"

The U.S. spends more per capita on health care than any other developed nation. It will soon spend close to 20% of its GDP on health—significantly more than the percentage spent by major Organization for Economic Cooperation and Development nations.

What is driving costs so high? As this series of charts shows, Americans aren’t buying more health care overall than other countries. But what they are buying is increasingly expensive. Among the reasons is the troubling fact that few people in health care, from consumers to doctors to hospitals to insurers, know the true cost of what they are buying and selling.

Contributions to employer-sponsored health coverage aren’t taxed, which makes it less expensive for companies to pay workers with health benefits than wages. Generous benefits lead to higher spending, according to many economists, because employees can consume as much health care as they want without having to pay significantly more out of their own pockets.

The prices of many medicines are hidden because pharmacy-benefit managers—the companies that administer drug benefits for employers and health insurers—negotiate confidential discounts and rebates with drugmakers."

https://www.wsj.com/articles/why-americans-spend-so-much-on-health-carein-12-charts-1533047243

I ran into something similar last week. I woke up Friday with symptoms of a blood clot. Last time this happened, they had me screen it through a blood test. The only way I could get that blood test this time was through the emergency department. They also wanted to do a Doppler which is the definitive test. With the Doppler, there wasn’t need for the blood test.

I really didn’t think that I needed to go through the emergency department and actually put off care because that was the only place I could get care. A week earlier I had gone to an urgent care to get screened. Later I called my personal physician. On vacation, it became obvious that I had a problem.

I do not know why we cannot get tested or screened for things without a doctor’s orders if the screening itself is not any more dangerous than a blood test. I should never t have had to take up space in an emergency room and get charged the exorbitant prices associated with such unless there is an emergency.

My bill will be thousands of dollars, I’m sure. Btw, it turned out to be a clot in the surface veins which is no big deal. My last clot was in the deep veins which involved hospitalization, and a medication that costs about $1,000 per dose, Lovenox, as well as being restricted to bed rest for about 5 weeks. Even though I dread the bill, at least this time I won’t be out of work, I just didn’t see the need for the emergency room fees for a screening test.

To me, an MRI is in the same category. You should be able to get it in a less expensive setting.

I'm sure some say the reason is competition, but the excuse I have heard is that it will be overused and therefore overcharged. If you have a new machine that costs 500 per use, it could be used for everything, with insurance picking up the bill.

What I'd love to see, (and therefore will never see) is a true breakdown of where the money actually goes.

x% to lawyers and lawsuit payouts
x% to insurance profits
x% to med school loans
x% to someone to fill out the insurance forms.
x% to cover other patients who don't pay
x% to actual cost of material
x% to Dr and nurse salary.

What keeps someone from setting one of these up with a cash fee?

I show up, install an MRI machine per code, find three imaging techs to run it and a receptionist to register people, and say, "Here's what your cost is."

No insurance. You want to know what you look like inside? PAY FOR IT.

You want the image analyzed? Go somewhere else. As it is now, the doctor diagnosing your condition is often in another state, viewing the image online.

"Oversupply" is a fancy word saying "our profit margins will decrease".

Joe J, here's the pull quote from Snoopy's post:

Among the reasons is the troubling fact that few people in health care, from consumers to doctors to hospitals to insurers, know the true cost of what they are buying and selling.

Who gets charged what is the trillion dollar question (thanks, Bernie). If you're a Medicaid/Medicare patient, your total is $X. If you're an HMO member, your total is $Y, if you're on a high-end insurance plan your total is $Z.

And I use "total" because that's a number you as the consumer never see. The practice's billing person, accountant, and possibly their insurance expert know the full amount, but that's probably about it. The government agency, the insurer and the HMO? probably not.

And $X<$Y<$Z. Someone is always being subsidized, possibly to cover the cost of the emergency room where people are known to simply skip out on their bill.

