It's no mystery. It's because third party pays, either insurance of teh gvt. So no one cares what it costs. Look at the difference between what a vet charges (and makes) and a doctor. The level of skill is similar, being a vet is probably harder although at least your patients can't complain and are very unlikely to sue you. But with veterinary care the owner pays directly, very few have pet insurance, so the owners CARE what it's going to cost to treat their animal. If the day comes when enough pet owners buy pet-vet insurance then the third party pays scheme will cause vet care to go thru the ceiling and poor folks who can't afford pet-vet insurance will not be able to afford to have their pets treated. I already have seen huge increases in what vet care costs over the past decade and more and more see them pushing for pet-vet insurance.
Assuming NJ is like NY, the taxes in NY on a $150,000 house are about ten times as high as they are in AZ. Salaries in NY are nowhere near
10 times as high, outside of NYC I doubt they are even 50% higher then AZ. The taxes in NY, and I'm assuming NJ but could be wrong, are just absence. I considered buying a second home sort of setup in NY but the taxes alone would cost more then my house payment in AZ. Just absurdly high.
If you worked in healthcare you might get it....here are a couple of examples:
Patient #1, elderly lady, bad heart, doc prescribes drug to lower cholesterol. Already takes heart and BP meds. Falls now and then, due to bad heart. Starts having GI upsets and real bad shoulder pain. Since she has a really bad heart, she has periodic spells of heart failure, requiring diuretics. She is already on more meds than most geriatrics can handle, so we put her in the hospital, stop all meds and start over. Voila! Someone read the label on her cholesterol drug and found out the GI upset and muscle pain was due to cholesterol drug. WTF is a cholesterol drug going to do for an 88 year-old. It has long been known that geriatrics are over-medicated and that they can't tolerate/don't need same dosages as younger patients.
Patient #2, another elderly lady. Been on hormones and diuretic ever since having hysterectomy in her 40's. Surgery x2 for bladder problems related to hyst. didn't help the bladder problems. Put her on a drug for stress incontinence. Put her in the hospital for diagnosis of chest pain. Oh! Again, someone read the label on her incontinence med: "do not prescribe for elderly patients".
If you haven't read about drug errors, hospital acquired infections, wrong-site surgery, you've missed a lot. Simple hand washing would help reduce deaths in hospitals but a lot of docs and nurses don't care.
I didn't imply that it was simple....my family avoids discussing death, to a fault. My kids don't want to think about mine. I asked for input years ago, trying to figure what their thoughts would be when faced with certain situations.
At my age, the 5 year survival might not be that attractive, depending on quality of life during the ensuing 5 years :o) Transplant? No damn way.
I'm in hospice care right now and nothing will be done to cure me but they are keeping me alive, I'm handling the cure myself. It hurts like hell when I exert myself but I refuse to sit on my butt and die. I go out and work when I can and the pain is less every time, plus I can take stairs a lot easier each time. It's been a while since I could take the
24' extension ladder off the ladder rack on my van and that's my next goal. ^_^
There is still a lot of fight in a lot of sick elderly :o) My mom was fully prepared to die after her diagnosis, but royally pissed that she had to be in bed to do it :o) She was a fighter, not in the brutal or abusive way, which is probably why she took on chemo and radiation without question.
A family friend, in nursing home at age 88, had a go-round with his son because pop's driver license was ready to expire and he wasn't going to let it expire without a fight. I almost forgot the trip my mom took around the block (without me) to prove to herself during cancer treatment that she could still drive, although walking was becoming very iffy due to weakness.
I've seen (and held hands with) quite a few elderly who were down and out when they came into nursing home but rallied with some patience and support.
I was relating the issue to my own stress symptoms....NEVER get headaches, but get ocular migraines (painless visual symptoms) now and then. Doc says stress, but they really don't occur at the worst times :o)
In my days in the OR, I kept mental track of the victims of AA and arrived at about 50% being due to drunks; the drunks were much less often the patient needing surgery.
One of the least stressful jobs I had was working in drug/alcohol rehab; it was pretty awesome. I was thanked, a few years later, for saving one guy's life because of a talk we had one night. Well, he was doing the work :o) We had a local judge who would rather send folks to treatment than to jail, so it was good for a number of people. Not everyone. Drunks and mean SOBs usually need help because life tends not to treat them well from early on.
Look on the bright side...did it keep you from ever driving under the influence? What are you doing about muscle spasms? Got a firm mattress? Normal weight? Exercise?
