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About that "World's Best Healthcare System" the U.S. is supposed to have...

tjcmd said:
$2,368, and that was staying in the hospital for five days. ThinkWithYourDick what a savings that would be today.
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http://www.census.gov/const/uspriceann.pdf

If that hospital stay went up as much as the median price of a house from 1963 to 2010, it would cost $29.179.

OR if you bought a 1962 Chevy Impala new it would have cost $2682. A 2014 Chevy Impala costs $26,860. So the hospital stay would cost $23,680 just to keep pace.


https://www.healthcarebluebook.com/page_ProcedureDetails.aspx?id=69&dataset=md&g=Appendectomy

BTW according to this a "fair price" for an appendectomy would $10.091. The inflation on this procedure is less than HALF that of an Impala or a house.


Hmmmmmmmmmmmmm
 
I was showing you that the price increase was not even as much as many other every day items. Hell a gallon of gas was $0.30 in 1963.

Your premise is baseless.
 
Deacon923 said:
Consumer electronics is about the worst possible comparison to medical services.

Consumer electronics are discrete, empirically testable, easily compared and researched consumer goods that provide a pre-defined set of experiences without regard to the personal characteristics of the individual purchasing them. They are optional items that no one needs to survive, and so are not purchased under any particular time pressure. They are therefore very susceptible to price competition and the market for them is quite efficient.

Medical services are classic credence goods. They are not discrete, since any given procedure or medicine is (or should be) part of a interrelated course of treatment customized to the individual. They are not easily compared and researched due to the opacity of pricing and the extremely specialized knowledge required to intelligently choose between different medical approaches. Even if steps were taken to make pricing and outcomes more readily available so that market participants could try to compare and research them, the outcome (and therefore the total cost) of a given medical service varies widely based on the individual characteristics of the purchaser, and is not knowable before the medical service is delivered. Many medical services are not optional (or at least, the option to receiving the service is very, very bad) and many of them are delivered under extreme time pressure, when no one has any ability to price shop. The market for medicine is, in other words, extremely inefficient, with all the market power resting with suppliers and very little resting with consumers. At the edges, with optional, simple, and non-time pressured services (like Lasik or simple dermatology procedures, exactly the examples your article used) an efficient market can develop. The overwhelming majority of medical care, however, and especially and particularly the care that costs the most, is not susceptible to any kind of reasonable market forces, and never will be.

Furthermore, the health of a country's population is a public good, leading to greater productivity and national wealth in the long run. In that way, it is very similar to security, efficient justice systems for the resolution of disputes, and secure property rights. Since health is a public good that cannot reasonably be delivered by the private market, governments should take steps to provide the services required by their populations.
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In some cases this is true.

But in the real world of the market, self insured payors (ie employer groups, state governments) are investing a ton of time, $ and effort to develop these tools b/c they believe they will help control costs. There is a huge push to ID cost effective/quality providers around elective, medically necessary episodes of care (think knee replacement). You'd be shocked at the price & quality variances in the market. The trick of course is case mix adjusting but don't kid yourself, cost transparency is here to stay and will only grow.

We have one employer group (very very large) that only covers some elective procedures in 2 facilities in the state. They cover travel/hotel expenses for the family BUT still save real $ as a result. Some employers require you to travel to a center of excellence in different states to get care. You are also seeing benefit differentials being based on this too to create steerage. Go here pay $x, go here pay $y. Castlight is one of the big vendors out there.

Its far from perfect but its certainly the direction we are moving in. Even the ACA has some cost transparency requirements.

I'll also see if I can dig around today and see if I can find the $ that are targetable here. Outpatient spend was growing at a huge clip a few years ago and of course most of that is prime for this work.
 
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RJKarl said:
I was showing you that the price increase was not even as much as many other every day items. Hell a gallon of gas was $0.30 in 1963.

Your premise is baseless.
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Yes, things interfered with by government (health care, education, energy, housing) have risen in price much more than the CPI. My claim is that health care was much more cost effective in 1965 than it is now. The median income in 1965 was about $6000. Today the median income is about $51,000. So if a hospital stay that cost $350 in 1965 costs $10,000 today it is a much larger burden on families now than it was before power hungry politicians started monkeying with doctors and hospitals. Maybe you can figure out on your own why during fiat money inflations not every price rises at the same rate.
 
Except the hospital stay you mentioned cost $2368. Using your income numbers as a benchmark, that $2368 would cost $20,168 today. Thus, "power hungry politicians" may have kept the price down not up.

