Health Insurance ramblings
I've been listening to podcasts last night and tonight about health insurance. Some interesting facts, before I get too boring:
Blue Cross was the first health insurance company, and was started at Baylor University of Dallas for local teachers before the great depression. After WW2, an IRS bureaucrat said that companies got tax breaks for providing health insurance to their employees, and bam! Health insurance was suddenly provided to employees by many companies. That is the reason our health insurance, but not groceries, is provided by our employers.
Also, the first 'chemical therapy' pharmaceutical that actually worked and was not 'snake-oil' was for.... (drum roll please)... Syphilis! That was in the very early 1900s. Too bad Capone did not get any...
So, now on to my ramblings of thoughts distilled from This American Life (2 one-hour long episodes), Planet Money, and Marketplace over the last couple of nights.
Our healthcare crisis in this country, our REAL healthcare crisis, is not about the uninsured. Don't get me wrong, my brother is uninsured and the uninsured are a big problem but it is not the biggest problem. The biggest problem seems to be the skyrocketing prices of health insurance. They have risen 130% in the last 9 years, and currently 1/3 of all health insurance money is believed to be wasted. The major reason for this is two-fold:
I am even personally guilty of very recently 'spending someone else's money'. A month or so ago, I went in for a physical / check-up. I was mostly interested in getting my kidneys and liver checked because they've never been checked before, and while I was there the doc commented on my ribs extending lower than normal. Upon this comment from the doc, I said "Let's get an xray." This is not because I thought my ribs extending lower than normal is even remotely serious or that it deserved investigation, but simply because of my curious nature. If I had been the one to foot the several hundred dollar bill for an xray, I would not have even considered it.
The podcasts discussed spinal surgeries and how fusing vertabraes is very common, but the common surgery involved screwing plates or rods to the vertabraes to fuse them together (instrumentation). I believe it was This American Life that said this was statistically no more successful than simply fusing the bones together with another piece of bone, but it is more expensive because it is more complicated and it allows the surgeon to also bill for installation of the plates or rods and screws.
A natural question is why doesn't the insurance company fight to keep their costs down, thus making more profits? Well, the insurance company has to keep their customers happy too, and they do this by keeping a majority of the doctors and hospitals available through their service. Large collections of hospitals and doctors have lots of clout, and can push back on these insurance companies' bullying.
An overhaul of the medical industry to get costs under control would need to start at the level of the doctors and those who decide what procedures to do in what circumstances. Perhaps you don't need that antibiotic for the sinus infection.
Next, we would need to keep people from wanting all of these crazy medicines and procedures. When you compare our life expectancy in the USA to a developed country that receives much less medicine and medical procedures, you'll find we don't live longer. This means we are receiving lots of health care that is absolutely not necessary. We need to ween people off from all this medicine, and I think this will take a generation to accomplish. Maybe a good first step would be to abolish prescription drug advertisements to the public.
And finally, we would need to hamper the pharmaceutical lobby. It is the largest lobby in the USA, and let me tell you that is really saying something! (Ok, I admit it. This reason is mostly because I want smaller government, and I think corporations need to get out of the government. This may not directly cause the reduction of healthcare costs.)
Thanks to dragonsbones for the link about sinus infections, and on that note: Good night, and good luck!
Blue Cross was the first health insurance company, and was started at Baylor University of Dallas for local teachers before the great depression. After WW2, an IRS bureaucrat said that companies got tax breaks for providing health insurance to their employees, and bam! Health insurance was suddenly provided to employees by many companies. That is the reason our health insurance, but not groceries, is provided by our employers.
Also, the first 'chemical therapy' pharmaceutical that actually worked and was not 'snake-oil' was for.... (drum roll please)... Syphilis! That was in the very early 1900s. Too bad Capone did not get any...
So, now on to my ramblings of thoughts distilled from This American Life (2 one-hour long episodes), Planet Money, and Marketplace over the last couple of nights.
Our healthcare crisis in this country, our REAL healthcare crisis, is not about the uninsured. Don't get me wrong, my brother is uninsured and the uninsured are a big problem but it is not the biggest problem. The biggest problem seems to be the skyrocketing prices of health insurance. They have risen 130% in the last 9 years, and currently 1/3 of all health insurance money is believed to be wasted. The major reason for this is two-fold:
- Doctors do not monitor costs, and actually, it is in their best interest to make the bill larger.
- Drug companies advertise to the public and then offer coupon cards to patients directly to promote name brand drugs that cost insurance companies many times more than generics, but due to these coupon cards the cost is the same to the patient. (Advertising to the public is illegal in many other countries but not in the good ol' USA. Also, these coupon cards for name brand drugs are a very new development, and the insurance companies don't yet have a good way to battle against them to keep costs down.)
I am even personally guilty of very recently 'spending someone else's money'. A month or so ago, I went in for a physical / check-up. I was mostly interested in getting my kidneys and liver checked because they've never been checked before, and while I was there the doc commented on my ribs extending lower than normal. Upon this comment from the doc, I said "Let's get an xray." This is not because I thought my ribs extending lower than normal is even remotely serious or that it deserved investigation, but simply because of my curious nature. If I had been the one to foot the several hundred dollar bill for an xray, I would not have even considered it.
The podcasts discussed spinal surgeries and how fusing vertabraes is very common, but the common surgery involved screwing plates or rods to the vertabraes to fuse them together (instrumentation). I believe it was This American Life that said this was statistically no more successful than simply fusing the bones together with another piece of bone, but it is more expensive because it is more complicated and it allows the surgeon to also bill for installation of the plates or rods and screws.
A natural question is why doesn't the insurance company fight to keep their costs down, thus making more profits? Well, the insurance company has to keep their customers happy too, and they do this by keeping a majority of the doctors and hospitals available through their service. Large collections of hospitals and doctors have lots of clout, and can push back on these insurance companies' bullying.
An overhaul of the medical industry to get costs under control would need to start at the level of the doctors and those who decide what procedures to do in what circumstances. Perhaps you don't need that antibiotic for the sinus infection.
Next, we would need to keep people from wanting all of these crazy medicines and procedures. When you compare our life expectancy in the USA to a developed country that receives much less medicine and medical procedures, you'll find we don't live longer. This means we are receiving lots of health care that is absolutely not necessary. We need to ween people off from all this medicine, and I think this will take a generation to accomplish. Maybe a good first step would be to abolish prescription drug advertisements to the public.
And finally, we would need to hamper the pharmaceutical lobby. It is the largest lobby in the USA, and let me tell you that is really saying something! (Ok, I admit it. This reason is mostly because I want smaller government, and I think corporations need to get out of the government. This may not directly cause the reduction of healthcare costs.)
Thanks to dragonsbones for the link about sinus infections, and on that note: Good night, and good luck!