The prices in the U.S system are wildly divergent from the rest of the world and enhancing international competition is a good way to remedy this. Thus, one way to implement universal health care is to allow import of any prescribed drug and the government will pay for any medical procedure + plane ticket if that cost is less than it is in the U.S. Perhaps a doctor visa would also help with costs.
doctor visa is a terrible idea, a) it would undermine the salaries of US doctors, b) it would drain doctors from poor countries where they are needed more than in the US.
IIRC, doctors already work on visas, and I don't think you would be 'pulling' doctors from other countries, not unless you're really good, which at that point you're only staying in your home country because you want to, not because you need to.
Exactly! Hospitals don't care about inefficiencies because insurance pays for it. Patients don't care either again because insurance pays for it. Insurance can't negotiate with hospitals as patients don't ever want to lose their doctors and revolt if insurance even brings up dropping a hospital for charging exorbitant rates. Add to it an insane 4 years in college + 4 years med school curriculum that does not incentiv…
>> Add to it an insane 4 years in college + 4 years med school curriculum that does not incentivize more people to even attempt getting into med school. While I agree with your points in general, this point is wrong. There are far more applicants for medical school (both MD and DO programs) than there are slots. I've been told this was done by the AMA to keep the supply of physicians in the US low to maintain high wa…
Don't forget a minimum of 3 years in residency making 30K-45K/year.
You're right about the AMA limiting the number of medical school students. DO schools are not regulated by the AMA. Unfortunately, there are not enough residency spots for all the DO and MD students that graduate each year and they compete with foreign students. Increasing the number, which the AMA is doing without increasing the residency programs is just going to leave more students with 100,000s of thousands of student loans and no income.
The prices in the U.S system are wildly divergent from the rest of the world and enhancing international competition is a good way to remedy this. Thus, one way to implement universal health care is to allow import of any prescribed drug and the government will pay for any medical procedure + plane ticket if that cost is less than it is in the U.S. Perhaps a doctor visa would also help with costs.
doctor visa is a terrible idea, a) it would undermine the salaries of US doctors, b) it would drain doctors from poor countries where they are needed more than in the US.
A) Lowering doctor salaries is part of the solution to health care costs. You could do this by educating them outside the U.S so they would have much lower student debt.
B) More people will enter the health care professions globally if there's a bigger market for their services.
Interestingly, we already discovered a mechanism for drastically reducing the cost of healthcare back in 1986. It's a way of crowdsourcing the problem called high copays . Basically, you have to pay out of pocket for 90% of your health care up to a (high) cap. It turns out that patients are very good at figuring out which health care will improve health and which won't - the high copay group had no statistically sign…
You would predict that discouraging healthcare "consumption" through higher co-pays would cut down on office visits for minor problems, but not for major issues, because with major health issues you have no choice not to go. How much is an office visit for runny nose? USD 50, USD 100? And how many frequent flyers are thee in the population, one out of ten, perhaps? It's just not plausible that it's the doctor-fetishi…
I explicitly said a 30% decrease in costs, not a 75% decrease.
Interestingly, we already discovered a mechanism for drastically reducing the cost of healthcare back in 1986. It's a way of crowdsourcing the problem called high copays . Basically, you have to pay out of pocket for 90% of your health care up to a (high) cap. It turns out that patients are very good at figuring out which health care will improve health and which won't - the high copay group had no statistically sign…
No, all that plan does is make people not go to the doctor when sick. They put stuff off until it is far too late, and they end up needing more expensive care that's much riskier.
If your narrative were true, medical consumption would go up and health would get worse. Neither of these happened.
Turns out medical consumption is well beyond the point of diminishing returns, and people are quite capable of determining what medical care is necessary.
This, times 1,000 !! Imagine you go in for an oil change. You ask how much it costs, and find out it's $20. Great. You get the oil change. One month later you get a bill for "environmental disposal" for $35. The next month you get another bill for "Safety specialist" for $15. This is how healthcare works in the US. If retail worked like this, we'd be in a worldwide depression in about 6 months. Lunacy.
yes.. another 1K. I blame doctors and insurance companies (but mostly the latter.. the former was taken for a ride long ago by the latter). An example of just how ridiculous this is: my son (who is almost 15), was recommended to have a 'pediatric echocardiogram'. The children's hospital that I took him to (a Tier 2 facility in insurance parlance.. which roughly means that my insurance company doesn't own them) indica…
That is outrageous. I am happy that I left the US and that my son has access to universal healthcare in Europe. I am happy to pay 50% of my income to taxes if it guarantees that I won't have to suffer a situation like you did (and that my kids can enjoy affordable higher education).
