Healthcare in America

WolfEyes

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So..if I am reading y'all correctly HMO's have brought costs down as they might, in the past, have had runaway costs with the increases in technology? No doubt liability played a part, as well. Did the HMO's help DRIVE that forward movement om technology?

Hmm...so? It was always destined to be a situation of us gong bankrupt due to the rising costs?

Am I off base in this?
I have never had any faith in HMOs reducing costs, much less passing on any "savings" to consumers. I don't see where they have anything to do with medical research, which is what drives the technology. Aside from funding research if they do even that.

Figure out a way to keep people from being greedy and no one would ever have to go bankrupt.
 
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Katheryne Helendale

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So..if I am reading y'all correctly HMO's have brought costs down as they might, in the past, have had runaway costs with the increases in technology? No doubt liability played a part, as well. Did the HMO's help DRIVE that forward movement om technology?

Hmm...so? It was always destined to be a situation of us gong bankrupt due to the rising costs?

Am I off base in this?
I'm not sure that HMO's have brought costs down more than HMO's have shielded us from the ballooning cost of health care, but at the cost of quality of care. There is a lot less that the typical HMO is willing to do for you when you develop health issues than they used to.
 
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HMOs most definitely have not shielded us from rising healthcare costs. The US spends about 17.7% of GDP on healthcare. The EU averages 9.6%.

In 1980 the US spent about the same per capita on healthcare as Germany and Switzerland. Today per capita healthcare cost is more than double any European country despite the much more limited access to healthcare in the US.

We pay more than any other developed country for healthcare by a large margin for worse outcomes. We lead the developed world in death by childbirth, infant mortality, and (with the exception of a few well off counties) have shorter life expectancy.
 

Katheryne Helendale

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HMOs most definitely have not shielded us from rising healthcare costs. The US spends about 17.7% of GDP on healthcare. The EU averages 9.6%.

In 1980 the US spent about the same per capita on healthcare as Germany and Switzerland. Today per capita healthcare cost is more than double any European country despite the much more limited access to healthcare in the US.

We pay more than any other developed country for healthcare by a large margin for worse outcomes. We lead the developed world in death by childbirth, infant mortality, and (with the exception of a few well off counties) have shorter life exoectancy.
Oh, no. What I meant was that HMO's have shielded us from costs compared to what we'd be paying if there was no health insurance whatsoever. I definitely agree that what we pay for health care in the US, even with insurance, is freaking insane.
 

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I'm just saying that the costs for healthcare diverge between the US and Europe at the same time that HMOs took over the healthcare system in the US.

It may just be a coincidence and some other factors changed costs in the US but not the EU at the same time HMOs stepped in to keep prices from rising faster (even though they already were rising faster than similar industrial nations) but Occam's Razer suggests maybe changes made once HMOs took over are the cost drivers.
 

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The one big difference that's gone in favor of the consumer is that now pre-existing conditions are covered. It used to be that if you had a condition, you had to pay obscene amounts for even basic insurance.
The ACA did A LOT of great things but didn't go far enough... I think it's worth mentioning that "regulation" has a totally different set of meanings to manufactures vs insurance companies. To manufacturers, regulation means being told what to do or not do, so they hate it most of the time. To insurance companies, regulation is just required to make sure everybody plays ball. You wouldn't be able to survive as the one "compassionate" insurance company who pays for preexisting conditions... it's just necessary to have the government dictate that they all pay for such things.
 
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danielravennest

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Countries with national medical systems didn't have the kind of cost increases we have had in the US. HMOs didn't drive costs down so much as centralized care in fewer hospitals then connected existing doctor's groups and management companies, driving out most of the nonprofits from healthcare. Today even not for profit hospitals are managed, staffed, cleaned, and catered by for profit contractors. They have also driven over specialization as fewer medical students find GP work rewarding and profitable. Which has added more to costs.
The other thing that's happened is increased staff. When I was a kid in Manhattan, early 60's, my doctor's office was a small ground-floor apartment in a larger apartment building (a common setup in the city). Waiting area, exam room, and that's it. I think he had a nurse, but no other staff. My current doctor's office in suburban Atlanta has a staff of about 10 - receptionist, record-keeper, several assistants/nurses that do the preliminaries (weight, B.P., temperature, verify my prescriptions), a phlebotomist (draws blood for tests), and one or two who deal with insurance & billing. Their office is a free-standing building the size of a large house.
 
