Why medical bills are killing us.

[semf]

The DOCTORS are the problem in my opinion. They over diagnose and over prescribe. These Doctors tell you to get this procedure, then bill the insurance companies up to the max.

I disagree.

Doctors are just much a victim in this as patients. If a doctor over-diagnoses and over-prescribes it's BECAUSE of the fear of litigation. They don't want to be sued so to cover their bases they'd rather err on the side of being overly cautious and tend to over-diagnose or over-prescribe so they can't be slammed with a lawsuit saying they didn't do enough.

And as far as doctors and over-charging for fees, to be insured to practice in a certain field (like obstetrics) cost big bucks. Big bucks they have to make up through fees.

 

[wsdesigner14]

Well in the article above it looks like providers are already set to increase premiums and in some places have. So I guess obamacare didn't truly do what t was invented to.

First, Obamacare's main provisions do not go into full effect until 2014. Secondly, health care premiums have been steadily increasing before Obama was even considering a presidential run. Look at this chart that shows the ridiculous growth of healthcare premiums in comparison with inflation: http://economix.blogs.nytimes.com/2009/09/16/your-health-care-benefits-in-charts/

Premiums and the cost of healthcare will only continue to rise if we allow these "free markets" to avoid regulation. The Time article specifically mentions how non-profit hospitals are making great amounts of money by charging patients ridiculous rates for anything from MRI scans to band-aides. Obamacare is by no means a magic bullet, and there definitely does not exist such a thing that could fix our healthcare/insurance industry. It is, however, a step in the right direction.

 

[sundoobie]

I disagree.

Doctors are just much a victim in this as patients. If a doctor over-diagnoses and over-prescribes it's BECAUSE of the fear of litigation. They don't want to be sued so to cover their bases they'd rather err on the side of being overly cautious and tend to over-diagnose or over-prescribe so they can't be slammed with a lawsuit saying they didn't do enough.

And as far as doctors and over-charging for fees, to be insured to practice in a certain field (like obstetrics) cost big bucks. Big bucks they have to make up through fees.

Then why not tackle the problem of lawsuits instead of drugging and addicting everyone on prescription drugs. Prescription drug abuse is at an all time high. These doctors are drugging the entire nation and people are becoming addicts. It's like someone can go see a doctor, tell em you're feeling anxiety and have bouts of depression, and they automatically prescribe you a drug. Then guess what happens to these pills... it gets passed along to other people.

Per that article above posted...

In 2010, the average teenager was prescribed 1.2 central nervous system drugs, which treat conditions like depression and attention-deficit hyperactivity disorder.

Personally based on my experience, Doctors are over diagnosing to make money. Why do I feel that way? Because I prepare payroll for a bunch of doctors in a health group and their monthly salary is based on Production dollars meaning how much money they make for the practice. If I was a Dr in this health group, why wouldn't I over diagnose? The more I charge the insurance companies.. the more I get paid.

 

[HankHill]

Then why not tackle the problem of lawsuits instead of drugging and addicting everyone on prescription drugs. Prescription drug abuse is at an all time high. These doctors are drugging the entire nation and people are becoming addicts. It's like someone can go see a doctor, tell em you're feeling anxiety and have bouts of depression, and they automatically prescribe you a drug. Then guess what happens to these pills... it gets passed along to other people.

A doctor isn't responsible for their patient passing out the drugs they prescribed. You want them to turn down providing help to someone simply because they assume that said person will be handing them out to friends?

 

[andee]

Then why not tackle the problem of lawsuits instead of drugging and addicting everyone on prescription drugs. Prescription drug abuse is at an all time high. These doctors are drugging the entire nation and people are becoming addicts. It's like someone can go see a doctor, tell em you're feeling anxiety and have bouts of depression, and they automatically prescribe you a drug. Then guess what happens to these pills... it gets passed along to other people.

A doctor isn't responsible for their patient passing out the drugs they prescribed. You want them to turn down providing help to someone simply because they assume that said person will be handing them out to friends?

Doctors are responsible for knowing what to prescribe. I am good friends with an ER nurse, and she often tells me about the doctors giving Vicodin (the MOST PRESCRIBED medication in the US) for things like "tooth aches," and "my back hurts." It is not hard to tell when people are doctor shopping. Trust me, I spent a lot of time doing that.

I am a healthy 20-something and I was able to get scripts for Oxycontin, Vicodin, Xanax, Klonopin and Adderall, just to name a few.

