My View on Health Care
The problem with the cost of healthcare in the U.S. - statistically shown to be the highest in the world – is why it is that high and who is paying for it? I can use myself as an example. Following is how the cost of the same, single chemo treatment for me was charged and paid for in the past depending on where it was given. The first figure shown is the amount that the provider charged, the second the amount Medicare "allowed" which determined how much they paid (80%) plus what our Supplement coverage paid (20%) and the last one the amount I paid
Mayo Clinic, Rochester, MN 6,400 5,600 0
Aspirus Hospital, Wausau, WI 16,900 5,800 0
Moffit Clinic, Tampa, FL 24,000 6,200 0
Lucky me, right? On the other hand, we did pay an insurance premium of $ 3,358 (Medicare Part B) over the period of time these payments were made. You can see what one of the causes for concern over sustainability is. So, which of these should be considered the healthcare "cost" - the cost to the provider, to the payer or to the patient? I don't know how the economists develop their statistics. I'm similarly puzzled by death and life expectancy statistics when pundits tackle health care issues. Do their statistics include death from violent crimes, drug overdoses, suicides, etc.?
One thing appears to have had a major effect and that is that our medical provider behavior has changed dramatically. "Back in the days" when I was still going to my family doctor, if I had a bowel problem he used the old sigmoid scope on me with no anesthetics. Today my internist sends me to a gastroenterologist who gives me a colonoscopy and throws in an endoscopy for good measure since I'm under anesthesia anyway all of which requires an anesthetist and an ENT guy with all of these specialists charging appropriately. When my CLL was diagnosed I had 32 CT scans done over a period of time. I counted up the millisieverts I'd been exposed to which were equal to those of a Hiroshima survivor and told the doctors to stop using them to which they agreed. My current doctor recently suggested we get a CT scan and I refused. I told him if he wanted to look at my innards he should take an X-Ray at a cost of $150 instead of the $1,000 or more CT and if he found something suspicious, then he could order the scan. He agreed too. Much of that behavior was caused by the increase in malpractice litigation so maybe we should blame the lawyers too. I think a lot more could be done to reduce costs if we stopped over-medicating and cut back on the use of expensive specialists to real and dire emergencies like we used to.