Cost of Health Care By Country, as Compared to Life Expectancy
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Re: Cost of Health Care By Country, as Compared to Life Expectancy
#2A response to the graphic suggests that while "this was evidence of an insane and inefficient healthcare system", "if [they] really wanted a chart that captures what’s wrong with America’s healthcare system, [they] should have gone to the Centers for Medicare and Medicaid Services’ national health expenditures data website and downloaded the figures showing how rampant third-party payment has resulted in consumers directly paying for less than 12 percent of healthcare costs. And when people are purchasing something with (what is perceived to be) other people’s money, it’s understandable that they don’t pay much attention to cost." (http://biggovernment.com/2009/12/29/the-real-healthcare-char...)
I'm sympathetic to this argument given that the American healthcare system is considerably different than many healthcare systems globally in that private insurers acting on behalf of employers (not the users of healthcare) pick up a significant portion of the pie (even if, on a per capita basis, Medicare spending is more than most countries like Canada - though this fact alone begs the question of why the US government wouldn't first seek to fix Medicare).
As a Canadian, the one thing I don't quite understand is how many of my countrymen are so quick to condemn the American system despite all the obvious signs that the Canadian system is unsustainable and failing (http://network.nationalpost.com/np/blogs/fullcomment/archive...). Further, you read about Animal farm like anecdotes (to be fair, I've seen first hand some of this in Canada as well), and you wonder whether or not healthcare systems abroad can really be distinctly categorized between those that are "universal" and "non-universal" given how radically different implementation is - an example from Japan here: http://biglizards.net/blog/archives/2010/01/my_family_the_v....
There are at least 2 other big problems with this graph if presumably it's being used to argue for changes in policy:
(1) The measurement of life expectancy "at birth". The US spends a considerable amount of money aggressively attempting to treat what would otherwise be considered stillborns. (2) The lifestyles of Americans that may have nothing at all to do with healthcare implementation (http://www.usnews.com/health/family-health/articles/2008/04/...) - ie this could very well mean that if the US miraculously grew an entirely public and universal healthcare system as modeled against XYZ country, US life expectancy might not necessarily get any cheaper or better - it is entirely possible that it would become more expensive and worse.
Re: Cost of Health Care By Country, as Compared to Life Expectancy
#3That's an awesome and persuasive infographic. In fact, it's main fault is that it's trying too hard to be persuasive. Putting the US above the legend detracts from the power of the raw data and strikes me as being unnecessarily editorial.
Re: Cost of Health Care By Country, as Compared to Life Expectancy
#4Oh I must be stupid. I spent a good three minutes trying to find where the United States was because I scrolled down.
Re: Cost of Health Care By Country, as Compared to Life Expectancy
#5A response to the graphic suggests that while "this was evidence of an insane and inefficient healthcare system", "if [they] really wanted a chart that captures what’s wrong with America’s healthcare system, [they] should have gone to the Centers for Medicare and Medicaid Services’ national health expenditures data website and downloaded the figures showing how rampant third-party payment has resulted in consumers di…
The problem with the Health Care debate is that it's become so polarized that advocates of Single Payer won't admit its failures in other countries while those opposed to Single Payer won't admit we have a problem.
Graphs like this are designed to create a visceral response but rationally they mean very little if not accompanied by an item by item breakdown of why the numbers are what they are.
For example, the Canadian system puts price limits on patented medicines while the U.S. system does not. That has nothing to do with being a Single Payer system but is definitely a factor that contributes to higher costs in the U.S.
Re: Cost of Health Care By Country, as Compared to Life Expectancy
#6A response to the graphic suggests that while "this was evidence of an insane and inefficient healthcare system", "if [they] really wanted a chart that captures what’s wrong with America’s healthcare system, [they] should have gone to the Centers for Medicare and Medicaid Services’ national health expenditures data website and downloaded the figures showing how rampant third-party payment has resulted in consumers di…
Also after a visit to a psychiatrist I found out they charge your insurance more, if you have it, than they would if you didn't. I'm not exactly sure what that was about, but if it was for sympathy, then it just shows that having a bureaucratic insurance company, private or government owned, would still have this problem of distancing the money from the patient.
However I'm still a large proponent of not only life as a right, but healthcare too.
Re: Cost of Health Care By Country, as Compared to Life Expectancy
#7Some reasons American medicine is very expensive:
1. Health insurance, but not treatment, is fully tax deductible. So if you buy your own penicillin, it's with after tax money, but if your insurance company buys it, it's pre-tax money. That's one of the reasons that health insurance is so widespred in America even for routine medicine like antibiotics and checkups. That's a major contributing factor in why the administrative costs are so high.
2. There's a shortage of doctors in America, and qualified doctors from other countries are not allowed to practice medicine in the United States. So there's good doctors from Canada, England, Japan, wherever that'd love to practice in the USA, but can't. This artificially inflates doctor's wages by restricting supply.
