The overview of the cases is available on the side link: Case: Paying Till It Hurts.
The purpose of this assignment is to give you all a chance to investigate in some depth the costly dilemma of our healthcare system. If our medical price structure remains the same, and there is no decrease in our close to $3 trillion bill, technology innovations will have limited effects. As we address other topics in the class, we can be reminded of these cases as examples.
Instructions:
Take a look at the cases described in the link above and post about the case you chose to do in class. I noted the ones I believe were chosen. If you missed class, then choose from those available and do the following:
- On this blog, please create a NEW POST and provide the following information:
- Article Title - provide a direct link (URL) to the article or multimedia site.
- Topic Discussed
- Provide a brief description of the article (1-2 paragraphs)
- What you learned from the article and links provided, reader perspectives, or other follow-up news.
- Add comments to your article that may help to inform the rest of the class what you found particularly interesting and revealing about the case.
- Comment on at least 2 other posts (or more).
Grading Rubric: 15 points - Post and discuss article on class blog (see #1) and provide sufficient detail to show what you learned.
Extra Credit: 1-2 points - Read and comment to others’ postings with some reflection and thoughtfulness. There is no limit to the number of comments you can make, as long as they provide some new information, ask an interesting question, etc. (see #3).
The Growing Popularity of Having Surgery Overseas
ReplyDeletehttp://www.nytimes.com/2013/08/07/us/the-growing-popularity-of-having-surgery-overseas.html
As of 2011 the average price of a hip replacement in the U.S. is $65,000. In Paris France the total price for a hip replacement was about $13,000 and this price is considered expensive by French Standards! With such an alarming difference in prices there’s no wonder Americans are going overseas for elective procedures. But can oversea medical surgeries be trusted? Can they meet the American standards of quality? “In the past few years, Americans are definitely more willing to go overseas and now appreciate that there is quality there, whereas seven years ago they didn’t have that perception.” American medical tourism is becoming more frequent and this growing number tends to be people who do not have insurance or whose insurance does not adequately cover the procedure they need.
One reason Belgium is able to keep healthcare costs down significantly more than the U.S. is the Belgian government’s ability to regulate medical fees, even though most doctors’ offices and hospitals are privately run. Because of the growing demand of oversea surgery, European governments and hospitals are now promoting their services and making their services both easier to access and accommodating to the American medical tourist. Michael Shopenn’s (the snowboard enthusiast) surgery is an example of the level of accommodation Belgium offers. The price for his surgery ran him $13,660 with a private hospital which not only include the surgery itself but also a round-trip airfare, medicine and doctors’ fee.
Patients who are unable to afford the high cost of American healthcare should be encouraged to turn toward oversea economical alternatives.
It is interesting that you compare France health care system to the United States system. My wife is from France and I can tell you first hand that there system is by fair grater then United States in many aspects. In France everyone has health coverage from the government. They do not have to worry about being able to afford a doctor bill or if there insurance will cover it. While making a regular doctor’s appointment they will generally have to wait longer then here in the US, it is fearless expensive. I know my wife has to get all 4 of were wisdom teeth pulled and it will coast her $120 for all four. This will cover everything from the operation to the medicine she will get after the operation. While in the US it will cost on average $1400.
DeleteMedical tourism is a very popular trend. Being from India, it is well documented and published of cases of people coming from Pakistan, Bangladesh, Sri Lanka and many other neighboring countries for healthcare. Several cases reported had no/not affordable treatment in their respective country and would successfully be treated in India. Looking at it from the other side, around the world medical education is imparted in the same way with a possible bias coming during internships where at certain places there might be more possible cases giving the doctor more experience or a doctors person school of thought on treatment. But the basics remain the same, with the same textbooks around the world. A visit to an well qualified doctor in any other country would basically be the same as in America and as Luis's article states much less expensive. So as Luis concludes medical tourism should be encourages from the economic impact and if the impact is high then it might even lead to a drive for lesser healthcare costs in America.
