|
|
|
() Insurance
Studies show 11%~13% of premiums go to administrative cost of the insurance company. (The trade association - America's Health Insurance Plans)
Lawyers
Plaintiffs in medical liability cases receive less than 28 cents out of every dollar spent on the medical liability system. The rest goes to personal injury lawyers and to cover administrative fees. (The Heritage Foundation, Backgrounder No. 1908, January 17, 2006)
The fear of litigation drives up the costs for every aspect of health care, and those added expenses are reflected in higher costs to the patient.
Neurosurgeons practicing in the U.S. today can expect to be sued every two years.( Yale Journal of Health Policy, Law, and Ethics, “Effective Legal Reform and the Malpractice Insurance Crisis” by Richard E. Anderson M.D., December 2004) Nearly three out of five OB-GYNs have been sued at least twice. (Manhattan Institute, “Malpractice Maladies: Doctors continue to flee states with out-of-control medical-injury verdicts,” 2005.) And about one-third of U.S. orthopaedists, obstetricians, trauma surgeons, emergency room doctors and plastic surgeons can expect to be sued in a given year. (Archives of Internal Medicine, “Defending the Practice of Medicine” by Richard E. Anderson, M.D., June 2004.)
In cases where the jury ruled for the defendant, the average cost of defense was $87,720 per claim. In cases where the claim resulted in no payment to the plaintiff (over 70 percent of claims) the average defense cost was nearly $25,000. (Physicians Insurance Association of America; cited in “Federal Medical Liability Reform,” Alliance of Specialty Medicine, July 2005.)
Drug Companies
Medicare Prescription Drug, Improvement, and Modernization Act of 2003: passed by both houses of Congress, signed by President Bush into law. The bill banned the federal government from negotiating with manufacturers for the drug prices for those enrolled.
As a result, drug prices are higher not just for those on Medicare but for the entire nation because insurance companies use Medicare pricing as benchmarks.
AARP recently found that in 2006, for the seventh year in a row, the average price for the 193 brand-name drugs most used by Americans over 50 increased faster than inflation - 6.2% versus 3.2%.
Drug profits are booming….
The pharmaceutical manufacturing was the most profitable American industry from 1995 through 2002. While its profitability has since declined, in 2004 drug companies were still the third most profitable industry (ranking only beneath mining and crude-oil production) and three times more profitable than the median for all Fortune 500 companies.
Doctors
To avoid falling into the fee-for-service trap, many of the health care systems that offer the highest quality care have their doctors on salary. Doctors at the Mayo Clinic, for example, all work on salary. This idea is not popular with specialists, the doctors who earn the highest incomes, but many primary care physicians may be willing to try it. Offering decent salaries to primary care doctors would save money by encouraging them to spend the time needed to provide high-quality, low-cost care.
Non-Paying Patients
The costs of treating the uninsured must often be absorbed by providers as charity care, passed on to the insured via cost shifting and higher health insurance premiums, or paid by taxpayers through higher taxes. (The Cost of Lack of Health Insurance, American College of Physicians)
With the current condition of the economy health care providers are seeing a rise in patient defaults further fueling rising costs.
Over/Under Treatment- Patient demands
Many physicians believe that demanding patients are the reason they are delivering so much unnecessary care. Patients insist on getting a prescription for a drug they saw advertised on TV, or on getting an unnecessary and pricey imaging test, such as a CT scan.
Other doctors insist that malpractice suits are the culprit when it comes to rising costs. The fear of being sued causes physicians to order unnecessary tests, send patients to specialists, and sometimes even do needless procedures.
Shawn D. Newlands, M.D., a professor of otolaryngology at the University of Texas Medical Branch in Galveston, says, “You have a patient who comes in with hearing loss. It might be an acoustic neuroma, a very rare [slow-growing] tumor.” Some doctors order an MRI for every patient who walks in the door complaining of hearing loss, says Newlands. But a more rational approach is to explain to the patient that there is only a small chance of a tumor. The doctor should say, “Let’s check your hearing in six months.” But many doctors don’t do that, says Newlands, because they worry the patient will go to a physician down the street, who will find a tumor, and the patient will turn around and sue the doctor who suggested waiting. He says, “It’s cheaper for the doctor to abuse the system and order an MRI for every patient with hearing loss.”
Swelling Numbers of Geriatrics Needing Costly Medical Care
As the baby-boomers age the health care providers are feeling the pressure and medical costs increase as their health declines.
AND THAT’S JUST THE BEGINNING!!
|
|