Duncan Roberts

Some maybe, but the majority are not. There are millions of dollars that get spent every day at hospitals, etc that can't be directly billed for. If a healthcare facility charged a little over the cost price for supplies it would be bankrupt within a few months.

Michael

You must be referring to residency pay. According to the following link, US physician salaries averaged about $200,000 in 1996.

http://wallstreetpit.com/5769-the-me...laries-so-high

According to a current survey, primary care physicians salaries currently average $202,000 and speciality care physicians average $356,000.

http://www.mgma.com/physcomp/

Some may argue that pay is not that high since many doctors maintain a private practice/office but the figures are after expenses.

Also recently republicans have been making an issue about the fact that 16,000 federal government workers were making over $200,000 and it was their opinion that government workers should not be paid that much. However they failed to mention that 90% of those making over $200,000 were doctors.

Michael

I agree. A lot of the costs associated with a hospital is the maintainance of sanitary conditions as well as the control over drugs. So even though they may charge $20 for a tylenol, a nurse has to acquire, dispense, and record that drug for every patient creating a large amount of overhead costs. Also sanitary conditions have to be very high since a sick person has a much greater chance of picking up an infection in a hospital than anywhere else.

However there seems to be a large abuse in end of life treatment. Typically an average patient sees about 40 different specialist during end of life treatment from gynecologists to brain specialists to foot doctors even if the patient is 90 years old and dieing of incurable cancer.

Tegwyn

No-one has mentioned the liability insurance hospitals and doctors must have to practice. If you want to see where a huge chunk of that cash goes to - look no further. I have friends in medicine and they constantly talk about changes in their practices due to the extreme increase in liability costs. The worst of which is obstetrics. It has become a vicious circle and we all lose because of it.

Egg and Cress

Wonder what the average annual salary is for lawyers? Insurance - that entity that we complain about so bitterly - includes the liability coverage. This premium is figured into every service, every pill, every MRI, etc. that is provided by any facility, which then comes into play when some yahoo files suit against a doctor or hospital or related healthcare worker for a truly frivolous complaint. The insurance company pays the defending lawyers' fees, which in themselves, are astronomical, and then pays the plaintiff another astronomical amount for, say, deprivation of benefits of co-habitation or pain and suffering, etc. The insurance company quickly re-calculates the liability coverage premiums and voila! higher premiums based on claims made - along with a pass-through to the patient! BUT! There's a slew of happy, lawyers on the periphery, all running as fast as their little legs will carry them, to the bank!

Mind you, I'm not defending any of this - just pointing out part of the "why" of such high costs of everything. Nobody wants governmental regulation - but my feeling is if the government regulated more in the medical world, i.e., what the pharmaceutical companies can charge for their products, etc., they might be fewer personal bankruptcies brought about by ill health or other physical catastrophes. Doesn't the government regulate costs for the NHS in England? Isn't that why a family is covered by the NHS from birth? Isn't that a good thing?

Squirrel

Funny thing is, I'm pretty sure doctors in the UK have medical liability cover (I used to work in the NHS), but it seems like when people sue in the UK they sue the hospital itself rather than individual staff.

Michael

There are very few frivolous lawsuits but they are the ones that get the most attention. Overall, medical malpractice insurance is only 1.5% of the total medical costs but republicans want to have tort reform to allow doctors to make more mistakes at a lower cost.

When a serious mistake is made, it is possible that the patient will no longer be able to work and/or require specialized care for the rest of their lives. Unfortunately a few doctors are prone to carelessness and seem to make a large number of serious mistakes raising medical malpractice insurance for everyone in that speciality.

Squirrel

Do they not have an equiv. of the GMC who can strike a doctor off?

Michael

There is the AMA (American Medical Association) which supposedly regulates doctors but it takes a lot of proof to pull a doctors license to practice. Also I consider the AMA as more of a union for doctors to protect the doctors instead of the public.

Egg and Cress

Lyonsden1193 and I worked for plastic surgeons for 14 years. During that time, that practice was involved in two "frivolous" lawsuits, one of which took nearly 10 years to come to a finish and cost the insurance company a bundle; the other was deemed unnecessary by all the lawyers in the case, so the plaintiff was paid a "nuisance" settlement. Having had to testify myself, I became privy to the many legal machinations most people don't know about and I discovered the patent subterfuge employed in making a plaintiff appear credible.

I have no quarrel whatsoever with serious mistakes being brought to court and have been aware of situations where medical malpractice was truly the problem.

Are you in either the legal or medical profession? I have a hard time believing that medical malpractice represents only 1.5% of total medical costs! Knowing how much our doctors paid for theirs, having heard how much other doctors in other fields are paying, one can only guess at the phenomenal cost of hospital and related staff liability insurance is. If you have access to accurate, reliable figures on that subject, I'd have no choice but to concede to your greater knowledge - I have no facts or figures to support my belief, other than my own, personal experiences.

Michael

The annual cost of medical malpractice have been estimate by many organizations and most agree that the figure is between 1%-1.5% of the total medical costs. However that figure gets inflated by republicans claiming the total cost is much higher because they claim physicians order unnecessary tests and procedures to protect themselves driving the true costs much higher.