Now, contrast that with say, car repair. Would you accept that the mechanic can not give you a reasonably firm price for a given repair? Now, check this out:

https://surgerycenterok.com/?procedure_category=wrist-hand#jump

Given that the state has chosen to limit supply in health care, should it not also limit supply in other retail businesses? say, limit the number of auto shops, or grocers? and if that's permissible, why stop there? realtors, barber shops and funeral homes could use some love, too.

I smell crony capitalism. You? ~ Amy

Nope.

It's not crony capitalism, it's Marxism.

Karl Marx was concerned about productive capacity and argued that having two companies compete to provide the same product or service was waste.

Marx worried that capacity in factories was being used inefficiently and argued that state control would promote the efficient use of productive capacity, which would lower costs for consumers and provide a better product. It did not.

His theory was put to the test in East Germany with the country's Trabant automobile manufacturing. The Trabbie was a marvel of engineering its first year in existence, and obsolete every year after that. It's two-stroke engine smoked like an Iraqi oil fire. The waiting list for a new Trabant was 15 years long - in fact, the DDR was the only auto market in the world in which a used car cost more than a new one, since you could drive the used one home that day and had to wait up to 15 years for the new one. While West German automakers were adding fuel efficiency, safety measures, and automatic transmission to their cars, the Trabant stagnated.

The Trabant did not offer rear seat belts even as late the 1981 model. Contrast this with the 1981 models of Audis, Opels, Volkswagens, etc. which not only offered rear seat belts, but shoulder belts, crumple zones, breakaway steering wheel columns, and other safety features.

Same thing with this doctor and his MRI. Canada's nationalized healthcare uses the same argument, that too many MRIs not being used is "inefficient." Waiting six months for an at-capacity machine to be available is, on the other hand, "efficient." - so what if your cancer gets worse in the meantime or you die, at least there was no waste in the system.

This is one of the reasons that healthcare costs keep rising so fast. Mark Perry has shown graphs that elective surgery costs have risen much more slowly than other health care because there is competition.

"And I use "total" because that's a number you as the consumer never see. The practice's billing person, accountant, and possibly their insurance expert know the full amount, but that's probably about it."

Point included here.

Medical VISA card? where do I sign up?

Another problem is that the existing MRI machines are under-utilized. It would be easy to book them 24/7, but here in Canada, the hospital unions would not allow it.

Reduce the supply means increases in price.

..and the government + union love to protect their monopolies...

"What keeps someone from setting one of these up with a cash fee?"

If a Dr can't do it, there's probably a few laws against it. Or the AMA or insurance would be harsh on any Dr that worked with you.

"No insurance"
Except with Obamacare you have insurance, or you have to pay a fee to not. Had a friend who's a DR and was trying something different. No insurance accepted, except you her office was your insurance. All patients had a monthly fee and you were covered for everything up to surgery. Some minor co-pays. The problem: Obamacare, if you MUST buy insurance then her 'no insurance' is effectively double billing. So Obamacare killed it.

The term "Crony Capitalism" is a Marxist slur for what is actually "Crony Socialism" or "Crony Government".

It is the government which hands out favors to companies supplying bribes. To my mind, it is the government which has the greater duty to the public.

If we really want more reponsible, less criminal government, then taking a bribe would be a 5-year crime, but giving a bribe would be blameless.

From that point on, no government employee would accept a bribe, for fear of being exposed by investigative bribe-givers.

That is also a reason for 1-party consent in all states. A person should be allowed to secretly record video and sound of any conversation with anyone else. This would tend to shut down requests for bribes by government, and illegal conspiracy by anyone.

Conan Says:

"It's not crony capitalism, it's Marxism.

Karl Marx was concerned about productive capacity and argued that having two companies compete to provide the same product or service was waste."

Marx also wanted the means of production to be owned by the community.

In this case the means of production is owned privately and those private interests are using the government to stamp out potential competition.

So it looks like Amy is correct because the heathcare system is by and large privately owned and operated.

Karl Marx certainly didn't advocate for private ownership of the means of production with government enforcement of monopolies or crushing of competition by legislation in favor of one private capitalist enterprise over another.

