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Outrageous Hospital Expenses

Getting relatively simple procedures is much more expensive in the US than elsewhere.

Take the cost of an appendectomy:

Or having a baby:

Or having a baby by C-section, a more invasive procedure that is not only more expensive in the US than elsewhere, but is often more common:

These prices beg for government regulation!

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Imagine the Cost of Imaging

Keeping with my recent theme on US healthcare prices, from the people at Vox media, here’s an illustration of how expensive it is to get an MRI in the United States versus other countries:

And the cost of a day in the hospital:



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If “Low-T” Killed Your Sex Drive, Your Television Might Be to Blame


There are some sad truths about being an aging male. Your muscle mass usually declines. You start feeling tired more easily. And there’s a good chance either you start losing interest in sex, or start experiencing a decline in sexual performance.

Here’s another truth—your testosterone level probably ain’t what it used to be. Which raises a question—would testosterone supplementation restore some of your youthful vitality?

That is certainly what manufactures of testosterone treatments wanted people to think when they began purchasing TV time to play ads encouraging men to get their testosterone level checked. But since the early onslaught of these “Low T” ads, medical science has taught us that testosterone replacement is often unnecessary. Moreover, unnecessary replacement can potentially lead to heart disease. That makes it likely that those television ads, rather than restoring people’s vitality, shortened their lives.

(To read the rest of this article, please visit Forbes.)

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More on US Healthcare Prices

In a recent post,  I showed two drugs that were much more expensive in the United States than elsewhere. One was  for rheumatoid arthritis and the other for hepatitis C. Today we get to look at a cancer drug, Avastin, and just how much more Americans pay for it than people in other countries.

This is not acceptable.

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The USA Is Number One… In Healthcare Prices!

The folks at Vox media put together a series of pictures, illustrating how much more expensive medical care is in United States compared to other developed countries. Today, and in the next few days, I’m going to circulate some of those pictures. Prepare yourself for horror!

Take medications, for example. (Please!) Pills for rheumatoid arthritis are often way more expensive in the US than elsewhere:

And hepatitis C:

The fastest way to increase the value of US healthcare is to reduce the price!

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What Confusion about Health Insurance Looks Like in the Doctor’s Office


Mark Letterman’s rheumatoid arthritis had been progressing unrelentingly despite popping dozens of pills each week – eight methotrexate pills on Mondays alone. Letterman felt like he was 63 going on 93.

If rheumatoid arthritis progresses unchecked, it is as debilitating of a disease as can be imagined. Don’t think garden variety arthritis that only interferes with activities like, um, gardening. Think: finger and wrist joints so inflamed it feels like your hands have suffered a heat stroke from the inside out. Imagine: the joints of your toes so damaged you have to purchase shoes at a medical supply store, even though you will still be lucky to walk on a good day. Rheumatoid arthritis is a severe, inflammatory disorder that simultaneously deforms and disables.

Letterman – a pseudonym – and his doctor gave permission for Verilogue Inc., a marketing company, to audio-record their interaction. The clinic appointment was one of many that my colleagues and I analyzed to see what happens when doctors and patients discuss healthcare costs. That appointment revealed a disturbingly common problem – sometimes doctors and patients get so confused about insurance coverage, they can’t figure out how best to treat patients’ illnesses.

(To read the rest of this article, please visit Forbes.)

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Smaller plates, less food

If you use a smaller plate when you eat, you’ll eat less food. Here’s a rather wonky summary of research on plate size, a “meta-analysis” showing that smaller plates mean you put less food on the plate and, thus, eat less food.

Less pie on your plate; less pie in your pie hole!

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Graphic Cigarette Labels Work!

Warning – the warning labels pictured below are graphic but, according to a recent study, they increase the chances that people will quit smoking.

Now we need to find a way to get legal permission to use such pictures, so we can shock people out of their habits.

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Physician (and Pharma, and Insurance Executive) Pay: Doing Too Well by Doing Good


American physicians deserve to be paid well for their work. As a physician, myself, I know what it takes to become a doctor in the U.S. Four years of late nights in the college library in hopes of achieving a GPA commensurate with medical school admission; then four years of medical school, which makes the college work load feel light in retrospect; then, in my case, three years of residency training, where an 80-hour work week begins, making everything before feel like a vacation. And in the case of more specialized physicians than me, like orthopedic surgeons or cardiologists, clinical training continues another handful of years. Moreover, becoming a physician in the U.S. carries enormous financial costs, with many Americans graduating from medical school with six-figure debt.

So I support paying American physicians well for their labors. But how well? Is more than $535,668 the right amount for the average – the average! – orthopedic surgeon to make? Should dermatologists – whose training is far less intense and prolonged than many other physicians – make a average of $400,898?

The U.S. has a healthcare spending problem, and soaring healthcare incomes are partly responsible. Importantly, those incomes are by no means limited to physicians. In 2014, the CEO of Aetna, an American health insurance company, brought home more than $15 million. In 2012, the CEO of the nonprofit Atlantic Health System in Morristown, New Jersey made more than $10 million.

With so much money spent on medical care in the U.S., there are many people involved in the healthcare marketplace who are doing very well by doing good. Consider pharmaceutical companies, historically one of the most consistently profitable industries in the private sector. These companies make a disproportionate share of their profits in the U.S., where they charge significantly higher prices for their products than they do in most other markets. Device companies also garner significant profits in U.S. markets.

I don’t begrudge anyone who makes a lot of money doing honest, legally sanctioned work. But all this money, all the healthcare spending that leads to these high incomes, comes either from the pockets of individual patients, or from the people enrolling in private health insurance plans, or from the employers subsidizing those plans or from taxpayers who fund programs like Medicare and Medicaid. And all this money – all these personal expenses and taxes – are posing a very heavy burden on the American public.

(To read the rest of this article, please visit Forbes.)

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The Benefits of High Health Care Expenditures

I write frequently about the high costs of healthcare, in the U.S. and in many other parts of the world. And in general, I believe strongly that most developed countries need to look seriously at how they’re spending healthcare dollars, and make great efforts to promote high value medical care. But in trying to control healthcare costs, we must not forget about the benefits of healthcare spending. Consider this picture, from a study by Warren Stevens and colleagues, showing that countries that spent the most on cancer care have also experienced the greatest decline in cancer mortality:

Our efforts to curb healthcare spending need to account for the value of the care we spend our money on.

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