It's 50% less inflation than earnings.
 
RJKarl said:
Except the hospital stay you mentioned cost $2368. Using your income numbers as a benchmark, that $2368 would cost $20,168 today. Thus, "power hungry politicians" may have kept the price down not up.

It's 50% less inflation than earnings.
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Rethink this. I am trying not to call you a stupid idiot.
 
So this relative exists in the same fantasy-land as the friend who had a recurrence of an unnamed illness in an unnamed country that most definitely had a single-payer system, right?
 
You changed the price of the operation after posting it. You did so only to make the numbers fit your bizarro world view.

I showed you how consumer goods like cars and homes went up more than the cost of the operation. You then said we should compare it to earnings. When that too would show that the prices have not gone up as much as earnings have, you dishonestly changed the price of the appendectomy.

The biggest problem in healthcare has nothing to do with the government. The biggest problem in healthcare between 1963 and today is insurance companies and the number of middlemen they have put between you and your doctor.
 
RJKarl said:
You changed the price of the operation after posting it. You did so only to make the numbers fit your bizarro world view.

I showed you how consumer goods like cars and homes went up more than the cost of the operation. You then said we should compare it to earnings. When that too would show that the prices have not gone up as much as earnings have, you dishonestly changed the price of the appendectomy.

The biggest problem in healthcare has nothing to do with the government. The biggest problem in healthcare between 1963 and today is insurance companies and the number of middlemen they have put between you and your doctor.
Click to expand...


Do I need to show you your error?
 
RJKarl said:
You changed the price of the operation after posting it. You did so only to make the numbers fit your bizarro world view.

I showed you how consumer goods like cars and homes went up more than the cost of the operation. You then said we should compare it to earnings. When that too would show that the prices have not gone up as much as earnings have, you dishonestly changed the price of the appendectomy.

The biggest problem in healthcare has nothing to do with the government. The biggest problem in healthcare between 1963 and today is insurance companies and the number of middlemen they have put between you and your doctor.
Click to expand...

It sounds to me like you're arguing that the rise in healthcare costs post '65 was fairly moderate. I don't believe that view is widely accepted.
 
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I said no such thing. What I have done is use his example to disprove his example. He brought up an appendectomy and its costs versus the costs of other things.

Clearly HC costs have skyrocketed, but so have other things. It's not all about the government as he alleges.
 
The Mangler said:
It sounds to me like you're arguing that the rise in healthcare costs post '65 was fairly moderate. I don't believe that view is widely accepted.
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RJ is incapable of understanding that $350 was the cost of an appendectomy in 1965 when the median income was $6000, both in 1965 dollars. Today that same cost would be at least $10,000 when the median income in today's dollars is something like $51,000. Health care was much more affordable then. RJ can't think outside his progressive thought prison.
 
tjcmd said:
It all true, Avalon. Face it.
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That looks like a $157 bill from 1959 that was covered by payments on account, so your details were fuzzy. Were appendectomies performed in a delivery room in 1959?

BTW, if that is really from you, you can tell the name of the person who uploaded it, just FYI. (Not sure where you stand on wanting anonymity on these here boards.)
 
avalon said:
That looks like a $157 bill from 1959 that was covered by payments on account, so your details were fuzzy. Were appendectomies performed in a delivery room in 1959?

BTW, if that is really from you, you can tell the name of the person who uploaded it, just FYI. (Not sure where you stand on wanting anonymity on these here boards.)
Click to expand...

I would never post personal information on an internet message board. That is just a typical hospital bill from the time. Discuss the issue if you want to, but stop trying to discredit ideas because I don't give you my credit card numbers.
 
tjcmd said:
RJ is incapable of understanding that $350 was the cost of an appendectomy in 1965 when the median income was $6000, both in 1965 dollars. Today that same cost would be at least $10,000 when the median income in today's dollars is something like $51,000. Health care was much more affordable then. RJ can't think outside his progressive thought prison.
Click to expand...

Here's your DIRECT quote:

"tjcmd tjcmd is online now
Ricky Peral

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Quote Originally Posted by ThinkingWithMyDeac View Post

I love the wow only 300 dollars, bkf tries that shit all the time. So you mean 5,000 dollars in todays money."

$2,368, and that was staying in the hospital for five days. ThinkWithYourDick what a savings that would be today.

Then i gave an ACTUAL industry source for what it would cost today:

"https://www.healthcarebluebook.com/p...g=Appendectomy

BTW according to this a "fair price" for an appendectomy would $10.091."

