After having read all the replies on this thread I have to jump in with some observations.

Having served for a 12 year term on the local county hospital board and just recently left the same board here are some of the trends we have seen.

Insurance:

There are a growing number of people who had insurance but dropped it due to the outrageous costs.

The insurance companies all have reimbursement schedules with every provider and hospital in the country. On average they pay 40-60% of charges.

Medicaid / Medicare:

Medicare pays very low rates but it does cover costs. The reimbursement rates are of course set by the Feds and vary by geographic location.

Medicaid is terrible! It does not even come close to covering costs and sometimes takes months and months to transmit payments back to the provider. You will see more and more providers opting out of accepting medicaid patients as time goes on.

Provider costs:

Doctors, like hospitals, are seeing costs rise monthly. Now you need to have an office manager that undertstands how to submit bills to insurance, medicare & medicaid. You have to spend untold $$$$ on software programs to code everything. The HIPPA privacy act has added a few more thousand dollars on to software expense for everyone. When your bill is rejected by the government or insurance companies for a coding error it cost a minimum of $300 per record to correct it and resubmit. And speaking of coding, the DRG manual of codes changes every time you turn around so you need a software update that costs $$$.

People complain about the cost of a provider visit, on average $65-$70. If you take away the increased costs to the provider of software, business coding specilists, insurance submition requirements you would see that same office visit drop to $30-$40.

Other influences:
While doctors have control over this hospitals do not. Illegal workers using valuable medical resources. Hospitals can not treat illegals unless it is an emergency situation. Rountine clinic treatment is off limits to them. There are countless programs for illegal workers to receive healthcare thru special community clinics. The costs of these clinics are in the miilions of dollars to taxpayers. Now illegal workers being here is another story for a different day, I'd like to point out that they pay no taxes and do not contribute to the healthcare system.

Medicaid / Medicare abuse:

It is a very, very small number of doctors that abuse the government programs and I can not remember the last time I heard of a hospital doing it.
Is there abuse by the patients? Yes there is, and like anything elese it's a rather small, but growing number. The number of retired persons on Medicare abusing the system is growing. Grandma likes to doctor shop and see's a new provider every month. We've run into this more often in the past year.
Medicaid abuse by patients? It's growing at a larger rate every month. It's not abuse as in money but rather healthcare. Medicaid user brings little Mary in for a cold and runs up a $150.00 bill to find out that there's nothing that can be done, it's a cold and it will pass. Some Medicaid users think the program is unlimited use of healthcare and will not even listen to the concept of "wellness." Now mind you, this is less than 5% of Medicaid users that do this but that's up 40% from last year.

Is there an easy answer? I don't know and I saw it first hand for years. Is there a solution? I think there is but it's going to take alot of work, change and attitude adjustment. Let's start by not running to the doctor for every ache and pain. Use common sense, if you have the flu it will pass, if you have a cold it will pass. Take some responsibility for your own well being.

As for the cost of drugs, that's another discussion entirely.

Thanks Everyone