Marx also wanted the means of production to be owned by the community.

One of Marx's theorized causes for the internal tensions that would fuel the eventual fall of capitalism and rise of class consciousness was capitalism's inefficient use of productive capacity.

So, yes Artie, concern over the inefficient use of resources and regulating the number of providers "for the public good" smacks of Marxism.

Conan,

I fear that you have made Marxist theory so expansive and pervasive as to be wholly meaningless.

When private corporate entities can lobby for political favors and provide excessive campaign contributions in order to secure legislation that offers them a competitive advantage... and you call that Marxism as opposed to crony capitalism it suggests that for you Marxism is a scapegoat that can be blamed for anything.

The entire reason that the Trabant is a good example of Marxism in action is because VEB Sachsenring was a government-owned corporate entity until the fall of Berlin wall and the reunification of Germany.

Community ownership isn't an optional feature of Marxism... it is a necessary component.

That you can find features of crony capitalism that remind you of Marxism doesn't allow you to ignore this requirement.

I fear that you have made Marxist theory so expansive and pervasive as to be wholly meaningless. ~ Artemis at August 2, 2018 3:17 PM

Artie, you've expended so much effort in your years on this blog nit picking the most minor points in people's posts in an effort to prove you are an intellectual that you regularly miss the forest for the trees.

Since you agree that state ownership of a corporate entity is Marxism in action ("The entire reason that the Trabant is a good example of Marxism in action is because VEB Sachsenring was a government-owned corporate entity...." ~ Artemis at August 2, 2018 3:17 PM), what makes state sponsorship and shielding from competition of a corporate entity any different, in real world terms?

Now, since we're discussing Marx, I'll leave you with this: "Why did Karl Marx dislike Earl Grey tea? Because all proper tea is theft."

By the way, it ain't "crony capitalism," it's "crony socialism."

From the linked Forbes piece:

"The New Oxford American Dictionary ... defines socialism as 'a political and economic theory of social organization that advocates that the means of production, distribution, and exchange should be owned or regulated by the community as a whole.' In practice, 'the community as a whole' means, and is represented by, a government agency."

Conan,

There you go once again unable to contain yourself to a civil conversation when the evidence available suggests you are wrong.

Let's just get to the crux of the issue here shall we?

If for you a private entity within a capitalist economy lobbies the legislature to create laws that give them a private corporate financial advantage in the market place isn't crony capitalism... then what pray tell is?

From what I have seem so far Marxism and socialism for you are the proverbial boogieman to blame for everything under the sun as of late... even when it is plainly driven by private corporate interests.

Conan,

Let's also take a moment to appreciate your working definition of the term "nit picking".

You show up to criticize Amy's use of the term crony capitalism... not nit picking.

I show up to criticize your criticism of the term crony capitalism... nit picking.

Do you see the obvious difference here Conan?... it it apparently only suitable to discuss distinctions in terms when you do it... but when it is done to you it is just "nit picking" of "minor points".

If it was such a minor distinction why exactly did you see fit to correct Amy in the first place?

YAAAWN.

Okay Conan... it looks like you have had a rough day. You are clearly cranky and tired... time for your nap.

Nope, Just bored with you, Artie. You're like a broken jukebox. Put a nickel in you and get a dollar's worth of crap out.

Conan,

You can call me a broken jukebox if you like... but you are still a joke.

You are the one who started off criticizing Amy for her use of terms only to throw a tantrum when I pointed out that your criticism was off-base.

The problem with you has always been that you like to dish out criticism but you cannot take it.

The honest joke about you Conan is that when you said this:

"nit picking the most minor points in people's posts in an effort to prove you are an intellectual"

You were projecting. Between the two of us I have no need to "prove" I am an intellectual.

The fact that you can dish out criticism but are incapable of receiving it demonstrates your own deep seeded insecurities.

I just like to have fact based discussions... but you are incapable of doing that if the facts do not support your position.

Zzzzzz.

I hope your caretakers gave you a warm blanket. I would hate to think they were neglecting you.