What do Americans think of the typical European system? (Paying more taxes and receiving almost free healthcare & education)
You're getting downvoted, but you're right. Currently, the US is implicitly subsidizing other countries in this regard. If we removed the trade barriers for prescription drugs, US prices would fall and other countries would end up paying more.
An alternative scenario might be that drugs would get cheaper in the US, European drug prices stay the same and pharmaceutical companies somehow scrape by with lower (but still positive) profit levels. Seriously, if drug companies were making a net loss in European and other countries, they'd just stop supplying in those countries and subsequently enjoy higher profits. Unless you're suggesting companies like Pfizer a…
You aren't taking into account the very high fixed costs but very low marginal costs for developing drugs.
yes.. another 1K. I blame doctors and insurance companies (but mostly the latter.. the former was taken for a ride long ago by the latter). An example of just how ridiculous this is: my son (who is almost 15), was recommended to have a 'pediatric echocardiogram'. The children's hospital that I took him to (a Tier 2 facility in insurance parlance.. which roughly means that my insurance company doesn't own them) indica…
That is outrageous. I am happy that I left the US and that my son has access to universal healthcare in Europe. I am happy to pay 50% of my income to taxes if it guarantees that I won't have to suffer a situation like you did (and that my kids can enjoy affordable higher education). What do Americans think of the typical European system? (Paying more taxes and receiving almost free healthcare & education)
To be perfectly frank, it would be fine with me, as I'm basically paying what amounts to a tax anyway. At least it would be explicitly stated as such, instead of this 'bait-and-switch' bullshit foisted upon us here in the US. I suspect that Obama threw down the gauntlet here with the ACA knowing full well it would modified down the road.. I believe his ultimate goal was, in fact, a single-payer system managed by the government (similar to, um, every other country in the world).. but of course couldn't call it that. It's not clear what the Republicans will do, but the 'cat is already out of the bag' as they say. If it's a tax, call it that.. we pay Social Security as a tax so we have some safety net when we're older.. nobody bitches about that (and Americans can really bitch.. just watch the news)... it's like 5%. Why not a similar tax for healthcare? Furthermore, why do we even need insurance companies? They have too much power over services and do ABSOLUTELY NOTHING with respect to our personal health. They're essentially payment clearing houses.. if we're going to privatize health, then we should mandate better price visibility of services and also better risk assessment of the ultimate receivers of the health care.. Currently, their risk assessment models are far too naive (blanket premiums with high deductibles).. Healthy people should pay less for their health care.. sick should go into higher risk pools and be paid out of the tax largesse managed by the government. Long ago, insurance companies began to amortize (health) risk through HMO's..when before that it was ostensibly pay-for-service through the doctors. They began to collect the money.. and then the service fees began to sky rocket (sounds like the US housing market, doesn't it?) Now the insurance companies know they have a huge target on their backs and are buying up all the hospitals and the private practices so now they own the 'last mile' of health care. Unfortunately it's a 45 year-old morass of legislation that no one (not even Google) wants any part of it. A good start is to mandate visibility into all services and let the consumers bitch and complain to the paymasters (their government, doctors, and insurance companies).. something will change. Until we know exactly how much things cost, we'll never be able to effectively optimize any of it.
>Universal healthcare is already much more cost effective than fully or semi-privitised health care. That's not true. Most developed countries have some form of privatized system, falling into your 'semi-privatized' definition. It's more cost-effective.
In many countries there is some element of private healthcare, but it only provides luxurious services that are in no way needed to treat health conditions (1-bed rooms in hospitals, choosing any doctor you like, shorter wait times for non-urgent treatments). Good examples here are UK and Germany. In both countries you'll get full coverage of any medical condition with public insurance. The reason that private elemen…
The UK is not a good example - it has a fairly unique nationalized system.
Germany, on the other hand, has a regional and national market system with compulsive health insurance, much like the ACA attempted. It's not a public only system by any means.
It's not about sharing a room, actually. It's about reducing the burden on the state, providing more efficient service for cost for everyone.