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Heathcare costs and availability and the availability in the US.

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Posted 11/3/2013 5:15 PM (GMT 0)
With all the recent talk about the ACA and the state of both health care costs and availability that we are and will experience I can't help but think there must be a better way.

I keep coming back to the fact that I can always get an immediate appointment for my dogs and cats at a Vet anywhere in the US within 2 days. This includes CT scans and other diagnostics. My ridgeback gets an echo cardiogram from a cardiologist every two years and it costs $250. I think my last one was over $2,000. His heart meds are $5 a month, exactly the same brand as a Human would take.
Years ago my dog was treated for cancer that included surgery, 45 radiation treatments and chemo for $6,000. My wife underwent the same protocol for well over $250k. The Vet who treated my dog used actual medical doctors from local hospital and universities who moonlighted to do the procedures. It was the best run hospital, bar none that I have ever seen. Preppers have found that antibiotics and medical supplies they stockpile are a fraction of the cost when bought from veterinary supply houses.
Why does the Veterinary System work so well and the Human Health Care system so poorly? Something to think about.
JT
Posted 11/3/2013 5:34 PM (GMT 0)
The over/under on when this thread gets locked?

Mel

Posted 11/3/2013 6:09 PM (GMT 0)
When we were moving to Europe, my hubby and the cat who got the vet´s approval within 2 weeks, boarded the plane together, and I joined them 3 months later. That is how long my visa process took.
Posted 11/3/2013 6:42 PM (GMT 0)
Good post, John,

I think there are a myriad of reasons for this. First the standard of providing care in animals versus humans is not the same. There are regulatory issues, litigation issues, and also a strong competition between veterinarians that we don't see in human physicians. By the last one I mean there are a lot more veterinarians per capita of people that will take the time to bring their pets to the vets versus the long lines and packed waiting rooms to see you. There is more competition. By litigation ~ when do you recall a doctor/pharma/hospital being sued for a billion dollars for pet malpractice? It happened here in Las Vegas where a bottle of single dose propaphal was too large and that encouraged a whacky physician to reuse syringes causing an outbreak of hepatitis. The doctor broke the law. The jury awarded a single man a half a billion from the Pharma with 100 more cases pending. The Pharma isn't going to pay for it over time ~ we all will. Malpractice suits are very rare in Vets as well. With the awards limited to the value of the property (Pets)

And on the competition piece, doctors offices are packed in most locations. When a dog catches a bad cold he goes and lays down until he feels better. Many humans go in for shots. One cost nothing, and the other a grand.

It's a difficult dynamic between humans and animals. FDA rules in humans are much stricter than they are for vets.

Just some thoughts. This should be a sold discussion without bad intensions. I think it's a great and relevant post.

Tony
Posted 11/3/2013 8:00 PM (GMT 0)
My doctors can't euthanize me if I'm really sick.
My vet did not have a 4 story atrium with a fountain.
A student can become a vet faster than becoming a physician.
Some of the people who work for a vet make low wages. People who help provide human care have licenses and are paid more.
As was mentioned, there are liability differences.
People will not forgo many treatments for themselves since insurance usually pays most of the bill.
A vet can deny services to customers who can't pay. The ER has to take everyone.
Posted 11/3/2013 8:07 PM (GMT 0)
Tony,
Good input, but I think you missed a major one. Most health care is paid by 3rd parties and costs are not transparent. We've all read about aspirin being billed at $200 when you're in the hospital, no one would tolerate that if they were paying, they would just bring in their own bottle. I think that Lazic surgery is a good example. The equipment has gotten much better and the prices have come down every year. It's not covered by any insurance or government program, prices are readily available to anyone and it's also regulated for safety and subject to malpractice suits.
Posted 11/3/2013 8:10 PM (GMT 0)
As others have pointed out, it has to do with competition and supply and demand, and the disruption of same in the health care "system." In your pet's case, you are paying attention to the prices, and in the case of most human health care, nobody's really paying attention and there's no incentive to. Normally, the patient doesn't care because insurance is paying, the insurance companies don't care because they will just pass the costs on, and those doing the billing certainly don't care. In the old days, your family doctor made house calls. Why? Sure, he was a kind man, etc., but I'm guessing it's actually because other doctors did and he wanted to keep your business. It's been pointed out that in the case of medical care outside of the normal system, such as laser eye surgery, dental care, etc., costs have not exploded like in the other areas and getting service is no problem. Why? Just like with pet care, there's no insurance, no third parties, prices are set and it's up to you whether you want to pay them or not. I don't know what the answer is. Health insurance and our health safety net programs certainly seem like good ideas, but they also seem to gum up the "invisible hand" that naturally regulates other areas of the economy.
Posted 11/3/2013 8:35 PM (GMT 0)
John,
I think I covered hidden costs from a different ante. Litigation. I agree that we don't manage our own costs because of insurance, but we also don't control hidden costs by way of jury awards and regulations.

