Your thoughts on the White House's request to send fishy emails on National healthcar

**astralis** · 12 Aug 09,, 00:04

Healther Skelter - Obama Death Panel Debate | The Daily Show | Comedy Central

**ArmchairGeneral** · 12 Aug 09,, 00:30

Originally Posted by astralis

of course, you do realize that it is because of the gaming of the system that health care costs have spiraled in the US.

Is it? I've heard this over and over, and I've heard all the theories about adverse selection and what have you, but I don't recall seeing much actual evidence. It's been rather frustrating, in fact, trying to find anything like a breakdown of where health dollars go. I'm beginning to suspect that no one actually knows. I'd be grateful for any good links or such you could send my way.

**gunnut** · 12 Aug 09,, 00:53

Originally Posted by ArmchairGeneral

Is it? I've heard this over and over, and I've heard all the theories about adverse selection and what have you, but I don't recall seeing much actual evidence. It's been rather frustrating, in fact, trying to find anything like a breakdown of where health dollars go. I'm beginning to suspect that no one actually knows. I'd be grateful for any good links or such you could send my way.

And of course if we pass national health care, no one will possibly game the system since everyone will have health care.

In that condition, everyone will game the system since there are no direct consequences.

I can tell you one thing for sure, if we had universal health care when I was unemployed, meaning I can go to a hospital on the government's dime, I wouldn't have been in such a hurry to find a job, and I certainly would have continued to play hockey. I would have been "gaming" the system.

**zraver** · 12 Aug 09,, 01:29

Originally Posted by ArmchairGeneral

Is it? I've heard this over and over, and I've heard all the theories about adverse selection and what have you, but I don't recall seeing much actual evidence. It's been rather frustrating, in fact, trying to find anything like a breakdown of where health dollars go. I'm beginning to suspect that no one actually knows. I'd be grateful for any good links or such you could send my way.

overall cost $2.4 trillion NCHC | Facts About Healthcare - Health Insurance Costs

Insurance company profits- less than $100 per year per enrollee Excessive Health Care Profits The American Catholic

cost of plastic surgery per annum $9.4 billion Cosmetic Surgery Fast facts...fun facts...at your fingertips!

money wasted on unneeded tests $210 billion

inefficient claims forms processing $210 billion

use of the ER as a substitute for having health insurance and a doctor $14 billion

unneeded procedures do to incomplete records $17 billion

discharging patients from hospital too soon, post- hospitalization issues $25 billion

Fighting hospital acquired infections $3 billion

Risky behavior related costs (smoking obesity etc) $423 billion

Staff turn over $21 billion

$4 billion in paper costs for writing prescriptions

$1 billion a year in over prescribed anti-biotic

health-care-six-money-wasting-problems.html: Personal Finance News from Yahoo! Finance

Some portion of 164 billion a year in traffic accident related care AAA report says that car accidents cost Americans $164.2 B. - Mar. 5, 2008

Elder care $309 billion Role Reversal: The High Cost of Elder Care - ABC News

$5.8 Billion in malpractice awards Michigan Hospital: Saying 'Sorry' Reduces Malpractice Suits - Incredible Health - FOXNews.com

$11.5 billion Medical Malpractice Insurance rates http://www.insurance-reform.org/StableLosses2007.pdf

$332 Billion in total drug costs

$116 Million spent on lobbying by drug companies

$99.73 Billion spent on marketing by drug companies

$50.03 Billion actually spent on drug R&D

Pushing Prescriptions - The Center for Public Integrity

**zraver** · 12 Aug 09,, 01:52

Possible savings (assuming a 50% reduction in waste)

$105 Billion in unneeded tests

$105 Billion via more efficient claims processing

$7 Billion via reduced emergency room visits if everyone had health insurence

$8.5 billion via fewer unneeded procedures

$12.5 billion via better post hospitalization care, longer hosptial stays to recover from procedures

$1.5 billion a year via better sanitation to fight infections

$212.5 a year if we all lived healthier

$10.5 a year via better staff retention

$2 billion a year using all digital prescriptions

$.5 billion via tighter use of antibiotics.

