How would the Tea Party deal with EMS Calls?

[uglyEMT]

Sorry ERDoc for not getting back to here sooner. Was pulling duty.

I understand the free enterprise side and "why should I expose myself when someone else does less but gets paid the same." It is understandable. Hell I see it everyday in my regular job, I make the same as the lump of crap sleeping in the chair next to me yet I do infinatly more than he does.

Here is my one problem in this train of thought. Why does a Doc, specialist, ect NEED to charge hundreds if not thousands of dollars for a procedure? Why does a pill that costs pennies NEED to be charged hundreds of percent more because it was administered in a hospital? Admin costs?? Sorry I call BS.

WHY does it NEED to be so expensive? Is it because most look at the medical industry and see dollar signs? "Hey I can get 5000 for reading an Xray so thats what I will contract it at, only took 5 minutes but hell I can get it." Sorry thats called greed.

Let me put it this way.... If I hired you for my hospital at 250,000 a year salary. Would your care change if you have seen 10 patients a day or 30? No matter what you get that salary. Instead of charging thousands per patient you make X amount no matter what. Care is care, why should the dollar amount be a consideration?

OK fine my ideas are Utopian and in my world everyone treats everyone equally. I get that. I just don't SEE where the costs come from. Why can I get on my rig day after day, deliver the best care I can all for nothing and not think twice about it yet the next town over charges 500 to 1000 (BLS/ALS dependent) for the exact same thing? NO I am not saying it should all be free and noone should make a living, what I am saying is why the disparity. When does the money become irrelevant?

I don't know, I guess I am stuck in a tangent and have become warped. No my volunteer status has nothing to do with it, I don't want to get into that can of worms again. I just don't SEE the costs nowadays. Why does it take 100,000 dollars for a 3 day hospital stay? Why do labs cost 10 grand? Admin costs don't cut it as an answer. I think the bottom line is GREED. When I hear the loudest proponents of non standardized payment I usually see them in their Armania suits, coming to the meeting in their Porche after leaving thier McMantion saying why shouldn't I be allowed to charge that amount per patient.

OK I will stop here, I am getting more and more worked up and probably will devolve further in this downward spiral of anger. I digress if I have offended anyone and all the previous statments are purely my personal beliefs not backed by any facts just questions.

[akflightmedic]

Why does a pill that costs pennies NEED to be charged hundreds of percent more because it was administered in a hospital? Admin costs?? Sorry I call BS.

WHY does it NEED to be so expensive?

Anyone who has purchased prescription medications has probably wondered why they cost so much. The media has reported on the issue of drug costs a few times with the slant usually being that drug companies are greedy, selfish, and uncaring. Therefore, it is not surprising that the public also shares this view. In their defense, the drug companies usually point to the cost of research. The media then responds with figures showing that the companies spend more on marketing than they do on research. Is the issue really as simple as greed versus the cost of research? The answer is more complicated. To shed some light onto this issue, we need to examine the process of drug development and the economics of manufacturing and selling drugs.

The first step in the development of drugs is the discovery of a new compound (natural or synthetic) that affects a medical condition. The first phase of development involves research into the biological and chemical properties of this compound to determine its effects--how it is absorbed, distributed, and eliminated in the body--as well as its safety. These early studies occur in the laboratory using cells on plates (tissue cultures) and animals. If the new compound is safe and effective in animals, the next phase is testing in a small number of healthy human volunteers to confirm the information from the animal studies and to gain further information on the effects of the compound. Finally, the new compound is tested in humans who have the condition for which it will be used. Once the compound is proven to be safe and effective for the condition, the company applies to the Food and Drug Administration (FDA) for a license to manufacture and sell this drug. The FDA tightly regulates the testing of new compounds in humans and has strict criteria for the approval of drugs.

Drug companies are like other companies in that they manufacture products that must be sold for a profit in order for the company to survive and grow. They are different from some companies because the drug business is very risky. For instance, only one out of every ten thousand discovered compounds actually becomes an approved drug for sale. Much expense is incurred in the early phases of development of compounds that will not become approved drugs. In addition, it takes about 7 to 10 years and an average cost of 500 million dollars to develop each new drug. This money is spent before the FDA approves the drug, and if the drug is not approved, the company loses the money. These expenses must be covered by the revenue from compounds that successfully become approved drugs. Moreover, only 3 out of every 20 approved drugs bring in sufficient revenue to cover their developmental costs, and only 1 out of every 3 approved drugs generates enough money to cover the development costs of previous failures. This means that for a drug company to survive, it needs to discover a blockbuster (billion-dollar drug) every few years. After a drug is approved, millions of dollars are spent on marketing in educating healthcare providers and conducting post-marketing studies. Drug companies spend a lot of money on marketing because of the stiff competition they face from other drug companies for their drugs, and in order to develop each drug's highest revenue-generating potential. Given the poor odds of discovering another successful drug, it is more efficient to maximize the returns on a drug that is already on the market through advertising. In this sense, drug companies are no different than any other type of company. In addition to maximizing returns on their investment through advertising, drug companies also spend money to find new uses for drugs or better ways of using them. These efforts increase the use of the approved drugs and also benefit patients. Additionally, drug companies donate millions of dollars to charities and provide free drugs to individuals or countries that cannot afford medications.