DeleteT.R. Reid covers both France and India. I'll get copies of them for later reading. For now, take a look at his overview of the healthcare models in different countries. Ch. 2, "Different Models, Common Principles"
DeleteThe Price of Prevention: Vaccine Costs Are Soaring
ReplyDeletehttp://www.nytimes.com/2014/07/03/health/Vaccine-Costs-Soaring-Paying-Till-It-Hurts.html
For doctors and private care physicians, the cost of vaccines just keeps getting higher and higher as big name pharmaceutical companies know how to heavily take advantage of their market. Dr Irvin, from the article, estimates that it would cost her practice about $70,000 a month to keep a fully stocked inventory of vaccines, enough to vaccinate every patient. And that's more than she even paid for four years of medical school.
Over the past 2 decades, the cost of a vaccine has steadily increased from single digits all the way to triple digits, and while vaccines are usually completely covered by a patient's insurance, it's the doctors that have to pay ridiculous amounts to keep stock. Because of the rising costs, some doctors have even started to refuse to vaccinate people that aren't long time patients. This creates a huge problem when schools require kids to have their proper vaccinations before they can start. From the article, one family even had to lie and say they didn't have insurance so they could pay a doctor to vaccinate their child. The child had already missed the entire first week of school simply because no doctor would agree to vaccinate the child, since the family was new to the area.
Pharmaceutical companies that create these vaccines know that they have a product that is in incredibly high demand, and they exploit this to seemingly no end. For example, since their vaccines are required for children to go to school, they can effectively inflate the price to whatever they want. People NEED to get these vaccines, and big billion dollar corporations are the only ones producing. They try to justify it by mentioning the high costs of creating these vaccines, but the article makes a good point: at what point did they start break even on these costs, and make billions of dollars in profits? Probably a long time ago.
I was surprised to read that the issue with our broken healthcare system extends to the area of immunizations. This is such a vital step for the patient looking to stay immune from life-threatening diseases. The unregulated cost of vaccinations impedes a child hoping to start school, that's the irony of the issue. A child is ready to begin his life as a student, yet he is at a risk if he cannot afford the proper immunization to do so. The issue is much deeper than economical issue. It's a social issue that pharmaceutical companies are yet unwilling to recognize.
DeleteLuis posted this NYT article on our Facebook group. It relates directly to this post, and it was published a week ago (1/29/16). The article, Drug Shortages Forcing Hard Decisions on Rationing Treatments is about how doctors now have to make choices about who is going to get the drug and who is not. It goes on to say,
Delete"In recent years, shortages of all sorts of drugs — anesthetics, painkillers, antibiotics, cancer treatments — have become the new normal in American medicine. The American Society of Health-System Pharmacists currently lists inadequate supplies of more than 150 drugs and therapeutics, for reasons ranging from manufacturing problems to federal safety crackdowns to drugmakers abandoning low-profit products. But while such shortages have periodically drawn attention, the rationing that results from them has been largely hidden from patients and the public."
So not only is their a shortage, but most patients and their caregivers, as well as policymakers and the public are not aware of how such shortages affect patient care.
Dr. Lurie, the federal health official in charge of emergency preparedness and response, argued that tools developed for disaster response, including ethical and procedural guidelines, should be applied. “Different places around the country are each doing their best to patch together their own guidelines,” she said, adding, “if they’re doing anything at all.”
Sadly, vaccines and cancer treatment drug shortages, among the more than 75 drugs the first week of January are now considered "the new normal." Read more...
I don’t understand why things like this are not regulated by the government? Especially if public school make it mandatory to have in order to go to school shouldn’t they provide a way to get those vaccines? I strongly believe that the government has to intervene in all aspects of the health care system in order to change how the system works because some were along the line we lost our moral since of diction. Medicine should be about helping every one not about who can make the most money.