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Noodles

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I can't count the number of times i I've had to tell people that about the ACA.
Didn't know it was a thing or didn't know "Obamacare" was the same thing.
 

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The other thing that's happened is increased staff. When I was a kid in Manhattan, early 60's, my doctor's office was a small ground-floor apartment in a larger apartment building (a common setup in the city). Waiting area, exam room, and that's it. I think he had a nurse, but no other staff. My current doctor's office in suburban Atlanta has a staff of about 10 - receptionist, record-keeper, several assistants/nurses that do the preliminaries (weight, B.P., temperature, verify my prescriptions), a phlebotomist (draws blood for tests), and one or two who deal with insurance & billing. Their office is a free-standing building the size of a large house.
This is similar to when I was a kid. Also, my Mom gave birth to one of my brothers at home, the doctor came to the house. Because of complications, she ended up in the hospital anyway but it was not uncommon to have a baby at home in the 50's. When I was taken to the family doctor, it was a small office with one nurse. She did the phlebotomy, shots, blood pressure, record keeping and even answered the phone. We paid in cash, I don't think we had insurance. For childhood vaccines, we were taken to the "well baby clinic", where we got our TB tests and all our vaccines before starting school. For any serious emergencies, we went to the county hospital which in all honesty, I thought was pretty unpleasant.
 

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Didn't know it was a thing or didn't know "Obamacare" was the same thing.
Well, that too, but also that it also been a lot better if the Republicans hasn't hobbled it. There world have been a government option, for one thing,they were dead set against that because ZOMG SOCIALISM (also, because of the insurance companies lobby, but they didn't say the quiet part out loud then). The insurance companies need to be regulated, but with their deep pockets, it won't get done.
 

Jolene Benoir

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I'm just saying that the costs for healthcare diverge between the US and Europe at the same time that HMOs took over the healthcare system in the US.

It may just be a coincidence and some other factors changed costs in the US but not the EU at the same time HMOs stepped in to keep prices from rising faster (even though they already were rising faster than similar industrial nations) but Occam's Razer suggests maybe changes made once HMOs took over are the cost drivers.
That rings true. Increased overhead in the form of the many, many employees that work at HMO's would add an overhead to all costs; a middle man.
 
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Rose Karuna

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Also, in the 50's and early 60's, going to the doctor because of an accident was an unplanned family expense. This generally resulted in being chewed out for doing something stupid that broke a bone or got you stitches. Unless you were missing a limb, parents usually just applied mercurochrome, slapped on a bandaid and cut you loose. If you have ever had mercurochrome applied to an open wound you realized that it was derived the tears of satan and after that you were much more careful about getting hurt.
 

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It's hard to believe in retrospect, but my mother convinced me that mercurochrome was less painful than iodine -- tincture of iodine was extremely painful. When Bactine began to be advertised, both old antiseptics were retired from our medicine cabinet, replaced by Bactine which didn't sting at all.
 

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I'm thankful I grew up in the Bactine era. I was quite the tomboy - no stranger to scrapes and scratches. Everything I've heard about Mercurochrome and iodine makes me glad I didn't have to endure either of them!
 
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Jolene Benoir

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I'm thankful I grew up in the Bactine era. I was quite the tomboy - no stranger to scrapes and scratches. Everything I've heard about Mercurochrome and iodine makes me glad I didn't have to endure either of them!
I remember having iodine used upon me, but never mecurochrome. Despite also being a tomboy, I didn't have that many childhood injuries. Glad for it. :)

On edit: I asked my mother what she used on me and she stated that she did use mercurochrome (she offered that up, rather than my direct asking of it.). Hmm...no lasting memories of it, likely because as I said, I didn't have too many childhood injuries. My injuries tended more toward sprained ankles. Many, many sprained ankles.
 
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Khamon

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One set of great-grandparents were determined to use the gigantic bottle of "merc" until it was gone; made for a long couple of weeks during Summer. The other greats and grands used iodine on the tiniest little thorn pricks. Mother was the first in the family to use that newfangled laboratory Bactine spray for sissies.
 
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Clara D.

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Mum was never real consistent.

Aerosol Neosporin, hydrogen peroxide, iodine, and rubbing alcohol were variously used.