November 03, 2009
Systemic Bloat Syndrome

I have a contact in the health insurance industry who tells me that the great under-discussed elephant in the parlor of the current healthcare debate is how much doctors charge for their services. So let’s discuss it. Take a look at the stunning charts in the article from which this is an excerpt, bearing in mind that the other countries deliver better results by practically any measure than our own system does.

Less, it turns out, really is more.

…There is a simple explanation for why American health care costs so much more than health care in any other country: because we pay so much more for each unit of care. As Halvorson explained, and academics and consultancies have repeatedly confirmed, if you leave everything else the same — the volume of procedures, the days we spend in the hospital, the number of surgeries we need — but plug in the prices Canadians pay, our health-care spending falls by about 50 percent.

In other countries, governments set the rates that will be paid for different treatments and drugs, even when private insurers are doing the actual purchasing. In our country, the government doesn’t set those rates for private insurers, which is why the prices paid by Medicare, as you’ll see on some of these graphs, are much lower than those paid by private insurers. You’ll also notice that the bit showing American prices is separated into blue and yellow: That shows the spread between the average price (the top of the blue) and the 90th percentile (the top of the yellow). Other countries don’t have nearly that much variation, again because their pricing is standard…


Posted by Jerome Doolittle at November 03, 2009 02:42 PM
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Not only do we pay more per unit, but doctors make sure that, where one unit of care will suffice, they turn it into multiple units.

Over a ten year period, in that long ago time when I had insurance, I saw three or four different doctors in an attempt to find one that would monitor my moles. None of them did anything that could begin to be described as "monitoring." Instead, each declared numerous moles had to be removed immediately (despite the fact that not a single biopsy had come back as anything other than "pre-cancerous" -- scary doctor talk apparently for "not cancerous at all"), but not one of them would remove more than one mole at a time. Over a decade I had a dozen moles removed. One. At. A. Time.

And how did they decide which moles needed removing? Well, initially they would point out specific ones which they claimed looked alarming. But funny thing, half the time, when I would go in for a removal, they would remove one different from what we had discussed previously. Sometimes they removed a different one accidentally -- they forgot which one was on the agenda. Other times I was told, "This one is easier."

I finally gave up trying to have anyone monitor my moles -- as I had been told to do because I have so many -- because it finally became clear to me that I was being used as a cash machine by the medical community.

Posted by: karen marie on November 3, 2009 5:58 PM

The Air Force is trying to recruit doctors by offering a practice environment free of insurance paperwork. Tag line: "No One Goes Through Medical School to Practice Insurance." See .

In other words, the U.S. military is making a *selling point* of its status as our principal domestic bastion of "socialized medicine."

Somebody should tell the Support Our Troops teabaggers. They'll sprain a brainstem having two thoughts at once.

Posted by: Martha Bridegam on November 4, 2009 2:14 AM
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