Waste in US Healthcare System: $700 Billion on average

[sciwizam]

Link

* Unnecessary care such as the overuse of antibiotics and lab tests to protect against malpractice exposure makes up 37 percent of healthcare waste or $200 to $300 billion a year.

* Fraud makes up 22 percent of healthcare waste, or up to $200 billion a year in fraudulent Medicare claims, kickbacks for referrals for unnecessary services and other scams.

* Administrative inefficiency and redundant paperwork account for 18 percent of healthcare waste.

* Medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11 percent of the total.

* Preventable conditions such as uncontrolled diabetes cost $30 billion to $50 billion a year.

* Paper-based system that discourages sharing of medical records accounts for 6 percent of annual overspending

And yet to be determined if Congress will do anything to deal with this issue of waste.

 

[Ozoned]

Originally posted by: sciwizam
Link

* Unnecessary care such as the overuse of antibiotics and lab tests to protect against malpractice exposure makes up 37 percent of healthcare waste or $200 to $300 billion a year.

* Fraud makes up 22 percent of healthcare waste, or up to $200 billion a year in fraudulent Medicare claims, kickbacks for referrals for unnecessary services and other scams.

* Administrative inefficiency and redundant paperwork account for 18 percent of healthcare waste.

* Medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11 percent of the total.

* Preventable conditions such as uncontrolled diabetes cost $30 billion to $50 billion a year.

* Paper-based system that discourages sharing of medical records accounts for 6 percent of annual overspending

And yet to be determined if Congress will do anything to deal with this issue of waste.

They already spent stimulus money to address the one I bolded. Tort reform will take care of a lot of the reduntant paperwork, and a lot of the others you listed.

 

[MotF Bane]

Originally posted by: sciwizam
And yet to be determined if Congress will do anything to deal with this issue of waste.

Congress, reduce waste? Surely you jest.

 

[her209]

Originally posted by: Ozoned
They already spent stimulus money to address the one I bolded. Tort reform will take care of a lot of the reduntant paperwork, and a lot of the others you listed.

I think the impact of tort reform is being overestimated. Doctors are still going to get sued and will still want to carry malpractice insurance and will still practice defensive medicine because of it.

 

[cubeless]

Originally posted by: Ozoned

Originally posted by: sciwizam
Link

* Unnecessary care such as the overuse of antibiotics and lab tests to protect against malpractice exposure makes up 37 percent of healthcare waste or $200 to $300 billion a year.

* Fraud makes up 22 percent of healthcare waste, or up to $200 billion a year in fraudulent Medicare claims, kickbacks for referrals for unnecessary services and other scams.

* Administrative inefficiency and redundant paperwork account for 18 percent of healthcare waste.

* Medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11 percent of the total.

* Preventable conditions such as uncontrolled diabetes cost $30 billion to $50 billion a year.

* Paper-based system that discourages sharing of medical records accounts for 6 percent of annual overspending

And yet to be determined if Congress will do anything to deal with this issue of waste.

They already spent stimulus money to address the one I bolded. Tort reform will take care of a lot of the reduntant paperwork, and a lot of the others you listed.

hyuk hyuk hyuk... funny one... the current gov't healthcare plans aren't on track to be electronic for years...

from medicare.gov billing page:

To file a Medicare claim yourself, you will need to print out and complete the form called Patient?s Request for Medical Payment, Form CMS 1490S. The form is available for download on cms.hhs.gov in the CMS Forms section. Once there, you will need to do three things: (1) print out the 1490S form; (2) select and print out the applicable instructions; and (3) review all of the information on this page about how to file a claim form.

 

[Patranus]

So if the government cannot control a system which was 22% of claims being fraudulent, why should the public trust government to run its entire health care system?

 

[miketheidiot]

Originally posted by: Patranus
So if the government cannot control a system which was 22% of claims being fraudulent, why should the public trust government to run its entire health care system?

22% of all claims public and private are fraudulent

 

[Ozoned]

Originally posted by: cubeless

Originally posted by: Ozoned

Originally posted by: sciwizam
Link

* Unnecessary care such as the overuse of antibiotics and lab tests to protect against malpractice exposure makes up 37 percent of healthcare waste or $200 to $300 billion a year.

* Fraud makes up 22 percent of healthcare waste, or up to $200 billion a year in fraudulent Medicare claims, kickbacks for referrals for unnecessary services and other scams.

* Administrative inefficiency and redundant paperwork account for 18 percent of healthcare waste.

* Medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11 percent of the total.

* Preventable conditions such as uncontrolled diabetes cost $30 billion to $50 billion a year.

* Paper-based system that discourages sharing of medical records accounts for 6 percent of annual overspending

And yet to be determined if Congress will do anything to deal with this issue of waste.

They already spent stimulus money to address the one I bolded. Tort reform will take care of a lot of the reduntant paperwork, and a lot of the others you listed.

hyuk hyuk hyuk... funny one... the current gov't healthcare plans aren't on track to be electronic for years...

from medicare.gov billing page:

To file a Medicare claim yourself, you will need to print out and complete the form called Patient?s Request for Medical Payment, Form CMS 1490S. The form is available for download on cms.hhs.gov in the CMS Forms section. Once there, you will need to do three things: (1) print out the 1490S form; (2) select and print out the applicable instructions; and (3) review all of the information on this page about how to file a claim form.

Like I said, they already spent stimulus money to address the one I bolded.

 

[StageLeft]

Originally posted by: miketheidiot

Originally posted by: Patranus
So if the government cannot control a system which was 22% of claims being fraudulent, why should the public trust government to run its entire health care system?

22% of all claims public and private are fraudulent

Yeah it seems in a way this is due to too LITTLE regulation than too much. After all it's the endless litigation and malpractice that is responsible for a lot of this. Reducing those influencing factors is a strictly governmental/regulatory influence. So this kind of waste, at least, would increase with reduced government influence on health care.

 

[DealMonkey]

Originally posted by: sciwizam
Link

* Unnecessary care such as the overuse of antibiotics and lab tests to protect against malpractice exposure makes up 37 percent of healthcare waste or $200 to $300 billion a year.

* Fraud makes up 22 percent of healthcare waste, or up to $200 billion a year in fraudulent Medicare claims, kickbacks for referrals for unnecessary services and other scams.

* Administrative inefficiency and redundant paperwork account for 18 percent of healthcare waste.

* Medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11 percent of the total.

* Preventable conditions such as uncontrolled diabetes cost $30 billion to $50 billion a year.

* Paper-based system that discourages sharing of medical records accounts for 6 percent of annual overspending

And yet to be determined if Congress will do anything to deal with this issue of waste.

Can we actually mandate away fraud, mistakes and preventable conditions?

"No diabetes for you! It's against the law!"

 

[cubby1223]

* Unnecessary care such as the overuse of antibiotics and lab tests to protect against malpractice exposure makes up 37 percent of healthcare waste or $200 to $300 billion a year.

Without tort reform, which the trial lawyers own the Democratic Party through campaign donations, this will not change.

* Fraud makes up 22 percent of healthcare waste, or up to $200 billion a year in fraudulent Medicare claims, kickbacks for referrals for unnecessary services and other scams.

Government has a horrendous record on reducing waste / fraud, this will not change.

* Administrative inefficiency and redundant paperwork account for 18 percent of healthcare waste.

Government is nothing but paperwork, this will for sure increase.

* Medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11 percent of the total.

Will mistakes likely increase or decrease when this reform reduces pay and increases workload? That answer is obvious.

* Preventable conditions such as uncontrolled diabetes cost $30 billion to $50 billion a year.

Falls on the backs of personal responsibility, which this health care reform bill does little to address.

* Paper-based system that discourages sharing of medical records accounts for 6 percent of annual overspending

Again, government = paperwork. Hard to believe the government will actually change this.



What exactly are we doing with this reform? All it seems we're doing is shuffling around who pays the bill, and even that Washington still hasn't any grip on :roll:

 

[blackangst1]

Originally posted by: cubby1223

* Unnecessary care such as the overuse of antibiotics and lab tests to protect against malpractice exposure makes up 37 percent of healthcare waste or $200 to $300 billion a year.

Without tort reform, which the trial lawyers own the Democratic Party through campaign donations, this will not change.

* Fraud makes up 22 percent of healthcare waste, or up to $200 billion a year in fraudulent Medicare claims, kickbacks for referrals for unnecessary services and other scams.

Government has a horrendous record on reducing waste / fraud, this will not change.

* Administrative inefficiency and redundant paperwork account for 18 percent of healthcare waste.

Government is nothing but paperwork, this will for sure increase.

* Medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11 percent of the total.

Will mistakes likely increase or decrease when this reform reduces pay and increases workload? That answer is obvious.

