In a new article, Bitter Pill: Why Medical Bills Are Killing Us, Time Magazine delves into why medical bills are so high. 

I had a fibrous cyst creating a boil on my neck several years ago. After a round of antibiotics, a doctor performed a 15 minute outpatient surgery, assisted by a nurse, in an examination room. It wasn't even an operating room. Local anesthetic was used. The incision was about 3/4", and I was given a prescription for Vicodin I really didn't need before I left. 

The bill was about $850. I was shocked. I might have expected $250, but $850?

Well, $850 is nothing in today's medical world. 

Time describes instances of non-life threatening household accident injuries that run up bills in the five figures. More serious problems like treating cancer can run up bills in the six- and seven-figure range with ridiculous line items described in excruciating detail in the article.

What makes the pain of high healthcare costs worse is that the health care providers seem to be profiteering with markups that are as outrageous as they are unjustified. So-called "nonprofit" hospitals are actually profit-making institutions. Have you noticed how your local hospital is adding on new additions like crazy while the rest of the economy is slow. It's a boom economy in healthcare, forcing unjustifiable costs on a public suffering in a totally separate economy.

The article argues something I've already written about here: the healthcare industry isn't a normal market and doesn't really operate in the normal economy the rest of us have to live in. It doesn't compete for the business it gets and there's very little operating to restrain their costs. Yes, your insurance company probably gets a discount of 40%-50%, but even with that discount it's hard to justify the line items on the bills. 

Of course, there are people who can't pay their bills and become write-offs and they become part of the high cost of healthcare, but not such a large part that bills need to be as high as they are. Likewise, insuring themselves against lawsuits filed by people who can't accept that (a) shit happens or that (b) some people's conditions are terminal no matter WHAT care they get is a costly problem.

Putting some controls on the legal problems the industry faces is an obvious need, and one that can be addressed. However, the reasons for high healthcare have mostly to do with greed—getting whatever the traffic will bear—rather than providing the best service possible at a reaonable price. It's an industry that has forgotten that its primary purpose is to provide a service, not to break the back of those it serves with unjustifiably high expenses.

Look, I like capitalism, but I've come to decide that there are places where capitalism doesn't work. We don't want police and fire departments, libraries, and parks to be run on a "what the market will bear" basis. I would think that we especially don't want our healthcare system run that way.

You have no better argument for socializing medicine than the system we have now.

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Oh my, you think our ancestors didn't have diabetes?  Do you even know what Type 1 Diabetes is?  It would be more accurate to say that our ancestors had a much lower rate of menopause - but only because few women lived long enough to experience it, and that is a great form of prevention.

Part of the problem may stem from a misunderstanding of the term 'holistic health'.  There are two common usages of the term - one in modern medical science, which approaches health care from a combined physical, psychological, emotional standpoint which includes preventative measures such as counseling for good diet, fewer vices, etc.  You don't seem to realize this side of the word exists.

The other use of the word pops up in 'alternative medicine' where it is often claimed that 'mainstream' medicine overlooks all these aspects.  The problem with the 'alternative medicine' holistic approach is that it assumes all disease results from emotional/energy imbalances and are best treated from that perspective - this is a view that sees people like Steve Jobs dying rather than facing facts - and it is not a very popular view in the skeptics community.

Diabetes I and II are related mostly due to a symptom, but are totally different diseases. The former is due to a malfunctioning pancreas, which seems to be hereditary, arriving as a birth defect. Type II, by contrast, is an inability of the body to process carbohydrates effiiently at the cellular level despite (or rather with regard to) having a functioning pancreas. It appears to be related to an unhealthy lifestyle.

Let's lighten the mood a little: Why americans don't deserve healthcare.

The situation is not as bad in Canada, given our socialized medical system, but it is still riddled with many similar problems.  With little to no incentive to restrict costs, regional health administrations can spiral out of control and completely lose focus on their intended purpose.  I've spoken with people who work for the 'Web Development Department' of a regional health authority - as opposed to working for the IT Department, which has nothing to do with the Medical Technology Servies Department.

The regional health authority cannot allow actual patients to log in to see where their files are moving - too much potential for privacy violations and the general view of the Regional Health Authority is that their customers are the hospitals and Nurses Union - not actual patients.

I'll just cut short there as even thinking about this just makes me Palin.

"We keep our rates the lowest in the industry. How do we do it? We pay the fewest claims!"

Why do you like capitalism? It is a short cut to progress and promotes competition, but at what human cost? Is the cost close to the same as religions cost on humanity? And are we so sure it's the only way to get those results? What are some alternatives never tried? right now the markets (money) informs everything on the limit we should invest. the govt prints money, then takes back the money they print in taxes to pay for services, entitlements, and defense. yes that an over simplification. all of which they say is dictated by free market rates, cost of living, and inflation/deflation. but really without a govt backing the debt on the money, it means nothing. so market restrictions that some complain about are always there. Here is where healthcare comes in. research how much money oncology and heart clinics make for insurance co, doctors, and hospitals. track the market at work there, with little restrictions. Look where the public thinks the research money is and they think should be going, and look at what most scientist socialized medicine countries that are mostly publicly finded think it should go. When the market says keeping those WITH disease alive as long as possible is more profitable then preventing the diseases to begin with, the human suffereing gets clearer.

Why do I like capitalism? I'll consider alternatives that reward individual effort and innovation. I think capitalism does that better than the alternatives. However, health care isn't a normal market and it's not clear that capitalism works there.


I tend to feel the same way as you about capitalism, although I've been rethinking those feelings recently.  One problem I see with capitalism is that it ignores the need to reward labour.  I used to think capitalism was great because it meant anyone could put up a shingle and sell their services - although the system has become so capital-centric that small businesses, which predominantly sell labour much more directly, are getting crushed.  I think there needs to be some sort of balance between capital and labour in order for an economic system to maintain innovation.

If labor was paid according to worth (which its not) what worth does a wall street investor have? When the banker controls how much he is worth they are going to make sure and say they are worth the most. If there is no level playing field then any discovery will have an arbitrary value placed on it by someone not qualified to make that evaluation.  

Labour tends to be paid according to it's value within the market.  Skilled labour tends to be paid more than manual labour, and the hard worker tends to be paid more than the slacker.

I'm in agreement about the banksters though - I have no idea how they work out billion dollar compensation packages even when managing failing companies.

The playing field is definitely not level - which is what I was referencing when talking about the need for balance between capital and labour rewards.

Yes, well it seems that social mobility is a strong indicator of hard work - within the middle class and heavily restricted to those born into the middle class.  That was enough to keep people pretty happy for the last 60 years.  The trouble is that the aristocracy, through their capital, are now pressing that middle class into a thinner and thinner margin just above the upper limits of poverty.


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