In this segment, we discuss the high cost of healthcare, both from a systems-perspective, as well as specific cases of patients, personal contacts, and our own medical bills. It's kind of crazy that we spend nearly twice as much per person on healthcare as THE NEXT HIGHEST HEALTHCARE SPENDING COUNTRY IN THE WORLD. You would expect that means we have significantly BETTER healthcare, but the #1 health indicator, our life expectancy, drags nearly 4 years behind other developed countries. While there is something to be said for the amount of innovative treatments and therapies created within our system, is it worth it if 99/100 fail? Is it worth it if 9/10 fail and subject those 9 persons to poor outcomes? There simply has to be a better way, where we can maintain our stronghold as healthcare innovators, without making our country so much sicker (at a significantly higher cost) than others. ENJOY!
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[00:00:00] We are talking about the absurd cost of United States health care in this segment.
[00:00:06] First, we talk about cost per capita compared to other first world countries,
[00:00:12] as well as the historical cost of health care, including as a percent share of our GDP.
[00:00:19] We discuss how much we spend on administrative costs and payer costs. These are costs of doing care for what we get back on health care. Our life expectancy remains somewhere in the 50s in terms of world ranking, yet our health care expenditure is by far more costly than any other country in the world. So what are we paying for? If we're not getting better health care by paying more money, then what are we
[00:01:42] paying for? Why aren't we fighting the system more? Why aren't we electing States we spend almost twice as much as the next highest spender in Germany per person. I would guess in 2024 now it's probably well over $13,000 considering the inflationary period we experienced in the last couple of years. Germany's is around towards healthcare, which is absolutely ludicrous. To add to that, we spend more on hospital administrative and payer administrative costs than anybody else in the world. That is one thing that since the year 2000 has been steadily increasing,
[00:04:24] especially since we've made the transition from paper charts to
[00:05:24] get medicines approved, get procedures approved. And in a busy day in clinic,
[00:05:27] a physician doesn't have the time
[00:05:28] to do all of these prior authorizations himself
[00:05:31] and see his patients.
[00:05:32] So it's just requiring more staff to handle more tasks
[00:05:38] that are all doing the same thing.
[00:05:39] And you didn't even mention doctors
[00:05:41] having to spend time battling denials
[00:05:44] or the patient realizing after the fact of its healthcare dollars is in the hospital. About 35%, and this was based on a study in 2018, that is far greater than any other countries. Another issue is we're spending a surprisingly low amount of money on primary care funding. It's because we don't have any primary care doctors. So most countries been between 10 to 15% of their healthcare budgets on primary care.
[00:08:06] money. It wouldn't save the people who are running the hospital and running the machines that run the hospital and doing the lab work. It wouldn't save them. You
[00:08:11] talk to physicians who've been at it for decades and decades, hospitals used to
[00:08:16] never be very full. We did have an emphasis on preventive care. You went to
[00:08:20] the hospital when things were absolutely severe and they're not doing well, things are going south. It's a very emotional time for them and their family.
[00:09:41] A lot of anxiety around death in the US,
[00:09:43] because we don't really talk about death.
[00:09:45] It's not really something that's embedded in our culture. and what things are important to them. Do they want to be spending these last moments in the hospital having all these things done to them instead of done for them? Obviously, this specialty was designed to increase the quality of patient care at the end of their life, but it's been shown over and over again that getting these services involved
[00:11:00] actually saves money too.
[00:11:03] People reach a state of acceptance
[00:11:05] and most people don't want everything that we need there. We brought a hospital bed home with us. Every member of our family was able to be there, pray together, sing together. My mom was able to die a more peaceful death surrounded by her family in her home, in her bedroom. Death is not fun for
[00:12:20] anybody, but I think it's something that two years, the bills that come with that are insane. One of my kids was born back in Septemberform cleft lip, a very small defect on his upper lip, he didn't have any problems from it. It can be associated with things like a cleft palate in your child and your wife staying for the birth of your child. And you probably also got a facility fee, not just a fee for all the services that you had, but we used our facility. You're now getting a facility fee.
[00:16:20] I'm surprised they didn't charge me for sleeping in the hospital room. A study published by patientrightsadvocate.org reviewed 2000 hospitals in February in 2023 and found that only a quarter of them had followed through with the price transparency rule requirements and just under half, not sufficiently identifying payer and plan names for each payer specific negotiated rates for their insurance.
[00:17:41] I loved when you said that Walgreens doesn't bill
[00:17:45] a consumer separately for its rent and electricity. From my understanding, it's going to depend on their insurance, how much of their plan is going to cover each of those, and how much more money the patient's going to get charged if we're billing for a complex visit. I think there has been some purposeful separation of that data from physicians.
[00:19:01] I'm pretty confident most doctors that you were discharged. I can tell you right now that the fluids and the antibiotics you're getting cost less than $200. But you may be charged whatever that hospital wants to charge you. There's no law, there's no set standard
[00:20:21] that they're allowed to charge.
[00:20:23] They will literally charge the insurance company
[00:20:25] or send a bill for anything If you go to the ICU, it's estimated to be somewhere around $10,000. You might as well go to the Ritz Carlton and rent out the executive suite. You're going to be treated a lot better. I'll tell you that. So once you hit one of these hospitals, there isn't really a set amount you're going to be charged. There's really no rhyme or reason. And the nursing staff and doctors don't have any control over what you're being
[00:21:44] charged.
[00:22:45] The insurance company just sends whatever amounts because they know if that bill is higher, they will end up being able to charge more for their premiums the following year.
[00:22:50] So in general, they end up increasing the amount of money they're getting from patients,
[00:22:55] depending on how big that patient's bills are.