Should surgery cost be standardized?

ninerbuff

http://online.wsj.com/article/SB10001424127887324059704578471453118371838.html

At John Muir Medical Center in Walnut Creek, Calif., the set price of treatment for fractures of the hip and pelvis averaged $64,016 per patient in 2011. Meanwhile, Wooster Community Hospital in Wooster, Ohio, set its price for treating such injuries at an average of just $3,986 per patient that year.

Now while I will agree that land cost and cost of living will play into a higher cost at John Muir (I live about 30 minutes away from it), we're talking $60,000 in difference for the same procedure? Until health care in the US stops being a for profit operation, the cost of healthcare in the US will be high.

Thoughts?


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tekwriter

Actually there are standardized costs for certain health care. Insurance companies work out a DRG with hospitals. DRG stands for a diagnosis related group. there is a set fee that is paid by the insurance company for all diagnoses in that group, whether the bill is over or under. I used to be a claims processor. Just a little something to add to your discussion.

jenilla1

http://online.wsj.com/article/SB10001424127887324059704578471453118371838.html

At John Muir Medical Center in Walnut Creek, Calif., the set price of treatment for fractures of the hip and pelvis averaged $64,016 per patient in 2011. Meanwhile, Wooster Community Hospital in Wooster, Ohio, set its price for treating such injuries at an average of just $3,986 per patient that year.

Now while I will agree that land cost and cost of living will play into a higher cost at John Muir (I live about 30 minutes away from it), we're talking $60,000 in difference for the same procedure? Until health care in the US stops being a for profit operation, the cost of healthcare in the US will be high.

Thoughts?


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There's a cost of living difference, but it's not THAT big! How disgusting!

jenilla1

Actually there are standardized costs for certain health care. Insurance companies work out a DRG with hospitals. DRG stands for a diagnosis related group. there is a set fee that is paid by the insurance company for all diagnoses in that group, whether the bill is over or under. I used to be a claims processor. Just a little something to add to your discussion.

The standardized costs are worked out between insurance companies and specific hospitals, though. The standard is different from place to place and from hospital to hospital. It's whatever they negotiate.

Jessi_Brooks

60 000$ difference is huge...

Maybe a standardized percentage based on living costs on the area? Not completely though, people should still be able to charge more if they feel they deserve more for better work.

Lyadeia

Are we talking the cost of the actual surgery, or the surgeon bill? Or even the facility charge? These are all different bills that you will receive for the same procedure. I can't imagine the procedure bill being that much different, but different doctors and hospitals can and will charge different prices. I refuse to say that is wrong, no matter how unfair it seems...because as a patient, you can choose where to have your surgery in a non-socialized system.

ninerbuff

60 000$ difference is huge...

Maybe a standardized percentage based on living costs on the area? Not completely though, people should still be able to charge more if they feel they deserve more for better work.

Health care shouldn't have to come down to better work though. It should be the same from patient to patient.

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ninerbuff

Are we talking the cost of the actual surgery, or the surgeon bill? Or even the facility charge? These are all different bills that you will receive for the same procedure. I can't imagine the procedure bill being that much different, but different doctors and hospitals can and will charge different prices. I refuse to say that is wrong, no matter how unfair it seems...because as a patient, you can choose where to have your surgery in a non-socialized system.

Not if your insurance directs you where to go though. The prices were for the same procedure only. Didn't include hospital stay I believe.

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MyChocolateDiet

i think that's way too big a difference.

somethings wrong. is this the price for everybody, and essentially the same aftercare stays, etc?

DavPul

Last time I checked this was still America and socialism hadn't been adopted.

BinaryPulsar

One time I was experiencing a medical emergency and the ambulance had to take me to the ER. They thought I did not have insurance and charged me over $160,000. I submitted it to my insurance to find out what was going on. When they found out that I had insurance the bill was reduced to a couple thousand dollars.

ETA: That was when I lived in California

triciab79

Its a free market for a reason. It drives research and development. Perhaps the care at that hospital is significantly better, they have a lower mortality rate, or they provide additional services to make the difference. If there was truly an issue with the cost another hospital would offer the service at a lower rate to compete with the hospital in question and as the first hospital lost business it would be forced to evaluate the cost. There is some reason why they can justify that charge or someone else would be undercutting them. That is how free market works. Forcing standardized pricing cuts services in areas where it is more expensive to operate. Businesses will protect their profit margins so anytime you demand a flat cost you are really demanding they lower the quality of care and forgo any research and development. It is why socialism and communism always fail to produce innovation. Where there is no motivation $ there is no innovation.

ninerbuff

Last time I checked this was still America and socialism hadn't been adopted.