$2.4 Billion via tort reform

$5.75 billion via malpractice insurance rate reform

$50.445 Billion via lobbying restrictions and limiting marketing to whats to more than is what is spent on actually developing a drug.

Total possible savings $523.445 Billion

**gunnut** · 12 Aug 09,, 01:52

Originally Posted by zraver

Insurance company profits Excessive Health Care Profits The American Catholic

I have a question: what is the correct profit for the insurance industry?

Originally Posted by zraver

cost of plastic surgery per annum $9.4 billion Cosmetic Surgery Fast facts...fun facts...at your fingertips!

I don't understand this link. Do you mean we spend too much, too little, or just right on cosmetic surgeries? Are these procedures covered under insurance? I can tell you my insurance policy does not cover any cosmetic surgery that is not corrective in nature.

Originally Posted by zraver

money wasted on unneeded tests $210 billion

How do we know that these tests are unneeded until we have the results?

Originally Posted by zraver

inefficient claims forms processing $210 billion

Hey...my company is in this business. We are trying our best to streamline the claim process.

Originally Posted by zraver

use of the ER as a substitute for having health insurance and a doctor $14 billion

Deny treatment. Other wise these people should be counted in the "have access" to health care category.

)

Originally Posted by zraver

discharging patients from hospital too soon, post- hospitalization issues $25 billion

Fighting hospital acquired infections $3 billion

Seems like these 2 issues should cancel each other out.

)

Originally Posted by zraver

Risky behavior related costs (smoking obesity etc) $423 billion

Massive tax on candy, soda, smoking, junk food, trans fat, fast food, red meat,...etc. Basically anything we deem to be "risky." Problem solved.

Originally Posted by zraver

Staff turn over $21 billion

I don't understand this. Aren't there normal turn-overs for staff in just about any business? How can that be included in the "wasteful" category?

Originally Posted by zraver

$4 billion in paper costs for writing prescriptions

I guess we could switch to an electronic system. But that costs money as well.

Originally Posted by zraver

$1 billion a year in over prescribed anti-biotic

This I agree. Too many people taking too many different type of anti-biotic.

Originally Posted by zraver

Some portion of 164 billion a year in traffic accident related care AAA report says that car accidents cost Americans $164.2 B. - Mar. 5, 2008

Tele-commute.

)

Originally Posted by zraver

Elder care $309 billion Role Reversal: The High Cost of Elder Care - ABC News

Thanks to Medicare. I have no problem with people spending their own savings to keep themselves alive. Medicare, through decades of modification, is way beyond basic now.

Originally Posted by zraver

$5.8 Billion in malpractice awards Michigan Hospital: Saying 'Sorry' Reduces Malpractice Suits - Incredible Health - FOXNews.com

$11.5 billion Medical Malpractice Insurance rates http://www.insurance-reform.org/StableLosses2007.pdf

Tort reform, which Obamacare opposes. Dems are owned by the trial lawyers union. Guess how John Edwards made his fortune.

Originally Posted by zraver

$332 Billion in total drug costs Pushing Prescriptions - The Center for Public Integrity

Seems like Walmart has the right idea. What does it charge? Like $4 for generic prescriptions?

**zraver** · 12 Aug 09,, 02:04

Originally Posted by gunnut

I have a question: what is the correct profit for the insurance industry?

Not what i was going at, just showing where the money is going.

I don't understand this link. Do you mean we spend too much, too little, or just right on cosmetic surgeries? Are these procedures covered under insurance? I can tell you my insurance policy does not cover any cosmetic surgery that is not corrective in nature.

Nope, just showing that of the 2.4 trillion a year in total HC costs, 9.4 billion is cosmentic.

How do we know that these tests are unneeded until we have the results?

Its what the research suggests

Hey...my company is in this business. We are trying our best to streamline the claim process.

Just showing where the money goes

Deny treatment. Other wise these people should be counted in the "have access" to health care category.

)

Not the business of my post, 7th asked for an actual cost breakdown of health care in America. I did my best to provide it.

Seems like these 2 issues should cancel each other out.

)

Not really, 1 is people who have to be re-admitted, the other is people who come in for X get staff and have an extended stay.