Unfortunately, we're both right.

Tony
Posted 11/3/2013 9:19 PM (GMT 0)
This post could get deleted, but watch this video as entertainment, rather than a political statement:

Why are Americans Health Care Costs So High?

...Jerry
Posted 11/3/2013 9:49 PM (GMT 0)
Jerry,

Don't see why your post should be deleted. It simply repeats facts that others have been putting forward on this thread and other threads. Although the guy speaks a bit fast, I do think he gives a good economic review of why our human health care service works so poorly, and answers the question as posted by John T.
Posted 11/3/2013 9:58 PM (GMT 0)
Insurance pays, that's why. Patient input is another, it's the rare dog or cat that complains so there is a level of care that is a bit higher. Not for drugs, of course. But you don't generally sedate a human , throw it on the table and do an MRI, CTR, Ultrasound or even x ray and then put them in a cage for a couple of hours to recover. Although you don't often have to physically restrain a human to sedate it. LOL On the other hand as a GSD breeder/trainer for 30 years I've had my share of $4,000.00 bills and not a few with a dead dog to show for it.
Posted 11/3/2013 10:54 PM (GMT 0)
"It's the rare dog or cat that complains so there is a level of care that is a bit higher."

LOL
Posted 11/3/2013 11:25 PM (GMT 0)
I have no insurance and pay out of pocket. It is near impossible to get the medical community to provide costs prior to treatment. Recently had a chest X-Ray and noted pulmonary nodules. Went to Pulmonologist and he had to repeat the very same X-ray. Would not say why the one from two days earlier was not good enough. Then recommended a CT scan of chest. The urologist had recommended a bone scan because of high PSA this in spite of no symptoms. After the scan the Pulmonologist wanted to do a bronchoscopy with biopsy. This is where the story really gets interesting and, I think, is why we pay so darn much.

Bronchoscopy Cost:

Pulmonologist fee: $460

Anesthesiologist fee: $2000 (for two hour max) $250/15 minutes thereafter.

Facility charge: $5000 to $16000. No explanation of why there is such a spread in the estimate and they noted rather ominously that this "was based on 2010" costs. I used to manage large capital projects for a major corporation and I would have been fired for providing such an estimate to my bosses.

Pathology fee: Unknown refused to provide any cost.

Worst case cost would be over $18500 for a diagnosis not treatment. I would not sit still for this even if I had insurance.

So far I have spent $1300 and have not received a definitive diagnosis. I asked the pulmonologist if we could do a needle biopsy. Much less expensive but he would be cut out of the deal. Two weeks and no reply in spite of follow up on my part with his office. I think it is time to find another pulmonologist who can move a bit faster than the current one.

I have always contended that the issue is not access to medical care but the cost of it. Without insurance it would be a lot less. We may have less choice and technology in the free market approach but I suspect that it would not be much less.

One more anecdote. I read an article when researching my initial treatment that showed that costs in a community go up when more than one provider has the same treatment capability. In my case radiation machine. Reason is the market demand for services is finite and each provider must get a return on their investment or at least return of their investment.

I am sure that the lottery litigation for medical mistakes also contributes to the cost in insurance premiums and unnecessary tests.

