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What is the greatest wasteful contributor to increased health care costs?
#Response DateOther (please specify)
1.1/30/2008 12:59:00 PMPharmaceutical reps
2.1/30/2008 1:17:00 PMInsurance companies who place profits ahead of patient well being
3.1/30/2008 1:24:00 PMMedication advertising both to consumers and physicians.
4.1/30/2008 1:39:00 PMhealth insurance companies overhead
5.1/30/2008 1:40:00 PMmarketing reps traveling first class, massive ads in huge wrappers, boxes and nonrecyclable containers that go unused.
6.1/30/2008 1:48:00 PM1) lack of malpractice reform resulting in defensive medical practices 2) overuse of emergency services for primary care and non-emergency care
7.1/30/2008 1:52:00 PMpressure and advertising to physicians
8.1/30/2008 1:55:00 PMordering of unneccessary test secondary to the fear of litigation
9.1/30/2008 1:59:00 PMlawyers and need to practice extreme defensive medicine
10.1/30/2008 2:09:00 PMDirect to patient advertising
11.1/30/2008 2:10:00 PMMarketing
12.1/30/2008 2:12:00 PMlitigation costs driving up unecessary test ordering by physicians
13.1/30/2008 2:15:00 PMdirect to patient advertising
14.1/30/2008 2:21:00 PMI think DTC is a terrible idea, since patients are encouraged to take medication they don't need. When physicians don't want to prescribe it, there becomes an issue of trust between the patient and the physician.
15.1/30/2008 2:26:00 PMHIPAA , bureaucratic paper work, layer and layers of only recorded messages and no people.A shortage of physicians that will increase
16.1/30/2008 2:28:00 PMDirect to consumer advertising.
17.1/30/2008 2:28:00 PMDirect to consumer advertising.
18.1/30/2008 2:31:00 PMInsurance companies
19.1/30/2008 2:43:00 PMfree access to medical care for illegal aliens
20.1/30/2008 2:44:00 PMLawsuit abuse.
21.1/30/2008 2:47:00 PMcreating artifical demand for the latest, greatest - patients not taking responsibility for their own behavior and health
22.1/30/2008 2:54:00 PMKickbacks from IV pharmaceuticals to physician practices.
23.1/30/2008 2:54:00 PMdefensive medicine--unnecessay testing and procedures
24.1/30/2008 2:59:00 PMTV ads.
25.1/30/2008 3:11:00 PMNot using the most effective, least costly medication
26.1/30/2008 3:13:00 PMdefensive medicine and lack of end of life withholding of futile treatment
27.1/30/2008 3:18:00 PMexcessive test generation
28.1/30/2008 3:19:00 PMDirect to patient advertising. Especially on TV.
29.1/30/2008 3:28:00 PMFree drug-promotion dinners
30.1/30/2008 3:35:00 PMPatient demand to make everything perfect, with lack of understanding of expected outcomes.
31.1/30/2008 3:47:00 PM1) antitrust legilation which prohibits MDs from bargaining with insurance companies 2) current malpractice laws 3) DTC advertising which gets patients to ask for medications which are inappropriate or even dangerous for them
32.1/30/2008 3:54:00 PMAdministrative paper work and bureaurocracy
33.1/30/2008 3:56:00 PMGrowing bureaucracy, complexity and cost of clinical trials
34.1/30/2008 3:56:00 PMdoctors themselves
35.1/30/2008 4:03:00 PMDTC advertizing.
36.1/30/2008 4:03:00 PMnew scientific discoveries, but it is a good thing!
37.1/30/2008 4:11:00 PMinsurance companies and liability crisis
38.1/30/2008 4:17:00 PMmedical malpractice lawyers
39.1/30/2008 4:20:00 PMUnavailability of a universal health care system.
40.1/30/2008 4:26:00 PMpatients getting a prescription, receiving the medication, but not taking it
41.1/30/2008 4:32:00 PM&quot;Throw-away&quot; marketing pamphlets from industry.
42.1/30/2008 4:44:00 PMthere are two with abundant evidence to support this claim: 1--end of life ICU and intensive care which is futile rather than hospice 2--excessive, expensive, unnecessary testing and consults for the anxious and litigious patients
43.1/30/2008 4:45:00 PMExcessive marketing by pharmaceutical and medical device manufacturers
44.1/30/2008 4:46:00 PMCurrent system of private health insurance totally determined by the market.
45.1/30/2008 4:56:00 PMDrug reps and lobbyists and lack of conviction by legislators
46.1/30/2008 4:56:00 PMMedical malpractice
47.1/30/2008 5:27:00 PMunder use of generics
48.1/30/2008 5:37:00 PMInsurance companies
49.1/30/2008 5:37:00 PMmalpractice costs
50.1/30/2008 5:41:00 PMGreed of corporations, e.g.: to sell a US$ 200 stent for 1,200 and a 600 for 2,500. To sell a 20 cents tablet for 1 dollar.
