Medical expenses vs savings

**asmom** · 12-02-2012, 05:06 PM

The number of support workers (Nurses, billing etc) artificially inflated by stupid rules.

As a nurse (a registered nurse to be exact), I do not consider myself to be a "support worker". And I can assure you that the numbers of nurses needed to provide health care to sick people are not inflated. Health care is extremely complicated and there is far more work to be done than taking blood pressures. Physicians may be sitting in their office but they are constantly answering phone calls from patients, filling and refilling prescriptions, reviewing labwork and radiology results and a myriad of other work that needs to be done. The same goes for nurses and other staff.

The idea that people should be allowed to go from high school to med school is so ridiculous, I won't even waste time dissecting it.

The average Joe can do a lot of things to reduce cost and burden on the healthcare system. The first suggestion is that you take care of yourself. Manage your weight, get recommended screenings like mammograms and colon cancer screening and stop smoking. Don't use the ER for your primary care. Oh yeah and when your 90-year old Grandma who has a heart condition and diabetes develops cancer, don't vow to fight it at all costs. That costs a lot of money.

**MKKShah** · 12-02-2012, 09:55 PM

Originally posted by asmom View Post

As a nurse (a registered nurse to be exact), I do not consider myself to be a "support worker". And I can assure you that the numbers of nurses needed to provide health care to sick people are not inflated. Health care is extremely complicated and there is far more work to be done than taking blood pressures. Physicians may be sitting in their office but they are constantly answering phone calls from patients, filling and refilling prescriptions, reviewing labwork and radiology results and a myriad of other work that needs to be done. The same goes for nurses and other staff.

Sure. I am not saying that Physicians are doing absolutely nothing. I just asking for a *free market*. Not sure if you understand what that means, but I think it is a good thing. It is what the USA, the greatest nation in the history of mankind, is based on. I am calling for an end to the cartel.

Yes, while the job you as a Nurse are doing is what I would call "god's work" (catholic nuns used to do similar work in this country before the corrupt system took over), I still think a Nurse is a support worker from a labor standpoint in the overall healthcare system (compared to Doctors, scientists and R$D specialists). And one that does not need an undergraduate degree to perform his/her work. But the cost is just placed on the average Joe, without his consent.

While the number of Nurses needed may indeed be large, I don't think that is for the "cartel" to decide. The free market can in fact do a good/better job. I personally know several people who believe that Nurse Practitioners should be allowed to expand the scope of their practice. I think so too. Guess who opposes this....no surprises there.

Originally posted by asmom View Post

The idea that people should be allowed to go from high school to med school is so ridiculous, I won't even waste time dissecting it.

While this may be "ridiculous" to you, I think not! and I will tell you why. Approximately 20% of American Doctors are foreign born DO NOT have an undergraduate degree. They went straight from high school to Med school. By the way, AMA has also mentioned in a recent report that these very same foreign born Doctor's are part of the "best and brightest" among all Doctor's in this country. So that leads me to this: Are American Doctor's so dumb that they need 8 or more years to learn the same stuff that those in France or Germany do? If so, shouldn't the system get rid of these dumb people in favor of smarter ones that can learn stuff much faster?

I have several Doctor's in my immediate family, all pulling in deep six figures, and they all confess that they wouldn't be doing this in any other system. It's a travesty that you would even think of defending these robber barons. Stealing from someone when they are sick, or poor is in fact the lowest that a human can go, and American Doctor's have shown that that is where they dwell.

Disclamer: If you are a Doctor or other healthcare worker, please do not take these comments personally (not unless you have a direct role in the creation of this system). Many people in this profession I know have chosen to be Doctor's due to their passion and not greed. These Doctors (and other healthcare workers) are as much victims of the system as the average Joe.

Originally posted by asmom View Post

The average Joe can do a lot of things to reduce cost and burden on the healthcare system. The first suggestion is that you take care of yourself. Manage your weight, get recommended screenings like mammograms and colon cancer screening and stop smoking. Don't use the ER for your primary care. Oh yeah and when your 90-year old Grandma who has a heart condition and diabetes develops cancer, don't vow to fight it at all costs. That costs a lot of money.

