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The US spends more on healthcare for no gain says new report from Johns Hopkins

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Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#71

Post by grecy »

harimau777 wrote: post #48

Are there any measures of how America does compared to Europe if you only count Americans that have good health insurance? It seems to me that many people who are opposed to socialized medicine don't necessarily disagree that it would give the poor better care; rather they fear that it will result in them receiving worse care.

> Are there any measures of how America does compared to Europe if you only count Americans that have good health insurance?

Anecdotally, I'd say they do crap.

Friends outside LA are upper-middle class. Extremely good health insurance for the last 20+ years. Had a baby, emergency C-section. Less than 12 hours later they were told they must move hospital or else pay the $60,000 per day out of pocket because their insurance wouldn't cover it anymore. They had to drive themselves, in their own car, less than 12 hours after an emergency C-Section, with the infant.

Of of this after paying through the nose for 20+ years for excellent health insurance.

As an Australia/Canadian this is barbaric, and utterly unacceptable.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#72

Post by buboard »

airstrike wrote: post #2

It's worth noting that the U.S. market does pay for the lion's share of patented drugs, effectively funding a significant portion of R&D that benefits the whole world years later when generics come into market (at least for those drugs which are not costly to manufacture, which happen to be the majority). I'm not saying this model is right. I'm just saying that doing away with it will have fundamental consequences to…

while it is probably true that US healthcare is subsidizing drug discovery (perks of being the strongest economy), there still seems to be an asymmetry in the US. E.g You spend 6-8 times more in administrative costs and about 2 times more in drugs:

https://jamanetwork.com/journals/jama/article-abstract/26746...

Administrative costs of care (activities relating to planning, regulating, and managing health systems and services) accounted for 8% in the US vs a range of 1% to 3% in the other countries. For pharmaceutical costs, spending per capita was $1443 in the US vs a range of $466 to $939 in other countries. Salaries of physicians and nurses were higher in the US; for example, generalist physicians salaries were $218 173 in the US compared with a range of $86 607 to $154 126 in the other countries.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#73

Post by anigbrowl »

airstrike wrote: post #16
brohoolio wrote: post #8

Earlier quoted context omitted.

I’m not sure what kind of R&D the $800 or whatever it costs now Epipen is paying for. R&D for lobbyists? Or profits because the company gamed the market.

The EpiPen is one of the "hard to manufacture" drugs I mentioned. Although it is top of mind to many, it is not representative of the market. EDIT: "hard to manufacture" is in quotes because it's what I said in my parent comment (though to be fair I said "costly to manufacture"), but I meant it as an umbrella term for everything that can't be substituted by generics

EpiPen is one of the "hard to manufacture" drugs

Yeah it must be very hard to manufacture when the manufacturer's revenue is going towards paying off a $465 million settlement for deceptive business practices. https://en.wikipedia.org/wiki/Epinephrine_autoinjector#Price...

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#74

Post by koboll »

Gibbon1 wrote: post #53
bluetwo wrote: post #22

Like the article says, previous research has come to the same conclusion. We pay much more, and are ranked nowhere near the top for lifespan, childhood mortality, and other measures. Obamacare was a great first step. Define what basic healthcare is and form markets that encourage apples-to-apples comparison. Let the free market work. Sucks that one party used this as a weapon to wrestle power. Oh well. Not going to a…

If you want an actual change that would have an effect change the law so that if a hospitals and doctors can't just balance bill patients, make them have to take the patients insurance company to court.

This is literally exactly how it works currently. Hospitals and insurance companies are all suing each other constantly over a ton of different things.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#75

Post by drb91 »

hacknat wrote: post #70
MichaelApproved wrote: post #49

Earlier quoted context omitted.

> Let the free market work Respectfully, enough with this free market garbage. The healthcare industry is not a free market, it can never be. It's not possible for the consumer to be educated. Even if you put emergencies aside, when an unconscious person can't start price shopping emergency rooms, you still have regular office visits that are impossible to price shop. Ask yourself when the last time you asked your ph…

Some providers actually have policies that prohibit giving out any pricing information. There are so many reasons why healthcare isn’t close to a free market. Here are a few: 1. All medical residents receive their salaries from Medicare. 2. It is illegal not to treat people who go to the emergency room. This actually makes the whole system socialized in some ways in that there is a guaranteed way to get healthcare wi…

Nit, that’s not socialization, that’s just right to service. You still shoulder the bill entirely yourself.