51.1/30/2008 5:43:00 PMdoctors ordering too many laboratory tests
52.1/30/2008 5:43:00 PMMoney spent on health care administration and CEOs of health insurance companies as well as the need to post profits to shareholders ultimately by denying treatment to patients.
53.1/30/2008 5:57:00 PMHealth care is run as a command economy, with fixed reimbursements, and not as a market, which is how the rest of America runs. Paying extra for now-shown-to-be-useless cardiac stenting (re: Courage study) is an example of how such reimbursements incentivize practice; similarly, nursing home care for late-stage dementia is always funded by other people's money, so that it goes on forever. What is needed is a &quot;buffered market&quot; so that rich and poor contribute copayments for services that are income-related, making those services similarly affordable at every income level, yet having enough of the characteristics of a competitive market to let the worthy services emerge as market winners.
54.1/30/2008 6:00:00 PMlawyers
55.1/30/2008 6:02:00 PMWorld-wide, probably the sale of patented drugs
56.1/30/2008 6:04:00 PMThe f.....ing malpractice insurance. And someone is thinking of pharmaceutical companies. The malpractice insurance is the biggest bane. All other things are miniscule
57.1/30/2008 6:20:00 PMadministrators
58.1/30/2008 6:31:00 PMOvermarketing and lack of use of generic medications.
59.1/30/2008 6:41:00 PMPracticing malpractice proof medicine.
60.1/30/2008 6:44:00 PMTechnology
61.1/30/2008 6:45:00 PMdefensive medicine caused by the threat of torts
62.1/30/2008 7:00:00 PMLaw suits and verdicts of billions?
63.1/30/2008 7:02:00 PMTreating the doctors for tours/conventions with pleasure
64.1/30/2008 7:03:00 PMThe lack of central EMR
65.1/30/2008 7:09:00 PMinsurance company overhead
66.1/30/2008 7:12:00 PMMe too drugs which are extensively and expensively touted and are really no better than the original medication eg omeprazole and nexium
67.1/30/2008 7:16:00 PMMedical insurance bureaucracy
68.1/30/2008 7:24:00 PMLack of primary care supervision of patients. Patients demanding ad lib consultation with varieties of specialists and tests that could be handled by primary care.
69.1/30/2008 7:38:00 PMPharmaceutical company's direct to consumer advertising.
70.1/30/2008 7:40:00 PMThe arcane and variable forms to be filled out and the criteria against which they are adjudicated to get paid for providing care. It is often the case that billing specialists are hired at a practice's expense, for no reason other than this.
71.1/30/2008 7:45:00 PMfee for service
72.1/30/2008 7:46:00 PMLack of good preventive health care managemente
73.1/30/2008 7:50:00 PMIncreasingly high tech evaluation and high cost treatment of simple problems, and patients expecting them or doctors feeling they have to use them or be sued if bad outcome occurs. Patients can go to sleep with benadryl OTC or spend 5-10$ per pill for something new. MRI for simple headaches; 3D sonos and C section for normal baby, etc.
74.1/30/2008 8:11:00 PMcost of medications; HMO CEO salaries
75.1/30/2008 8:17:00 PMoveruse of health care
76.1/30/2008 8:24:00 PMexcess drug costs
77.1/30/2008 8:41:00 PMDefensive medical practices
78.1/30/2008 8:41:00 PMThe use of brand-name medications, such as Norvasc, when inexpensive options such as HCTZ are available and recommended as firstline by national panels such as the JNC-7. Nobody sells HCTZ so doctors use the brand-name. The same thing can be said about aspirin.
79.1/30/2008 8:52:00 PMdirect-to-consumer advertising
80.1/30/2008 9:00:00 PMThe extremely inefficient medical records system. We all use different systems. One nationwide system would be a great first step.
81.1/30/2008 9:38:00 PMExcessive paper work. Many companies require that prescriptions I write (printed from electronic record, so readable) be done on their own forms. Medicare's requirement to justify fingerstick testing with inordinate paper work. (Nobody does this for fun).
82.1/30/2008 10:37:00 PMThe for-profit insurance industry, which is not only unregulated, but outside the confines of the Sherman Anti-trust Act.
83.1/30/2008 10:53:00 PMbuorocracy
84.1/30/2008 11:07:00 PMLAWSUIT
85.1/30/2008 11:11:00 PMBad life style choices of the American public and Increased administrative costs due to health insurance restrition in processing claims and pharmacuetical prior authorizations
86.1/30/2008 11:22:00 PMPrivate health insurance.
87.1/31/2008 12:39:00 AMDrug marketing
88.1/31/2008 12:41:00 AMunnecessary advertisement by TV, throw away med. Journals,representatives visits.
89.1/31/2008 12:43:00 AMFrivolous malpractice claims
90.1/31/2008 1:22:00 AMThere are too many choices!
91.1/31/2008 1:23:00 AMdirect consumer advterising to consumers
92.1/31/2008 2:10:00 AMinsurance company profits
93.1/31/2008 2:27:00 AMadministration of health plans.
