Why is Obama saying that our healthcare costs are way too high?

[Anonymous]

Anonymous wrote:This is the most medicated society in the world. People love the convenience of their drugs and the pharm companies thrive on it. Don't want to have your period? There's a pill for it. Back pain? Why relax, stretch and get your spine adjusted when there's a pill to trick your brain into not feeling the pain and tension that is still really there? Oh does that pill not work, let's try another, and another and another. Can't sleep or quit smoking? Try this new drug that will give you bizarre dreams and perhaps suicidal thoughts! Our babies are drinking breastmilk laced with anti-depressants and we are eating food laced with hormones. We love our drugs, and it is expensive!

France, Italy and Japan outrank us in longevity, diet, stress management and chronic pain care, yet their drug consumption is considerably and proportionately lower than ours, per the World Health Organization.

Where can I find that WHO data?

[Anonymous]

Anonymous wrote:Interesting article by Atul Gawande, one of the most insightful medical writers today, pointing mainly to overuse of medical treatments stemming from a culture of treating patients as "profit centers":

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all

Loo, it is the patients who drive the demand. They come in the office and they want something, anything. That costs.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Over-utilization due to the compensation system is the heart of the issue. Malpractice is the bum leg. It's important, but the heart is what's going to kill the patient.

Much over utilization come from patient demand (labor epidural) and fear of malpractice suits (MRI, lab work).

Are you suggesting that women should not have access to epidurals during labor?!

[Anonymous]

I'm not the PP but if we have to choose between paying for epidurals during labor or chemotherapy for leukemia (and yes, it will come down to that sort of nit-picking), you better believe I'd rather that my tax dollars pay for the chemo. Not for restricting access (you'd just have to pay for it), but yes for restricting payments.

[Anonymous]

Epidurals are available in many countries and it doesn't break their budget. We could have any number of health systems, including nationalized, and still give our women epidurals.

[Anonymous]

Are you suggesting that women should not have access to epidurals during labor?!

New poster here---

No, but I recognize that they are 100% elective for vaginal birth. And are not even made routinely available in many European countires. The epidural is largely an American phenomenon.

[Anonymous]

why should we choose-this is a silly topic. FYI my epidural helped when I had a emergency csection as they only had to add more meds and would have had to completely knock me out since they had to get the baby out pronto so I wouldn't have been awake for the birth. Healthcare should be worked on for excess but this is just not an area up for discussion.

[Anonymous]

Anonymous wrote:

Are you suggesting that women should not have access to epidurals during labor?!

New poster here---

No, but I recognize that they are 100% elective for vaginal birth. And are not even made routinely available in many European countires. The epidural is largely an American phenomenon.

Epidural rates are going up all over the place. It is not "an American phenomenon". In the UK, 1/3 of births were with epidural, not counting the 23% c-section rate (!) And those numbers were from 2005. It is sure to have gone up by now. It is somewhat cultural (Italy has a very low rate), but it is not American, nor for that matter is American equivalent to "bad".

[Anonymous]

Anonymous wrote:

Anonymous wrote:Let's get to the heart of it. Everyone is paid for each test, procedure, etc. they do. The more you run, the more you make. Sure, some of that money goes to outside lab companies, but plenty doesn't. The whole system incents overuse.

Agree. Health care is a business in this country, therefore maximizing profit is going to be a goal. Whether its milking a patient with tests, unnecessary surgery, jacking up insurance premiums or extensive pharmaceutical marketing for drugs that get pulled off the shelf 2 years later.

I do not understand this logic. My doctor does not make a profit by ordering tests for me, since 90% of these tests are performed by other vendors. I am in an HMO, so he doesn't even get paid more if I visit him more. The same goes for the lab that does my bloodwork -- they are on a retainer and do not get paid per a test. The hospital where my doctor works is run by a non-profit. Yes, there are for profit aspects to healthcare, but I don't see a huge conspiracy.

There have been lots of studies on this and defensive healthcare is very expensive. There was an article in Consumer Reports on this subject about a year ago. Defensive healthcare sends doctors and patients down crazy paths since these extra tests often turn up abnormalities that in many cases are benign but require even more tests.