Capitalism is fine for business. But healthcare shouldn't be a for profit venture. Part of the reason people near poverty level don't get check ups is because they can't afford the premiums to cover health care.
The number one cause for bankruptcy is medical expenses.

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triciab79

Last time I checked this was still America and socialism hadn't been adopted.

Capitalism is fine for business. But healthcare shouldn't be a for profit venture. Part of the reason people near poverty level don't get check ups is because they can't afford the premiums to cover health care.
The number one cause for bankruptcy is medical expenses.

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For profit is what drives research and development in the US. Don't be so quick to get rid of it or you can kiss any chance of a cure for any disease out the window. The reason so many people are so close to poverty is that they don't plan appropriately. They figure someone will always bail them out so they play when they should study, play when they should work, play when they should raise their children, play when they should plan, spend when they should save, and buy Iphones and bling instead of health insurance. Many of the "poverty level" people have more gadgets and gold than I will ever see in this life. I work everyday to pay for their food, housing, and education, I shouldn't also have to sacrifice my level of healthcare so they can get that for free too.

HelloDan

It is why socialism and communism always fail to produce innovation. Where there is no motivation $ there is no innovation.

Maybe it's a US thing, but why do you assume that everyone is driven by money?

Lots of people are motivated to do things for the greater good. An example take software development, there are loads of open source projects out there, with lots of innovation, all driven by the idea of making things better, not by amassing as much money as possible.

Also on the flipside, because a socialised medical system has no benefit from carrying out expensive treatments, as it doesn't take profits, a lot more focus can go into prevention. A privatised medical system has no interest in prevention (unless it can charge a load of cash for it) because it's better to wait for the disease and treat it, thus taking a greater profit.

Another point worth considering, is that people consider that as long as they are covered for healthcare "I'm OK", if someone isn't covered that's there problem. However having a healthy population benefits everyone, both in the simple concept of eradicating certain diseases, and in bigger ideas, such as having a more productive labour pool.
This is why certain services such as the fire departments and police work on a public service basis, rather than a private basis.
It may be your neighbours house that was burgled, or the apartment below you that is on fire, but it is in your interest for these issues to be resolved, even if you're not the direct beneficiary.

It's not really about socialism v capitalism/free market (whatever you want to call it) either, as I don't think either one is inherently better, just that they have different areas of suitable application.

ninerbuff

Its a free market for a reason. It drives research and development. Perhaps the care at that hospital is significantly better, they have a lower mortality rate, or they provide additional services to make the difference. If there was truly an issue with the cost another hospital would offer the service at a lower rate to compete with the hospital in question and as the first hospital lost business it would be forced to evaluate the cost. There is some reason why they can justify that charge or someone else would be undercutting them. That is how free market works. Forcing standardized pricing cuts services in areas where it is more expensive to operate. Businesses will protect their profit margins so anytime you demand a flat cost you are really demanding they lower the quality of care and forgo any research and development. It is why socialism and communism always fail to produce innovation. Where there is no motivation $ there is no innovation.

The US isn't the only place where innovation happens. Many countries all over the world contribute to research and development of their own and still have complementary health care for patients.

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DawnieB1977

Reading this makes me glad to be English! The NHS isn't perfect, and we do pay for it in our taxes, but I'm glad I can go to hospital if necessary and not be given a huge bill.

triciab79

Its a free market for a reason. It drives research and development. Perhaps the care at that hospital is significantly better, they have a lower mortality rate, or they provide additional services to make the difference. If there was truly an issue with the cost another hospital would offer the service at a lower rate to compete with the hospital in question and as the first hospital lost business it would be forced to evaluate the cost. There is some reason why they can justify that charge or someone else would be undercutting them. That is how free market works. Forcing standardized pricing cuts services in areas where it is more expensive to operate. Businesses will protect their profit margins so anytime you demand a flat cost you are really demanding they lower the quality of care and forgo any research and development. It is why socialism and communism always fail to produce innovation. Where there is no motivation $ there is no innovation.

The US isn't the only place where innovation happens. Many countries all over the world contribute to research and development of their own and still have complementary health care for patients.

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Can you name one socialist country with anywhere near the cancer research taking place in the US?

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sparkleponyprincess

The reason so many people are so close to poverty is that they don't plan appropriately. They figure someone will always bail them out so they play when they should study, play when they should work, play when they should raise their children, play when they should plan, spend when they should save, and buy Iphones and bling instead of health insurance. Many of the "poverty level" people have more gadgets and gold than I will ever see in this life. I work everyday to pay for their food, housing, and education, I shouldn't also have to sacrifice my level of healthcare so they can get that for free too.

Got any reliable sources for that? Or did you once see someone who "looked poor" with an iPhone?

