“… why is a cotton ball $100?”

Same reason that we have $30,000 hammers and toilet seats in military contracts. The price competition is on the package as a whole, with line items being pretty much completely unregulated and not subject to price competition.

This also occurs all over the drug industry, with individual pills priced the same, regardless of the dosage! So an 80 mg simvastin (generic statin) pill costs the same as a 10 mg pill.

The price mechanism in the health care industry is totally fubar’d.

As to “WHERE IS THE MONEY GOING?”, IMHO, the bulk of it is going to health insurers, who have totally abandoned the notion of spreading risk over the population in favor of excluding anyone from coverage who might pose the slightest risk, and graduated billings to the rest, depending on the amount of perceived (not actualized) risk.

Second in my list of villains, is the hospital and specialist industries, with a huge number of specialists setting up their own clinics (Bruce, take note) instead of using the facilities at their affiliated hospital. This results in massive overbuilding, which costs money, and somebody’s gotta pay for it. Bear in mind that insurers always are first in line to get their slice of the ever-expanding torrent of money flowing into the health care field.
And hospitals are growing like topsy, as well.

This is all reminiscent of the situation in the airline industry, back in the pre-competition days, when fares were regulated. The airlines back then competed on service instead of on price.

What is different in the health care industry is that providers ARE permitted to compete on price, but the trend to do ever-greater amounts of plumbing into the condition of the patient, via CAT scans, MRIs, a horde of molecular biology blood tests that detect a huge number of conditions in parallel, etc, etc.

And is this a bad thing? After all, isn’t knowing more better than knowing less? It all depends upon to what uses that data is put to. In today’s health care industry, it is used to justify ever-higher health insurance premiums and to support the need for further testing, a positive feedback situation in which the element of judgement and reasonableness is totally absent.

And yes, malpractice awards are an element in the mix as well, but to my way of thinking they are far below the amounts of money that is poured into the above monetary flows. And I think that malpractice awards (and many verdicts) are ridiculous.

The cure for all this?
1) take control out of the hands of the politicians, by way of an informed population and an honest, introspective health care industry willing to manage patient costs as much as they manage their health care.

OK, you can stop laughing now.

http://business.theatlantic.com/2009/07/matt_taibbi_gets_his_sarah_palin_on.php

You are about to witness a major league, sophisticated takeover of pretty much the entire banking system by the insiders. For most small banks, it will be difficult if not impossible to compete….”
http://www.economicpolicyjournal.com/2009/07/all-interstate-bank-barriers-coming.html
~~
“…I used to think that alcohol was the most dangerous legal drug but I can’t say for sure anymore. I don’t know if Edgar Bronfman still kills more people than the corporations based in Basel, Switzerland. What I do know is that over a million people are presently locked up in the Prison Industrial, ‘McPenitentiary’ Complex for entrepreneurial activities related to prohibited comestibles . They’ve got a flashing banner on their website which says, “Over one million served”.

Putting people in prison for association with illegal drugs is the way the big guys deal with the competition. The illegal drug industry is controlled by the men in suits, which is the reason the quality has been so bad for so long.

I realize that a lot of people use illegal drugs to escape from the possibilities of their bright, shining future in this “best of all possible worlds” but there are others whose shamanistic intentions for self-inquiry pose a definite threat to the quid pro quo, status quo of, “You’re my bitch and she’s my ho,” assembly line- hamsters on a treadmill- legal drug existence in the Brave New World. As at any time in recorded history, visionaries had better watch their ass. The civilians in the mix are usually watching someone else’s ass and that’s how they come to hear the steel doors slam behind them, once the effects wear off.

I’ll have to digress a little here for the sake of illustration and explanation…”
http://zippittydodah.blogspot.com/

So yeah, someone walking into the office without insurance gets tagged. In fact some doctor’s won’t even make an appointment for someone without insurance. I have personal experience with that. They won’t say they don’t take non-insurance patients. They will say they don’t have any openings. A friend had that happen. I called within hours had an appointment for the next day. Described the symptoms, got the prescript. F’em.

Thanks. In a pinch I had to give my father a bath. We were joking around and I said “I promise not to do anything illegal”. He replied “don’t forget this is Alabama. Its all in the fambly.”

I’m not so sure about that one. If you have the cash to pay, but no insurance, there is always a different rate. My experience has been it’s cheaper if you don’t have insurance. There always seems to be the rate “if you have insurance” and then the 30% off rate if its out of pocket and you have the cash up front. In fact, for certain procedures (obviously not emergency) I’ve actually haggled down some rates for dental work. Those guys definitely overcharge.

Tanman – Great story, you managed to bring a little comedy into what is otherwise a fairly grim task (taking care of ailing parents). Having been there myself, I can totally relate. And of course, it goes without saying, enjoy your parents while you still have them! I’ve already lost both of mine.

Not, “why are MY costs so high, when THEIR cost is so low.” Not, “the way we are paying for it is wrong, disjointed, unfair, unequitable, etc.”

WHY IS HEALTHCARE SO EXPENSIVE? WHERE IS THE MONEY GOING (NOT, WHERE IS/SHOULD IT COMING FROM)?

(I’d submit that the trouble started when insurance companies extended past “catastrophic coverage” into a Costco / Price Club business model, cheating business, the medical profession, and patients in the process. But this is just goading you all on.).

So, gang, why is a cotton ball $100?