..intubate coral snake bite victims on ventilators for weeks until the effects of the toxin wear off--potentially costing hundreds of thousands of dollars per bite..
Granted, the antivenom situation is ridiculous, but the quote above exposes yet another, much larger ridiculous issue: why is it OK to charge "hundreds of thousands of dollars" for a few weeks of hospital stay?
Is it because lung vent. machines are $1 billions apiece, or what? How do they come up with those ridiculous bills? Are they really riding 1000% profit margins there or what's going on?
"So… in terms of the real economy, this was an $83 transaction, equivalent to what you might spend on dinner for two. But instead of being paid with a credit card swipe, there were apparently multiple clerks involved at the doctor’s office and the insurer. Negotiations happened behind the scenes. A paper invoice was printed and put into an envelope by hand. A check was mailed through the U.S. mail"
The idea behind health insurance is spending other people's money. If health insurance provides no benefit over just putting money in your savings account, people will just do that instead. Then the system collapses.
(Pooling the money is more beneficial than keeping it to yourself, because the insurance companies can invest it better than an individual can. Think of the interest you get on $1000 vs. what you get on $1,000,000. One buys you a cup of coffee, the other supports you for life. When the insurance companies leverage your premiums in this way, it means that the actual money the spend is nearly free. It's a pretty good deal.)
My high deductable plan doesn't cover anything until I spend $1.5k on health costs in a year. (Except preventive health stuff, that's all covered.) After you pay 1.5k they cover everything. My company and I pay a premium for this coverage (it's not nearly as high as the co-pay and HMO plans available).
Really, when I got to the doctor once or twice a year, for a whopping grand total of about $70/visit, then spend MAYBE $100 on prescriptions/other medications with my prescription discount card, it's really not worth that extra $30 every two weeks.
I don't want to pay for my hypochondriac neighbor's daily doctor visits, or for their kid's sniffles. The way I (and a lot of other Americans) see health insurance is that it should pay for things that would bankrupt you, I can handle the small stuff.
The best part about HSAs is that they are pre-tax accounts, so they help with your income tax costs. This also has the effect of making medical things cheaper because you didn't lose 30%+ on that money before having to spend it. I'm just hoping Congress doesn't cut the usefulness of HSAs with their new health care garbage...
It's only tax-free if your contribution is less than the standard deduction. I don't spend $7500 on healthcare per year, so I can't even deduct it. Maybe if I buy a house I can't afford, then I'll have some deductable interest to push me over...
(If your employer handles the FSA/HSA, then it's pre-tax no matter what. I'm W2, but my employer simply doesn't offer that benefit because it costs them too much money.)
I don't want to pay for my hypochondriac neighbor's daily doctor visits, or for their kid's sniffles.
Well, that's what the co-pay is for. $20 every time you visit the doctor adds up if you visit unnecessarily -- the real cost that the doctor bills the insurance company isn't even much higher than that. Insurance companies aren't losing money on people who see the doctor every week.
(Why do I like the current system? Because the premium I pay is almost exactly matched to my monthly health maintenance cost. And I have protection in the case of disaster, or generally expensive medical procedures.)
Maybe, but only if that forced a real market in healthcare, with transparent and advertised prices and no tying between different services and specialists, so one could actually shop around. Right now, it's damn near impossible to get a rate sheet out of a doctor's office or a hospital, and they don't much like giving quotes on the phone either. Even auto mechanics are more transparent than that (they'll at least give you a quote or estimate if you insist on one). Why can't I go to five different doctors' websites and see five different rate sheets for what they charge for a range of common things, like standard office visits or vaccinations? Why won't a hospital tell me up front how much a surgery will cost, in total after all the different fees (surgeon, anesthesiologist, materials, etc.) are included?
If you actually think that the UK's financial problems have anything at all to do with NHS, well there's probably an extreme right wing party waiting for you.
Thats not a very constructive comment, but taking the trollbait - there are examples of other countries around the world (my own for example) that have public option health cares who's economies aren't in the tank.
Just to clarify: all of the industrialized world (except for the US) has universal health care.
As for the troll, a couple of points:
1. Britain has government-controlled health care, not just government-funded health care. In Canada, where I live, the government is the single payer but health care itself is provided by a wide variety of small and large businesses, including doctors' offices, walk-in clinics, testing labs, and so on.
2. Among industrialized countries, Britain is at the very low end of the spectrum for health care expenditures, either per capita or as a percent of GDP. Government-funded and -controlled health care in Britain has done a phenomenal job of containing costs.
