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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

#91

Post by sailormoon »

hs wrote: post #34

of the three countries that have highest (and surprisingly parallel) slope: japan, south kore, mexico ... it suggests that #visit correlates with LE ... and health coverage is unimportant but there are countries that have less #visit but more expensive (it suggests patients go to doctor not only for consultation) ... so #visit is an unreliable predictor so is cost to me it seems the most predictive is location (yes,…

You could probably get 90% of the benefit of the Japanese lifestyle by moving to a walkable urban environment like NYC, selling the car, and eating the japanese diet. You'd probably have to visit there first to see what that actually is. Any other East Asian diet would be fine as well - hell, a pre-1970s American diet would probably be fine.

I am curious if those life expectancy figures have been controlled for smoking, though. If not - wow.

Re: Cost of Health Care By Country, as Compared to Life Expectancy

#92

Post by sailormoon »

SamAtt wrote: post #5
cwan wrote: post #2

A 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 Canad…

Spot on. People absorb some opinion from somewhere - it's almost a cultural, tribal thing. They adopt that opinion. And then confirm it endlessly via Google University's excellent and popular Confirmation Bias program, as demonstrated by the GP's links.

All systems fail, even if it's only rarely. But as soon as they do people seize upon the failure as if it's some kind of conclusive proof of the gut feeling they had all along. They are seemingly completely incapable of thinking in terms of statistics and average, large-scale outcomes. This is, of course, not at all confined to the health care "debate". The situation is so bad that I wonder if some kind of rational risk assessment/statistical thinking course should be introduced in schooling.

Re: Cost of Health Care By Country, as Compared to Life Expectancy

#93

Post by chasingsparks »

ams6110 wrote: post #60
chasingsparks wrote: post #42

Graphs are abused. Graphs are meant to present data clearly and concisely. The most clear and concise presentation method should be used. If it is not, there are reasons to be skeptical. This graph is not the best presentation imaginable; it's not even mediocre. It is meant to appeal visually to those who already have reached the conclusions it is meant to illicit; it is graph porn. Health care spending and quality i…

The research question is one that occurred to me. Do these cost data include spending on medical and pharmaceutical research? I would imagine that the bulk of that spending occurs in those same countries that are "above" the average line in this graph, and could contribute to that skewing.

U.S. patients certainly subsidize drug research. There are frequent calls for re-importation of drugs from other countries because, often, they are identical to the U.S. drugs, but have been bought by foreign governments exercising monopoly purchasing power. It makes sense for the drug company to sell at the discount because the manufacturing cost is so low that it is still profitable. Consequently, U.S. patients, who do not get the monopoly proxy, pay the higher cost.

This often leads to accusations of price gouging. However, looking at the returns on investment from publicly listed companies suggests that they are not charging extortionary fees. There financial figures are in line with that of the tech industry.

Granted, drug costs only one element among many in the debate, but I am pretty confident in saying that if drug costs were uniform, other countries would be paying more and the U.S. would be paying less (relative to current spending.)

Re: Cost of Health Care By Country, as Compared to Life Expectancy

#94

Post by Avshalom »

nzmsv wrote: post #67
Alex3917 wrote: post #58

In addition to health insurance being broken, it seems like most doctors are really terrible in the U.S. I read the other day that it takes on average seven years to correctly diagnose a medical condition. Some diseases, like celiacs, have an average time until diagnosis of 10 years. If you haven't already read How Doctors Think, it's truly horrifying. Unless you have something like strept throat, you're generally pr…

> Someone really needs to make a crowdsourced website where you can post all your symptoms and test results, and then offer up a bounty to anyone who can figure out the correct diagnosis. Just like that episode of House :) Except in the show most responses were things like "alien abduction" or "this thing my homoeopathic treatment cures". Oh yeah, and there were quite a number of these. How would you solve the swarm…

Oh that's easy. Create a crowdsourced website where you can post all your diagnoses, and then offer up a bounty to anyone who can figure out the legitimate ones.

Re: Cost of Health Care By Country, as Compared to Life Expectancy

#95

Post by Avshalom »

Alex3917 wrote: post #68
ams6110 wrote: post #64

Earlier quoted context omitted.

I'm sorry to hear of your health problems, but unfortunately doctors don't have tricorders yet. It's quite incorrect to suggest that people with "zero intellectual curiosity" are sought out by medical schools, in fact it's a preposterous claim. We have made great advances in medicine in the past 100 years, but complete understanding of the human organism and its diseases still lies far in the future. Some diseases ha…

"It's quite incorrect to suggest that people with "zero intellectual curiosity" are sought out by medical schools, in fact it's a preposterous claim." Medical schools are famous for only admitting people who A) went to college B) had high GPAs C) are 'well rounded', meaning they participated in lots of school clubs or whatever. This seems like more or less a recipe for selecting candidates with low intellectual curio…

people who did well in college and had numerous extra curricular interests and activities is a recipe for low intellectual curiosity?

Re: Cost of Health Care By Country, as Compared to Life Expectancy

#96

Post by sailormoon »

Alex3917 wrote: post #66
carbocation wrote: post #61

Earlier quoted context omitted.

Someone with even a remote familiarity with the practice of medicine would not refer to Lyme disease, one of the great imitators, as 'trivial'. The rest of your post, though forceful, similarly suffers from having no idea what you are talking about. Regarding the length of time from the onset of low-risk chronic diseases (unpleasant though they may be), you are right that this is a problem but dead wrong about the ca…

"Someone with even a remote familiarity with the practice of medicine would not refer to Lyme disease, one of the great imitators, as 'trivial'." The fact that it is an imitator makes it easier to diagnose, because a competent doctor will test you for it whenever you have unexplained symptoms. While it's true that the blood tests aren't very accurate, most of the problem is that doctors just don't get people tested i…

The fact that it is an imitator makes it easier to diagnose, because a competent doctor will test you for it whenever you have unexplained symptoms.

