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Health costs lost on many Americans
President Barack Obama talks with Vice President Joe Biden during a bipartisan meeting to discuss health reform legislation with congressional members at the Blair House in Washington, D.C.
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Bob Moon: Tempers flared at times as President Obama and congressional Republicans faced off on health care today. But despite -- or perhaps because of -- the seemingly never-ending drama, a lot of Americans are greeting the debate with a shrug. Maybe because most of us just don't feel the full impact of soaring health care costs.
From Washington, Marketplace's Nancy Marshall Genzer reports.
Nancy Marshall Genzer: President Obama brought up the issue of skyrocketing health care costs again and again at the summit.
PRESIDENT OBAMA: Let's talk about the substance, how we might help the American people deal with costs.
But many Americans don't have a good sense of those costs. Most of us get our insurance through our employers. The premiums are deducted automatically from our paychecks. We're disconnected from the cost of health care. Five out of every $6 in health care spending today is paid for by someone other than the patient. That is, your employer or the government, through Medicare or Medicaid. So...
DANIEL KESSLER: Nobody really cares about cost. And when that happens, then you get to where we are today.
That's Daniel Kessler. He teaches business and law at Stanford University. He says if people don't have to think about cost, they're more likely to ask for expensive tests that may not be necessary, and press for high-priced prescription drugs they've seen advertised on TV.
Glenn Hubbard says that puts a strain on the entire health care system. He's dean of the Columbia Business School, and worked in the Bush administration.
GLENN HUBBARD: Individuals will tend to, all else equal, consume too much health care. It's what drives up the cost of our insurance and our health care.
And, Hubbard says, it holds down our wages. He says if employers were able to spend less on health insurance premiums, many would pay workers more.
Hubbard also says Americans would cut out unnecessary care if they had to pay a bigger share of their health care costs. The tricky part is making sure that truly sick people don't delay care they need, because of the cost.
In Washington, I'm Nancy Marshall Genzer for Marketplace.
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Finally, some coverage of the _real_ problem with health care! The consumers of health care are usually not the ones paying for it. That and the reliance on employers to provide it. Between those, we (America) have created a condition which prevents free-market competition from giving the consumers the best possible service at the lowest possible price.
Lasik Eye Surgery has become consistently cheaper and higher-quality over the past 20 years...while most other health-care costs have risen. Why? Competition. As it is not covered by most health care, people have to spend their own money for it. When faced with this, they shop around and look for the best deal. Apply this to the rest of the health care system and you have the solution. Not quite as simple as it sounds, of course, but not as hard as congress is trying to make it, either.
I am extremely disappointed with your recent coverage on health care reform issues. On Feb 25, you interviewed 2 professors: Daniel Kessler and Glenn Hubbard - the latter who worked in the Bush Administration. . Kessler said" if people don't have to think about cost, they're more likely to ask for expensive tests that may not be necessary, and press for high-priced prescription drugs they've seen advertised on TV." You did not offer any serious questioning of this argument. How are people supposed to know what tests they should get? They will be very sensitive to cost and may not get needed tests, and there is good evidence that people who have to choose between food and medicine will buy the food, because they have to eat. This results in added health care costs - hospitalization or expensive procedures.
"GLENN HUBBARD: Individuals will tend to, all else equal, consume too much health care. It's what drives up the cost of our insurance and our health care." Why doesn't he think that the huge profits made by some insurance and all pharmaceutical companies are responsible for the costs
"And, Hubbard says, it holds down our wages.", but there is no proof that employers will restore those wages , or that employees will be able to get comprehensive health care.
I have had Type 1 diabetes for 50 years - and if I hadn't had really good health insurance, I'm sure I would be disabled by now. The costs of insulin, syringes, chemstrips for the many blood sugar tests I have to do a day are daunting - not to mention the burden of just managing the disease. I think we are smart enough to figure out different ways to incent people to get good care, and not punish people who are trying to manage their conditions. Obviously, these 2 men have good health care coverage and enough income to buffer themselves against extraordinary medical expenses. Not exactly your average employee.