Once again, these are all good points. However, they do not address the core issues I have presented to you. Even if all Americans weighed the textbook weight, did not smoke, got colon exams etc., they would still each be short 1.5 - 2 million, which would have been "stolen" by the healthcare system.

What problem do you have with the free market?

**MKKShah** · 12-02-2012, 09:59 PM

Originally posted by Lewis Parrott

Reading this really makes me appreciate the UK health system because The National Health Service covers all expenses. Although, I had to wait 4 hours to be seen last time despite that fact I was vomiting profusely and could hardly breath. I literally begged the receptionist for medical attention but she continued to tell me I had to wait my turn

Thanks for your response. I am not advocating socialism. I am in fact asking for the exact opposite. Remove monopolies. Remove cartels. Just plain old free market. The same market that gave us Coke, Pepsi, the iPhone, Android, all the fancy autos and even our leaders.

Free market folks...free market.

**disneysteve** · 12-03-2012, 08:32 AM

Originally posted by MKKShah View Post

I think the following needs to be done:

- Fight back against the doctor's cartel. Although every field in America has undergone great labor productivity, doctors have only seen it stagnate, and possibly decline. This is due to severe restrictions placed on the number of doctors (AMA through LCME etc.)

I have no idea what the "doctor's cartel" is and I can tell you as a practicing physician for the past 20 years, I've never been invited to join it.

As for productivity, I am busier than ever, seeing more patients per hour than ever. I am also inundated with all manner of forms and reports to fill out for insurance companies, disability, Social Security, schools, employers, government agencies and more that suck up an increasing amount of my time that could be much better spent actually caring for patients. Also, thanks to electronic prescribing and medical record systems, many doctors are far more productive than in the past.

- Increase the number of seats in medical colleges, and admit more applicants

How will flooding the system with more doctors help? I will agree that if some type of universal insurance does get enacted, we will absolutely need more physicians. I'm swamped now. There is no way my practice can accommodat[QUOTE]e a bunch of new patients who suddenly gain insurance. But short of that, more doctors will just increase overhead even more and make it harder to make a living. How is that a good thing?

- Limit the number of hours worked by a residents to 40 hours a week. This will automatically double the number of available residency positions. (wages can be reduced to compensate for this)

How will limiting the hours double the spots? You are assuming that all there is to residency is on call work at the hospital. You are also assuming that all residents work 80 hours per week. Neither is true. Most of the education of residency takes place during normal business hours. Residents make rounds with the attending physicians. Residents work in doctors' offices to gain clinical experience in a supervised setting. If you want to double the number of residents, you'd need to find twice as many places for them to work and twice as many attending doctors to educate them.

- all the above will increase competition and doctors will be scrambling to serve us (so that they can earn their keep). We will be able to get appointments at convenient hours (such as after work, weekends), and better customer service. And all at vastly reduced costs.

So you think that flooding the market with doctors will improve customer service. Do you really think that doctors earning minimal salaries will have an incentive to provide great care and service? Medicine is hard work, mentally and physically draining. Some days, it's all I can do to get home before I crash after a hectic day in the office. The fact that I earn a decent income (and not the kind of numbers you seem to think) at least makes the job tolerable. By no means did I go into this profession for the money, but if you come along and slash my salary, I doubt I'd keep doing it. There are many, many fields which are less demanding and less stressful that pay far better. What you will accomplish is chasing out doctors like me who are thorough and compassionate, leaving behind the doctors who are just running patient mills, getting patients in and out as quick as possible to try and make a buck.

- Every time I go to the doctors office, I see a nurse taking BP/pulse etc. for no more than a minute, and yet I see the doctor sitting in his office (mostly doing nothing). He could very well do this work, and save on the overall cost. (again increasing competition will achieve this).

I doubt that you will find many doctors sitting around "mostly doing nothing" in their offices. I get to my office at least an hour before my first patient to do paperwork, refill prescriptions, review labs and other tests (x-rays, MRIs, stress tests, etc.). During my lunch hour, I do more of the same. After my last patient I do still more of the same. Do I ever have down time? Sure. I'm at work today and typing this message but I can tell you that this post was typed over the course of about 4 hours, a little bit at a time.
Also, it isn't financially advantageous for me to do work that I can have done by someone earning a fraction of what I earn. That isn't a good use of resources.