Also, I thought it was funny that the article in the Post earlier this week about the person who built the Green house that went Platinum was a medical malpractice lawyer. Everyone was saying it was a great idea, but that they didn't have the deep pockets to do what she had done. Well, I have a pretty good idea where her deep pockets came from.

[Anonymous]

Anonymous wrote:Epidurals are available in many countries and it doesn't break their budget. We could have any number of health systems, including nationalized, and still give our women epidurals.

BUt where does it stop. We should have this and that and that and $$$. The point is that we are overutilizing. To me, we need a bare bones system that pays for the necessities only. Labor epidurals are not necessities. I am not sayng that women should not be allowed to have them. The patient should just have to pay out of pocket for these types of extras.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Are you suggesting that women should not have access to epidurals during labor?!

New poster here---

No, but I recognize that they are 100% elective for vaginal birth. And are not even made routinely available in many European countires. The epidural is largely an American phenomenon.

Epidural rates are going up all over the place. It is not "an American phenomenon". In the UK, 1/3 of births were with epidural, not counting the 23% c-section rate (!) And those numbers were from 2005. It is sure to have gone up by now. It is somewhat cultural (Italy has a very low rate), but it is not American, nor for that matter is American equivalent to "bad".

Trust me, they are concerned about that trend too.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Epidurals are available in many countries and it doesn't break their budget. We could have any number of health systems, including nationalized, and still give our women epidurals.

BUt where does it stop. We should have this and that and that and $$$. The point is that we are overutilizing. To me, we need a bare bones system that pays for the necessities only. Labor epidurals are not necessities. I am not sayng that women should not be allowed to have them. The patient should just have to pay out of pocket for these types of extras.

Well you could point to anything and say it's a slippery slope. But pain management is standard in all other procedures involving significant pain. So I don't see why singling out childbirth makes sense, especially since we have given pain medication for decades during childbirth, but they used to be heavy drugs that narc'ed out the baby. If you want to start somewhere, ban anesthesia for colonoscopies. Give them a versed at most. I say that as a male who has had a colonoscopy.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Epidurals are available in many countries and it doesn't break their budget. We could have any number of health systems, including nationalized, and still give our women epidurals.

BUt where does it stop. We should have this and that and that and $$$. The point is that we are overutilizing. To me, we need a bare bones system that pays for the necessities only. Labor epidurals are not necessities. I am not sayng that women should not be allowed to have them. The patient should just have to pay out of pocket for these types of extras.

Well you could point to anything and say it's a slippery slope. But pain management is standard in all other procedures involving significant pain. So I don't see why singling out childbirth makes sense, especially since we have given pain medication for decades during childbirth, but they used to be heavy drugs that narc'ed out the baby. If you want to start somewhere, ban anesthesia for colonoscopies. Give them a versed at most. I say that as a male who has had a colonoscopy.

It is natural pain, a part of life. Frankly, American patients may need a dose of tough love as quoted by someone else. Lots of things hurt. Breast feeding feels like someone slicing into your nipples, but you do it, because that is life.

[Anonymous]

I had to have major surgery on my breast as the result of mismanaged infection from 'painful' breastfeeding and doctors who 'pooh-poohed' the developing pain much as you do above. Not accessing the most advanced, comprehensive pain management and medical treatments in a sensible way is barbarous--not 'part of life'.

[Anonymous]

Only in childbirth would pain management be shunned as "natural" or "elective." Break a bone or slice into your flesh, I assure that pain is natural but would you shun pain management then just b/c "that's life" "it's natural." I highly doubt it.

And, I'm sorry but I'm not reading through all 5 pages here, if someone has not already posted it, anyone interested in this topic must read the recent article (also cited to in a recent Stephen Pearlstein column) by Atwul Gawande in the New Yorker. He makes a very persuasive case that over-utilization IS the problem.

I'm not going to recite the entire article here. You can find it online. But, it is tremendously persuasive and is generating a lot of discussion. He concludes, basically, that the front lines for bringing down costs lies with the doctors. Wonderful article.