Massive tax on candy, soda, smoking, junk food, trans fat, fast food, red meat,...etc. Basically anything we deem to be "risky." Problem solved.

Again not the direction of my post. Actually I would prefer more PE in school. It really had results in Arkansas.

I don't understand this. Aren't there normal turn-overs for staff in just about any business? How can that be included in the "wasteful" category?

Obviously the experts decided that there was $21 billion over and above what would be considered normal.

I guess we could switch to an electronic system. But that costs money as well.

just showing cots

This I agree. Too many people taking too many different type of anti-biotic.

yup

Tele-commute.

)

please, less people on the highway means more room for me.

Thanks to Medicare. I have no problem with people spending their own savings to keep themselves alive. Medicare, through decades of modification, is way beyond basic now.

The AARP will be showing up to burn you out shortly. In all honesty however, they did pay into the system.

Tort reform, which Obamacare opposes. Dems are owned by the trial lawyers union. Guess how John Edwards made his fortune.

preaching to the choir, but its still part of the annual cost of health care in America.

Seems like Walmart has the right idea. What does it charge? Like $4 for generic prescriptions?

What about the TV ads? Pharmamercials and office visits by drug reps are a big part of the cost of health care in America

**ArmchairGeneral** · 12 Aug 09,, 03:08

Originally Posted by zraver

Possible savings (assuming a 50% reduction in waste)

$105 Billion in unneeded tests

$105 Billion via more efficient claims processing

$7 Billion via reduced emergency room visits if everyone had health insurence

$8.5 billion via fewer unneeded procedures

$12.5 billion via better post hospitalization care, longer hosptial stays to recover from procedures

$1.5 billion a year via better sanitation to fight infections

$212.5 a year if we all lived healthier

$10.5 a year via better staff retention

$2 billion a year using all digital prescriptions

$.5 billion via tighter use of antibiotics.

$2.4 Billion via tort reform

$5.75 billion via malpractice insurance rate reform

$50.445 Billion via lobbying restrictions and limiting marketing to whats to more than is what is spent on actually developing a drug.

Total possible savings $523.445 Billion

So almost half of the savings here is from getting us to live healthier and be thinner. Fat chance. So to speak. And I'm trying to figure out how one would increase staff retention without increasing staff remuneration.

Anyhow, thanks for the info, interesting stuff.

**ArmchairGeneral** · 12 Aug 09,, 04:12

Here's an interesting bit from the CBO, probably been posted somewhere already, but what the heck. Director’s Blog Blog Archive Prevention and Wellness

**indus creed** · 12 Aug 09,, 04:45

Originally Posted by gunnut

How do we know that these tests are unneeded until we have the results?

Hey...my company is in this business. We are trying our best to streamline the claim process.

Deny treatment. Other wise these people should be counted in the "have access" to health care category.

)

Tort reform, which Obamacare opposes. Dems are owned by the trial lawyers union. Guess how John Edwards made his fortune.

Gunnut,

A lot of tests are unneeded. Part of the problem is with torts. Physicians are scared shitless to bypass tests. I have read somewhere that John Edwards made his first fortune by convincing a jury that a blotched delivery caused a cerebral palsy which was commented as a scientific impossibility.

Patients are one of the biggest problems in US health services. Allow me to cut and paste from a blog's comments section:

You forgot the key inflationary component - patients.
System does not cost anything to the patient - employers, insurance, government foot the bills. So people freeload on the health care system. They want the best care and pay nothing.

They want it to be free or have somebody else pay for it. They have created collectivism thru insurance and government to spread the cost, pass on the cost.

Patients want the best, so they maximize their use of health care system. Doctors get to bill more, so they too maximize their care of patients. Insurance companies do not have to pay anything out of their own pocket - they simply pass on the costs on as insurance premiums.

The employers pass it on to the consumers of their products and serivices. Government does the same - pass it on to tax payers. Thus there are no built in checks and balances against sky-rocketing cost inflation.

The cost structure spirals up making it the most expensive system. It creates massive problems for self-employed and uninsured people as they can not afford the inflated health-care costs.