3. American doctors are typically required to get an undergraduate degree, medical degree, and do a below market, crazy hours residency in order to be able to practice medicine. That's 8-10 years of study and below market working to practice medicine. Now, medicine is very important and needs to be done right, but I don't believe for a second that a focused apprenceship couldn't teach a very specific kind of medicine - say arithscopic surgery - in just 2-4 years under a highly trained doctor, but this isn't an option.
4. The Food and Drug Administration requires new drugs to be proven not only for safety, but also efficacy. That's an incredibly high and expensive burden to meet - that means that drugs need to be proven to work to a certain standard, instead of just not harm. This adds years of development time and millions of dollars in cost to the new drug development cycle.
Those are all legislated reasons that increase the cost of medical insurance, doctors, and drugs. They'd be fairly easy to remove -
1. All medical and health expenses can be written off taxes regardless of insurance. Employees can choose to convert som of their wages to a medical or health plan tax free to both the employer and employee. (Currently, under most circumstances, only employer-provided health insurance can is tax free)
2. Allow any doctor in a country with reasonably competent medical standards to practice in the United States.
3. Require that doctors be able to demonstrate that they can practice their area of medicine capably. Be flexible in how they demonstrate that. Note: This will incur high opposition from medical schools and current doctors who are currently enjoying the wage premium and had to go through the very long, difficult, and expensive system.
4. Change the drug standard from "safety and efficacy" to only safety. Drugs will come to market much faster and cheaper. There's plenty of people and organizations that will test proven safe drugs for efficacy for free or nominal cost once drugs hit market, and efficacy will get understood with time. Put this way - a proven safe but questionably effective treatment against heart disease being held off the market for five years and costing much more to get to market is not a good thing. If it's certainly safe, then let people make the decisions with their physicians, instead of having the FDA take such a strong gatekeeping stance.
Technology has progressed such that we don't need government protection from ourselves as much any more. The current set of legislation has greatly increased the costs of doctors and medicine. Regardless of political position, and regardless of stance on other health issues, addressing these four points will make the medical system fairer, more effective, and and less expensive with relative ease.
Admittedly, there's some powerful entrenched interests that are winning in the current arrangement, and will oppose these simple improvements.
Re: Cost of Health Care By Country, as Compared to Life Expectancy
#8I wonder if this controls for various other lifestyle choices.
I find it ironic that the government spends so much money subsidizing high fructose corn syrup, and then spends even more treating the health problems that result from it. If we didn't have an agricultural system that makes unhealthy food cheap and healthy food expensive, perhaps we wouldn't have quite so many obesity-related illnesses.
Same thing with parking lots and interstates being subsidized while dense urban development (walkable/bikeable neighborhoods) is not. Cars kill a lot of people outright through accidents, and then indirectly through people becoming couch potatoes.
Usually by the time people come under care of the health care, the battle's already been lost. Acute, lifesaving interventions on otherwise healthy people aren't all that expensive. Chronic conditions caused by 40 years of neglect are. I'm curious if we'd get both the cheaper health care and the longer life expectancy of European countries if our cities were laid out like theirs and our agricultural system didn't dump massive amounts of subsidies on the corn industry.
Re: Cost of Health Care By Country, as Compared to Life Expectancy
#9A response to the graphic suggests that while "this was evidence of an insane and inefficient healthcare system", "if [they] really wanted a chart that captures what’s wrong with America’s healthcare system, [they] should have gone to the Centers for Medicare and Medicaid Services’ national health expenditures data website and downloaded the figures showing how rampant third-party payment has resulted in consumers di…
Ah, spurious comparisons and anonymous blog posts - is there nothing you can't obscure?
The US spends considerable amount of money aggressively attempting to treat what would otherwise be considered stillborns.
I regret to inform you that this particular meme is without foundation. I have had extensive discussions with UK and Euro obstetricians about it and the story that there is some massively divergent standard of care or different administrative classification for births involving medical complications is complete BS, from the same people who go about asserting that family planning is a single step away from forced abortions. The measurement of statistics for things like live births and so forth rely on standardized UN definitions, same as US statistics.
Re: Cost of Health Care By Country, as Compared to Life Expectancy
#10A response to the graphic suggests that while "this was evidence of an insane and inefficient healthcare system", "if [they] really wanted a chart that captures what’s wrong with America’s healthcare system, [they] should have gone to the Centers for Medicare and Medicaid Services’ national health expenditures data website and downloaded the figures showing how rampant third-party payment has resulted in consumers di…
Also after a visit to a psychiatrist I found out they charge your insurance more, if you have it, than they would if you didn't. I'm not exactly sure what that was about, but if it was for sympathy, then it just shows that having a bureaucratic insurance company, private or government owned, would still have this problem of distancing the money from the patient. However I'm still a large proponent of not only life as…
One might argue that (up to a point) this justly represents the cost of administering the patient's insurance claim, whereas the patient who pays cash is only charged the cost of treatment and does not incur any administrative overhead.