DeleteI'm not so sure that the research and development is as expensive as they claim. Much of these companies put out these “gag clauses” signed by their employees which conveniently hides the costs from the public eye. Strange? Suspicious? I believe it so. Sadly, even health economists comment that you need a PhD to understand the system of charges that these companies have in place. To my understanding, these companies roam a private market that goes unchecked and very unregulated. And I agree with Tyler. These companies really should be about helping people. Instead pharmaceuticals have become the newest for-profit business model.
DeleteVery true. While it can be said that R&D of new drug discoveries are expensive. The price of the drug far outweighs the initial R&D price. This is a topic we will cover in more detail. Case in point: A congressional review of more than 300,000 pages from Turing Pharmaceuticals and Valient Pharmaceuticals reveals how executives planned to maximize profits while fending off publicity over the price hikes. This has been all over the press. Martin Shkreli is associated with Turing, but Valeant is just as bad. Here is link to a NY Times article about Valeant's CEO, J. Michael Pearson, who was apparently hospitalized so had to step down. Yeah, right. He was forced to step down, but made yet another lame excuse. http://www.nytimes.com/2016/01/26/business/valeant-chief-michael-pearson.html. There are other links related to Valeant at the end of this article as well. Words do not describe these evil men who only care about profit over patients who rely on their drugs.
Delete~American Way of Birth, Costliest in the World~
ReplyDeletehttp://www.nytimes.com/2013/07/01/health/american-way-of-birth-costliest-in-the-world.html?_r=0
I decided to read up on the cost of birth in the US because, my wife and I just had our first child and thought this would be an interesting read. This is something I can relate to because, everything is expensive when having a baby.
This case involves Renee Martin during her pregnancy. At seven months into her pregnancy, she was already noticing the cost of having a baby and the procedures available to her and all she can do is think about how much it will cost. At that time, her current policy did not cover maternity care. Prior to birth, she called the local hospital to ask about how much child birth / maternity care. The hospital could not give her a clear answer, but gave her a range from $4,000 to $45,000. Just for basic ultrasounds and radiologist cost (one appointment) over $1,100. When doing some research from other moms and the NYTimes, she found that childbirth in the US is expensive and new born are the largest payout programs in the world. Approx. $4 Million annual birth is over $50 BILLION dollars.
Some stats;
Newborn care was about $30,000 for a vaginal delivery while a C-section cost $50,000. With insurance companies paying a part of it.
Cost in other countries;
Switzerland, France, and the Netherlands tops out at $4,000
(Price goes up with C-sections)
BIG POINT, With all the extra money into child care, American has the highest rates of both infant and maternal death among industrialized world.
Lab tests, mother's age, scans, and emergency room visit, are just huge costs in one week. In the end she had the baby, but was constantly getting blindside with bills that 6 or more months to pay off. She had to pay $32,000 total. overall. This doesn't include diapers, wipes, bed, (toys) on top of that.
During my wife's pregnancy, we had insurance through the Army and was thankful that we didn't have to pay out of pocket for most of it. (expect circumcision, that was $300 :/)
Good read and it's worth it in the end.
I had absolutely no idea how expensive having a child is. I have always heard about the cost of raising one, but never about how much expense is involved in the actual pre-natal and childbirth process. Especially disturbing is your big point about infant and maternal mortality rates being the highest among the industrial world despite the ridiculous costs of bringing a child into the world.
DeleteHere is an article from the BBC that compares the cost of childbirth in the U.S. to other countries around the world. Staggering. http://www.bbc.com/news/business-31052665
Deletehttp://well.blogs.nytimes.com/2014/08/05/why-we-should-know-the-price-of-medical-tests/
ReplyDeleteIn the article “Why We Should Know the Price of Medical Tests” I learned that our medical system is very bad at letting patient know there prices. The article was mostly about a study ( “Price Transparency For MRIs Increased Use of Less Costly Providers And Triggered Provider Competition”) that took place over two years. It provided members who were scheduled to get an elective magnetic resonance imaging test with a list of other places they could go to get the test at a lower coast. The result was that the program reduced cost by $220 a %18.7 per test over the course of the two years. This led to hospitals in the area to lower their prices because they were losing patient referrals.