* Preventable conditions such as uncontrolled diabetes cost $30 billion to $50 billion a year.

Falls on the backs of personal responsibility, which this health care reform bill does little to address.

* Paper-based system that discourages sharing of medical records accounts for 6 percent of annual overspending

Again, government = paperwork. Hard to believe the government will actually change this.



What exactly are we doing with this reform? All it seems we're doing is shuffling around who pays the bill, and even that Washington still hasn't any grip on :roll:

What you and I probably arent understanding (because many here and the government themselves keep telling us) is that if we throw another couple dozen people into this already fucked up quagmire of a system, it will actually lower costs.

 

[Kadarin]

This past Sunday, 60 Minutes did a story on fraudulent Medicare claims out of Miami, and it was pretty illuminating in that Medicare fraud has replaced drug trafficking as the highest grossing crime in the area. The government would do well to hire a lot of investigators and enforcement here; the reduction in waste would easily pay for the whole thing. Sometimes it's astonishing how inept the government can be on some things.

 

[Patranus]

Look. If government wants to prove that it can do something right, clean up the fraud and waste and once that is done, come back with the government option.

The fact that they claim that they are going to fund the majority of it with these cuts without being able to show that they will actually be able to make the cuts is disturbing. Even if you are pro government option, this should worry you.

I am opposed to the government option right now but would feel a s*little* bit better about it if the government could show that these saving actually exist and the government can take advantage of the savings.

 

[shadow9d9]

Originally posted by: Patranus
Look. If government wants to prove that it can do something right, clean up the fraud and waste and once that is done, come back with the government option.

The fact that they claim that they are going to fund the majority of it with these cuts without being able to show that they will actually be able to make the cuts is disturbing. Even if you are pro government option, this should worry you.

I am opposed to the government option right now but would feel a s*little* bit better about it if the government could show that these saving actually exist and the government can take advantage of the savings.

Government doesn't need to prove anything. With insurances constantly denying pre-existing conditions, denying coverage, and outright dropping unfavorable clients, while increasing profits 10 fold in 5 years, they need to be eliminated.

 

[Doc Savage Fan]

Originally posted by: her209

Originally posted by: Ozoned
They already spent stimulus money to address the one I bolded. Tort reform will take care of a lot of the reduntant paperwork, and a lot of the others you listed.

I think the impact of tort reform is being overestimated. Doctors are still going to get sued and will still want to carry malpractice insurance and will still practice defensive medicine because of it.

Estimates range from 2% to 10%.

 

[CPA]

Originally posted by: sciwizam
Link

* Unnecessary care such as the overuse of antibiotics and lab tests to protect against malpractice exposure makes up 37 percent of healthcare waste or $200 to $300 billion a year.

* Fraud makes up 22 percent of healthcare waste, or up to $200 billion a year in fraudulent Medicare claims, kickbacks for referrals for unnecessary services and other scams.

* Administrative inefficiency and redundant paperwork account for 18 percent of healthcare waste.

* Medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11 percent of the total.

* Preventable conditions such as uncontrolled diabetes cost $30 billion to $50 billion a year.

* Paper-based system that discourages sharing of medical records accounts for 6 percent of annual overspending

And yet to be determined if Congress will do anything to deal with this issue of waste.

Not only will then not do anything about it, but UHC will assuredly make each much, much worse.

 

[Hayabusa Rider]

Originally posted by: Patranus
So if the government cannot control a system which was 22% of claims being fraudulent, why should the public trust government to run its entire health care system?

What is the criteria this study uses(not P/N's guess) for fraud?

The late great whoring Spitzer went through pharmacies to combat fraud. It was really a witch hunt to get money from fines.


The biggest "fraud" we committed was an obscure reg not known to anyone but them. It seems that you must write the time a prescription is phoned in on a medicaid RX. That was close to a million bucks. Spitzer hired temps to do most of the audits and gave them a list of every possible violation no matter how obscure, lovingly prepared by bureaucrats. They spent hours going over years of files for the purpose of fines and to make Spitzer look good. The inspector were embarassed by some of the stuff they had to do.

That's fraud. Right.

 

[Genx87]

22% of our costs are from fraud?

/facepalm

 

[Hayabusa Rider]

Remember that fraud is loosely any claim that someone can find a technical reason not to pay as well as real fraud. I see this all the time.

Also you may remember Granny (a fictional person for illustration) went into the hospital and they kept her a little longer than they planned? I shouldn't be surprised if she were alive today because of some creative billing to keep her until it was safe to let her go.