Most small companies can not afford the insurance premiums for their staff. Government can nationalize insurance - but that still does not address the root cause that has created the vicious cost inflation in the first place - collectivism without individual responsibility.

In fact, government funded/insured health-care system will prove to be even more inflationary and may breed corruption and inefficiency on top of current mess.

**zraver** · 12 Aug 09,, 04:59

Originally Posted by ArmchairGeneral

So almost half of the savings here is from getting us to live healthier and be thinner. Fat chance. So to speak.

Look at the reduction in smoking. Not that I am for a fat tax but things can be done. In Arkansas mandatory PE class with bench marks the kids had to meet cut the juvenile obesity rate.

And I'm trying to figure out how one would increase staff retention without increasing staff remuneration.

Anyhow, thanks for the info, interesting stuff.

Scheduling changes so that doctors, nurses and staff have to work fewer hours per shift (same hours per week).

Painting the walls to less institutional more homey and comfortable colors and the use of art.

Less glaring lighting where not needed.

Student loan forgiveness for long term stays at a location.

Housing assistance (loan guarantees, help with lower interest rates in trade for long term contracts)

Plus there is a whole discipline of industrial psychology.

**gunnut** · 12 Aug 09,, 05:15

Originally Posted by indus creed

Gunnut,

A lot of tests are unneeded. Part of the problem is with torts. Physicians are scared shitless to bypass tests. I have read somewhere that John Edwards made his first fortune by convincing a jury that a blotched delivery caused a cerebral palsy which was commented as a scientific impossibility.

Patients are one of the biggest problems in US health services. Allow me to cut and paste from a blog's comments section:

You forgot the key inflationary component - patients.
System does not cost anything to the patient - employers, insurance, government foot the bills. So people freeload on the health care system. They want the best care and pay nothing.

They want it to be free or have somebody else pay for it. They have created collectivism thru insurance and government to spread the cost, pass on the cost.

Patients want the best, so they maximize their use of health care system. Doctors get to bill more, so they too maximize their care of patients. Insurance companies do not have to pay anything out of their own pocket - they simply pass on the costs on as insurance premiums.

The employers pass it on to the consumers of their products and serivices. Government does the same - pass it on to tax payers. Thus there are no built in checks and balances against sky-rocketing cost inflation.

The cost structure spirals up making it the most expensive system. It creates massive problems for self-employed and uninsured people as they can not afford the inflated health-care costs.

Most small companies can not afford the insurance premiums for their staff. Government can nationalize insurance - but that still does not address the root cause that has created the vicious cost inflation in the first place - collectivism without individual responsibility.

In fact, government funded/insured health-care system will prove to be even more inflationary and may breed corruption and inefficiency on top of current mess.

I absolutely agree with you. The real reform is to detach health insurance from employment. This system is a relic of WW2 price and wage control courtesy of FDR. The war is over. Time to change the system.

**Bluesman** · 12 Aug 09,, 05:27

Originally Posted by JAD_333

Not necessarily. There is a provision of the Presidential Records Act that "allows the incumbent President to dispose of records that no longer have administrative, historical, informational, or evidentiary value, once he has obtained the views of the Archivist of the United States on the proposed disposal."

Also it "requires that the President and his staff take all practical steps to file personal records separately from Presidential records."

Oh, well then, we're all set, and in the hands of a known square-dealer like Obama, what's to worry about? What could possibly happen?

**gunnut** · 12 Aug 09,, 05:27

Originally Posted by zraver

Not what i was going at, just showing where the money is going.

Very well. I just have some questions about these numbers. It would be nice to know exactly how these numbers are arrived at.

Originally Posted by zraver

The AARP will be showing up to burn you out shortly. In all honesty however, they did pay into the system.

The interesting thing is AARP so far has not really objected to Obamacare. The end result of Obamacare is the dismantling of the current Medicare as we know it.

Originally Posted by zraver

What about the TV ads? Pharmamercials and office visits by drug reps are a big part of the cost of health care in America

I'm not quite certain about this. Drug companies have to make their money somehow, right? Develop a new drug, gotta sell it to make some money, fund the next research...