I have found that gardening is my best stress relief...plant something, care for it, watch it grow/change, look forward to what it will be. Or join the YMCA, swim some laps or do stationary bike; great low-impact exercise for backs.
"Robert Green" wrote in message news:kumrfk$6pu$ snipped-for-privacy@dont-email.me
I don't think it *IS* fixable. Not without some sort of huge, traumatic social/political upheavel at least. Its like everything else: once you've got it, it becomes a necessity and a "right".
For most of my life health insurance was something that individuals purchased. I don't recall there being all that many companies selling it either (my memory may be faulty on that)...there was Blue Cross...the Kaiser Plan...what else?
Personally, I chose to buy a major medical plan with a hefty deductible (about $5000 in 2013 money) and pay the regular stuff myself. Worked out fine; the major medical wasn't particularly expensive and was there if I needed it (only once).
Things changed when I became a corporation; the state insisted I insure all employees - I was an employee too - for everything including the mundane. Like splinter removal. My costs tripled and I don't recall any sort of government subsidy other than it being a business expense.
It seems to me that what we need is more people willing to tell the government to take a hike, I'll take care of myself, thank you. The problem is that there are now so many people that don't think that way and *WON'T* take care of themselves. How to keep them from being a drain on the rest? Tell them to FOAD? Require purchase of a major medical? Auto insurance is required, why not that? And even though auto insurance is required, many people don't have it. There has always been - and always will be - a certain percentage of people that are socially irresponsible; in the past, they were more or less left to fend for themselves or to charity. Maybe FOAD isn't such a bad thing :)
Or maybe if docs didn't have an inflated sense of what they are worth the insurance companies would be paying them less and the uninsured would be able to pay the more realistic fees.
"Robert Green" wrote in message news:kumnu9$ol2$ snipped-for-privacy@dont-email.me
They are indeed but they need to be addressed. Another one is euthanasia.
My niece's 3 year new hubby was just diagnosed with ALS (Lou Gehrig disease). He is 56 and is now a walking dead man, average 39 month survival.
For those unfamiliar with the disease, it prevents renewal of muscle tissue resulting in gradually declining ability to control voluntary muscular action. Breathing is one such action. The victim loses the ability to walk...to move arms and hands...to eat...to talk...to breathe. Eating and breathing can be accomplished artificially but the patient ultimately succumbs to something, often pneumonia. And even though artificial means can help eating and breathing, the patient can do nothing...can't move, can't talk. All they can do is lie there motionless and think...hour after hour, day after day, week after week...
I had another friend a number of years ago. When she got to the lie there and think stage she somehow managed to convey her desire for death to her husband. He obliged, smothering her with a pillow. Myself and others wrote to the sentencing judge urging leniency; he was sentenced to five years probation with the proviso that he spend one night a year - the night of his dead wife's birthday - in jail. Seemed fair to me.
If I ever had this disease I would off myself before I got to the "lie there and think" stage. I would far rather be able to avail myself of legal euthanasia; easier on me, easier on the survivors.
I had a protestant friend of mine who couldn't get married by their preferred pastor until they had gone to a pre-marriage retreat. Their PP had been married 3 times and was currently between wives. They decided this was a seminar on what NOT to do.
This is another part of the system that drives up costs and adds to demand (which drives up costs because of the barriers to supply such as med school and residency). I submit that we haven't had health
**insurance** (defined as taking a major, but relatively rare risk and spreading it among many people) since the demise of the old major medical coverage.
I think HSAs do the trick. They give you a tax free way to take care of the minor stuff, save up for the big stuff, and then pay for it.
My wife was on a bunch of meds too. Every once in a while, we sit down with the doctor and review. After a couple of tries, she refuses any cholesterol drugs too.
She recently had a major surgery and they changed meds again and changed dosage on her heart med. Seemed ok for a couple of week, then her heart rate increased considerably. She called the cardiologists office and the nurse said to come in for the first available appointment in about 10 days. That day, she went back to her old dozed and thing went back to normal. When we saw the doc, I told him she would have had an extra 800,000 heart beats tot he appointment day. Pissed him off and they changed how they talk to patients now.
You have to take control of your care. You (or a close family member) have to be your own advocate You have to review your medications.
You don't even need to go that far. Look at the difference in price (and in inflation) between what a plastic surgeon gets when the person pays for it and when it is covered by insurance. Fascinating look.
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