The fact that coast of any kind of test is not common knowledge to the patient is almost mind blowing. As a consumer of heath care or “patient” we are use to just going to where the doctor tells us and getting a test done. We do not even think about asking how much this is or were we could go to get it cheaper. At the same time the hospitals know this and will charge much more for the same test that we could go a few miles away and get done at a fraction of the coast. This study shows that when the patient is informed of the coast and give a list of the price, they will generally go to the lower cost option. This at the same time will force hospitals to lower their own prices to be more competitive with in the market. I believe that this should me a mandatory practice with in all heath care systems. You should be provide with a list of all the places with in a reasonable distance that provide the test that you are taking and how much it would coast. This would give the patient the same power that a consumer has in any other market.
I think it is pretty disturbing that costs are so hidden from us as consumers in the health care industry. That makes it pretty clear that hospitals may actually value our money more than our well-being. When we aren't even given the information we need to make informed decisions regarding our healthcare choices, there is a very serious issue with the system.
DeleteI agree with Kelly, during my wife's pregnancy, they never told us once what the final bill would be. During the hospital tour, they would show use all of these cool rooms, different birthing suite, not once did they tell us about price. Why should they? If a baby comes, your not going to say "switch me hospital" because of price.
DeleteType 2 Diabetes Face a Flood of Drugs and Tests
ReplyDeletehttp://www.nytimes.com/2014/05/22/us/type-2-diabetics-face-a-flood-of-drugs-and-tests.html?_r=0
This article stresses the issue of Type 2 diabetes. More specifically, it addresses the problems connected to the overtreatment of the disease as well as the diversity in cases which can occur. According to the article, “an estimated 25 million Americans” have type 2 diabetes, so what does this mean for how treatments are provided? One of the many dilemmas for people diagnosed with type 2 diabetes is that there are countless medications and treatments that are commonly used to keep the disease under control. With this comes a serious problem; patients are uninformed about their situation and often overpay for unneeded medications. There appears to be a very serious need for a better understanding, both from patients and doctors, as to what the different levels of intensity of type 2 diabetes truly require in terms of treatment plan.
I believe that this article fits nicely into some of the core concepts that we have already addressed in class. People using the health care industry are treated as consumers rather than patients, with doctors seeming to spend increasingly less time talking with their patients in order to determine the underlying effects of any ailments. With this, there appears to be a trend that patients are being given a sort of “blanket treatment”, which may not be addressing their specific needs. This article mentions the gross overpayment that regularly occurs, specifically with people suffering from type 2 diabetes. While some people truly are in need of rigorous medication to maintain their health, others benefited from simply changing their diet and exercise plans. A closer look at the unnecessary overmedication of people with this condition would be interesting to learn about.
I think that the core of what we've discussed in class are the alternative or preventative treatments of these diseases and illnesses. Much like cars, our bodies need to be cared for. Misused and neglected cars can break down before their fullest potential and I liken our bodies to have the same nature. Our lifestyle and dieting seems to be the key to living a longer and healthier life. Nonetheless, I agree that the healthcare system is over medicating these patients unnecessarily. The bigger question is what can be done instead if you've already been diagnosed with diabetes?
DeleteThe fact that patients are uninformed about treatments and the cost tells us that healthcare is a failed market, where patients and even the doctors are not provided with the necessary information to make smart, economical decisions.
DeleteAll true, but as you read elsewhere, the spiking costs of insulin are devastating to diabetics. "Injectable insulin, which keeps some diabetics alive and others out of serious health crisis, has soared in the last couple of years." When asked about the cause, Penn Medicine endocrinologist, Mark Schutta, simple said, "Greed." Type 1 diabetes is not something you can control like you can with Type 2. Here is an infographic (pdf) that explains the difference and spikes in cost.