Exactly. The effort required to meet insurance and then government regulations for a doctor or hospital to get paid is through the roof. I was at the doctor not long ago and noticed a sign at the desk that if you paid in full with cash or credit he would give you a price that was close to or below many people's rising co-pays.
* why is it OK to charge "hundreds of thousands of dollars" for a few weeks of hospital stay?*
Sigh... I've been a critical care nurse for years, and here is the answer:
When a person is in the ICU on life support, it's not just "staying in the hospital for a few weeks on a ventilator" it requires 24/7 care on a 1:1 or 1:2 nurse patient ratio. That is, every hour, on the hour a highly trained nurse goes in to your room, takes your vital signs, observes you for any minute changes in condition, documents those changes, monitors how much you've peed in the last hour. A person on life support is also probably on a myriad if IV drips that each have to be controlled with a separate pump.
I've cared for patients on death's door that have easily had 25 separate medications slowly dripping into the patient at rates of 3-5 cc's per hour, and any number of those medications in the wrong doses could kill the patient. Each of those medication rates are changed, and titrated from minute to minute or hour to hour depending on the patient's changing condition.
That's just nursing care, not to mention a Pharmacist with a Phd that's awake 24/7 to double check the safety, concentration and contraindications on each of those 25 drips. They have to be ready to send me a replacement does within minutes of my requesting it.
Not to mention having at least one doctor that's an intensivist. That is, she's gone to school for 15 years to learn how to manage cases like coral snake bites that they might only see once or twice in their entire career. They have to be on call 24/7. Not to mention a toxicologist, perhaps a cardiologist *(12-14 years of school) or a neurologist (easy 12-14 years of school) on call 24/7 in case the person develops a worsening neurological or cardiac symptoms.
And, you need to have a system in place to handle the dozens or hundreds of lab tests this patient is going to need on an on going basis. A lot of those results need to be made available on a "STAT" basis, which is, I need those results within 1 hour or less.
Plus all the added infrastructure: specialized beds to prevent pressure sores, IT infrastructure or organize those lab test and doctors orders.
I could go on.
Not to mention, antivenom is incredibly expensive to purchase. I worked in LA, 5 miles outside of Hollywood. We had a patient bit by rattle snakes in Griffeth park. Each vial of horse serum (rattle snake anti-venom) costs around $3000 each to manufacture. We gave this person 25 vials of antivenom in the first 24 hours, and he needed 25 vials a day for the next week. We indeed had to call the local zoo and all the area hospitals to obtain extra vials.
And, by the way, most hospitals work on a profit margin of 0.5 - 1.5% if they make money at all.
Health care costs a lot, because we demand a lot from our system, like forcing every hospital in LA to maintain a stock of 6 vials of rattle snake anti-venin, so that when one drunk ass hat tries to catch a rattle snake in Griffeth Park in Holly wood, we can save his arm from going necrotic.
Note that they call it "horse serum" because antivenom is produced by putting venom into horses in tiny amounts over long periods and then extracting antibodies from them.
> I'm curious... why is it that so much antivenin was required? If that much is needed, why do hospitals only stock six vials apiece?
Because odds are they won't need it. They stock to buy time until they can get enough for a single patient.
To put it another way, if there's an average of one patient/year in an area with 10 hospitals, what's the right amount for each hospital to stock? Remember - they have lots of other things that they could stock with comparable odds.
The dose is based on the extent of envenomation, weight of the person, and ongoing symptoms.
Horse serum is actually a giant pain in the ass to deal with. It's a crystalline structure that is really hard to dissolve. And, when it gets dissolved, it tends to foam terribly. It generally takes at least 1/2 an hour of slow mixing to dissolve the crystals and get them to stop foaming.
So, to compensate for the difficulty in mixing the horse serum, they don't put as crystallized serum into a vial, and the dose requires multiple vials. The standard adult dose is 4-6 vials depending on the size of the person.
Hospitals don't stock too much of the stuff (unless you're in an area where rattlesnake bites are endemic) because of cost and infrequency of use.
Granted, the antivenom situation is ridiculous, but the quote above exposes yet another, much larger ridiculous issue: why is it OK to charge "hundreds of thousands of dollars" for a few weeks of hospital stay?
Is it because lung vent. machines are $1 billions apiece, or what? How do they come up with those ridiculous bills? Are they really riding 1000% profit margins there or what's going on?