According to the actuarial consulting firm Towers Perrin, medical malpractice tort costs were $30.4 billion in 2007, the last year for which data are available. We have a more than a $2 trillion health care system. That puts litigation costs and malpractice insurance at 1 to 1.5 percent of total medical costs.

http://prescriptions.blogs.nytimes.c...th-care-costs/

During the past 30 years, about 90,000 medical malpractice lawsuits have been filed each year and about 22,000 are settled each year. That does not mean that 3/4ths of the lawsuits are frivolous since that is a much more complex issue since facts become subjective.

According to some, there are about 250,000 deaths and many more permanent and/or long term injuries each year due to medical malpractice such as incorrect drug prescriptions, not ordering correct procedures, neglect, incompetency, poorly performed procedures, etc. but only about 5% of those end up as lawsuits. Others claim those figures to be highly exaggerated and the true figure is much lower. There is no way of determining the real figures.

We all make mistakes in our profession and it would be ludicrous to believe that the medical profession does not. In many cases, it can be very difficult to prove medical malpractice unless an autopsy or medical records are provided to the plaintiff since the only people involved were partisan medical staff. This does not necessarily mean that failed lawsuits are frivolous but only may only indicate lack of information available to the plaintiff.

Sometimes a lawsuit can be obscure such as a doctor leaving a hospital and the patient develops complications and dies. Is this medical malpractice? Should the doctor have anticipated those complications? Other times the lawsuit is straight foreword such as where a doctor amputates the wrong leg but those are unusual lawsuits and very difficult to cover up.

Hiro11

Since this keeps coming up, a note to the newly arrived: health insurance is an absolute necessity here in the US. It is not optional. The healthcare system here is based on employer-subsidized insurance. Paying for healthcare without insurance is (somewhat) possible, but roughly equivalent in cost outlay to paying for a private space program. Do not take a job without good health benefits. Do not move here unless you've firmly negotiated and fully understood (in exhaustive detail) your out-of-pocket expenses for these benefits prior to arrival. Do not quit a job here without clearly establishing new health insurance benefits elsewhere. If you plan on getting coverage through a spouse, clearly understand these benefits prior to arrival. If you do take a job without good health benefits or plan on living without employer-provided health insurance, count on (tens of) thousands of dollars every year in expense to cover these costs. To give a sense of the magnitude we're talking about here: total employer-provided benefits can easily account for ~30% of your total compensation here, even at high-paying jobs. Private insurance is much more expensive than even that. Don't count on a safety net. These should all be a major considerations when thinking about moving to the US. Please, please, please take this seriously.

Egg and Cress

Okay - next question: is that 1-1.5% of the billed charges for various medical services, materials, etc., or of the discounted amounts actually paid by insurance companies and/or whatever discounted payments uninsured individuals may be able to negotiate? Also, does it include unpaid charity services costs? I probably sound like I'm getting picky, but I'm a die-hard skeptic when it comes to "official" figures. And, no, I'm not trying to pick an argument - just trying to get at honest information......if there is such a thing.

Michael

The government knows what the total health care bill for the US is. In 2008, that was a little more than $2.3 trillion. The accounting firm estimates that total expenditures for litigation, medical malpractice insurance, and everything associated with with the litigation including profits for the insurance companies to be $30.4 billion. Therefore $30.4 billion/$2.3 trillion would be 1.32%. Even if it is a charitable organization, that is included since they also have costs for staffing, drugs, and facilities. So therefore the $2.3 trillion was the total cost of health care including profits for hospitals, doctors, pharmaceutical companies, insurance companies, and all other medical services and someone is paying that cost whether it is an individual, business, charity, or the government.

That $30.4 billion is less than the annual cost to hospitals and doctors for defaults and bankruptcies for medical bills. Therefore without universal health care, those bankruptcies will be a greater burden than litigation.

Whether it is bankruptcies or litigation, the costs are normally passed on as higher prices to paying patients and increased insurance premiums. For bankruptcies and charities, sometimes the local government also picks up part of the cost.

lyonsden1193

Yet another discussion on Health Insurance and why it costs so much!.
Well here is my 5 pence worth... as usual we get some numbers thrown into the ring to either blame Doctors, nurses, Hospitals or Lawyers for the situation. As far as the true cost of Malpractice insurance there are a lot of hidden costs that are not calculated into the numbers given. Every Doctor I know(and I know several) order tests to play CYA just in case (fear is the prime motivator) Where is that hidden cost. I worked for a Plastic practice for 14 yrs as a business mgr and know that Malpractice insurance represented a lot more than 1.5% of the practice costs. I also know that when the costs of lawsuits were added up it did not include some very pertinent costs to the situation. The cost of taking a Doctor out of circulation for days at a time so that preparation for depositions could be made. The cost of effectively shutting down a small practice for 3 weeks so the first trial could be held and then a further 4 weeks for the second one. These costs were not included in any official accounting by the Lawyers.

Lets get on message here ... the true cost of health insurance and its apparent exhorbitant cost in the USA is created by every one.
The people who have 401k's and IRA's are as guilty as anyone. Everybody wants a profit on their investments and most retirement plans include healthcare stock. Living in Memphis we have a great portion of the population that lives near the poverty line but would rather spend their money on fancy cell phones and a fancy ride rather than contribute ANY money toward their own well being... The true cost of healthcare is the cost of being in a captive market..it is a must have so either grin and bear it or everybody shut up and pull together to reduce the costs.... rant over!!..

PS as it tis the season ... BAH Humbug