22 percent intentionally billed with no medical reason? I don't buy it

 

[WhipperSnapper]

Originally posted by: sciwizamAnd yet to be determined if Congress will do anything to deal with this issue of waste.

If Congress really wanted to do that, they would seize control of all the hospitals and tell the doctors that they now work for the new Federal Health System. Then they would announce that the nation is adopting the British system where the federal government will be a single payer providing national health care, effectively putting the insurance companies, business benefits plan managers, medical billing specialists, health insurance agents, and just about everyone else who makes money from the health care system yet has noting to do with the actual provision of health care out of business, saving the nation a couple percentage points worth of GDP spent on health care while achieving full coverage, liberating businesses and would-be small businessmen, and achieving 100% coverage.

 

[shira]

Originally posted by: sciwizam
Link

* Unnecessary care such as the overuse of antibiotics and lab tests to protect against malpractice exposure makes up 37 percent of healthcare waste or $200 to $300 billion a year.

* Fraud makes up 22 percent of healthcare waste, or up to $200 billion a year in fraudulent Medicare claims, kickbacks for referrals for unnecessary services and other scams.

* Administrative inefficiency and redundant paperwork account for 18 percent of healthcare waste.

* Medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11 percent of the total.

* Preventable conditions such as uncontrolled diabetes cost $30 billion to $50 billion a year.

* Paper-based system that discourages sharing of medical records accounts for 6 percent of annual overspending

And yet to be determined if Congress will do anything to deal with this issue of waste.

It would be wonderful to eliminate all waste in health care. Realistically, it's not remotely possible.

Take for example "medical mistakes". First of all, what's a "mistake?" Suppose a doctor makes a reasonable diagnosis on the basis of a set of test results, and the diagnosis turns out to be incorrect; is that a "mistake"? Even more important, should an effort be made to reduce that form of "mistake?" That would entail costly tests to eliminate the possibility of (unlikely) esoteric conditions and/or the use of more specialists to render second opinions that in most cases will support the original diagnoses. It could easily cost much more to reduce mistakes than the cost of the mistakes themselves.

As to obvious blunders: People aren't perfect, and I don't think it's reasonable to expect that a system can be devised that prevents humans from being human.

So I'm skeptical that it's possible to achieve substantial savings by reducing "mistakes."

How about fraud (which the article claims accounts for 22% of the waste)? It's easy enough to say that a lot of fraud exists, but how do you reduce it? More checks and balances? More paperwork? More administrators? The article already says that "administrative inefficiency and redundant paperwork" constitutes 18% of the waste. Do you see the point?

How about overuse? The best way to reduce overuse is rationing. Yet the right's BIGGEST criticism of the centralized health care systems of other first-world countries is that they ration services. The right also says they want government to reduce waste in the health care system. They can't have it both ways.

 

[WhipperSnapper]

Originally posted by: her209

Originally posted by: Ozoned
They already spent stimulus money to address the one I bolded. Tort reform will take care of a lot of the reduntant paperwork, and a lot of the others you listed.

I think the impact of tort reform is being overestimated. Doctors are still going to get sued and will still want to carry malpractice insurance and will still practice defensive medicine because of it.

If we do have tort reform, where does the expense of caring for people who were injured from medical malpractice or mere mistakes go? Do those costs just magically vaporize? If doctors stop fearing malpractice and lawsuits, will they make more mistakes, increasing the amount of medical malpractice and the costs of malpractice and mistakes?

What you people don't realize is that the torts system also compensates injured people for their injuries and reduces the amount of malpractice. How exactly it should work under a socialized national health care system, I don't know, but injured people do need to be compensated for their injuries or at least cared for and we do need and want to have deterrents against negligence and recklessness.

 

[WhipperSnapper]

Originally posted by: Patranus
So if the government cannot control a system which was 22% of claims being fraudulent, why should the public trust government to run its entire health care system?

Because every other first world nation in the world seems to be able to do a good job of it for a much lower percentage of GDP while having 100% coverage, zero medical bankruptcies, a more content populace, and businesses that have been liberated from insurance concerns?

 

[WhipperSnapper]

Originally posted by: cubby1223

* Administrative inefficiency and redundant paperwork account for 18 percent of healthcare waste.

Government is nothing but paperwork, this will for sure increase.

How do the other first world industrialized nations make it work then while providing 100% coverage for a lower percentage of GDP? To hear you tell it, it's metaphysically impossible.