Shame on you!
I am beginning to worry about the qualifications of professors at our universities. Mr. Kessler claims that we don't have any concern over rising health care costs because we don't see the real cost. I might not know the real cost but I am aware of where the payments for it come from. Every year our employee contribution goes up and the coverage seems to go down. I am sure my employers share of the cost is even worse. Without that cost, my employer would be able to make more profit, enabling them to pay more for my services - if they chose not to lose me to a competing business who would also have more profit for the same reasons. I am reminded of a professor I had in college who was puzzled by the drop in enrollment. He claimed that it could not be the (even at the time) exorbitant cost of tuition since most of the students didn't pay their own fees. I took a small poll of classmates and found that most were on their own dime or were under student loans that had to be paid back - we were very in tune to the cost of education and just one more increase in tuition from jumping to the community college. Come on educators, get your heads out of the books and into the game!
From my personal experience of still having some mysterious autoimmune disease I can say that most doctors over perform on test for two reasons. One, they believe they can fix your problem so therefore they assume you don't have a disease that is outside of their realm of knowledge. Second, if they don't figure out what your problem is then they will never know what it was and thus reaffirming their misconceptions without ever learning. Seriously, almost every doctor I go to has some agenda laid out for diagnosing me. I went for a sleep study lately. He didn't even bother reading my symptom history I wrote out and said I think you are a perfect candidate for a sleep study. I said will this help my numbness? He said probably not. This is the truth, we have greedy doctors in certain specialty fields that pay more. Why are they greedy? Are they bad? No, but that's the way the system is setup. It pay for procedures. It doesn't pay for follow up on the phone or extra if you can figure out the problem without performing an MRI.
I found Thursday's Market Place comments on Americans' knowledge of health benefits to be very demeaning. I have zero interest in overusing my benefits - who wants to spend all their time in the doctor's office or the lab being poked and punctured? I have a fair idea of what these things cost and certainly know the cost of my insurance premiums and drugs. Let's hear some real news and less of your correspondents' personal opinions.
All you self employed folks may know what your medical costs, but those who work for someone else certainly do not. I pay $20 per doctor's visit, pay very little for blood tests, and pay $40 per month for my blood pressure medicine. Do I know hom much the cost of the blood test is? No. Do I know how much the pharma costs? No. I think my experience is much more typical of average Americans than those who are self employed. It would be very nice to be untethered from corporations who dole out our medical insurance at the expense of our paychecks. Really, the cost of medical insurance sprialled throughout the 2000's, and the income of average Americans went down even as productivity increased. Do you need someone to connect the dots for you?
American patients have a habit of suing health practitioners.
So, insurance companies charge health practitioners very high malpractice insurance premiums.
In turn, health practitioners tend to over-diagnose and order every possible test and procedure for patients, in order to avoid lawsuits and even higher premiums.
The result is that patients end up paying more.
The sooner we all stop stepping on each other to try to make more money for ourselves, the better.
"He [Glenn Hubbard] says if employers were able to spend less on health insurance premiums, many would pay workers more."
Really? Is Mr. Hubbard talking about American companies? In America, if can employers spend less on employee costs (including insurance premiums) most of them will not pass that on to their employees by paying their employees more. What will more than likely happen is that the executives in these companies have another reason for rewarding themselves with even bigger bonuses. Why do you think jobs are being outsourced to other countries?
When did American Public Media and NPR for that matter, start passing off editorials as news? Most Americans don't care about health care reform? Really, where did this so-called "fact" come from? Shameful reporting, biased and belongs on an editorial page. C'mon editors can't you do better? Or does Rupert Murdoch own our public radio airwaves now?
I am extremely grad that President Obama and the Democrats in congress are talking about health care cost containment and have been discussing the public insurance option again. I believe that would be one important tool although not the only. I think patients have to sacrifice a little and be more prudent with their health care spending. Doctors have to give up their lavish lifestyle. Pharma and Drug manufacturers should also get some haircuts. And finally the insurance companies should cut their litigation and administrative costs.
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