So we have the entire cost being cheaper as opposed to the TJMD's quote for earnings. HE LOSES ON THAT ISSUE.

Now let's look at his alleged $350 for the cost of the procedure-

According the link above:

Physician Services
Fee: $1,227
Fee Details: Physician fee for procedure and routine postoperative care. Surgical removal of the appendix.
Pricing Agreement:
Printable Detailed Pricing Agreement
Anesthesia
Fee: $724
Fee Details: Price is for an average surgery time of 1 hour and 15 minutes. Prices may go up or down based upon the actual surgical time required."

This puts the total cost of the procedure (without hospital stay)-apples to apples at $1951

AGAIN USING TJMD's own base numbers of $6000 average earnings versus $51,000 today, the $350 TJMD uses would be $2975.

Thus for his own example (and his own numbers), whether you use entire hospital stay or just doctors' costs, the cost today has less of an economic impact on the average person than it did in 1963.
 
tjcmd said:
Yes, things interfered with by government (health care, education, energy, housing) have risen in price much more than the CPI. My claim is that health care was much more cost effective in 1965 than it is now. The median income in 1965 was about $6000. Today the median income is about $51,000. So if a hospital stay that cost $350 in 1965 costs $10,000 today it is a much larger burden on families now than it was before power hungry politicians started monkeying with doctors and hospitals. Maybe you can figure out on your own why during fiat money inflations not every price rises at the same rate.
Click to expand...

http://whitehousetapes.net/clip/ric...n-all-incentives-are-toward-less-medical-care

Some fairly significant things have changed since the 60s.

"This is a transcript of the 1971 conversation between President Richard Nixon and John D. Ehrlichman that led to the HMO act of 1973:

John D. Ehrlichman: “On the … on the health business …”

President Nixon: “Yeah.”

Ehrlichman: “… we have now narrowed down the vice president’s problems on this thing to one issue and that is whether we should include these health maintenance organizations like Edgar Kaiser’s Permanente thing. The vice president just cannot see it. We tried 15 ways from Friday to explain it to him and then help him to understand it. He finally says, ‘Well, I don’t think they’ll work, but if the President thinks it’s a good idea, I’ll support him a hundred percent.’”

President Nixon: “Well, what’s … what’s the judgment?”

Ehrlichman: “Well, everybody else’s judgment very strongly is that we go with it.”

President Nixon: “All right.”

Ehrlichman: “And, uh, uh, he’s the one holdout that we have in the whole office.”

President Nixon: “Say that I … I … I’d tell him I have doubts about it, but I think that it’s, uh, now let me ask you, now you give me your judgment. You know I’m not to keen on any of these damn medical programs.”

Ehrlichman: “This, uh, let me, let me tell you how I am …”

President Nixon: [Unclear.]

Ehrlichman: “This … this is a …”

President Nixon: “I don’t [unclear] …”

Ehrlichman: “… private enterprise one.”

President Nixon: “Well, that appeals to me.”

Ehrlichman: “Edgar Kaiser is running his Permanente deal for profit. And the reason that he can … the reason he can do it … I had Edgar Kaiser come in … talk to me about this and I went into it in some depth. All the incentives are toward less medical care, because …”

President Nixon: [Unclear.]

Ehrlichman: “… the less care they give them, the more money they make.”

President Nixon: “Fine.” [Unclear.]

Ehrlichman: [Unclear] “… and the incentives run the right way.”

President Nixon: “Not bad.” "
 
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No, you can't deal with reality or ever be honest.
You said:

"RJ is incapable of understanding that $350 was the cost of an appendectomy in 1965 when the median income was $6000, both in 1965 dollars. Today that same cost would be at least $10,000 when the median income in today's dollars is something like $51,000. Health care was much more affordable then. RJ can't think outside his progressive thought prison."

I showed you an industry source that gave the NUMBERS for the procedure.

You said - $350 into an income of $6000. this would be 5.8% of their income

The industry source I linked to said the same procedure would cost $1951 .

TJMD said the income level of today is $51,000. Thus the procedure would cost 3.8% of today's average income.

This is as basic a direct math problem as there could be- If Procedure A cost X in Year Y and Income was Z-what percentage of income is that procedure.

I plugged in your numbers for income and the cost of the procedure in 1963. I thin put your number for income and the industry's cost for the procedure in 2010..

If you can't understand this, it's very lucky for you that breathing is a reflex action, because you would be too stupid to breathe.

Or it could be that you are totally dishonest.

It's your choice, are you stupid or dishonest?
 
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