Health Care's Biggest Money-Wasters

CNNMoney.com:

NEW YORK (CNNMoney.com) -- Down the drain: $1.2 trillion.

That's half of the $2.2 trillion the United States spends on health care each year, according to the most recent data from accounting firm PricewaterhouseCoopers' Health Research Institute.

Read the whole story: CNNMoney.com

Comments

[boredwell]

The electronic file share is a mixed blessing. Because the information- test and lab results are transferred into the patient file arbitrarily, they become blended into the case history by DATE. They should each be separately indexed on different file pages. To save time, I've learned to bring copies to appointments.

As for the "evidence based" tests "proven" to provide "positive outcomes" to best aid physicians in opining a diagnosis, the guidelines are outdated. The doctors will prescribe a series of tests, beginning with the cheaper, lower tech ones, that, in my experience, fail to deliver positive "evidence." Thus the diagnostician, needing better information to support a more definitive outcome, inevitably orders the most expensive (hi-tech) test LAST. This stepping stone approach fails because it adds to the cost, waste valuable time and delays prognosis.

I could go on but everyone who has ever entered the medical-industrial complex knows that our system require more than a quick fix.

[lib liberal]

The disconnect between the problems facing main street and Washington keep widening. For the past 6 month's we're nothing but talk of regulation, but zero action. What a joke.

good articles... http://www.iamned.com

[PlayTOE]

Canadian Health care covers everyone equally ... and costs about 1/2 what the USA pays for care.

Public health care is the ONLY option that makes sense.

[PWM]

What gets me is the Republicans gave Iraq in total around $950 million so they can rebuild their universal healthcare system. Iraq is 1/10 the population of the US. If we increase that by 10, we have $950 billion - which is what Obama wants over a decade.

So the Republicans have no problem using American tax money, running up our National Debt, to bring universal healthcare to Iraq, but heaven forbid Americans get healthcare.

For a quick link: http://www.democracyfornewhampshire.com/node/view/6700

[Arrecho]

Check it out:

http://www.whitehouse.gov/realitycheck/

Pass it around

[vippy]

What happened to the old days, when doctors made house calls? A doctor made a fairly good living,
and patients were happy. Where is this profit margin now, why do we have healthcare providers who need this huge profit margin to be compared to on the stock market? Why do we need CEOs for those providers who make $ 16,000 per hour? Are we insane?

[julia23]

I had a doctor make a hotel call in France recently. Apparently they still do that there. It was free, and the meds were only $10

[dogdiva]

I'd like to know where the alternative to going to a emergency room only costs $65 to $70. 15 min in the Midwest costs about $130 when the insurance company negotiates it. Now I could believe it if it were the new 'free clinic'.

I wager all these things on his list still exist in tact after what we call health care reform. If the Congress doesn't make them federal law they sure aren't going to be corrected voluntarily.

[Genell Subak-sharpe]

On a recent triip to the Czech Republic, my 4-year-old grandson fell in a park in the small town of jitec. he was taken to the local ER, and within 15 minutes, he was being x-rayed and examined by a neurologist. Luckily, the head wound was not serious and the cut was closed with a couple of stitches by another doctor. Total time: about 90 minutes; total cost, $35. The visit would have been free if we were Czech residents. Earlier that week, I saw a doctor in Prague who confirmed a diagnosis of shingles (herpes zoster). No waiting time to see the MD, who refused to charge for her consultation. She prescribed an anti-viral drug that would have cost about $300 in the US; cost in Prague, $38. Again, it would have been free had I been a Czech resident. My daughter and her family, who live in Prague, pay $30 a month for a comprehensive family policy that covers ALL medical, dental, and drug expenses for her and her husband and two young daughters. They pick their own doctors, dentists, etc. ). Of course, this is "socialized" medicine, but anyone in the Czech Republic has full access to health care. Friends in Vienna enjoy a similar health-care plan, where doctors do make housecalls. And both countries enjoy better health-care outcomes than the US at a much lower percapita cost. What's wrong with this picture?

[OETKB]

There's going to be 3 parts:

Ignoring Doctors Orders: Better interviewing techniques on the par of the physican would be a bigger help here. Making the patient the enemy is never a good idea. Educating the doctor is always a better idea. Also preventive care adds to costs. It does not reduce it. It requires more personnel to care for patients and people will live longer. Although a goal we don't want to remove, old age care is our largest medical outlay. Medicare accounts for 50% of nation's health expenditure. No savings here either.

Ineffective Use of Technology: Medicine is at its best when there is excellent personal care. The technology is suppose to enhance this by removing time consuming tasks. This would allow more nursing care and hence increase the health care budget. Nurses have always fought for smaller patient to doctor ratios. Good attention and infection control calls for single patient rooms, again adding to expenses for good reason, but still making care more costly. Again, no savings here.

[OETKB]

This list is a bit problematic. It disregards some facts of medical economics and puts far too much onus cost reduction on the ill that will only be confrontational, interfering with the doctor-patient relationship. My critique is as follows:

Overtesting: The costs for testing are relatively fixed. It costs no more for a lab to do 1000 tests versus 2000 tests except for the small expense for materials and upkeep of equipment. Personnel is any service's major outlay and changes little because of technology can handle doubled loads without adding to personnel. In fact most hospital's labs are under utilized and seek to have outlying labs or pick up from doctors' offices. If this revenue disappeared the hospital would have to find some new source of income to pay for other service like inpatient care. No savings here.

Processing Claims: This is probably a true assessment but hints to a better solution. Under a Single Payer Plan there would be double the savings or more as billing departments would be reduced to a fraction of what they are now. This is a biggy.

To be continued in 2 comments. Not possible to fit in 250 words.

