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Medical Insurance and Medical Industry

Why is medical treatment so prohibitively expensive in the US ? Why do the dentists charge exorbitant amount of money to fix your teeth ? If a minor operation for appendicitis costs in excess of $ 18,000 then something is definitely wrong with the system. The insurance companies and medical industry appear to be hand in glove with each other. They stand to benefit from one another, at the expense of the patient. It just looks like a big fraud to me.

ahhhh, the virtues of the unfettered free market

Who regulates this sector?

Re: Medical Insurance and Medical Industry

quote:

Originally posted by Omega_M Why is medical treatment so prohibitively expensive in the US ? Why do the dentists charge exorbitant amount of money to fix your teeth ?

Because 1) they can, and 2) they know you'll sue them for everything they've got if they fuck up, so they have very expensive malpractice insurance! At least I'd guess that those are probably a major piece of it.


If a minor operation for appendicitis costs in excess of $ 18,000 then something is definitely wrong with the system.[/quote]

That's definitely an expensive surgery, but day-yum what hospital did you go to?

quote:

(1) Department of Surgery, Vanderbilt University, 801 Oxford House, Nashville, TN 37232-4753, USA (2) Department of Medicine and Center for Health Services Research, and Nashville Veterans Administration Medical Center, Vanderbilt University Medical Center, Vanderbilt University, 801 Oxford House, Nashville, TN 37232-4753, USA Received: 3 April 2004 Accepted: 16 September 2004 Published online: 23 December 2004 Abstract Background Despite multiple studies comparing laparoscopic and open appendectomies, the clinically and economically superior procedure still is in question. A cost analysis was performed using both institutional and societal perspectives. Methods A decision analytic model was developed to evaluate laparoscopic and open appendectomies. The institutional perspective addressed direct health care costs, whereas the societal perspective addressed direct and indirect health care costs. Baseline values and ranges were taken from randomized controlled trials, meta-analyses, and Medicare databases. Results From the institutional perspective, open appendectomy is the least expensive strategy, with an expected cost of $5,171, as compared with $6,118 for laparoscopic appendectomy. The laparoscopic approach is less expensive if open appendectomy wound infection rates exceed 23%. From the societal perspective, laparoscopic appendectomy is the least expensive strategy, with an expected cost of $10,400, as compared with $12,055 for open appendectomy. Conclusions The decision analysis demonstrated an economic advantage to the hospital of open appendectomy. In contrast, laparoscopic appendectomy represents a better economic choice for the patient.

source

And those figures come from a Vandy guy of all people! I can assure you, they charge top dollar at that place! But $18,000+? Sheesh! I think you need a 2nd opinion!

quote:

The insurance companies and medical industry appear to be hand in glove with each other.

Of course they are. They deal with each other on a daily basis. They probably have dinner with each other! But if you have insurance, the cost of your operation just went down by 50%. Still expensive, but more manageable over time. But $18,000+? Sheesh! I think you need a 2nd opinion!

quote:

They stand to benefit from one another, at the expense of the patient.

But if you have insurance, the cost of your operation just went down by 50%. Still expensive, but more manageable over time. So you stand to benefit too (in a sick, twisted way).

quote:

It just looks like a big fraud to me.

Insurance is a necessary evil to ensure access to the best healthcare possible. It sucks, but it sucks more when you don't have it.

1. You don't pay for you, you pay for you plus the people who don't pay.
2. Doctors no longer dictate medical care, the government, insurance companies and fear of litigation do.
3. Over regulation inflates costs dramatically.
4. Medicine is technology and new technology costs more than old technology.
5. Medical practioners require intensive training which costs time and money; rewards must merit such time and cost.

But more than any of those reasons...abuse of the system.

I had a friend who got operated on. He said his final bill was about $18K. Of course I didn't see the bill, but I don't see any reason why he would lie about it. It was kind of an emergency. He developed a pain all of a sudden when he was in the school. and they had to transfer him to a hospital ASAP. They might have done other tests, he might have been taken to the ER. I dunno.

Besides, according to your source, it cost $12,055 for open appendectomy. And that was in 2004. I see no reason why the figure should not be around $ 18,000 in 2006, taking into account operation charges, hospital fees etc.

It's really too much to say that docs charge because they can. They charge because they know the insurance company will pay for you. And to me it appears all inflated. There should absolutely be no reason for them to charge even so much as $ 7000. That is a lot of money. Not taking into consideration the doc fees, how much would the actual expenditure be for the operation ? Hardly anything that can add up to these amounts.

Just because I can sue the doc for his negligence in my case, does not mean that he has the right to overcharge everybody so that he can pay my damages. There needs to be other way to punish the doctor for his negligence then. Besides, how many docs get sued in their life time where they've had everything taken away from them ?

In my opinion, it's all a big fraud. All the prices are inflated. And the government doesn't do anything about it. The docs get very rich. The high costs of medical treatment ensure that every sensible person buys an insurance for his life time. So the insurance companies profit enormously from this racket. Everybody earns at the the patient's expense. It's pathetic, if you ask me.

The first people to blame for high health care costs are not doctors. Doctors make no more than they ever have, and many specializations make much less, with some (OB/GYN) actually losing money in order to cover costs. If you want a list of people to "blame" here's a list:

Politicians
Lawyers
Non-paying/abusing Patients

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