That is a very unfair thing to say, IMO. You cannot just do unlimited blood tests for everyone who might possibly be at risk of $something. Lyme disease is notoriously hard to diagnose and also very rare. It is unfortunate that the case you referred to turned out the way it did. Our medical knowledge is far from perfect, and no doubt it was a learning experience for everyone involved. But it's going way too far to call the doctors "incompetent". If anything it is our entire medical system that remains "incompetent" and calling out individual practitioners is very unfair.

Re: Cost of Health Care By Country, as Compared to Life Expectancy

#97

Post by Alex3917 »

sailormoon wrote: post #96
Alex3917 wrote: post #66

Earlier quoted context omitted.

"Someone with even a remote familiarity with the practice of medicine would not refer to Lyme disease, one of the great imitators, as 'trivial'." The fact that it is an imitator makes it easier to diagnose, because a competent doctor will test you for it whenever you have unexplained symptoms. While it's true that the blood tests aren't very accurate, most of the problem is that doctors just don't get people tested i…

The fact that it is an imitator makes it easier to diagnose, because a competent doctor will test you for it whenever you have unexplained symptoms. That is a very unfair thing to say, IMO. You cannot just do unlimited blood tests for everyone who might possibly be at risk of $something. Lyme disease is notoriously hard to diagnose and also very rare. It is unfortunate that the case you referred to turned out the way…

"Lyme disease is notoriously hard to diagnose and also very rare."

It's probably one of the most common, if not the most common, systemic diseases. Any time you have multiple symptoms that can't be explained, lyme is pretty much the first thing a competent doctor would test for. Sorry, but any doctor who heard the list of shooter's symtoms and doesn't instantly think lyme is incompetent. And it's really not that rare, even in absolute terms. Off the top of my head I can think of five friends who have gotten it, and those are only the ones I know of.

Re: Cost of Health Care By Country, as Compared to Life Expectancy

#98

Post by joe_the_user »

joe_the_user wrote: post #24
lionhearted wrote: post #7

Some 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 admini…

1. The structure of an unstrained free-market medical system is well-suited for rent-seeking rackets. Doctors and hospitals tend to be monopolies. Even with competition, few are competent at choose between competitors, etc. This situation has historically been restrained by modest regulation and by the fact that most people entering health care are motivated by the desire to help others. These restraints are gone . 2…

I honestly wish someone would reply and refute my argument above, it's so depressing to think about the consequences...

Re: Cost of Health Care By Country, as Compared to Life Expectancy

#99

Post by DanielBMarkham »

joe_the_user wrote: post #98
joe_the_user wrote: post #24

Earlier quoted context omitted.

1. The structure of an unstrained free-market medical system is well-suited for rent-seeking rackets. Doctors and hospitals tend to be monopolies. Even with competition, few are competent at choose between competitors, etc. This situation has historically been restrained by modest regulation and by the fact that most people entering health care are motivated by the desire to help others. These restraints are gone . 2…

I honestly wish someone would reply and refute my argument above, it's so depressing to think about the consequences...

It is depressing. If I am about to die, I will pay whatever you want to charge. And if you collude with others, my negotiating position is toast. In addition, as a free citizen I am always able to invent a treatment that is so expensive that my fellow countrymen can't afford it. That's the nature of being a free person. Yet my fellow countrymen seem to be pretty pissed at this and are threatening to take whatever treatments I might invent and distribute them to the needy. You can call it socialism, but it's also just populist politics.

All this means that traditional market principles don't map exactly in the world of health care (I think they mostly map, just not exactly)

If I am not about to die, but I'm not paying my bills, then you're no longer providing me a service -- you're providing it to whoever is paying. And they're just playing numbers games trying to keep making more than they are spending.

There are some real, serious, foundational problems with health care. None of the current proposals by any party will even begin to fix them. What we're going to end up with, unfortunately, is a situation like every other big political problem -- the politicians will get more votes arguing about it and keeping it broken than they will actually fixing it. So it will remain broken.

Sorry -- not cheering you up so far, huh?

I could spitball some possible solutions. Make it illegal for anybody to pay my medical bills except myself, my family, and charities. Require all doctors to perform 2 years of public health service instead of some of the internships they are currently doing. Have a national standard definition of all medical procedures and require all health providers to publicly post prices for those procedures. Take the percentage of people who cannot afford treatment each year and require all health providers to provide that percentage of free service.

Of course none of that will ever happen.

I will say something political simply because it amazes me: the party who is on television right now demonizing the insurance and pharmaceutical companies is also the party that cut deals with these same industries to limit imported drugs and not have a public option. This virtually guarantees that those industries will be printing money for the foreseeable future. If I told you this five years ago you'd call me a fantastical liar. It's incredible.

Re: Cost of Health Care By Country, as Compared to Life Expectancy

#100

Post by anigbrowl »

chrischen wrote: post #32
anigbrowl wrote: post #10

Earlier quoted context omitted.

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.

Perhaps, but this administrative overhead would likely be existent with a public option too.

Probably so; it depends how much bureaucratic overhead is imposed upon the medical professional. This might seem selfish, but secretarial services ain't free and time spent filling out claim forms is time that could be used in seeing patients.

Then again, you might argue that some medical professionals make so much anyway they should just eat the overhead as a cost of doing business, but that's a different discussion.

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