 

[dajoka004]

Can we cut the ******** generalizations in this thread? You're anecdotal evidence doesn't apply to all physicians.

 

[DCAllAfrican]

Man, I had hemmeroids. I was in PAIN. I sat in the waiting area for about 6 hours. I finally saw someone. They "looked" at me, told me to eat more fiber. Sent me home.

$400

So they tell me that I recieved LEVEL 3 service. Man, a doctor came and "looked" at me for 3 mins. Level 3, I am disputing that nonsense.

 

[Belgium]

what country is it that you live in?

Also you do realize that $50 for an MRI covers a fraction of the the cost to perform an MRI, the $50 doesnt even cover the cost for the radiologist to read it.

Belgium, it's below my username...

Do you realize you're getting ripped off? Without insurance an MRI is about $400 to $500 I believe over here.

Radiologists don't read MRI scans, they're immediately forwarded to the doctor who prescribed the MRI. I'm not sure if you can even get an MRI without a doctor's prescription for it and if you can it's probably not covered by insurance. You can also get MRI's done at private radiology institutions if you want to get it done asap, slightly more costly though.

Are you guys not informed of costs or anything? I've always been fully informed of every single cost, how to limit them as much as possible etc.

 

[dajoka004]

Belgium, it's below my username...
Do you realize you're getting ripped off? Without insurance an MRI is about $400 to $500 I believe over here.
Radiologists don't read MRI scans, they're immediately forwarded to the doctor who prescribed the MRI. I'm not sure if you can even get an MRI without a doctor's prescription for it and if you can it's probably not covered by insurance. You can also get MRI's done at private radiology institutions if you want to get it done asap, slightly more costly though.

Are you guys not informed of costs or anything? I've always been fully informed of every single cost, how to limit them as much as possible etc.

You get what you pay for. There's a reason why radiology has its own residency.

 

[andee]

Can we cut the ******** generalizations in this thread? You're anecdotal evidence doesn't apply to all physicians.

I think you're a smart guy, so it's really a shame that you're so blinded by your profession/ future profession

Please tell me why Vicodin is THE MOST PRESCRIBED DRUG IN THIS COUNTRY. I will provide links if you want. Is this a generalization? Anecdotal evidence? 131 million prescriptions written in 2011. Ok, Dr. Joka, does this seem reasonable at all?

Painkillers are now the NUMBER ONE cause of accidental deaths in America. Because 15,000 people/ year are too stupid to use as directed, right?

 

[munmiso]

It is always easy to overgeneralize about a group of people if you don't really know them (or don't really know how they work).

You should stop seeing doctors as a uniform group of people that behave in a specific way.

In the end we are not all that different.

1. Doctors work for money. That's clear, right?

For normal standards the salary of doctors might seem 'enough'.

However, it is always not easy to turn down the opportunity to make some more.

Although doctors are supposed to be ethical

it is some doctors (not all of them) who can't withstand the temptation of more income by overdiagnosis and overprescription.

I am not defending doctors who do that,

but I am saying, that that you won't get rid of the problem as long as you put incentives for doing so.

2. Doctors seem to be in charge of the health care system, but they actually are not.

I often hear people say why don't doctors tackle this problem and that problem in the health care system.

Even in my country, there are a lot problems in the healthcare system that I would like to change.

However, politicians usually don't listen to doctors unless their request is backed by public interest,

and the public normally doesn't listen to doctors, because many think we are greedy moneymakers.

Along the way, there comes a time for doctors when they stop speaking out in behalf of public interest.

Again, I am not saying that this is right,

just saying the public should be more concerned, and should not leave it to doctors to tackle problems in the health care system.

It's your health that is on the line.

Doctors know plenty of other doctors to know, how to take care of their own health.

3. As for the lawsuits, you can't get rid of them.

If you're a victim of malpractice, you should be compensated for your pain.

Doctors being careful to avoid the possibility of malpractice is not necessarily bad.

In my opinion, you should be more concerned with doctors getting financial incentives on overdiagnosis and overprescription.

Besides, you wouldn't be complaining that much about doctors being careful, if the tests and drugs weren't as expensive.

And if they weren't, doctors wouldn't receive those big incentives.

The bottom line is, you can't expect from every doctor to take care of you in a perfectly ethical way.

Probably a reason why the health care market should not be a free market but rather needs more regulations.

