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High US health care spending explained by its high material standard of living

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Re: High US health care spending explained by its high material standard of living

#21

Post by Broken_Hippo »

scarface74 wrote: post #13

Slightly off topic but is there is a such thing as universal affordable good healthcare? I've talked to a few U.S. citizens that worked abroad who said healthcare in European countries is universally available but the demand outstrips the supply causing longer wait times to get treated than in the U.S. and that they prefer the U.S. system. These are of course people who have good jobs in the U.S. with company provide…

So far, I'm quite pleased with the Norwegian health care system - though to be honest, most of my experience has been through "working" as a CNA (it was actually part of language classes), classroom learning, a few doctor's visits, and the stories of other immigrants.

Everyone is covered by the national health insurance. No more worries about getting hit with a huge health care bill. Children have a lot of free stuff - most health care and dental (braces are an exception). I can change my doctor a couple times a year if I want. Some things just make sense: For example, the government sends me a letter to remind me to get cancer screenings every 3 years (I'm female) - and this stuff isn't as possible with the fragmented system in the states.

Now, the downsides are things like longer wait times. This does suck, for sure. Some of this is simply being cost-effective, I'm sure. But other cost effective things work out: For example, if you need a home nurse, you get one covered up to 6 times a day. Free, because it is cheaper than a nursing home. Dental can tend to be expensive and folks have some odd ways of going about this. For example, I've heard of a group of Norwegian dentists in... Poland?... that cater to Norwegians. The cost is often cheaper, even when factoring in the travel costs.

There is a private health care system. The government still pays their normal rate to the private provider and the patient pays the difference. Some folks use this to go around the waiting times and I'm guessing this option would seem more similar to the American system for folks with insurance - though I'm not sure it is ever like the nearly on-demand medical care one comes to expect in the states. The system is vastly better for those with poor coverage or those that have good coverage but can't afford to use it.

Hopefully, if the US does a single-payer system, they take a look at some of the downsides and try some things to lessen them.

Re: High US health care spending explained by its high material standard of living

#22

Post by [deleted] »

scarface74 wrote: post #13

Slightly off topic but is there is a such thing as universal affordable good healthcare? I've talked to a few U.S. citizens that worked abroad who said healthcare in European countries is universally available but the demand outstrips the supply causing longer wait times to get treated than in the U.S. and that they prefer the U.S. system. These are of course people who have good jobs in the U.S. with company provide…

[deleted]

Re: High US health care spending explained by its high material standard of living

#23

Post by lemming »

yummyfajitas wrote: post #6
arcticbull wrote: post #4

Strange, this neglects that portion of health care spend that is accounted for by profits, by marketing expenses and administrative/billing bloat that ensues. It also neglects that for its massively higher spend 10% of Americans aren't covered and therefore don't receive preventative care yielding massively higher final costs, and it doesn't take into account the WHO ranks the US system as 31st in the world dramatica…

What do you mean "neglects"? Did the author somehow remove that from his numbers? The WHO ranks the US low because 62.5% of their score is a measure of inequality. Only 37.5% of their score is related to actual health care measures (health outcomes and patient satisfaction). The US scores #1 on patient satisfaction. http://www.who.int/whr/2000/en/whr00_en.pdf

I assume patient satisfaction only takes into account people who managed to become patients, and doesn't include people in the U.S. who needed treatment but couldn't get it.

Re: High US health care spending explained by its high material standard of living

#24

Post by oscilloscope »

yummyfajitas wrote: post #6
arcticbull wrote: post #4

Strange, this neglects that portion of health care spend that is accounted for by profits, by marketing expenses and administrative/billing bloat that ensues. It also neglects that for its massively higher spend 10% of Americans aren't covered and therefore don't receive preventative care yielding massively higher final costs, and it doesn't take into account the WHO ranks the US system as 31st in the world dramatica…

What do you mean "neglects"? Did the author somehow remove that from his numbers? The WHO ranks the US low because 62.5% of their score is a measure of inequality. Only 37.5% of their score is related to actual health care measures (health outcomes and patient satisfaction). The US scores #1 on patient satisfaction. http://www.who.int/whr/2000/en/whr00_en.pdf

Patient satisfaction is positively correlated with mortality. It does not necessarily indicate superior care. https://www.ucdmc.ucdavis.edu/publish/news/newsroom/6223

Re: High US health care spending explained by its high material standard of living

#25

Post by ricardonunez »

ramparrt wrote: post #17
scarface74 wrote: post #13

Slightly off topic but is there is a such thing as universal affordable good healthcare? I've talked to a few U.S. citizens that worked abroad who said healthcare in European countries is universally available but the demand outstrips the supply causing longer wait times to get treated than in the U.S. and that they prefer the U.S. system. These are of course people who have good jobs in the U.S. with company provide…

The Australian system is far from perfect but does come some way to solving this. It is effectively 2 tiered: 1) Public Medicare, the publicly funded system available to everybody. 2) Private insurance, paid for by the individual and tailored to their needs. To pay for the public system everybody pays a Medicare levy as part of their income tax. The levy is coarsely means tested. If you have private insurance then th…

This sounds in some ways similar to Mark Cuban's solution.