- Limit medical malpractice lawsuits.

On this point, I will agree with you. I think, and others have proposed, that there needs to be some type of review board that vets potential malpractice suits and decides if they have merit before they can proceed. The vast majority of cases are nonsense. Something like 85% of all malpractice cases are won by the doctor, but it costs a fortune to defend those frivolous cases both in actual court costs and in lost productivity for the doctors' offices.

- Limit pharmaceutical company patent protection to a bare minimum.

I do think there are issues in the pharma industry but I also think it is more complex than you may realize. At the same time you are arguing for a free market system, you are also proposing regulating the industry and potentially reducing competition. You can't have it both ways. One problem I see in the industry is what we call "me too" drugs. That's when one company comes out with a new type of medication and then 3 or 4 or 7 other companies come out with a slightly different version to do the same thing. There are some advantages to that, but it does result in higher costs, at least initially.

- Medicare fraud. The less said the better. The amount runs in the 10s of billions or dollars, possibly 100+.

True. I won't argue with this. Fraud and waste are rampant.

I think doing things like the above will greatly reduce healthcare costs, and will ensure that almost every american earning the median wage will be retire a millionaire by age 60.

I think you are making a huge leap here. You are assuming that if people spend less on healthcare, they will save more for retirement. I think it is far more likely that they will dine out more often, hang an even bigger TV on their wall, get a new car, spend more at the mall or otherwise fritter away the savings.

Instead we have a system where the robber barons (i.e doctors, lawyers, insurance company execs ) are driving Ferrari's and the regular hardworking Joe is dying (or likely to) in penury. Pathetic.

I don't know what doctors you've been talking to but I've never seen anyone driving a Ferrari or anything similar (okay maybe a Porsche or two). I bought a "new" car in June, a 2006 Camry, replacing my 1998 Camry. I paid $16,000, hardly extravagant.

Let me end by repeating one of the commandments...."Though shall not steal"...I think that's a good one.

If you really believe that those of us who are working our butts off taking care of patients day in and day out are stealing, I'm not even sure how to respond to that.

**moneybags** · 12-03-2012, 09:30 AM

- Every time I go to the doctors office, I see a nurse taking BP/pulse etc. for no more than a minute, and yet I see the doctor sitting in his office (mostly doing nothing). He could very well do this work, and save on the overall cost. (again increasing competition will achieve this).

My doctor's office has a medical technician do this. It's more cost effective for the doc to use her time doing more complex things.

I think you are making a huge leap here. You are assuming that if people spend less on healthcare, they will save more for retirement. I think it is far more likely that they will dine out more often, hang an even bigger TV on their wall, get a new car, spend more at the mall or otherwise fritter away the savings.

Absolutely!

**Mjenn** · 12-03-2012, 10:22 AM

Originally posted by MKKShah View Post

Thanks for your response. I am not advocating socialism. I am in fact asking for the exact opposite. Remove monopolies. Remove cartels. Just plain old free market. The same market that gave us Coke, Pepsi, the iPhone, Android, all the fancy autos and even our leaders.

Free market folks...free market.

Interesting, I also have National Health Care (although not GB) and find that it resolves about 80% of the issues you listed in your post. Except for different reasons instead:

The government has set caps for pharma companies saying it will not pay more than XXX for a given medicine -- and big pharma has accepted

No frivolous lawsuits - medical malpractice is covered by insurance and there are set amounts awarded for different issues. Each patient carries this insurance and pays out of pocket (I pay, for example 250 dollars/year)

Residents are limited for the amount of hours they can practice -- but this is for patient safety rather than increase spaces.

However the opposite is true with nurses vs. doctors. Since nurses are less expensive per hour, but are also highly skilled employees -- nurses deal with a large amount of 'well-visits' such as pediatric well visits, pregnancies without complications, minor injuries that need to be seen immediately -- and then the nurse will pass the case on to a doctor if need be. This means the doctors can work on priority cases and their time, which is more costly, is used more effectively. A doctor is a mighty expensive paperpusher.

Like someone else here posted -- biomed analysts take blood tests and blood pressure -- often less costly than nurses.

