The invisible hand wouldn't allow that.

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Response to jsr (Reply #42)

Sun Dec 2, 2012, 04:46 PM

51. The "invisible hand" around our throats. nt

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Response to BlueStreak (Reply #27)

Sun Dec 2, 2012, 09:43 PM

68. You are on the right track...

The CMS must abide by a rule passed by congress that drugs may not be reimbursed for more than the average price of the U.S. marketplace. Drug companies are bullied by other countries to supply drugs at cut-rate prices under threat of patent invalidation. Drug companies make up the difference by jacking up the price in the U.S.

Another factor is that the CMS is mandated to cover EVERY drug that is approved by the FDA regardless of cost. More facts to consider... the majority of cancer care costs come in the last 6 months of life. Cancer drugs are most effective when matched with a specific genetic marker. Most cancer treatments are prescribed regardless of genetic marker "just in case" they might help. The average full treatment cost for Erbitux is $160K and the drug sold $703M in 2011. The average treatment cost for Avastin is around $100K and sold $2.6B in 2011. If it were mandated that only those patients who matched the label and had the right genetic marker receive Erbitux and Avastin, we would save about $2B in health care costs a year on just those two drugs... 2 drugs.

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Response to Mr. Blue Sky (Reply #68)

Sun Dec 2, 2012, 10:04 PM

71. It is time to stop being patsies on trade

If there are countries playing unfairly on patents, then we need to deal with that problem. The answer is not to make the American citizen subsidize the citizens of other countries.

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Response to BlueStreak (Reply #71)

Sun Dec 2, 2012, 10:18 PM

72. The drug companies lobbied for this rule...

We need to stop being patsies to our representatives in congress who are dependent on drug co. donations. Look at how much $$$ these drug co's spend on lobbying each year.

The drug companies cave to these countries because they know they can "make it up" in the U.S. All we need to do is change the rule.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 11:55 AM

29. As one of my other countryman (Australian) said>>

"Why to you people put up with that ridiculous horse-shit??"

I answered> It's not entirely the American's fault...our right-wing media does its best to keep damaging news regarding insurance companies down to a very small roar. A lot of people just don't know the true facts.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 11:55 AM

30. Which is why you can't keep Medicare as is...

 

If you don't fix the cost problems and increases and don't use reasonable judgment to curb excess services, it's going to drive us broke.

Medicare needs to change because the system needs to be changed.

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Response to dkf (Reply #30)

Sun Dec 2, 2012, 12:16 PM

36. *IF* that is true, it can only be done by identifying what is authentically excess relative to

whatever it is that protects that in-efficiency, i.e. we need to figure out what is validly excess service and measure that against other forms of Medicare abuse in health care systems, e.g. excessive executive and administrative costs that, amongst other things, go into things like contracting with Risk Managers who interfere with more effective treatment modalities, including preventative and proven effective alternative treatments and procedures.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 12:07 PM

32. For years I have listened to my idiot relatives bitch about

health care being 1/6 of the GDP and how the government should never be in charge of an "industry" of that magnitude. (a little factoid they got from listening to limbaugh, BTW).

And my response was always, the fact that health care is that big of an "industry" is precisely WHY the government should be in charge of it. There's too much money being made by the middle men in the health care bidness and the government which doesn't need to make a profit or keep shareholders happy could facilitate the dealings between consumer and provider at a lot cheaper rate.

IOW, why the fuck, in a modern industrialized country, does health care account for such a large portion of the GDP? Somebody is sucking a lot of money out of the system.

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Response to tularetom (Reply #32)

Sun Dec 2, 2012, 12:12 PM

33. YES!!!! Thank you.

This precise point has been rattling around in the back of my mind for years. Every time it comes to the fore, someone swats at it, but this is the precise and accurate summation.

Thank you.

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Response to tularetom (Reply #32)

Sun Dec 2, 2012, 12:22 PM

39. +++1google!

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Response to tularetom (Reply #32)

Sun Dec 2, 2012, 12:27 PM

40. There is an entire professional field, in long-term care, devoted to how to fuck with CMS ...

It goes under the heading of Risk Management, which is a necessary institutional effort that gets hideously abused by number crunchers who use spreadsheets to avoid looking at and actually being with the real persons in those beds.

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Response to tularetom (Reply #32)

Sun Dec 2, 2012, 02:49 PM

49. +100 n/t

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Response to xchrom (Original post)

Sun Dec 2, 2012, 12:21 PM

38. K&R!

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Response to xchrom (Original post)

Sun Dec 2, 2012, 01:12 PM

45. The second chart's interesting to me..

For two reasons - one is that the cost of the medication seems to have generally been going down, which isn't something I'd expect from, well, anything in this economy.

The other's that the drop in prices in the UK is really big - from about 60% of US prices down to what looks like 45% or so. Anyone know what's been going on over there?

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Response to Posteritatis (Reply #45)

Mon Dec 3, 2012, 01:15 AM

81. Yes. We subsidize Europe's healthcare. Half the big drug companies are European

and they give the EU a discount that they can afford because they charge us too much. Everyone in Europe knows it and they expect the US to pay more so they can pay less. Guardian UK had an editorial condemning US efforts to control medical costs. They said it would raise the prices that British drug companies had to charge in the UK.

It is one great big scam on the part of Europe which seems to consider us (still) their colony.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 03:33 PM

50. And yet too many people are dying or suffer from chronic, untreated disease

in this country because of it. If everyone was getting the health care they needed, even if that expensive, it would be not so criminal. But it is criminal because of the people left untreated, who die because they can't afford health care, or go into debt and lose everything if they attempt to get care.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 05:52 PM

55. You should be PROUD!

This IS "The Uniquely American Solution"!!!!
We're #1 !!!