Here's the post: http://blogmaverick.com/2017/03/08/some-thoughts-on-fixing-o...

Re: High US health care spending explained by its high material standard of living

#26

Post by Spooky23 »

arcticbull wrote: post #4

Strange, this neglects that portion of health care spend that is accounted for by profits, by marketing expenses and administrative/billing bloat that ensues. It also neglects that for its massively higher spend 10% of Americans aren't covered and therefore don't receive preventative care yielding massively higher final costs, and it doesn't take into account the WHO ranks the US system as 31st in the world dramatica…

If you are going to nitpick over what should and shouldn't be there, don't forget the implicit subsidy of socialized health plans borne by US ratepayers. Price controls on prescription drugs, for example impact pricing in the US.

Also don't forget about how the US's socialized system - Medicare makes the whole system really bizarre by setting defacto price controls and encouraging over capacity of hospital beds and under capacity of primary care.

Re: High US health care spending explained by its high material standard of living

#27

Post by throwaway2048 »

yummyfajitas wrote: post #20
huxley wrote: post #19

Earlier quoted context omitted.

Note: World Health Organization report is from 2000

Do you have something more current?

what you really mean to ask is "Do you have something more current that supports my biases about healthcare"

Re: High US health care spending explained by its high material standard of living

#28

Post by DanBC »

yummyfajitas wrote: post #20
huxley wrote: post #19

Earlier quoted context omitted.

Note: World Health Organization report is from 2000

Do you have something more current?

We have something more relevant, which is that the US spends far more on healthcare than anywhere else, but is in the 10 OECD countries with the lowest life expectancy.

http://visual.ons.gov.uk/how-does-uk-healthcare-spending-com...

> While the USA outspent the UK on healthcare (£6,311 and £2,777 per person2 respectively) in 2014, average life expectancy at birth in the USA was 78.8, compared with 81.4 in the UK.

> Despite spending, by far, the largest amount on healthcare, the USA was among the 10 OECD countries with the lowest life expectancy.

Re: High US health care spending explained by its high material standard of living

#29

Post by tcbawo »

anonymousDan wrote: post #9

So his claim that the us has a higher standard of living is based on it having a higher AIC. But does this take into account that countries with higher taxation and hence public expenditure could reduce the need for households to spend money on public goods/services?

I find it odd to compare the nations of Europe individually, but taking the United States as a whole. Availability of subnational metrics probably makes this difficult, but averaging West Virginia and California is probably distortive.

Re: High US health care spending explained by its high material standard of living

#30

Post by malandrew »

arcticbull wrote: post #4

Strange, this neglects that portion of health care spend that is accounted for by profits, by marketing expenses and administrative/billing bloat that ensues. It also neglects that for its massively higher spend 10% of Americans aren't covered and therefore don't receive preventative care yielding massively higher final costs, and it doesn't take into account the WHO ranks the US system as 31st in the world dramatica…

What amazes me is how few people value the value of profits in our system. The US is responsible for ~40% of the world's output in terms of medical research, which is 10x the country with the second largest amount of output, England.

Profits provides the impetus for many of the medical advances invented here in the US, and many of these advances find their way to other countries. Because of profits, the US is essentially the medical R&D powerhouse for the world and every human in the world benefits. We help make more care options available to more people are lower prices sooner.

In a way, the US is providing socialized medical care over time beyond its borders and for more people instead of having it just be socialized in the present.

Until I hear solutions that acknowledge this very important detail, I'm going to remain skeptical of all comparisons with countries with socialized medicine and attempts to take the US in that direction. I learned long ago to be skeptical of anyone criticizing any system where they can't point out the value of that system versus the others they prefer.

Making the US healthcare system function like the socialized medical systems seen in Europe risks destroying the profit motive and therefore jeopardizes improvements in medical care quality, speed, options, etc. for everyone everywhere.

I far prefer a system where some lose out in the present in favor of a system where far fewer people lose out in the future. This is essentially the trolley problem. We can provide care for X people in the US who don't have care in the present or we can provide care for several times X people in the US and elsewhere in the world in the future.

[1] https://www.forbes.com/sites/matthewherper/2011/03/23/the-mo...

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