Must-read article from Time magazine re. healthcare costs - page 2

by tswim 3,194 Views | 18 Comments

"Bitter Pill: Why Medical Bills Are Killing Us" Interesting read, with insights into hospital billing practices, and significant implications about our nation's future if we continue to ignore the debt lobbed upon... Read More


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    Paid $200 a few years ago for a single shot vaccination not covered by insurance at our local medical corporation. The doctor left the medical assistant to break the news of the cost.
    Last edit by Susie2310 on Mar 1, '13
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    Quote from Altra
    Agree with BlueDevil, DNP ... the article is so simplistic as to be virtually meaningless.

    I almost cringe to ask this question, but ... (crossing fingers) ... surely at least the nurses reading this thread realize that the "$1.50 acetaminophen pill" ... includes the hospital's cost of pharmacy staff, nursing, equipment leasing (e.g. Pyxis), etc.
    How it is simplistic? It's 25 pages long.
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    Quote from AQEELSMOM

    How it is simplistic? It's 25 pages long.
    ^It IS simplistic; from the point on how a marker that is used in Peri-Op can be "reused" (my reply: YUCK!!!!); a liter if NSS "also used for cleaning contacts" (my reply: the WHY of NSS is MORE than cleaning; homeostasis!!!)...those are the tree of my pet peeves.

    As someone who has lived without insurance before getting Medicare, and STILL having to buy additional insurance, they do charge the same, and if you don't have insurance, they have to recapture the risk.I had to make hard choices still, sometimes going without medication in order to get yo and from work and school, and put food in the table...and I am ONE person. I endured it as a young person in my 20s, but after having a severe case of the flu, I went out and got private health insurance before I was dropped because if a life altering medical event.


    Yet, business and hospital economics are a dance that can be complicated in perspective; however, people really shouldn't feel as though they have to go bankrupt to receive good care.

    There should be a curb on costs that the outside vendors do as far as powerful meds, routine meds, labs, and hospital stays; in turn, people who treat and care for patients should be compensated fairly as well. My sticking point is should COOs and upper management be the bulk of the money that is charged to patients? No. Should there be a cap on malpractice??? In my opinion, yes.

    The malpractice craze has reduced hospitals to the detriment of our healthcare system. L&D units are saturated with patients; sometimes forcing Drs to increase scheduled C-Sections to anticipate the higher acuity emergency clients. I remember being a coach for one of my sister during her first pregnancy, and the doctors not wanting to do ANY cuts-episiotomy, let alone a C-Section; when I was in my Maternity rotation, I saw physicians not bat an eye for a C-Section.

    The system SURELY needs an overhaul, and it's not as simplistic as the article alludes...it's like, "all healthcare has to do is" mentality, when it negates the involvement of the care, which should be compensated; and I feel as though nurses should be compensated well.

    As complex as ACA is; at least it provides a framework, we have the ability to tweak it as it goes along, at least it is a start.

    The light at the end of my tunnel is at least I have recovered enough to keep my Medicare and have a great insurance plan that is reasonably priced. I would like my clients to have the same opportunity as I have, while not compromising nursing wages, and improving lives so they can afford to be healthy enough to come in on tune ups when needed, and better quality of life=increase in personal wealth.

    Healthcare is a full-proof business...people will constantly need nursing, whether educating a pt on a med, Pathophysiology the WHY of all things in the body and reinforcing the interpretations of the medical team, skilled maintenance care; and providing the holistic nursing experience in order to improve the patients health. We will be here 24-7-365, regardless.
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    You make some really good points. I am from Canada (and I am not a nurse yet - just a civilian), and coming from that background, I guess my overall thought on the whole thing is that healthcare should be a right, not a privilege. I think its in a societies best interest that people are healthy. But then again, the easiest way to control people is to keep them in fear - and people fearing over their health is a good way to do that.

    I understand that people need to be compensated for their work - but to what degree? Doctors and nurses in other developed countries do just fine. Why is it that in America healthcare costs are so much higher than other places?

