----- Original Message ----- 
From: "Ronn!Blankenship" <[EMAIL PROTECTED]>
To: "Killer Bs Discussion" <[EMAIL PROTECTED]>
Sent: Sunday, May 16, 2004 4:16 PM
Subject: Re: SS and Medicare projections


> What is (are) the reason(s) why the US has far higher medical costs than
> other major countries without a corresponding advantage in the statistics
> of health?  Is it (are they) something such as an excess of obvious
> inefficiencies in the system, or is it frex something like that the US
> spends a disproportionate amount of the money spent on research and
> development of new medical procedures and medicines, and other countries
> can take advantage of those new advances without having had to have paid
> for their development, or what?

Its probably a combination of reasons.  We do pay far more than any other
country for drugs.  But, since twice as much is paid for advertisement as
for research, (I've seen these numbers several places, and I haven't seen
them challanged) its not clear how much of this goes to the inherent
overhead in our system.  Yes, it help funds drugs that take years to
develop with a small chance of sucess but a high payout (like breakthrough
AIDs drugs), but generally drugs that simply work around a patent are a
much better bet.  I don't think 200% overhead sounds all that efficient,
either.

Second, we have yet to deal with the cost issues in "once in the hospital,
no benefit can be denied" type of medicine.  The real alternative is some
sort of system that allows for everyone to have Toyota Camery care, but not
Lexus care, once they are in.

Third, our poor way of handling medical malpractice adds to the costs.  The
physicians should find a way to self-regulate, but they face the difficulty
that most self interest groups have to do this.  The next most efficent
means is governmental oversight.

Fourth, our payment system is a nightmare.  For example, if you don't have
insurance, and don't have the skill set and knowledge to negociate up
front, costs are absolutely unbelievable.  For a 2.5 day hospital stay,
including a 6 hour surgury, and a day in intermediate care, and one leak
test, we were charged $54,000.  Luckily, we had pre-negociated a fixed
price.

This type of pricing has tremendous overhead costs involved...with debt
collection agencies buying debts, etc.

Fifth, we have a system that won't pay for preventative care for the
uninsured, but will pay for emergancy care.  Thus, the logic is to wait
until its an expensive crisis to do anything.

Of all of these, I think the second one is the most important, and will
grow in importance as time goes on.

We have physicians on the list who can add their better informed opinions.

Dan M.


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