Medical Billing and the Discrepancy Paradox of the Rising Healthcare Costs

health care spending continues to grow at its fastest rate in our history. In 2005, total national health care costs rose 6.9 percent - twice the rate of inflation - reaching $ 2 trillion, or $ 6,700 per person [Catlin, Cowan, Heffler, et al, 2006]. Currently the total spending represents 16 percent of gross domestic product (GDP). In the next decade, U.S. health care spending is expected to increase at a similar level, reaching $ 4 trillion in 2015 [Borger et al, 2006 ].

Although some experts argue that our health care system is expensive because it is riddled with inefficiencies, excessive administrative expenses, inflated prices, poor management, waste, inadequate, and fraud [health insurance cost, 2008], at least the remaining three key factors, namely, aging population, expensive medical innovations, and defensive work, contribute significantly to the overall cost picture.

1. An aging population - In the U.S., the share of population aged> 65 years is projected to increase from 12.4% in 2000 to 19.6% in 2030.Broj persons aged> 65 years is expected to increase from about 35 million in 2000 to an estimated $ 71 million in 2030, a number of persons aged> 80 years is expected to increase from 9.3 million in 2000 to 19,500,000 in 2030 [Public health and aging: Trends in aging --- United States and worldwide, 2008, Kaiser Family Foundation, 2006]. "A growing number of elderly people is increasing demands on the public system and social services. Chronic diseases that affect older adults disproportionately, contribute to disability, reduced quality of life and increased costs." [UN, 2002] 125 million Americans have one or more chronic diseases (eg congestive heart failure, diabetes.) Chronic diseases account for 75% of all health care expenditures. Source: Burrill & Company, 2006
   
2. expensive innovations -
   
   • U.S. biotech industry surpassed the pharmaceutical companies for the third consecutive year as the primary source of new drugs, and biotech revenue jumped nearly 16 percent to a record $ 50.7 billion in 2005. Source: Ernst & Young LLP, 2006
     
   • the United States is the world's largest and wealthiest pharmaceutical market, accounting for about 48% of the world. Per capita expenditure on drugs is U.S. $ 1,069 in 2006, almost double the level found in the rest of the world. Source: Espicom Business Intelligence, 2006
     
   • ... about 30% of new products in development are "combo products" - including medical devices with built-in components or pharmaceutical Biologics. [Combination Products-Navigation Two FDA Quality Systems, Microtest White Paper, 2007]. The market combination products is estimated at $ 5.9B in 2004, and will continue to grow at a compound annual rate of 10% by 2009. By 2009, the market is expected to reach nearly $ 9.5B in the world with most of the revenue from the drug eluting stents and steroid-eluting electrodes. Source: Navigant Consulting, Inc. In 2004, the U.S. held about 65% of drug-device combination products on the market. By 2010, the U.S. is projected to retain 57%. Source: Business Communications Inc
3. "defensive" medicine - "One of the major cost in the delivery of health care, and junk and frivolous lawsuits risk of frivolous litigation drives doctors. - I heard on this - driving doctors to prescribe drugs and procedures that May not be necessary just to avoid lawsuits to be called the defensive practice of medicine ..... See, lawsuits not only drive up premiums, which runs. the cost to the patient or the patient's employer, but lawsuits cause the documents to practice medicine in an expensive way to protect yourself in the courtroom. defensive practice of medicine affects the federal budget. a direct cost of liability insurance ineizravne cost of unnecessary medical procedures raise costs for the federal government at least $ 28 billion annually. "[the U.S. President George Bush, Arkansas, 26 January 2004]

Now let us observe a paradox:

1. On the one hand, participants in each secondary industries, including insurance companies, hi-tech and pharmaceutical engineers and scientists, and lawyers, have increased their profits in step with the increase in cost at all speeds up the pace.
   
2. On the other hand, medical and chiropractic office owners - real service - not only failed to keep up with raising costs, but they lost a significant portion of their income. In fact, between 1995 and 1999, at a time when most wages in the U.S. rose 3.5 percent after adjusting for inflation, average physician net income from the practice of medicine, adjusted for inflation, fell 5 percent [Reed and Ginsburg, 2003 ]. In 2006, median compensation for the specialty and the primary physician grew only 1.7 ($ 322,259) and 2 ($ 171,519) per cent or more slowly than the CPI of 3.2 percent [MGMA physician compensation and production survey: 2007 Report] . For comparison, the costs of health care to beat inflation by 3.5%, achieving an annual growth rate of 6.7 [consumption, 2008]

divert our focus away from trying to find solutions to the problem of rising costs health care, ask another question: How, as a paradoxical situation is possible without deliberate and systematic strategy against the service?

References:

1. Catlin, C. Cowan, S. Heffler, et al, "National health spending in 2005." Health Affairs 26:1 (2006): 142-153.
   
2. Borger, C., et al. "Health spending projections to 2015: Changes on the horizon," Health Issues Web Exclusive W61: 22 February 2006.
   
3. Health Insurance Cost, National Coalition on Health Care from January 4, 2008
   
4. Public health and aging: Trends in Aging --- United States and around the world, from January 4, 2008
   
5. United Nations. Report of the Second World Assembly of aging. Madrid, Spain: United Nations, 8 April - 12, 2002.
   
6. Kinsella K, Velkoff V. U.S. office for a list stanovništva.Starenje World: 2001. Washington, DC: U.S. Government printing, 2001, Series P95/01-1.
   
7. U.S. Census Bureau. International databases. Table 094th The center of population, by age and sex. 2008
   
8. Henry J. Kaiser Family Foundation. Employee health benefits: 2006 annual survey. 26th September 2006.
   
9. President Bush calls for medical liability reform, Baptist Health Medical Center, Little Rock, Arkansas, January 26, 2004
   
10. Marie C. Reed, Paul B. Ginsburg, Behind the Times: physician income, 1995-1999, Data Bulletin No. 24, March 2003
    
11. Medical Group Management Association (MGMA) physician compensation and production survey: 2007 Report
    
12. Medicare spending - United States Government accountability Office (GAO), testimony before the Subcommittee on Health, Committee on Energy and Commerce, House of Representatives, 6 March 2007, 101 health-care costs
    
13. health care spending as off 15th January 2008

Posted in: billing, medical billing discrepancy paradox rising healthcare costs