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POLICY/THE INDUSTRY/QUALITY: Why health care costs so much, reason #498

Two angioplasty procedures on a 93 year old in one week.

Former President Ford underwent his second heart procedure in a week at the Mayo Clinic when stents were placed into two of his coronary arteries to increase blood flow, his spokeswoman said Friday. The angioplasty procedure on the 93-year-old Ford was successful and he was resting comfortably in his room at the hospital in Rochester, spokeswoman Penny Circle said in a statement.

Oh, and this was at Mayo, the bastion of low cost conservative medicine. So if you’re keeping score using the Dartmouth stats that means that if he’d have gone to New York University Hospital, he’d have had EIGHT procedures this week!

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chas.ReinertJohn FembupBarry CarolMatthew HoltGretchen Dahlen Recent comment authors
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chas.Reinert
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chas.Reinert

Survival figures pro and con

Gretchen Dahlen
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re: “Real numbers” – you make my point exactly, Matthew. With wild, exorbitant “discounts” such that almost no one pays actual charges, the true “cost” of any given health care service isn’t necessarily known (hence my less-than-perfect use of the word ‘apparent’), and institutions who have done the calculations are unlikely to publish them. All we really know is $50,000 discounts skew reality, and health insurance premiums keep rising, of which a good portion goes to overhead, not care. Which leads to unaffordability . . . Peter’s Aug. 30 comment above about aligning costs and prices & limiting discounts warrants… Read more »

John Fembup
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John Fembup

“is it worth it spending tens of thousands of dollars keeping him live a little longer?”
Well, I suppose Ford prefers to keep live a little longer, so he might well answer “yes”.
But, maybe, do ya think he actually has a duty to die now, and save the rest of us some money? What is the annual Medicare tab again? Mightn’t all that money be better spent to pay 100% of the cost of routine health care services for the young & healthy, rather than paying for the expensive care of people who are all going to die soon anyway?

Matthew Holt
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Matthew Holt

Barry–I dont know the specifics but at least the UK has got a body (NICE) which actually does look at the QALY scores for interventions and decrees which ones are worth it or not. The hard question is, given that Ford is 93 and even if he is healthy will likely die within 2-5 years anyway, is it worth it spending tens of thousands of dollars keeping him live a little longer? It’s the same question as the one you posed regarding cancer patients, those with dementia, etc. It may well be that the answer for Ford is that he… Read more »

Barry Carol
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Barry Carol

Matthew, Would cardiac stents be made available at taxpayer expense to a 93 year old in Canada, UK, Western Europe, Japan, or Australia? In President Ford’s case, if he is otherwise reasonably healthy for his age, he might be able to pass UK’s QALY metric. I actually have less of a problem with this then providing ultra expensive drug treatments to Stage-4 cancer patients or expensive surgery to elderly dementia and alzheimers patients or kidney dialysis to those who have lost much of their cognitive ability. We need to focus on reducing utilization, especially with respect to these end of… Read more »

Peter
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Peter

Posted by: Gretchen Dahlen | Aug 29, 2006 9:20:07 AM
“…apparent high cost of health care.”
Does that comment align with the “apparent” number of people who can’t afford insurance, or the “apparent” number declaring bankruptcy for medical bils, or the “apparent” practice of hospitals using the “Charge Master” rates for the uninsured?
“What would happen if Medicare was limited to the amount of discounts it was able to take, and there was closer alignment among prices, costs and payments by all payers?”
Sounds like universal healthcare to me.

Matthew Holt
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Matthew Holt

Gretchen–no one pays charges. Come back with some real numbers!
The real question is why all private plans dont just pay at the Medicare rate. If I was a private insurer I’d be pushing for that, and ammassing as much market power as I could to do so.

Gretchen Dahlen
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Medicare Cost-shifting contributes “nicely” to the apparent high cost of health care. FY 2005 Angioplasty with drug coated stent (DRG 527) shows national average charges of $43,096, but Medicare payments averaging just $14,047 (meaning 67% of charges are shifted to other payers). Pacemaker implant (DRG 116) also shifts 2/3 of its average $42,462 charges. Heart bypass surgery (DRG 109) reports over $51,000 per case on $75,536 average Medicare charges goes UNPAID. What would happen if Medicare was limited to the amount of discounts it was able to take, and there was closer alignment among prices, costs and payments by all… Read more »

Peter
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Peter

I bet the former Pres. has some of that good ole governement paid insurance.

Donald E.L. Johnson
Guest

So are the Dartmouth stats specific to 93-year-old former college linemen?
Come on Matt, what are you trying to say?