We couldn't simply borrow one of the 31 Universal Health Care Plans already in operation in civilized countries where Medical Bankruptcy is UNKNOWN, and already have PROOF that they can provide better Care at 1/2 the Price.
Oh NO!
We HAD to design a a "Uniquely American Solution" that firmly enshrines
the parasitic For Profit Health Insurance Cartel as the ONLY gateway to Health care in America,
and postpones the implementation of a workable Single Payer system for at least another generation.

Well Done!
Mission Accomplished!!!


You will know them by their WORKS,
not by their excuses.
Solidarity99!
--------------------------------------------------------------------------------------------------------------------------------



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Response to bvar22 (Reply #55)

Sun Dec 2, 2012, 06:37 PM

59. Spot on! n/t

 

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Response to xchrom (Original post)

Sun Dec 2, 2012, 07:51 PM

60. 60 Minutes now. nt

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Response to xchrom (Original post)

Sun Dec 2, 2012, 10:43 PM

74. An article from 2010

Highlighting how the centralisation of ancillary services stifle innovation and drive up costs. It's about needleless catheters and stopping infections. A more efficient, safer and cheaper product being squeezed out by corrupt political and financial practices.

"After months of trial and error, Shaw hit on the idea of surrounding the tip of the syringe with six petal-like flanges, which could flare open to make way for the catheter port. Unlike some of the solutions floated by big medical device makers, such as coating the ports with silver, Shaw’s innovation added only a few pennies to the cost of production. And it seemed to be remarkably effective: a 2007 clinical study funded by Shaw’s company and conducted by the independent SGS Laboratories found the device prevented germs from being transferred to catheters nearly 100 percent of the time."

"In the case of syringes, the incumbent heavyweight has long been Becton Dickinson, or BD, a New Jersey–based company that controls 70 percent of the syringe market and has a lengthy history of trampling competitors. As early as 1960, BD was brought up on Justice Department charges for its anticompetitive practices—among them price fixing, buying up patents to kill its rivals’ innovations, and forcing hospitals to buy its syringes to get other essential supplies, some of which were only produced by BD."

"Often, these large companies used their clout to squeeze hospitals on prices. To keep costs in check, in the 1970s many medical facilities began banding together to form group purchasing organizations, or GPOs"

"Originally, these purchasing groups were nonprofit collectives and were managed and funded by the hospitals themselves. But in the mid-1970s, the model began to shift. Some large hospital chains started to spin off for-profit GPO subsidiaries,..."

"Then, in 1986 Congress passed a bill exempting GPOs from the anti-kickback provisions embedded in Medicare law. This meant that instead of collecting membership dues, GPOs could collect “fees”—in other industries they might be called kickbacks or bribes—from suppliers in the form of a share of sales revenue."

"This situation only grew thornier in 1996, when the Justice Department and the Federal Trade Commission overhauled antitrust rules and granted the organizations protection from antitrust actions, except under “extraordinary circumstances."

Full article at link.

http://www.washingtonmonthly.com/features/2010/1007.blake.html


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Response to xchrom (Original post)

Sun Dec 2, 2012, 10:56 PM

75. I think drug patents are unethical and drug research ought to be socialized.

The pharmaceutical corporations as they now exist can go directly to hell, do not pass GO, do not collect $200. No further drug patents will be granted. Current privately funded drug research programs would be required to seek public university affiliations.

We could cut DOD budgets and use some of these funds to power university medical research. The "win" for medical researchers when they discovered new medicines would be knowing they saved lives, academic recognition, a steady job, and for very big discoveries a Nobel Prize, celebrity, and a "researcher-for-life" sinecure, even for a researcher who decides to spend the rest of their life on a tropical island observing beach wildlife with a drink in one hand.

All new medicines would be open source to be manufactured by anyone with the capacity to do so safely. All medicines, even the latest discoveries, would be "generic."

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Response to xchrom (Original post)

Sun Dec 2, 2012, 11:11 PM

76. We Need A System Reset To Realign US Prices With The Rest Of The World

eom

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Response to cantbeserious (Reply #76)

Mon Dec 3, 2012, 05:09 PM

87. Indeed. In 15 years that graph will look the same

Maybe then we can admit that we really have a problem. First we had a breakdown without a system in place. Then we put in place a broken as designed system. After a decade and a half of suffering with it, and a bad situation constantly getting worse maybe no excuses will be left?
Lots of people around here will be dead then.

Maybe that's what it will take? The willfully blind dying off.

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Response to xchrom (Original post)

Sun Dec 2, 2012, 11:57 PM

78. K&R.

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Response to xchrom (Original post)

Mon Dec 3, 2012, 12:05 AM

79. Health Ins going up 5X's the rate of inflation...

 

Wages have gone up ZERO.

So how are people supposed to pay this increase?
\
Oh.. they don't.. they just die.

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Response to xchrom (Original post)

Mon Dec 3, 2012, 01:12 AM

80. European drug companiesmarkup prices in the US so they can cut prices at home.

A few years ago the Guardian UK had an editorial decrying efforts to rein in medical spending in the US. Their beef? If US consumers paid less for drugs, British drug companies would have to start charging more at home.

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Response to xchrom (Original post)

Mon Dec 3, 2012, 09:32 AM

84. i wonder what the first graph would look like...

....if the price of drugs in the u.s. was brought into line with other countries.

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Response to xchrom (Original post)

Mon Dec 3, 2012, 05:12 PM

88. Kicked and recommended.

Thanks for the thread, xchrom.

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