Healthcare in the US

[Mythos]

Ever wondered what is the major reason healthcare in the US is so expensive? I am sure you have, you are reading the TWC forums after all.

Read this. It seems American doctors generally overuse their assets and medical tools, especially when doing so gives them more income. Shows how this for-profit health care system is unsustainable and how it makes doctors put their financian interest over their patients' health.

[Viking Prince]

Private competitive care can be both more efficient and less efficient than central planning. A problem with a government system is the reluctance to fund development of more expensive procedures that may in the longer run produce lower cost or better life.

There is also the problem of litigation -- a problem very much tied to the government. If the government did not allow trial judgments to reach outer space, then doctors would not order 'needless' tests to prove to a jury that they were acting in the patient's interest.

There is also a tendency of central planning to lower compensation for services which has the direct effect of lowering the availability. This means waiting lists and scheduling which are not listed as costs in the accounting system. A common example is expensive equipment in an urban area. A specific piece of equipment is in every hospital and perhaps double the capital investment that can be used in the short run. Is this wasteful? What about an improved device that is a real improvement over the existing equipment? With a government waiting list, there is no incentive to make the capital improvements. With the 'over capitalization' any hospital not making the improvement will simply lose out on all of the patients to the forward looking hospital that makes the investment.

Give me a specific example of where a social planner can make the perfect allocation and I will counter point for point with how the competitive environment will beat the social planner in the long run.

[Aldgarkalaughskel]

Ever wondered what is the major reason healthcare in the US is so expensive?

The answer is simple, yet incomprehensible. The United States is alone among developed and civilized nations with the absence of a universal health care system. All government health care programs have restricted eligibility, and there is no national system of health insurance which guarantees that all citizens have access to health care. No wonder why the US health care system is only the 37th on WHO's ranking:
http://www.photius.com/rankings/healthranks.html

Health isn't business. Health is a basic need of every human, a core value of human life, and therefore it should be ensured by the community through universal health care and government funded programs.

[Viking Prince]

Health is an economic activity.

I would rather you not delve too great into the WHO rankings in this debate unless you really know how the rankings are created and what happens to a ranking when the society is less homogenious.

btw - Ever wonder why the superior state run systems do not have the Harvards and the Mayo Clinics?

[Mythos]

Health is an economic activity.

Only if you make it so.

btw - Ever wonder why the superior state run systems do not have the Harvards and the Mayo Clinics?

It is the end effect that matters. Those state run systems may not have the Harvards and the Mayo Clinics but they also do not have people not going to the doctor because they can't afford it, they don't have people not getting surgery because they can't afford it. The end effect is that the OVERALL health of the population is considerably greater, therefore that population is more productive. The end effect.

[Aldgarkalaughskel]

Health is an economic activity.

Care to explain why do you think that?

I would rather you not delve too great into the WHO rankings in this debate unless you really know how the rankings are created and what happens to a ranking when the society is less homogenious.

WHO is in independent organization, a branch of UN, that acts as a coordinating authority on international public health. WHOSIS, the WHO Statistical Information System, is an interactive database bringing together core health statistics for the 193 WHO Member States. It comprises more than 100 indicators. It is fairly objective and thorough.

btw - Ever wonder why the superior state run systems do not have the Harvards and the Mayo Clinics?

How is that an argument for explaining the lack of universal health care? Are those clinics able to provide health service to all citizens perhaps?

[Babur]

btw - Ever wonder why the superior state run systems do not have the Harvards and the Mayo Clinics?

What? the UK has a state-run healthcare system yet some of the best universities in the world can be found here.

[aletoledo]

What? the UK has a state-run healthcare system yet some of the best universities in the world can be found here.

Yet other countries rank well above England, like Malta for example. What is the famous medical university in Malta again? The point being that the rankings are based on limited criteria and don't encompass everything. In fact, thats how all statistics are used to produce whatever you wish them to produce. So when you see a list that ranks Malta near the top, you have to wonder where their medical research is coming from. Is the US solution to model after Malta, shutting down all medical research and simply waiting for other countries to do the heavy lifting?

Read this. It seems American doctors generally overuse their assets and medical tools, especially when doing so gives them more income. Shows how this for-profit health care system is unsustainable and how it makes doctors put their financian interest over their patients' health.

I don't think it's fair to call for-profit healthcare unsustainable, because there are other factors at work. The 1973 HMO Act is what I think set the current trend in healthcare that we see today. It was the federal government's attempt to manipulate the healthcare system and it has resulted in what we see today. We can all agree that the current system is broken, but the question then isn't what form of socialistic system we need to move to, but what is the best system. Remember that the US had a healthcare system prior to 1973, so what is wrong with that model?