94.1/31/2008 2:49:00 AMdefensive medicine, being practiced MORE and MORE
95.1/31/2008 3:02:00 AMNew drugs touted to be best when there are equally good old drugs that are cheap.
96.1/31/2008 3:23:00 AMFear of malpractice lawsuit. Third-party payors who add little value to medical care.
97.1/31/2008 3:45:00 AMlawyers
98.1/31/2008 4:21:00 AMBig Pharma GREED!!!!!
99.1/31/2008 6:56:00 AMPatient's own mistakes
100.1/31/2008 10:01:00 AMdrug companies making unreasonable profits
101.1/31/2008 10:12:00 AMAdvertises
102.1/31/2008 10:45:00 AMLack of single payer system
103.1/31/2008 12:37:00 PMlitigation
104.1/31/2008 1:39:00 PMMalpractice lawsuits
105.1/31/2008 2:34:00 PMDirect advertising to patients, over-the-top marketing to physicians (e.g. extravagant displays at national meetings)
106.1/31/2008 3:15:00 PMInsurance company administration
107.1/31/2008 3:57:00 PMsamples (fancy labels and packaging)
108.1/31/2008 4:02:00 PMHaving non physicians making medical decsions
109.1/31/2008 4:05:00 PMWide spread and very expensive advertising on TV, radio, and newspapers.
110.1/31/2008 4:08:00 PMuse of ineffective therapies
111.1/31/2008 5:16:00 PMI would estimate that pharmaceuticals, new technolgy/devices and insurance companies are at least on the list
112.1/31/2008 5:55:00 PMlitigation related costs
113.1/31/2008 6:10:00 PMPhysicians not up to date, 'fake' patients
114.1/31/2008 6:40:00 PMdefensive medicine over ordering
115.1/31/2008 7:01:00 PMDefensive medicine - it is unacceptable to use simple judgement any longer because there is always slight chance for error -so we way overtest and overtreat.
116.1/31/2008 7:11:00 PMthe insurance industry
117.1/31/2008 8:03:00 PMLawsuits
118.1/31/2008 9:00:00 PMUnqualified physician initiating non directed therapies
119.1/31/2008 9:20:00 PMUse of the ER for &quot;routine care&quot;
120.1/31/2008 9:27:00 PMinsurance companies and government intervention along with a lack of appropriate, unbiased oversight by medical organizatons like the AMA
121.1/31/2008 9:29:00 PMsalaries, liability, unnecessary procedures and meds, way too expensive and overkill equipment and meds
122.1/31/2008 9:29:00 PMDrug advertising to consumer
123.1/31/2008 9:39:00 PMdrug companies are definitely a part
124.1/31/2008 10:43:00 PMdirect to consumer advertising
125.1/31/2008 11:49:00 PMExpenditures on the end of life
126.2/1/2008 12:24:00 AMHospitals with exorbitant charges and pharmaceuticals
127.2/1/2008 12:31:00 AMgovernment programs
128.2/1/2008 12:31:00 AMgovernment programs
129.2/1/2008 12:32:00 AMgovernment programs
130.2/1/2008 2:18:00 AMexcessive laboratory and clinical testing to look for rare disorders causing common signs and symtpoms
131.2/1/2008 2:23:00 AMinsurance companies
132.2/1/2008 2:37:00 AMunrealistic patient expectations non-compliance
133.2/1/2008 2:43:00 AMliability concerns lead to a lot of testing and consultations
134.2/1/2008 2:51:00 AMPatient who choose not to purchase health insurance
135.2/1/2008 3:23:00 AMCare of terminally ill very old patients
136.2/1/2008 4:18:00 AMMalpractice
137.2/1/2008 6:58:00 AMlack of electronic medical records
138.2/1/2008 1:06:00 PMthe us government!
139.2/1/2008 2:35:00 PMDirect marketing to the consumer
140.2/1/2008 4:28:00 PMcost of medications
141.2/1/2008 8:16:00 PMInappropriate end-of -life tests and management.
142.2/2/2008 2:23:00 AMFor my practice, beaurocracy and paper work generated in processing and appealing claims - but this is probably not a majpor driver of health care costs.
143.2/2/2008 6:12:00 AMExcessive end of life care in hopeless situations
144.2/2/2008 3:59:00 PMInappropriate medical malpractice cases
145.2/2/2008 4:35:00 PMinsurance companies care in the last weeks of life
146.2/3/2008 3:24:00 AMinsurance company bureaucracy
147.2/3/2008 10:05:00 AMPatient non compliance and health illiteracy, not providing good preventative care
148.2/3/2008 7:37:00 PMfda approval practices
149.2/3/2008 8:29:00 PMdirect to consumer advertising of pharmaceuticals
150.2/3/2008 9:36:00 PMinefficiency..having to waste time and hiring more manpower to deal with the increased administrative burden.
151.2/5/2008 5:45:00 AMDirect-to-consumer advertising.
152.2/7/2008 1:57:00 AMInsurance and reimbursement bureaucracy