Who really pays for health care? It might surprise you!

I found this article by Jay Hancock very interesting.

Who really pays for health care? It might surprise you | Cincinnati.com | cincinnati.com

The article was published in a lot of City newspapers.  The facts he mentions didn't surprise me, because I think I understood most of them conceptually.  However it did confirm my beliefs.



It is clear that the Government & Employers have been paying for most of our medical care for years, so Obamacare really didn't make much change, except for forcing people who weren't paying their fair share to start paying also.



The real problem is the actual cost of the medical care is so much higher in the US than any other country in the world.  We need to figure out ways to reduce that cost without affecting the quality of health care. As an engineer, I like to break the cost down to its basic elements and then see what can be done to "value engineer" each component.  All of those little components where we have waste, fraud or abuse in our system adds up to huge numbers in the overall system.



Some of the big cost components are:

1. Fraud --We have heard estimates of huge amounts of fraud in medical claims.  These include insurance fraud of many different types.

2. Conflicts of Interest -- Medical providers, whether doctors, drug companies, or hospitals all have a profit motive to sell more of their product or service whether it is needed or in the best interest of the patient.

3. Hypochondria -- We have a lot of people now who request, or insist on additional medical care based upon incomplete knowledge of their health situation, which is often influenced by marketing from drug companies

4. Ineffective treatments -- Even though there are new and improved treatments for many diseases, doctors continue to perform or prescribe treatments that are less effective or more expensive

5. Barriers to "self help" -- Patients with many symptoms could, in fact, diagnose their own medical problems with very high accuracy and prescribe their own remedies for minor problems.  However, our US system of delivering medical care is "tilted" to require everyone to go to a doctor for almost every problem.  This increases the overall medical costs, and sometimes actually delays getting the proper care.

Examples of this include:

• We go to doctors because when a doctor prescribes a medicine, it is covered by insurance, vs paying for an over-the-counter medication at a drug store.
• We go to the doctor because we find it hard to get the facts we need to help us diagnose our problem.  However, now there is a wealth of knowledge available on-line...but can we trust it?
• We go to a doctor because the medication we need for a simple problem is sold "by prescription only." It doesn't make a lot of sense why some medications are only sold by prescriptions--for example topical treatments for toenail fungus