 

[dajoka004]

I think you're a smart guy, so it's really a shame that you're so blinded by your profession/ future profession

Please tell me why Vicodin is THE MOST PRESCRIBED DRUG IN THIS COUNTRY. I will provide links if you want. Is this a generalization? Anecdotal evidence? 131 million prescriptions written in 2011. Ok, Dr. Joka, does this seem reasonable at all?

Painkillers are now the NUMBER ONE cause of accidental deaths in America. Because 15,000 people/ year are too stupid to use as directed, right?

Show me where I argued against you on that issue. Narcotics are overprescribed. American adults act like children when it comes to pain, and too many doctors cave in because it's the easy way out.

 

[Belgium]

Overprescription is another of those things... It's near impossible to get strong painkillers here unless you have cancer or similar diseases.

After my kneecap stabilisation surgery, which is extremely painful, I couldn't get anything stronger than Tramadol.

Don't you get Vicodin or even Oxy just for getting your wisdom teeth removed over there too? That's ridiculous.

 

[andee]

I think you're a smart guy, so it's really a shame that you're so blinded by your profession/ future profession

Please tell me why Vicodin is THE MOST PRESCRIBED DRUG IN THIS COUNTRY. I will provide links if you want. Is this a generalization? Anecdotal evidence? 131 million prescriptions written in 2011. Ok, Dr. Joka, does this seem reasonable at all?

Painkillers are now the NUMBER ONE cause of accidental deaths in America. Because 15,000 people/ year are too stupid to use as directed, right?

Show me where I argued against you on that issue. Narcotics are overprescribed. American adults act like children when it comes to pain, and too many doctors cave in because it's the easy way out.

Can we cut the ******** generalizations in this thread? You're anecdotal evidence doesn't apply to all physicians.

My "generalizations" are based on facts. Not all doctors over-prescribe painkillers, but enough do to make it one of the biggest issues in the healthcare industry. To connect this to the thread, a lot of this is done for profit. Don't be naive. Pill mills exist and doctor shopping is something that goes on all the time. All a doctor has to do is say, "Sorry I'm not giving you narcotics, but here's some ibuprofen" and it's done.

 

[sundoobie]

Overprescription is another of those things... It's near impossible to get strong painkillers here unless you have cancer or similar diseases.
After my kneecap stabilisation surgery, which is extremely painful, I couldn't get anything stronger than Tramadol.

Don't you get Vicodin or even Oxy just for getting your wisdom teeth removed over there too? That's ridiculous.

Bro I got prescribed vicodin from my cousin whose a Dentist for a dental crown. Getting pain killers here is no problem!

 

[dajoka004]

My "generalizations" are based on facts. Not all doctors over-prescribe painkillers, but enough do to make it one of the biggest issues in the healthcare industry. To connect this to the thread, a lot of this is done for profit. Don't be naive. Pill mills exist and doctor shopping is something that goes on all the time. All a doctor has to do is say, "Sorry I'm not giving you narcotics, but here's some ibuprofen" and it's done.

That wasn't in reference to anything you posted. Physicians don't make money off drug prescriptions. If you want to argue that physicians can make more money by being more willing to prescribe narcotics in order to attract more patients, then I won't disagree that there are physicians who do that.

 

[miketysonthekiller]

I went to the ER some weeks back due to an AC injury and they looked at me took x-rays and gave me ******g motrin, nothing else. I got so heated that the hospital was about to bill my insurance mad money just for ******g motrin, that **** won't help fix the issue, its just a damn pain killer, how does that help? I was so mad. I need to educate myself on the medical field a bit more for these type of things.

 

[sundoobie]

That wasn't in reference to anything you posted. Physicians don't make money off drug prescriptions. If you want to argue that physicians can make more money by being more willing to prescribe narcotics in order to attract more patients, then I won't disagree that there are physicians who do that.

However... research states that Doctors do indeed get some perks from Pharm companies.

http://www.propublica.org/blog/item...-most-take-drug-industry-perks-gifts-payments

About 84 percent of doctors in a nationwide survey reported having some type of relationship with the pharmaceutical and medical device industry in 2009, according to a study published in the latest Archives of Internal Medicine.

NPR, which partnered with us on our recent Dollars for Docs investigation, spelled out some of the perks covered by the study:

Free samples of drugs: About 63 percent of the surveyed doctors accepted those last year compared with 78 percent in 2009.