Prior to the 1973 HMO Act, there was a lot more charity hospitals, so people didn't really go without healthcare as they do today. After the feds enacted their new rules, it basically created behemoth HMOs that sapped all the resources from the charity system. So I find it perplexing that people want to conclude that government is needed to solve a problem that they themselves created. Whats next, looking to the government to solve the problems surrounding the drug war, since they opened that can of worms as well? It seems obvious to me that the feds need to step away from the mess they created (healthcare and drug war) and allow more sensible and non-political alternatives to emerge. You might argue that they screwed things up too much to just leave it alone now, but asking the person that caused the problem to fix it seems like a recipe for prolonging the disaster.

[Ahlerich]

Health is an economic activity.

while this can be true i think its not desirable.

i drive on the road and when i see a porsche or ferrari passing me i get a bit jelous that i cant afford that but i can handle it, living without one.

would piss me off though if i cant afford teeth anymore.

my point is, even in germany one can see the tendency of a emerging 2 class medical care system.

we all pay our taxes no matter how much you earn - the government should try to give us all the same health care.

the ultimate question will be: shall we save his live or is he too poor to deserve it? thats a step back for a compassionate society

1st article of the german grundgesetz is "the dignity of the human is untouchable" how can that be true money decides who may have teeth and who doesnt

[Viking Prince]

while this can be true i think its not desirable.

i drive on the road and when i see a porsche or ferrari passing me i get a bit jelous that i cant afford that but i can handle it, living without one.

would piss me off though if i cant afford teeth anymore.

my point is, even in germany one can see the tendency of a emerging 2 class medical care system.

we all pay our taxes no matter how much you earn - the government should try to give us all the same health care.

the ultimate question will be: shall we save his live or is he too poor to deserve it? thats a step back for a compassionate society

1st article of the german grundgesetz is "the dignity of the human is untouchable" how can that be true money decides who may have teeth and who doesnt

You have either misunderstood the meaning or you are just posturing to a position. I will assume it is a misunderstanding. Healthcare is an economic activity because it involves utility as an economic term. There is no getting around this unless you think that healthcare is not a good with providers and consumers.

Being that it is an economic activity, there is a marginal effect to consumption and that means trade offs with other economic activities. There comes a point in your personal circumstances where there may be other goods more important than teeth. More probably there are limits to how much resoureces you will spend on your teeth. Maybe it is how often you make office visits or whether you pay for special services such as whitening. But there needs to be individual consumer decisions on the marginal analysis of costs and benefits. This is no differant than eating. You go to the store and make selections based on costs and benefits of food and all other expenses in your budget.


What is there about the cost of healthcare that makes this different from eating? Why do we help the poor with food and, yes, healthcare also? It is because of the common agreed value of a social safety net. But we still give the individual the power of allocating the resources because no government or social planner can judge the differant gains to personal utility as well as the individual.


So why must there be universal healthcare provision with a single provider? It seems a bit inconsistent since we already have provision with a social safety net. Perhaps the net can be better funded and perhaps more people should be covered, but why cover everyone? It is almost like people believe in a free lunch effect or something similar.

[Ahlerich]

You have either misunderstood the meaning or you are just posturing to a position. I will assume it is a misunderstanding. Healthcare is an economic activity because it involves utility as an economic term. There is no getting around this unless you think that healthcare is not a good with providers and consumers

i know. it shouldnt be handled like economy around any other goods. it shouldnt be competitive, there shouldnt be a best quality for the highes bidder like when i buy a car or computer.

thats what i am worried about. the demand shouldnt regulate it. standard rules should regulate it ensuring everybody gets the same treatment.

[MathiasOfAthens]

The right will scare you with tales of socialized medicine with long waits and refused service. But we already know how HMOs will tell their payees not to go this hospital, how they order hospitals to send patients to other hospitals, and how non payees are thrown on the streets. HMOs are in the business of providing care, its a business with profits and risk and the top percentage of income from insurance holders goes to the corporations that control life and death.

A healthy population is a productive population.

http://www.pnhp.org/
Physicians for a National Health Program

The reason we spend more and get less than the rest of the world is because we have a patchwork system of for-profit payers. Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. Combined, this needless administration consumes one-third (31 percent) of Americans’ health dollars.
Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $350 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do.

http://www.wfpl.org/CMS/?p=5772

Advocates for a single payer healthcare system gathered in Louisville Thursday for what’s become an annual rally.
This is the second year the group has gathered outside of the Humana building. Protestor Dr. Ewell (Yule) Scott with Physicians for a National Health Plan says he favors a government-provided insurance program because it would cut down on the paperwork he and his patients have to file.
“If we went to a single payer plan, the efficiencies would be so great; it makes so much more sense to do it that way,” he says.
Jim Turner with Humana says the company is in favor of health care reform, but not a single payer system. He says the first thing that should be changed about health care is the cost.
“If we don’t get costs down, if we don’t get the health care inflation rate more in line with the overall inflation rate, it’s going to be really tough for any health care reform to be effective and work over the long-term,” he says.
Congress is expected to begin debating health care reform this summer.