Don

 

Posted 11/3/2013 11:53 PM (GMT 0)
Vet's don't encounter anywhere near the legislation and regulation. If I were to go into medicine, I would be a veterinarian.
Posted 11/4/2013 1:37 AM (GMT 0)
good video, Jerry.

I saw a great video today. A Dr. responds to a congressman about what he says about the ACA point by point proving that each point made by the politician is a lie.
Posted 11/4/2013 3:19 AM (GMT 0)
Davidg
Why did you interject both politics and the ACA into this discussion? The topic had nothing to do with either and it should remain that way.
Posted 11/4/2013 3:41 AM (GMT 0)
Um, John, I was responding to Jerry who posted a video about medical costs and his statement that it would get deleted with a note about another good video I saw just today which also focused on medical costs. Relax, go give your Ridgeback a hug.

PS - the ACA was the first thing you raised in your first post here, and by saying "ther emust be a better way" you interjected politics technically. And, btw, since we are getting our first puppy we are shopping for pet insurance because we know people who have spent thousands of dollars on their pets.

Post Edited (davidg) : 11/3/2013 8:49:40 PM (GMT-7)

Posted 11/4/2013 4:14 PM (GMT 0)
John T, DavidG,

You guys both have accessible email addresses. If you could come to an accommodation off line it would be easier for the Mods to pretend they haven't noticed that this thread has been skating on the edge from the start. When you start accusing each other of politicizing the issue then... well, the mods can't take sides; what we can do...
Posted 11/4/2013 4:28 PM (GMT 0)
I' cool. I'm only concerned because I have the over in Mel's line and want to take his money.
Posted 11/4/2013 9:03 PM (GMT 0)
Good one, John.

But please don't pretend this isn't political. It was from the start

Mel

Posted 11/4/2013 9:21 PM (GMT 0)
Mel,
Honestly it wasn't. It was davidg's post on finding a dog that got me thinking about the fact that the health care I get for my pets is less costly, costs are more transparent and availability is greater than my own. If a related health care industry (Vets) can deliver a service that is both available, satisfactory and much less costly, why can't our current system? That question deserves some thought. The high cost of health care is driving the politics of health care. If we found a way to significantly lower costs most of the political issues would go away. I've never found any issue related to our pet's healthcare that is political.
Posted 11/4/2013 9:23 PM (GMT 0)
I, for one, do not see how a discussion about the cost of health care is political. I think both the left and the right agree that reducing the cost is a good thing.
Posted 11/4/2013 9:33 PM (GMT 0)
Mel, I wish someone would explain to me how this forum can pursue a discussion of healthcare strategies without it being deemed "political" by someone.  Quite clearly, there are a few posters here who are enamored of the changes stemming from passage of the ACA.  There are others who don't like the changes at all.  And there may be a few who are indifferent.

If those opposed voice their concerns, or even use the terms "ACA" or, God forbid, "Obamacare," their comments are immediately labeled "political."  The truth of the matter is that, like the public at large, probably half of us favor the new law and half oppose it, and BOTH positions are undeniably political.  Criticisms of the law may be political,  but praise of it is equally political.

I've never before encountered a law that we, as citizens, can't discuss, praise, or criticize, as we see fit, but I guess we have one now.  So, even though we as cancer survivors are uniquely dependent on our health insurance and medical providers, maybe we should just put a huge "TABOO" sign around our changing healthcare situation and forbid discussion, pro or con or indifferent.

Post Edited (clocknut) : 11/4/2013 3:18:07 PM (GMT-7)

Posted 11/4/2013 10:13 PM (GMT 0)
Clock:

I totally 100% agree with you.

I see no way of NOT getting political when discussing the new law.

So let's not pretend here.

That's why I mentioned the over/under on this thread. I figured about 25 posts for over/under.

Looks like the Over.

(Incidentally, I don't think it's 50-50!)

Mel

Posted 11/4/2013 10:22 PM (GMT 0)
Since we seem to have degenerated into discussion of "who started it" I will respond to what seems to be the general agreement that it has started and I will stop it.

By my count this is 25 so both under and over lose.
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