DeleteAs Hospital Prices Soar, a Stitch Tops $500
ReplyDeletehttp://www.nytimes.com/2013/12/03/health/as-hospital-costs-soar-single-stitch-tops-500.html?_r=0
This article explores the topic of how our hospitals crank up the costs of very simple procedures costing patients in need of care thousands of dollars. It also explores the differences of costs between hospitals across the United States and even just across town. One patient was billed $3,355.96 for five stitches on his finger. Another was charged more than $2,000 for three stitches after being bitten by a dog. A student was charged $3,000 for six stitches after she tripped running up a path. But the biggest mystery is what are the factors causing this price fluctuation? Why are these simple procedures costing so much?
Economists say the rising costs within hospitals are “fiscal, not medical: Hospitals are the most powerful players in a health care system that has little or no price regulation in the private market.” Though the rising costs of drugs, medical equipment and other services have already been accounted for in explaining the detrimental costs of healthcare within hospitals, it still doesn’t explain the eye popping charges that are tacked on at the end of the day. Glenn Melnick, a professor of health economics at the University of Southern California, states that hospitals “set prices to maximize revenue, and they raise prices as much as they can — all the research supports that.” Dr. Warren Browner, the chief executive officer of California Pacific Medical Center (one of the hospitals criticized for their high costs for healthcare), defends the hospitals position in what patients are billed stating that there is a good reason why they charge what they do and that the hospitals must have highly trained professionals on call 24 hours a day and 7 days a week. “Hospital care is extremely expensive to produce and to have available for everyone in the community…” The hospital must constantly upgrade equipment as new medical technology is constantly on the rise and they also upgrade hospitals to meet the needs of patients. “We take every penny of the revenue we earn and use it to build new and better facilities for everyone in the city.” Health economists criticize this saying that these are unnecessary expenditures.
At the California Pacific, Codeine will cost you $20 and a bag of IV fluid is $137. On the other side of town, at the University of California San Francisco Medical Center, those items are only charged $1 and $16. On the other hand, the University Medical Center charges $1,600 for an amniocentesis (also called an amniotic fluid test) which is only $687 at the California Pacific hospital. Is there some sort of discrepancy? Interestingly enough, when it comes to surgical procedures, the prices vary greatly as well. The only difference is that the costs of surgical procedures are so great, you can buy a brand new car at the price you’ll pay for the hospital visit and that doesn’t even include the doctor’s fees.
What I found most interesting was the fact that there were so many hospitals bought out by companies including but not limited to Banner and Sutter. Banner now owns the University of Arizona hospital. Statistics prove that the costs of equipment, procedures, care, medication and etc. given to patients during their stay at one of the hospitals owned by these healthcare companies goes up astronomically. Shouldn’t regulations be put into place? Or should we allow the free private market to continue unchecked?
Regulations have to be put into place but as we watched in the previous assignment of Escape Fire, the insurance companies and senate are in a strong position to change any regulations that might affect their position. New financial models have to be developed by the goverment where there can be a tradeoff between healthcare cost-insurance companies-pharmaceuticals. A question to think about that has been missed; Where do medical equipment companies come into play? What are the actual finances behind these?
DeleteIt is interesting that here in Arizona, they charge you $800 dollars for an IV bag, when it costs $1.00 to make. It seems that the hospital don't care, but in reality, hospitals need to make up the money that they lose due to people not paying, I think that's why in some cases they overcharge.
DeleteI think we should investigate this further... Maybe we should ask Dr. Andrew Weil what he thinks. You'd think that there would be a cost savings when hospitals merge - less overhead, better handle on costs, etc. Apparently, transparency is what matters most to control costs. Call them out. Ask local news to cover it.
Delete