[Mikelus Trento]

Ever wondered what is the major reason healthcare in the US is so expensive? I am sure you have, you are reading the TWC forums after all.

Read this. It seems American doctors generally overuse their assets and medical tools, especially when doing so gives them more income. Shows how this for-profit health care system is unsustainable and how it makes doctors put their financian interest over their patients' health.

Doctors would argue right back that the reason tests are over-used is that they would rather err on the side of too much than too little, since the too little approach will be more likely to get them sued by lawyers. So the arguement could be made that high fees are due to excessive litigation, rather than greed.

The other factor for high fees (compared to 30 years ago) is the vastly larger number of people who get their health care with insurance aid. This has created an entire additional layer of expenses for the bureaucracy.

[Phier]

Ever wondered what is the major reason healthcare in the US is so expensive? I am sure you have, you are reading the TWC forums after all.

Read this. It seems American doctors generally overuse their assets and medical tools, especially when doing so gives them more income. Shows how this for-profit health care system is unsustainable and how it makes doctors put their financian interest over their patients' health.

You know without getting into details, I have to meet another doctor in 10 mins to discuss a case, if the problem is our for profit system, how come so many (if not all) socialized systems are complaining they need more and more funding, year after year?

[Kjertesvein]

You know without getting into details, I have to meet another doctor in 10 mins to discuss a case, if the problem is our for profit system, how come so many (if not all) socialized systems are complaining they need more and more funding, year after year?

That I can tell you: HAve you ever seen the free bird chickens scream for food? Well there you have it.


In reality, it's complicated of various factors:
+They might not use competition of the private comapys on the minor issues. Washing, security, mechanical maintnens.
+The heads of the hospitals need to use up a bag of money each year, so that they don't go low on money the next. If there is bad planning, then bust in the found.
+Pay checks of the employes must rise with the growth of the rest of the population.

=If you have a good year, then most people in a counry will get a higher pay check. The hospitals must follow up on this chicken fight, if not then they will be let behind. Ergo, less admirable to work there.

[JP226]

how do you know all this?

[aletoledo]

how do you know all this?

If you're directing the question at me, I read a lot of history (as probably everyone else here does as well). In addition, I have been involved in the healthcare field, so I have a perspective that can see many of the different angles involved.

IIMO the OP's linked article is very good. It is an honest piece, nothing is fabricated and everything is reasonable. I'd recommend everyone to read it if they haven't yet. The only thing I would would challenge it on is that it leaves out many details. As much as that author abuses places that have high medicare costs, he doesn't really point out any of the billing problems with medicare that allow for such high billing rates. The medicare system allows for unrestrained billing/testing, in addition the examples the author uses in the article of spending restraint are places that devised policies that were outside of government purview. Doesn't that mean that the government is the problem and that these private systems are what are required to curb spending? The author seems to allude that the government should enact programs like the Mayo Clinic for billing, but considering politics today, thats really doomed to failure. Government has been the problem, not the solution in all of his examples.

[Mercedes with Square Wheels]

healthcare is expensive because medicine costs too much make medicine cost less and healthcare will not be expensive

drop prices

[Sidmen]

Medicinal companies have profit margins five and a half times greater than is average. That means, they make 5x the profit per dollar they charge than most other companies. That surely contributes to the high cost.

Doctors and nurses in the USA also make a LOT more than they do elsewhere. Something around 156k in the US per year compared to 120k in britain (which is higher than elsewhere itself). That also contributes to the huge cost. Then there is the fact that our Hospitals make profits on top of everything they charge for meds and employee costs, unlike elsewhere.

Think of it like this: In the USA, you go to a hospital and sign a blank check for them to do whatever they can think of to make sure your well. And you hope they don't do stuff that makes no sense, or that they aren't just finding stuff to do to make a little more money off of you.

In Other health care systems, the people are hired and paid to fix you, they won't make more if they take longer, and probably don't want to keep working on you once your patched up, so you get sent home no problem as soon as your not in trouble any more.

[Daovonnaex]

Threads like this are great because people just fall back on ideology to argue with instead of looking at the data and how the actual underlying systems operate