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HEALTH CARE COSTS SUMMARY (Cliff Notes)

SUMMARY OF THE TOP TEN CLAIMS ABOUT RISING HEALTH CARE COSTS

 

Claim #1: The Un- and Underinsured raise health care costs. = TRUE AND FALSE

How it’s True:

truePeople without health insurance often do not go to the doctor for preventive health care, so when they do go the illness has progressed to the point of needing very expensive treatment.

trueCovering the costs of health care for the uninsured increases health insurance premiums for all.

How it’s False:

falseThe uninsured do not overuse our hospitals:

  • An uninsured person is twice as likely to use emergency services as someone with insurance BUT most of the people who visit emergency rooms have private health insurance.
  • Hospitals collect more on debts from the insured than from the uninsured – BUT the uninsured are billed higher prices because they do not have access to discounts.
  • The fastest-growing segment of hospitals’ unpaid bills is from people with health insurance.

For an in-depth look at this claim, go here.

 

Claim #2: People do not take responsibility for their health. = TRUE AND FALSE

How it’s True:

truePoor eating habits and lack of exercise lead to obesity, which can lead to Type 2 diabetes, high blood pressure, heart disease, and joint problems – all expensive conditions to treat.

trueOther bad habits such as alcoholism, smoking, drugs, not taking prescriptions properly can lead to bad health.

trueThe most popular U.S. prescriptions treat health problems that a change in diet and exercise alone might cure.

How it’s False:

falseThings beyond our control may have an even bigger impact on our health:

  • Family/Genes
  • Where we live/environment
  • Large portion sizes in restaurants
  • Addition of corn sweeteners to every thing we eat from juice to salad dressings to breakfast cereal.

falseAmericans only get half the amount of recommended care

falseOur primary preventive care system is crumbling.

falseAmericans do not know enough about how to promote their own health.

For an in-depth look at this claim, go here.

 

Claim #3: Medical Errors and poor quality raise our health care costs. = TRUE

How it’s True:

trueNearly a third of U.S. health spending is for inefficient or unnecessary care.

trueMedical errors are reaching epidemic proportions.

For an in-depth look at this claim, go here.

 

Claim #4: Malpractice costs increase as errors rise. = FALSE

How it’s False:

falseMalpractice costs for doctors are going up, but payouts to patients are not.

falseThe malpractice system does not incorporate real oversight and accountability.

For an in-depth look at this claim, go here.

 

Claim #5: Medical advances/technology inflate costs. = TRUE AND FALSE

How it’s True:

trueMedical advances increase costs.

  • These advances are themselves expensive.
  • These advances are overused.

How it’s False:

falseThings that help us diagnose and treat can limit the severity/longevity of the illness and reduce the cost.

falseTechnology adds cost in some areas and decreases it in others.

For an in-depth look at this claim, go here.

 

Claim #6: Hospital care is expensive – that’s just the way it is. = FALSE

How it’s False:

falseHospitals can get their costs under control by doing more to prevent medical errors

falseHospitals can further reduce overhead costs by reducing inefficiency:

  • Not trying to “keep up with the Joneses” – to compete for patients, hospitals believe they must offer every possible diagnostic tool, specialty, surgery and treatment.
  • As hospital systems get bigger and bigger, administration and billing becomes hugely inefficient.

falseSome hospitals are also engaging in fraudulent billing; for-profit more than not-for-profit.

For an in-depth look at this claim, go here.

 

Claim #7: Insurance companies limit costs. = FALSE

How it’s False:

falseInserting a middleman into any system creates costs.

falseInsurance companies profit by limiting/denying care, which drives up costs in the long run.

falseInsurance companies largely promote cost-shifting, not cost-saving.

falseThe complications of dealing with a huge insurance system adds costs to the providers, government and patients.

For an in-depth look at this claim, go here.

 

Claim #8: Newer, better drugs lead to more usage of drugs. = TRUE AND FALSE

How it’s True:

trueAmericans are using more drugs than ever before.

How it’s False:

falseOnly 35% of “new” drugs are truly new, the rest are copies or slight variations.

falseMost drug company costs come from marketing, not R&D.

falseDrug advertising and freebies encourage doctors and patients to use drugs that may not really be necessary

falseDrug company lobbying:

  • Is keeping cheaper generics from being available
  • Is keeping government from negotiating lower prices.
  • Is preventing us from reimporting cheaper drugs from other countries.

falseDrug company misrepresentation of actual production costs and outright fraud inflates costs.

For an in-depth look at this claim, go here.

 

Claim#9: Doctor’s salaries are too high. = FALSE

How it’s False:

falseU.S. doctors make more than those in other countries – but insurance and pharmaceutical company CEOs are millionaires, and pediatricians, family physicians and surgeons are not.

falseOur system works in such a way that specialists make far more than primary care doctors, who are being forced by student debt, overhead and insurance costs to get out of the business.

For an in-depth look at this claim, go here.

 

Claim#10: Administrative overhead makes costs rise. = TRUE

How it’s True:

trueInsurance administrative costs are the fastest-rising component of health care spending.

trueDrug company R&D funding is increasingly used to pay physician researchers who then promote the drugs.

trueDrug company marketing staff and expenses are on the rise.

true15% of all U.S. health care spending goes towards billing.

trueLobbying expenses add costs to the system.

For an in-depth look at this claim, go here.