I, for one, have no problem that a doctor makes more money, considering the years of training and experience required for the job. While the country I live in does not require a BA in medicine to enter med school, it is something I think the US does better --- med students attending my childbirth looked to be about 20, no thanks!--- it shouldn't be something that just 'anyone' can do. It takes a highly developed skill set of being good with people, good in science, good under pressure, and good at analyzing... it is not just for everyone and it shouldn't be.

Where I live we have some of the top ranked health care in the world (and top ranked maternity care for pregnant women) at a mere fraction of what you pay in the US.

I am not saying that the US needs to socialize, but that nationally run medicine can and does offer many great alternatves that save everyone money.

**asmom** · 12-03-2012, 03:06 PM

Originally posted by MKKShah View Post

While this may be "ridiculous" to you, I think not! and I will tell you why. Approximately 20% of American Doctors are foreign born DO NOT have an undergraduate degree.

And many of those doctors come over here and are not able to get licensed in the states.

Originally posted by MKKShah View Post

What problem do you have with the free market?

No offense, but I can tell by your comments that you do not really understand the complexities of the medical system nor the work that physicians and nurses do.

**SavingSweetOneL** · 12-03-2012, 05:39 PM

Hi,

I agree with the other responders.

I'm a Certified Nurses Assistant. I have mostly cared for people in thier homes. A major part of my work and training, in my work, is to be a "First Line Observer". Since i am the one with the most contact with a client/patient, I need to observe things about them and thier health, and report it to my supervisors, so they can recieve the care they need for anyting unsual/out of the norm.

My sister is a pediatric surgeon. She saves children's lives everyday, by providing emergency surgery to them, when they need it the most. She told me during her residency, she earned $4.00 dollars an hour. I earned at the time $6.00 an hour for my work. Now, of course she works more hours, and crazy hours than I do, and earns more per hour, but that was a really strange discussion for me at the time.

And, for years she has driven a cost effective Geo Metro to work.

Thanks, DS for responding and the nurses as well.

SweetOneL

**Gailete** · 12-06-2012, 07:10 AM

Well as someone that has had both her knees replaced, I was very happy to see that my orthopedic surgeon had an undergraduate degree in Mechanical engineering! What better degree to have to truly understand the motions the bones and tissues make before doing surgery on them.

As a nurse, I can tell you that when working I wasn't a 'support worker'. I was an essential person in the care of patients. It was my call to docotros to alert them to problems in hospitalized patients that was able to nip problems in the bud. That is what nurses are trained to do.

I'm not really sure that anything you mention will help our health care system in this country.

**feh** · 12-07-2012, 07:13 AM

Originally posted by asmom View Post

And many of those doctors come over here and are not able to get licensed in the states.

No offense, but I can tell by your comments that you do not really understand the complexities of the medical system nor the work that physicians and nurses do.

Ditto. Wondering why health care can't be sold/bought like Coke and Pepsi are indicates a lack of understanding.

**BunionDR** · 07-19-2013, 02:03 PM

Outpatient Surgery Covered by Most Health Plans

More and more outpatient surgical procedures are being covered by insurance. Most PPOs cover surgeries such as bariatric surgery, hyperhidrosis surgery, and other procedures you may not have realized are actually covered.

This is good to note when weighing the pros and cons if you are considering surgery. Always research first to see if the surgery you are considering could possibly be covered by your insurance. That might be the make it or break it factor for you.

**sherylgray** · 07-22-2013, 03:35 AM

You can't avoid medical expenses, it may occur anytime. You can set up a health savings account (HSA) either yourself or through a group plan with your employer. Health savings account holders can use their savings funds to pay for medical expenses on a tax-free basis.

**Gailete** · 07-22-2013, 05:48 AM

Health savings account holders can use their savings funds to pay for medical expenses on a tax-free basis.

Unfortunately, self-employed people without health insurance can't take advantage of a HSA. I'm not sure if any self-employed people can. I'm not sure why as I'm under the impression that a bank manages them. It would be nice to help cover the cost of medical needs in a more level basis. Instead we have to pay for the expenses and then at tax time deduct a certain amount of our income, prior to getting a deduction. I'm not sure financially how some would come out with an HSA or the out of pocket like we do by the end of the year or if that would depend on total income and taxes owed.

**greenskeeper** · 07-23-2013, 07:35 AM

It pays to be healthy

Medical expenses vs savings