[rkischuk]

This is putting things exactly backwards. The argument is roughly "Treating a minor condition cost $24k, which could wipe people out financially, therefore PPACA is important."

Where is the outrage over this price? What part of PPACA does ANYTHING to reduce this cost? PPACA does essentially 2 things: 1) It makes insurance "affordable" for people who previously couldn't obtain it at all. 2) Drastically increases demand for health care, without adding to supply or controlling costs any other way.

Insurance is simply a distribution of cost over a risk pool. If relatively mundane life happenings cost $24k, and nothing is being done to fix that, we're in real trouble, and I think we are.

Nothing done to increase the pool of doctors. Nothing done to control medical lawsuit costs, which transfer money from the insurance pool to individuals. Nothing done to control the cost of drugs (and in some cases, aggravated by making more expensive drugs "free").

Bring the cost down to $2,400 and "wiping people out" isn't as big a concern.

[tptacek]

We also need to increase the pool of doctors.

We probably don't so much need to deal with malpractice insurance, since that fix doesn't (to employ a congenial metaphor) change the exponent in the Big-O cost of health care.

We need to make it simpler to get drugs on the market, but we also need to walk the tightrope of doing that while regulating pharma marketing, particularly to medical practices.

We need to restructure care in the US. We recognize that the E.R. is a terrible provider-of-first-resort and that non-emergency E.R. visits are damaging the system. We need to start realizing that M.D. doctors are also poor providers of first resort, and get a nationwide system of low-cost clinics deployed. That's already starting to happen at places like Walgreens.

We very much need to figure out how to start exploiting the Internet to provide some level of routine care for patients.

These are all things that do need to happen. But they don't have much to do with the problem that insurance problems are randomly bankrupting large numbers of Americans. We need to fix that problem first. Face it: the most expensive cohort of patients in the US, accounting for by far the majority of our exposure to rising medical costs, have had socialized single-payer health care for decades. Access to private insurance and the "cost curve" of health care are simply orthogonal problems.

[ScottBurson]

I think we really would do best to attack the cost explosion problem at the same time we attack the coverage problem. Fixing the coverage problem is mostly a matter of political will (granted that the opposition has been bitter). Getting costs under control requires far-reaching changes to the health care system itself and will take years at best.

[zaphar]

It wasn't a minor condition. It was a staph infection. Don't let the term bugbite mislead you. His son wasn't in the hospital for a bugbite. He was in the hospital for a life threatening infection from an antibiotic resistant infection. That is far from minor.

Disclaimer: I'm not arguing for PPACA in any way but if you are going to base you argument on billing for a "minor" condition then make sure it's actually a minor condition.

[rkischuk]

So... MRSA Staph Infection... what is the cost to correctly diagnose? And what is the cost of the antibiotics?

I'm not a doctor, but most non-boutique antibiotics are dirt cheap.

I didn't intend to trivialize the illness. I more meant that this could happen to _anyone_. And if this is the cost for things that can happen to anyone, we have a real problem on our hands. Much like it's a problem that a basic, no-complications, baby delivery costs $15-20k.

Insurance is math, and the math gets scary quickly unless costs are controlled.

[zaphar]

It's more than just diagnoses and antibiotics. It's monitoring the child for 2+ days. And broad spectrum antibiotics than can kill resistant staph infections I imagine aren't cheap either. Not to mention you can't just administer them. You have to monitor their effect continuously to make sure they actually are having an effect.

As to happening to anyone yes in the same way that anyone could get hit by a car. It's a rare occurrence. most people will not be getting staph from a bug bite. It's totally possible that 23k is an egregious amount to bill for his treatment but I think you are going about making that argument from the wrong position.

Are you capable of diagnosing an MRSA Staph infection? What all exactly is involved in diagnosing it? Looking at it? or do you need complicated lab tests? Does it require a consult with someone who specializes in infectious diseases or can just anyone do it? How do you dispose of medical waste from treatment? Are there any complicated regulations that increase the cost there?

All of these questions should be what fuels the debate around medical billing. The fact that you as a patient have very little visibility into all of that is in my mind the issue.

Arguing about how anyone could be hit with life threatening illness or injury is a potent and emotional distraction.

[bzbarsky]

> but most non-boutique antibiotics are dirt cheap

The whole problem with MRSA is that you need boutique antibiotics to treat it! You don't have to be a doctor to know that, by the way; Wikipedia will tell you that part.

Agreed with you on the baby delivery part. Though it only costs that much in a hospital. In states where alternate arrangements involving a midwife are legal (not Illinois!) the cost can be much more reasonable for a no-complications birth.

[tghw]

From the article, at least a two day hospital stay, IV, antibiotics, the time of the nurses checking in on him, the doctor(s) rounding on him, and the orderlies and cleaning staff keeping the place clean. Staying in the hospital is not cheap.

[lox]

In Australia, at a private hospital, it's around $800 a night from memory.

[mikeash]

MRSA-infected bug bites which require hospitalization are not "relatively mundane".

The PPACA does not reduce this cost. It does prevent it from bankrupting individuals.