    What this all boils down to, for me at least, is priorities. Are our priorities based around the details of structures that are obviously failing us? Or are our priorities based around revamping a system that is not fair, not moral, and quite honestly, kind of corrupt.
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    Quote from LadyFree28

    The malpractice craze has reduced hospitals to the detriment of our healthcare system. L&D units are saturated with patients; sometimes forcing Drs to increase scheduled C-Sections to anticipate the higher acuity emergency clients. I remember being a coach for one of my sister during her first pregnancy, and the doctors not wanting to do ANY cuts-episiotomy, let alone a C-Section; when I was in my Maternity rotation, I saw physicians not bat an eye for a C-Section.
    Can you elaborate on this a little bit? Why are doctors being forced to increase c sections? Is it because of time restraints?
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    Quote from AQEELSMOM

    Can you elaborate on this a little bit? Why are doctors being forced to increase c sections? Is it because of time restraints?
    ^about 10-15 years ago, in my metro area, my courts had no caps in malpractice, and it was really out if control...Still is, because there is still no cap. Lots of plaintiffs will apply in the closest city that has jurisdiction, so lots of cases were filed in my city's courts, and the juries handed out huge awards. In turn, malpractice insurances went up exponentially, especially for specialists, like OB-Gyns and Orthopedic Surgeons.
    A percentage moved out of the state, or stopped delivering babies; the remainder went with hospitals that could afford to provide malpractice insurance for them. The hospitals that were in no shape to provide it either closed their L&D wards or had to be absorbed by the bigger, richer hospitals. When you have less L&Ds and now you have a surge of new pts coming father and needing care where your unit has the capacity of your original clientele based in demographics, and hospital patterns, then you have an issue. There is about 10 hospitals that have L&D units when there were at least 20 at one time. When I did my rotation, they were doing renovations on that particular unit to accommodate more moms and babies. There were on average 50 pts scheduled to deliver with a 20-bed unit.

    Currently, most community hospitals, including the one that I started my healthcare career in, is managed by one of the bigger, richer hospitals that now fully manage at least 5 different community hospitals in the area, when they were freestanding at one time. I left there when they were concerned whether they were going to remain open. This was in 2002. Malpractice costs have made more doctors move around and in turn, if they were sustaining 50-60 percent of revenue, nurses lost their jobs and hospitals closed. Hospitals had to create a cushion between the decreasing of Medicare reimbursement and lack of malpractice caps. They tried through legislation to assist in those costs, but during that time there was the bubble burst in the 90s that some places were still recovering from, so it was still bad, especially for the small hospitals. Fast forward today, they now have joined certain hospital networks to seek financial security and viability. I am in an area where healthcare research, and our healthcare in general has a good reputation with certain healthcare networks; making care sought after.
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    Just a point: "free market"=FOR PROFIT.
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    Just because it was long, doesn't mean it was any good, lol. I stand my my opinion that it was badly written and the examples badly illustrate the problems at hand. Tylenol costs $14 because of capitation payments, and because nursing services aren't charged separately. Capitation payments simply cannot be explained in 25 pages. It could take 2,500 pages over the course of at least a semester, and the learner needs to know how to do college algebra at a minimum and should have an accounting background as well, otherwise it might take 2 semesters.

    CEOs earn what they do for the same reason Aaron Rodgers and Joe Flacco do-because the cream always rises to the top and there are relatively few people who can do what they do. Not just anyone can throw a football like those guys do, and not just anyone can run a large health care system. If you want to hire the best talent, you have to be willing to pay what the market* will bear.

    *market. There is that word again. Listen, I don't think health care ought to be run as a free market, it is inherently unethical. But the ways things are is the way things are, and I live in the here and now, not in a fantasy world of they way things ought to be. In a just world athletes would not make $120 million dollars unless they are solving world hunger in their spare time, and CEOs wouldn't earn 800X the average salary of their employees. The world is not a just place, and healthcare remains a for-profit industry. As long as this is the case, profits will always come before people. Every. single. time.
    Why anyone expresses surprise or upset about this when this is what we collectively vote for again, and again, and again, simply boggles the mind.

    I sincerely hope the Brandon is correct and we see Universal single payer health care in our lifetimes. I doubt it, because American's have historically been exceedingly stupid and selfish on this point, but I'd really like nothing better than to be wrong.
    Altra likes this.
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    I'm just a baby nursing student and I definitely know my place in this forum, and I won't pretend that I know anything about capitation payments. This is also probably why the article didn't seem simplistic to me lol But I just want to know if your explanation for the prices is the one we should be giving our patients? 'The system is too complicated for you to understand, and the way things are, is the way things are' ? I mean if the system is unethical, then why defend it? To be honest I really don't mind if athletes make a ton of money, I don't mind when anyone who is successful makes a lot of money... but when they are making that money off the backs of bankrupted sick people? Yea i'm gunna have to say I take issue with that... Maybe you're right and they need every cent to have incentive to run these healthcare companies, but my gut is telling me otherwise. I also don't think Americans are stupid or selfish, I think they're uninformed. And maybe articles like this can help change that... just sayin
    Artistyc1 and sneeds like this.


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