In a nutshell, the price paid by a patient for a medication must cover the costs of developing new compounds that become approved drugs and compounds that fail to become drugs, as well as marketing, post-marketing studies, and a profit. The profit ensures that the company provides a return to investors. Profit is the incentive for the risk that the company takes. Without the promise of a reasonable profit, there is very little incentive for any company to develop new drugs. There is no denying that drugs are expensive. However, the price of drugs should be weighed against their benefits. Since many drugs reduce pain and suffering, prevent disease, or extend life, they should be seen as miracles. Viewed in this light, and compared to other items that cost as much or more but do not provide the same level of benefit, drug prices may not be so unreasonable.

They are all in each other's pockets....paranoia is creeping in! It IS a conspiracy!

[uglyEMT]

Thanks AK for that info. I did know a little but this clarified a few things for me.

I guess what i was leaning twords with my statment wasn't so much as the cost of a medicine in general but more twords the charged cost in hospital care.

I go to Walgreens and buy a bottle of Tylenol for 20 bucks and has 50 tablets in it. I go to the hospital and during my stay I am given 2 Tylenol and my bill shows 20 bucks. Thats what I was getting at, the markup.

I know its all about profit margins and such. I just don't like it.

[Just Plain Ruff]

I had read somewhere that of 100 drugs being researched that only about 10 get approved if even that number.

I do not begrudge the pharmaceutical industry making money on their investment, it's no different than Lego making huge amounts of money by selling their product, except Lego isn't needed for your health.

i think that's where the public and news media has their knickers in a bunch on the cost of medications. I think the public thinks that because it's for their health and it keeps them well that they shouldn't have to pay the high price of the drug. That pharmaceutical companies should provide the drug for a discount. If the ER's free then why can't the drug be free? that sort of mindset.

I take metformin, Insulin, Gemfibrozil, aspirin and allopurinol. All this for a monthly copay of 125.00

I would pay the full price if needed because this is what is keeping my blood sugar in check and my body somewhat healthy.

[paramedicmike]

OK, I got you. Sorry about that. I had a thought process in my head that didn't quite make it to the keyboard. If we continue to go down the line of becoming a single payer system (ie the govt) then doctors, EMTs, paramedics, nurses have basically become employees of the govt. Our payments will only come from the govt, our regulations come from the govt and our rationing will come from the govt. There will be a third party in between (the hospital or EMS service). That is what I meant by the employee of the state comment.

Got it. Thanks for the clarification.

This is a bit off track from the current discussion but just about every physician with whom I've discussed this topic has wanted a single payer system for health care reform. Is there really no way to separate the idea of physicians becoming state employees with a single payer system for health coverage?

[Just Plain Ruff]

Got it. Thanks for the clarification.

This is a bit off track from the current discussion but just about every physician with whom I've discussed this topic has wanted a single payer system for health care reform. Is there really no way to separate the idea of physicians becoming state employees with a single payer system for health coverage?

yes, there is one idea that has been out there. Just don't accept health insurance. Be a concierge doctor to your patients who can afford to pay you your rate. Sometimes those rates are lower.

i was uninsured a couple of years ago, I had an agreement with a doctor's office that I would pay cash. My doctor had a flat 50.00 fee for me to come see him. If he drew labs, he would charge me 5.00 over cost of the lab. EKG was 25.00 over cost. A single office visit would cost me no more than 100.00

Often discussing cash prior to being seen in the doctor's office can get you better deals than even the insurance companies get.

[DFIB]

yes, there is one idea that has been out there. Just don't accept health insurance. Be a concierge doctor to your patients who can afford to pay you your rate. Sometimes those rates are lower.

i was uninsured a couple of years ago, I had an agreement with a doctor's office that I would pay cash. My doctor had a flat 50.00 fee for me to come see him. If he drew labs, he would charge me 5.00 over cost of the lab. EKG was 25.00 over cost. A single office visit would cost me no more than 100.00

Often discussing cash prior to being seen in the doctor's office can get you better deals than even the insurance companies get.

Have had similar situation in the past as an uninsured patient. I would negotiate with the providers and actually was impressed at the willingness of Drs to work with me. I think the best deal was getting a toe nail removed fo 100 bucks. My wife had to send that guy cookies.

[xlq771]

Socialized health care, like we have here in Canada would be better than what the US has now.

Socialized health care, like we have here in Canada would be better than what the US has now.

[flamingemt2011]

ER doc, you are looking pretty hot with your shirt off, are you top or bottom ? And please don't pretend you are not gay with that sexy photo !

[ERDoc]

Yup, you figured me out. Here is a little more of me in my Congressional gym attire. Hope you like it.

I'm always top and I always drive.

Edited September 17, 2011 by ERDoc