There are many systematic causes for poverty. The economy is crap, and if someone was born into poverty and had difficulty getting an education, that makes it even harder to get a job and get a proverbial leg up. Poverty also decreases access to birth control, resulting in larger family sizes, and since childcare is often quite expensive, this also makes it difficult to find employment. Also, when it's hard to put food on the table and pay for medication--- even with government assistance-- it's damn hard to save much.

There are a LOT of things to consider, and awareness of the high-level situation, as well as a broad, data-driven picture (not a gut reaction from one anecdote) is important.

triciab79

Reading this makes me glad to be English! The NHS isn't perfect, and we do pay for it in our taxes, but I'm glad I can go to hospital if necessary and not be given a huge bill.

How long do you wait for a non emergency? I can get in to see my doctor tomorrow without an appointment. If my baby runs a fever I can take him to his doctor or one of the 15 urgent cares or 5 hospitals within a 5 mile radius of my house and yes I pay for it but so do you. You either pay from your pocket, pay through your taxes, or pay in quality but everyone pays.

HelloDan

Can you name one socialist country with anywhere near the cancer research taking place in the US?

Most funding for cancer research comes from taxpayers and charities, rather than from profit-making businesses. In the US, less than 30% of all cancer research is funded by commercial researchers such as pharmaceutical companies.

Eckhouse, S.; Sullivan, R. (2006). "A Survey of Public Funding of Cancer Research in the European Union". PLoS Medicine 3 (7): e267. doi:10.1371/journal.pmed.0030267. PMC 1513045. PMID 16842021.

ninerbuff

Last time I checked this was still America and socialism hadn't been adopted.

Capitalism is fine for business. But healthcare shouldn't be a for profit venture. Part of the reason people near poverty level don't get check ups is because they can't afford the premiums to cover health care.
The number one cause for bankruptcy is medical expenses.

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For profit is what drives research and development in the US. Don't be so quick to get rid of it or you can kiss any chance of a cure for any disease out the window. The reason so many people are so close to poverty is that they don't plan appropriately. They figure someone will always bail them out so they play when they should study, play when they should work, play when they should raise their children, play when they should plan, spend when they should save, and buy Iphones and bling instead of health insurance. Many of the "poverty level" people have more gadgets and gold than I will ever see in this life. I work everyday to pay for their food, housing, and education, I shouldn't also have to sacrifice my level of healthcare so they can get that for free too.

Lol, wait when we're speaking of bail outs are you excluding big banks with lots of money too?:laugh: While I won't disagree with your statement of how people handle money, I'm more than sure that people who have health insurance are paying a big chunk for it. Most working people have jobs that offer health care benefits and pay for them yet still can be near the poverty level. Got an aunt who's a nurse, owns a house, no fancy car, but a lot of her money goes to my cousin's heart problems (born with).
And if you didn't know it already, whether you think you're paying for it or not, other peoples health care bills that aren't paid for by insurance, is collected from taxes you pay.

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triciab79

The reason so many people are so close to poverty is that they don't plan appropriately. They figure someone will always bail them out so they play when they should study, play when they should work, play when they should raise their children, play when they should plan, spend when they should save, and buy Iphones and bling instead of health insurance. Many of the "poverty level" people have more gadgets and gold than I will ever see in this life. I work everyday to pay for their food, housing, and education, I shouldn't also have to sacrifice my level of healthcare so they can get that for free too.

Got any reliable sources for that? Or did you once see someone who "looked poor" with an iPhone?

There are many systematic causes for poverty. The economy is crap, and if someone was born into poverty and had difficulty getting an education, that makes it even harder to get a job and get a proverbial leg up. Poverty also decreases access to birth control, resulting in larger family sizes, and since childcare is often quite expensive, this also makes it difficult to find employment. Also, when it's hard to put food on the table and pay for medication--- even with government assistance-- it's damn hard to save much.

There are a LOT of things to consider, and awareness of the high-level situation, as well as a broad, data-driven picture (not a gut reaction from one anecdote) is important.

Here is your data driven:

I was raised in one of the poorest areas of the country. I come from a large family but I was taught a work ethic and that it is wrong morally and socially to depend on others for what you are capable of doing for yourself. I worked hard and I have never taken a single dime from the government.

When I was in high school I worked as a cashier at a grocery store to help out. I would stand there everyday and watch the people in line trade their food stamps with other people in the store for cash so they could buy beer. It happened every single day that I worked, without exception.

There is an entire generation who see nothing wrong with taking from the government. What they don't seem to get or perhaps don't care is that they aren't taking from the government they are taking from me. They are able bodied and capable of working but everything is beneath them. There is not nor has there every been a job I consider beneath me if it puts food on my children's table. I expect the same of the people I give money to "help".