[OETKB]

Part 3

Hospital Readmissions: This depends and is a conclusion reached from too far away from the ground level. If patients are frailer and sicker they will be admitted and readmitted more often. Further hospitals because of reimbursement rules push patients out by cook book guidelines, even if their physician wants them in longer. The waste here is marching orders forums by hospital management and poor use of case managers time. This once more goes to the fixed cost argument. For a particular insurance company it may reduce cost but overall no savings. This claim loss to the hospital will have to made up somewhere. Again no savings to the overall health care bill.

Unnecessary ER Visits: The same economics holds here since the hospital will be out of cash if these paients don't show up. So the cost will have to replaced for the same reasons given under the lab above. The expense for the ER is pretty fixed withing a wide range of service. Sorry no savings.

Hospital Acquired Infection: No strong issue here. This can be a savings in time and expense of medications.

[OETKB]

Sorry 4 parts:

This piecemeal approach is leading us to Rube Goldberg solutions. It is the payment system that is at fault here. It drives resources to where a buck can be made when the underlying nature is a fairly fixed cost system. It is the addition of personnel and real estate that adds to the bill. This can not all be stopped nor should it, but a single payer by budgeting hospitals so they do more careful planning for their services and allowing people to visit their doctors in their offices would help greatly. However, by far, the most benefit to the nation is controlling administrative costs. Single payer's biggest strength is just that and it has a proven 44 year record with Medicare with a 3% overhead.

I'm done

[MacTheBlogger]

But please, everyone, be sure to ignore the myriad examples of massive waste, bloat, fraud, corruption and sloth inherent in every government endeavor.

Evidently that's okay, because, you know, the politicians "care" about us.

[JohnFromCensornati]

So, I think you're saying that we've got nothing to lose because the government won't do any worse and they don't have a profit motive.

[MacTheBlogger]

I have no problem with the profit motive. At least I know what the motivation of a business is, and I can make choices accordingly. I'm responsible for my own decisions, I'm not one who points the finger and whines when I screw up.

But the notion that we should make massive changes because "things can't get any worse" is naive at best. Politicians and the federal bureaucracy have proven over and over and over how untrustworthy and wasteful they are. I'd rather keep their slop to a minimum. Not gone, just to a minimum.

I'd also rather see better, more flexible, more efficient, more effective regulation on the part of the government. But I'm not holding my breath.

[Peter007]

Actually the government has an incentive to do worse. The purpose of of many Government agencies is to maintain themselves. The must spend their annual budget because if they don't, it will be cut the next year. Government agencies are created to solve a problem and then their role becomes expanded.
Insurance companies have an incentive to cut costs. They make more money. The cost cutting most of us are aware of have to do with denying coverage and forcing doctors to do less expensive procedures. The ones we don't hear of are not as sensational so they are not in the press.

[CoyoteMan]

What I have noticed is health care providers in this country don't treat your current problems.
They are looking for what I call the Golden Fleece.

In plain language, the Golden Fleece is that big time disease that will kill you quicky but in the meantime the health care industry makes big bucks supposedly treating you. All the while telling you that you'll be fine!

Seems I'm 15 colonoscopies "behind" according to my doctor.
But ain't nobody sticking a camera up my ass!!
Got it?

[MeinNH]

No room for the camera with your head up there.

[Arrecho]

http://www.whitehouse.gov/realitycheck/

[watchTVgetSTUPID]

This is how to save hundreds of billions ... early identification of at-risk people for expensive chronic deseases by using low cost genetic sequencing. Note the article on human sequencing by 3 techs in one week with a million dollar machine. In a few years it will be even 10 times cheaper.

Soon we will be able to figure out statistical predispositions for many health issues by systematically sequencing 20,000 people covering hundreds of health issues (100 people sequenced who have a particular desease. Done for 200 deseases). That way preventative health care can be targeted where it is necessary (e.g. Breast cancer, diabetes).

Also that way accurate diagnosis can often be made. Also that way beter understanding of deseases through understanding unique proteins generated by bad genes can be identified and thus lead to better medicine.

Today a $100 million investment with 300 techs could sequence 5000 people a year. Probably a lot cheaper than $10,000 per person.

This could help make Obama's health cost savings through prevention work well. Every 1% drop in health costs over 10 years is 1.7% of the annual GDP or savings of $220 billion

[enoughalready13]

I was just the victim of a collossal waste in the healthcare industry. I go to the doctor for a regular check-up. Everything is fine except my iron count is low. So what does the doctor do? Do they suggest an iron supplement for a few weeks and see if it improves? Do they take the bloodtest again to rule out a fluke? No. The doctor is convinced it is serious, despite PROOF in previous bloodtests that my iron count is historically low. The problem is those tests were not administered by my current doctor. They were records I just kept. So ... get this ... I have both an endoscopy and colonoscopy to rule out a more serious issue. Now, I guess I could have refused, but the doctor was insistent and it was *covered* by insurance, so I figured I should be safe, although in my heart I knew this was overkill. I am in my thirties! I knocked on wood it wasn't something more serious and am thankful my insurance covered it. But really, I take 3 medications I have been on for years, amounting to thousands of dollars every year, and those are NOT covered? Meanwhile, while reviewing my bloodtest results myself, I noticed my cholesterol was high, which the doctor never even mentioned! Now THAT would be something important, but there's no expensive/invasive procedure to schedule. When the prognosis is eat better and exercise, it's just not a big enough revenue-generating issue.

[Carolab]

Change doctors.

[Arrecho]

You know, I did that and this doctor prescribed the same. Similar case with the low iron count and also similar case concerning the cholesterol

[watchTVgetSTUPID]

Just wait till your doctor tells you he needs to operate or you might not live.

[einstein10]

Many have similar experiences!

[Carolab]

For some strange reason, my comment re #6 about MRSA got scrubbed. What's up with that?