I saw an interesting article a while back. It looked at the benefits adjusted income of workers in the US since 1980 or so. Basically, the “disappearing wage growth” at of the last part of the 20th and early 21st century fir the bottom of the income curve is largely (although entirely) explained by the increasing cost of health care as a component of compensation.
The US spends more on healthcare for no gain says new report from Johns Hopkins
161–170 of 537 posts
Re: The US spends more on healthcare for no gain says new report from Johns Hopkins
#162Earlier quoted context omitted.
I'm not sure (possibly because I read the book years ago). The other two countries handle it differently. Japan's healthcare cost is the lowest of the three though, at 5% GDP, despite an aging population of heavy smokers. So there doesn't seem to be that much overhead.
Despite Japan's aging, heavy-smoking population, Japanese people tend to be very healthy for reasons that aren't necessarily related to their healthcare system.
And Americans tend to be overweight and unhealthy. Access to healthcare doesn't automatically shift culture to live a healthier lifestyle (and I suspect it might even do the opposite).
Re: The US spends more on healthcare for no gain says new report from Johns Hopkins
#163It'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…
R&D should be publically funded like basic research is. We can say 'these drugs are expensive because they are expensive to research' all we want because it's true, but this statement ignores the problem of it all, and that is every step of the way from a customers insurance payment to research and development, there is skimming. Private health insurance cannot run at cost, private biotechnology companies cannot run…
I'm a diehard capitalist working in Wall Street and I could not possibly agree more.
Healthcare is not like other goods and services because (a) it's an universal need for which price sensitivity is zero (b) no one should have to pay life-crushing bills because they had no luck in the genetic lottery and (c) even for those health risks that people can control (obesity, cardiovascular problems), we have to admit that educating the population to eat better, sleep more and exercise is a pipe dream, particularly in the U.S. where shitty food is everywhere, the lobby for junk food and sugar is rampant, labeling and advertising for food is downright evil and work is incredibly demanding (unbelievably more demanding than in Latin America or Europe).
Healthcare and Education should be entirely subsidized by the government. Everything else can just be regulated to various degrees, always with the dual goal of minimizing state intervention while ensuring the market remains competitive.
Re: The US spends more on healthcare for no gain says new report from Johns Hopkins
#164Re: The US spends more on healthcare for no gain says new report from Johns Hopkins
#165Earlier quoted context omitted.
Why would you cap healthcare prices for insurers, they don’t set prices. You mean providers? Half of US healthcare spending is public payers - Medicare and Medicaid. They do set prices for providers and still spend far more than other countries. And if you’ve been involved in US healthcare you’d realize it’s drowning in regulations already. It’s not a free market by a stretch.
I did mean providers, I worded that poorly. US government does not set max prices for procedures, checkups, test, drugs etc as other counties have wisely chosen to do. The reason we spend so much on Medicare and Medicare is because people are less hesitant to use the service. On a per capita basis, the public payers have reduced overhead and costs compared to the private markets. If you have sources proving me wrong,…
The cost of procedures for Medicare and Medicaid is still much higher than for other countries.
Yes, they reduce costs by saying “this is what we’ll pay”, but it’s still much more costly than other countries’ systems.
Re: The US spends more on healthcare for no gain says new report from Johns Hopkins
#166Earlier quoted context omitted.
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
To save others the Googling: SG&A = Selling, General and Administrative Expenses.
I'm not sure that you disagree with me. The higher the price the higher the returns, but price too high and you earn less money, because volume is not fixed. (I'd bet a lot less Viagra would be sold if it cost $500 per pill.)
That was the genius of Martin S. He felt, correctly, that Daraprim was mispriced. That's why the price per pill was raised to $750 from $13.50.
Re: The US spends more on healthcare for no gain says new report from Johns Hopkins
#167Earlier quoted context omitted.
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 t…
Just got hemoroids frozen and cut with laser. Cost here in USA under premium insurance was $12,000. Went to Germany got it done on the same equipment in luxury stay for 14 days at $870. Plus $800 plane tickets. Meanwhile a friend of mine had a heart attack. As a Bank of America emplyee he had somewhat goog insurance that paid some. He was left with $180,000 bill.
> As a Bank of America emplyee he had somewhat goog insurance that paid some. He was left with $180,000 bill.
Forgive my ignorance but how is that possible? The highest out of pocket maximums for Marketplace plans is $15700 for an entire family.
Re: The US spends more on healthcare for no gain says new report from Johns Hopkins
#168The 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…
From what I understand, the healthcare market isn't free at all. LOTS of regulation is what has caused this mess I believe.
Re: The US spends more on healthcare for no gain says new report from Johns Hopkins
#169Earlier quoted context omitted.
It’s more complicated, the insurers essentially tell providers how to practice (ie prescribe this generic not the name brand, don’t prescribe 30 day Rx prescribe 90 day and don’t see/treat them in the meantime, etc...) and if the providers don’t listen the provider gets dropped from the network and either the patients are forced to new providers who the insurers control behind the scenes, or more and more the patient…
Insurers control care to reduce costs. The upward pressure on prices is from providers. In terms of these insurers who control providers, can you give an example?
The upward pressure on prices is also from the insurers. Insurers have an "80/20 rule" from Obamacare that only 20% of their revenue can be spent on non-medical expenses (ie. profit, insurance administrative overhead, etc.). They pretty quickly hit the caps, and now only by increasing medical expenditures (the other 80%) can the pie slice that contains their profit grow year after year.
Re: The US spends more on healthcare for no gain says new report from Johns Hopkins
#170Earlier 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…
>If you don't pay your premiums, nothing happens, but if you need healthcare you're not covered until you pay your back premiums. So what happens if you don’t pay your premium but then have to use the ER? Do they refuse to take you, or are you stuck with a bill? Does that bill go away if you pay your back premiums or not!
Don't quote me, but I've read many places in the US that ER's are required to take you if you are in a life threatening situation and if you cannot pay, the hospital just ends up owning the costs and then passes those costs to everyone else through insurance fees.