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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

#131

Post by euske »

DennisP wrote: post #104
mikeg8 wrote: post #81

The book The Healing of America by T.R. Reid, 2010 was a phenomenal look at this subject and the conclusion was this: we are the only developed nation whose government allows for-profit health insurance companies to exist with ZERO regulation to cap healthcare prices. Because of this, we spend 20% of every dollar on "administrative" costs compared to 3%-7% in the European and Asian countries. The goal for American he…

I read that book too, and agree it's phenomenal. It's not just about capping insurance profits. The countries doing the best also have price controls on the healthcare providers. Doctors make a lot less money. On the other hand they generally don't have to pay for medical school. France, Germany, and Japan all have similar systems, according to the book. They have private nonprofit insurance, some kind of mandate to…

One of the main reasons why I gave up career in the States and came back to my home country (Japan) was healthcare. I had a day surgery in the US and the whole experience (i.e. bills) just scared heck out of me. I am very happy with the system here. Everything is extremely efficient compared to the US. A little while ago, I had this mysterious headache and went to an orthopedist, dentist, psychiatrist, neurosurgeon then took an MRI. All within one week. My Canadian friend told me that it would be a half-year ordeal in Canada. By the way, I'm not rich.

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

#132

Post by Alex3917 »

refurb wrote: post #116
Alex3917 wrote: post #61

Earlier quoted context omitted.

R&D includes a lot of (most?) but not all advertising. It probably doesn't include things like running DTC ads on TV. But it does include things like: - Paying doctors to prescribe the drug to patients for "research purposes." - Paying doctors for their "valuable opinions" about the drug. - Paying for advertising to recruit patients into clinical trials. And so on. I don't think there are any industry-wide statistics…

For the first point you mean clinical trials? I wouldn’t call that advertising. The 2nd point sounds like consulting fees, not advertising. And the 3rd point is required to recruit for clinical trials. And the drug doesn’t even have a brand name at the point. Doesn’t seem like what the general public would call advertising.

> For the first point you mean clinical trials?

Usually post approval clinical trials. Since pharma companies wouldn't be allowed to pay doctors to prescribe their drugs for no reason, they just spin up new trials after the drug is already approved and pay doctors in exchange for getting the patients to do something nominal like filling out a survey.

> The 2nd point sounds like consulting fees, not advertising.

Consulting is a form of advertising, at least in the way it's actually done in the pharma industry.

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

#133

Post by airstrike »

wil421 wrote: post #93
airstrike wrote: post #27

Earlier quoted context omitted.

As a U.S. immigrant who struggles to find truly healthy food choices in Manhattan of all places, I couldn't agree more.

Most really healthy people cook for themselves.

That's what I do too, but every once in a while you have to buy prepared food and the portion size, calorie count and amount of sodium / sugar in American food is simply staggering

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

#134

Post by tdhoot »

jeromeparadis wrote: post #110
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.

> ...rather they fear that it will result in them receiving worse care. In Canada, we have free healthcare. If you have the money you still can go private if you think you'll get a better care. But I guarantee you won't go private for hearth surgery. There's not market for it because the care you get is already the best in the public sector.

I'm Canadian and as far as I know you don't have a private option in most provinces. The only option is to travel to the United States and pay for it yourself.

https://en.wikipedia.org/wiki/Healthcare_in_Canada#Restricti...

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

#135

Post by DennisP »

tdhoot wrote: post #125
DennisP wrote: post #104

Earlier quoted context omitted.

I read that book too, and agree it's phenomenal. It's not just about capping insurance profits. The countries doing the best also have price controls on the healthcare providers. Doctors make a lot less money. On the other hand they generally don't have to pay for medical school. France, Germany, and Japan all have similar systems, according to the book. They have private nonprofit insurance, some kind of mandate to…

>> Japan has a clever way to handle the mandate. If you don't pay your premiums, nothing happens, but if you need healthcare you're not covered until you pay your back premiums. Wouldn't it always be a good idea to not pay premiums until you have a major expense then?

You could, but you'd have to keep the money in savings anyway, and there'd be some hassle at a time when you might not want to deal with hassle. In practice, it turns out most people just pay their premiums, at least in Japan.

But if it turns out to be a problem, you could always charge interest.

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

#136

Post by airstrike »

pravda wrote: post #129
cameronh90 wrote: post #44

Earlier quoted context omitted.

It does appear to be the case that the US funds most pharma R&D due to Americans overpaying relative to the rest of the word. In some cases (China, India) this is due to weak IP protection, but in other cases (Canada, UK, Europe) it's more to do with our governments having a stronger negotiating position and setting hard limits on what they'll spend for a given benefit to patients. Some characterise this as freeloadi…

The "freeloading" meme is the creation of public relations groups employed by the pharma industry. Drugs in the US are priced at the profit-maximizing price. That profit-maximizing price has nothing to do with how much pharma earns in other countries. And it has absolutely nothing to do with the cost of R&D. R&D is a sunk cost, has no effect on drug pricing.

> And it has absolutely nothing to do with the cost of R&D. R&D is a sunk cost, has no effect on drug pricing.

That's not how this works. Volume is fixed because you effectively already know how many patients there are and COGS is minimal because drugs are generally very cheap to produce, so price and SG&A are the key drivers to determine returns

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

#137

Post by tdhoot »

nerdponx wrote: post #40
vasilipupkin wrote: post #34

I think it’s hard to compare these numbers across countries. For example, a richer country could choose to spend more on stuff that ultimately makes little difference in outcomes. For example, fewer people per hospital room or better hospital food or shorter wait times for a non threatening disease.

I'm not sure this holds up to scrutiny. Why don't other rich countries (e.g. Canada, which lets you pay for your own healthcare if you want) have this problem?

Source on Canada letting you pay for your own healthcare? It's usually prohibited.

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

#138

Post by joshcain »

tdhoot wrote: post #125
DennisP wrote: post #104

Earlier quoted context omitted.

I read that book too, and agree it's phenomenal. It's not just about capping insurance profits. The countries doing the best also have price controls on the healthcare providers. Doctors make a lot less money. On the other hand they generally don't have to pay for medical school. France, Germany, and Japan all have similar systems, according to the book. They have private nonprofit insurance, some kind of mandate to…

>> Japan has a clever way to handle the mandate. If you don't pay your premiums, nothing happens, but if you need healthcare you're not covered until you pay your back premiums. Wouldn't it always be a good idea to not pay premiums until you have a major expense then?

I'd guess there's some kind of interest/penalty you have to pay along with the back premiums.

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

#139

Post by bitcoinmoney »

tdhoot wrote: post #125
DennisP wrote: post #104

Earlier quoted context omitted.

I read that book too, and agree it's phenomenal. It's not just about capping insurance profits. The countries doing the best also have price controls on the healthcare providers. Doctors make a lot less money. On the other hand they generally don't have to pay for medical school. France, Germany, and Japan all have similar systems, according to the book. They have private nonprofit insurance, some kind of mandate to…

>> Japan has a clever way to handle the mandate. If you don't pay your premiums, nothing happens, but if you need healthcare you're not covered until you pay your back premiums. Wouldn't it always be a good idea to not pay premiums until you have a major expense then?

Then they’ll add up the premiums?

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

#140

Post by HillaryBriss »

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…

> Ask yourself when the last time you asked your physician how much a service cost.

ummmm... last year. I always ask the doctor or dentist how much something's gonna cost. (not that I get a reliable, accurate answer, but I still ask.)

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