MyChocolateDiet

http://online.wsj.com/article/SB10001424127887324059704578471453118371838.html

At John Muir Medical Center in Walnut Creek, Calif., the set price of treatment for fractures of the hip and pelvis averaged $64,016 per patient in 2011. Meanwhile, Wooster Community Hospital in Wooster, Ohio, set its price for treating such injuries at an average of just $3,986 per patient that year.

Now while I will agree that land cost and cost of living will play into a higher cost at John Muir (I live about 30 minutes away from it), we're talking $60,000 in difference for the same procedure? Until health care in the US stops being a for profit operation, the cost of healthcare in the US will be high.

Thoughts?


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Wait, what? Okay assuming this is the price for essentially the same procedure, amount of personnel, and aftercare days....wouldn't it be cheaper then to just fly to Ohio? Isn't it like when people fly to brazil or wherever for their tummy tucks? Can't they fly to where they want the surgery or like the price better?

DavPul

Last time I checked this was still America and socialism hadn't been adopted.

Capitalism is fine for business. But healthcare shouldn't be a for profit venture. Part of the reason people near poverty level don't get check ups is because they can't afford the premiums to cover health care.
The number one cause for bankruptcy is medical expenses.

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Of course health care should work on free market principals. If I'm rich, I want access to more and better. If I'm broke, I get a lower standard of care. Or no care. That's how capitalism works. I think we should have a universal health care system in the US, but even still people with mo money get mo options. The education system works the same way

ninerbuff

Its a free market for a reason. It drives research and development. Perhaps the care at that hospital is significantly better, they have a lower mortality rate, or they provide additional services to make the difference. If there was truly an issue with the cost another hospital would offer the service at a lower rate to compete with the hospital in question and as the first hospital lost business it would be forced to evaluate the cost. There is some reason why they can justify that charge or someone else would be undercutting them. That is how free market works. Forcing standardized pricing cuts services in areas where it is more expensive to operate. Businesses will protect their profit margins so anytime you demand a flat cost you are really demanding they lower the quality of care and forgo any research and development. It is why socialism and communism always fail to produce innovation. Where there is no motivation $ there is no innovation.

The US isn't the only place where innovation happens. Many countries all over the world contribute to research and development of their own and still have complementary health care for patients.

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Can you name one socialist country with anywhere near the cancer research taking place in the US?

Why does a country have to be socialist to offer free health care? Canada, Japan and England aren't and all offer great research for cancer.

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HelloDan

Slightly off topic, but maybe interesting to some nonetheless.

I think the effect of privatised health actually goes far deeper than people imagine. I work for a large multinational, and through my experience, I find in general (it's a generalisation, not everyone) people in the US are less likely to criticise the way things are done, and stir up changes, than Europeans. I don't know exactly why this is, and its likely many cultural reasons, but in discussing, one thing that came up was that health coverage is generally linked to employment, and people are far more cautious about stirring things up and upsetting management for fear of ending up with no job and no health coverage.

Don't get me wrong, this must apply everywhere, as even taking the healthcare situation out, ending up with no job is not great, but I still think the healthcare plays a significant factor in this dynamic.

weevil66

For profit is what drives research and development in the US. Don't be so quick to get rid of it or you can kiss any chance of a cure for any disease out the window. The reason so many people are so close to poverty is that they don't plan appropriately. They figure someone will always bail them out so they play when they should study, play when they should work, play when they should raise their children, play when they should plan, spend when they should save, and buy Iphones and bling instead of health insurance. Many of the "poverty level" people have more gadgets and gold than I will ever see in this life. I work everyday to pay for their food, housing, and education, I shouldn't also have to sacrifice my level of healthcare so they can get that for free too.

This is only a tiny bit true. But, it's mostly ignorant and from the mouth of someone who has not gotten cancer, then dropped from all insurance, and unable to get treatment because its not affordable. Wool is pulled so far over your eyes that you actually think you're right. I'm just going to tell you that you are very wrong. Until it happens to you though, you won't believe it. And, there is no amount of planning that prepares you for $1,000 pills each that you have to take daily. I don't know about you, but that would drain my savings pretty fast. Silly people and their capitalistic belief system. That's not how it works at all.

Added to this is that some people could not afford insurance because they have pre-existing conditions. When I was working for places that did not offer insurance I tried like hell to fet private insurance and was denied by all the ones around because of a pre-existing. I would have had to go through major risk govt insurance tbat was about $600 a month and that was 20 years ago.

Even with med ins medical expenses are horrific. My husband was on so many meds and had so many docs and hosp visits that if i didnt work at a place that gave me additional discounts we would not have been able to eat or afford his meds orpay bills.