The only thing that approaches socialized healthcare is free flu shots.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#76

Post by orangecat »

grecy wrote: post #33
airstrike wrote: post #2

It's worth noting that the U.S. market does pay for the lion's share of patented drugs, effectively funding a significant portion of R&D that benefits the whole world years later when generics come into market (at least for those drugs which are not costly to manufacture, which happen to be the majority). I'm not saying this model is right. I'm just saying that doing away with it will have fundamental consequences to…

Except that every company involved in the healthcare industry in America (drug companies, insurance companies, hospitals, etc.) make hundreds of billions (or trillions) in profit each and every year. The reason for the high prices is because healthcare in the US is an extremely, extremely lucrative for-profit industry.

Health insurers and hospitals have profit margins under 5%. Pharma margins are larger but not outrageously so.

https://www.investopedia.com/ask/answers/052515/what-usual-p...

https://www.advisory.com/daily-briefing/2017/05/18/moodys-re...

https://www.bbc.com/news/business-28212223

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#77

Post by ekun »

cpncrunch wrote: post #62
airstrike wrote: post #2

It's worth noting that the U.S. market does pay for the lion's share of patented drugs, effectively funding a significant portion of R&D that benefits the whole world years later when generics come into market (at least for those drugs which are not costly to manufacture, which happen to be the majority). I'm not saying this model is right. I'm just saying that doing away with it will have fundamental consequences to…

But R&D isn't included in the OECD health spending database as far as I can tell. http://www.oecd.org/els/health-systems/health-data.htm

I think it wouldn't be explicitly included, but it goes into the bottom line of big pharma companies. There is a very lengthy process of getting drugs through the FDA which makes investment's return-on-investment difficult to justify without raising already available drug prices.

(edit: Having said that, our healthcare costs are out of control and it's not directly because of the R&D. It has more to do with wild overhead in insurance and HMOs where only a small fraction of what consumers pay goes to healthcare.)

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#78

Post by ModernMech »

MichaelApproved wrote: post #49
bluetwo wrote: post #22

Like the article says, previous research has come to the same conclusion. We pay much more, and are ranked nowhere near the top for lifespan, childhood mortality, and other measures. Obamacare was a great first step. Define what basic healthcare is and form markets that encourage apples-to-apples comparison. Let the free market work. Sucks that one party used this as a weapon to wrestle power. Oh well. Not going to a…

> Let the free market work Respectfully, enough with this free market garbage. The healthcare industry is not a free market, it can never be. It's not possible for the consumer to be educated. Even if you put emergencies aside, when an unconscious person can't start price shopping emergency rooms, you still have regular office visits that are impossible to price shop. Ask yourself when the last time you asked your ph…

> They finally gave me an estimate of "it'll be nominal", so I accepted the procedure. Turned out to be ~$200. I'm currently disputing it and refuse to pay based on their original quote of "nominal".

This is a case of expectations. $200 is nominal as far as medical procedures go. Based on my last couple encounters with healthcare, $200 barely gets you in the door. I paid $2000 on my last ambulance ride. My last stay was $14,000 for a couple days. That's with insurance.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#79

Post by ModernMech »

kps wrote: post #64
MichaelApproved wrote: post #49

Earlier quoted context omitted.

> Let the free market work Respectfully, enough with this free market garbage. The healthcare industry is not a free market, it can never be. It's not possible for the consumer to be educated. Even if you put emergencies aside, when an unconscious person can't start price shopping emergency rooms, you still have regular office visits that are impossible to price shop. Ask yourself when the last time you asked your ph…

A free market would have patients and physicians reaching a supply/demand equilibrium, with facilitating brokers taking a small cut. In the US, patients go bankrupt and physicians go bankrupt — money flows to the parasites who set prices: administrators and insurers.

> A free market would have patients and physicians reaching a supply/demand equilibrium

And what happens when the market is not in equilibrium? It means some services are priced out of reach for some buyers. When the market is commodities like soy beans, that's okay... it means some people don't buy soy beans. When it's healthcare, it means some people don't get healthcare and they die. Not so good.

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