Gifts (meals and drinks mostly): Some 71 percent of docs took those in the recent survey compared with 83 percent five years earlier.

Direct payments (mainly for speaking and consulting): About 14 percent of docs say they got paid for something they did for industry in 2009. That's half the proportion who said that in 2004.

 

[dajoka004]

A lot has changed since 2009. Go find a newer article. We've already discussed this a few pages back.

 

[utvol23]

Belgium, it's below my username...
Do you realize you're getting ripped off? Without insurance an MRI is about $400 to $500 I believe over here.
Radiologists don't read MRI scans, they're immediately forwarded to the doctor who prescribed the MRI. I'm not sure if you can even get an MRI without a doctor's prescription for it and if you can it's probably not covered by insurance. You can also get MRI's done at private radiology institutions if you want to get it done asap, slightly more costly though.

Are you guys not informed of costs or anything? I've always been fully informed of every single cost, how to limit them as much as possible etc.

Thanks but I am a radiologist so I think I know who interprets an MRI. You are crazy if you want an primary care doctor interpreting your MRI LOL. Do you know how many primary care doctors I consult with who have no idea what a stress fracture looks like on an MRI? Not sure how it is done in belgium but if your PCP is interpreting an MRI its a disaster waiting to happen. There is a reason radiology is one of the longest residencies after medical school. 5 years and 1 year fellowship. Which is just as long if not longer than many surgical specialities.

 

[utvol23]

A lot has changed since 2009. Go find a newer article. We've already discussed this a few pages back.

Yep I already stated the rules with regards to pharm companies changed drastically in 2009 or somewhere around there.

 

[younglorious973]

i go to school full time and work part time at an EMT company (saturdays only) and my boss told me after expenses last year he made 3.5 million dollars!
i wanted to punch him in the head when i heard that number and then saw my hourly pay rate.

 

[dajoka004]

i go to school full time and work part time at an EMT company (saturdays only) and my boss told me after expenses last year he made 3.5 million dollars!
i wanted to punch him in the head when i heard that number and then saw my hourly pay rate.

Good for him. The high cost of ambulance services should be a deterrent. Unfortunately it's not. In my time spent in the ED and running with the squad, I'd say ~80% of patients didn't need the services of an ambulance. They could have driven themselves or had someone else drive them.

 

[Belgium]

Thanks but I am a radiologist so I think I know who interprets an MRI. You are crazy if you want an primary care doctor interpreting your MRI LOL. Do you know how many primary care doctors I consult with who have no idea what a stress fracture looks like on an MRI? Not sure how it is done in belgium but if your PCP is interpreting an MRI its a disaster waiting to happen. There is a reason radiology is one of the longest residencies after medical school. 5 years and 1 year fellowship. Which is just as long if not longer than many surgical specialities.

I don't mean to offend, I'm just going by my experiences. My MRI scans have always been forwarded to the doctor who prescribed it. I've had lung and brain MRI's.

I've never been in direct contact with a radiologist. I think the only time a radiologist tells you about your scan is when you have one at the ER instead of a non-ER consultation with a specialist. Don't take my word for that though.

I'm 18 and while my English is very good I'm not entirely sure what a primary care doctor is. Some help with that would be appreciated.

My neurologist gave me an MRI appointment to check for brain tumors or other abnormalities. She also made another consultation appointment with her a few days after the MRI where she gave me a detailed walkthrough of the scan and what it meant. It's standard procedure here for scans to be forwarded to the specialist who gave the MRI order and they will explain the results, not a radiologist.

Same thing when I had a lung MRI, forwarded to lung specialist immediately and no contact with a radiologist.

It's possible the doctors its forwarded to discuss the results with radiologists but they are very much capable of reading and interpreting scans themselves. It's mandatory.

 

[jehul]

We da bessst (at least when it comes to overcharging customers. Basically as long as there's no transparency on the matter, US healthcare costs will remain much higher than anywhere else in the world.

Interesting article on the matter:

http://www.washingtonpost.com/blogs...ow-americas-health-care-prices-are-ludicrous/

One note: Prices in the United States are expressed as a range. There’s a reason for that. In other countries, prices are set centrally and most everyone, no matter their region or insurance arrangement, pays pretty close to the same amount. In the United States, each insurer negotiates its own prices, and different insurers end up paying wildly different amounts. That’s what Steven Brill’s explosive article was about, and it’s why you see U.S. prices expressed as a range rather than a single number.