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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

#361

Post by tapland »

dougmwne wrote: post #342
JAlexoid wrote: post #258

Earlier quoted context omitted.

Why would you care, when your copay is $30 flat?

Every time I use my health insurance in the USA I peel back another layer of this onion of a scam. I've started doing most of my health care abroad even though I'm insured just so I don't have to deal with this industry. I doubt posting prices online will do much because it seems like a quick fix to a systemic issue. 1. Go for a 3 minute, 30 second ENT appointment about earwax. Think I'm just paying a co-pay. Receive…

It surprises me that that behavior is even legal. It shouldn't be in a modern democracy.

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

#362

Post by Robin_Message »

kitd wrote: post #359
SmellyGeekBoy wrote: post #356

Earlier quoted context omitted.

Not strictly true - we do pay a nominal fee for prescription drugs and NHS dentists (although some classes of people, eg students and retired people, are exempt).

Additionally, a lot of long-term care in the UK is provided by charities (Cancer Research, Macmillan, Heart Foundation, etc) which can be expensive but IIRC doesn't appear in the NHS budget.

True enough. I was thinking of specialist Doctors appointments, which are covered. It seems crazy, in a kind of roll your own adventure way, to pay for diagnosis, per specialist.

I sort of imagine conversations going like:

Doctor A: You might have this other nasty thing, but I'd have to send you to doctor B to check. Doctor B will cost you a hundred bugs. Patient: I don't have a spare $100 Doctor A: we'll just hope it isn't that then. Me: WTF?

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

#363

Post by ObnoxiousProxy »

vasili111 wrote: post #235
cmrdporcupine wrote: post #221

Earlier quoted context omitted.

One of the problems with the Canadian system is frankly its proximity to the U.S. A large portion of our homegrown medical talent goes immediately south of the border for higher salaries (see your point about price controls on healthcare providers above).

If you need talents to stay in your country then you need to pay them more.

Yes you are correct, but that is why Canadian healthcare is less efficient on a cost per dollar basis than it could be (Im Canadian). Canadian doctors dont get paid as much as their US counterparts but are generally higher paid than their European counterparts partly due to this reason already. Yet Canadian healthcare is not as efficient as say UK for example.

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

#364

Post by rscho »

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…

Absolutely true. As a doc, the US problem boils down to a cultural issue that can be summarized as:

"there is no reason my money should pay for the care of others, but if I personally need care, then it should be of the absolute best quality and should be provided until my last breath no matter what"

The people maintain the system themselves by insisting on that, and that is the root of every other problem. Before alleviating restrictions for med school, US people should think about pulling the plug on the legions of evidently terminal patients receiving maximal care that just prolongs their intense suffering every day around the country.

Why do you think your doc does every exam under the sun as soon as you step foot in the office?

1 - if solo, more money; if networked, makes you look better for the "employer" (insurance company/hospital/HMO, etc.)

2 - if you have too many exams, you will complain on the internet. If you have too few exams and something goes wrong, you will drag the doc into court.

Weigh the incentives and I think even the most conservative person should see a problem.

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

#366

Post by distant_hat »

whitepoplar wrote: post #186
kenhwang wrote: post #162

Earlier quoted context omitted.

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).

It would be great if gym memberships could be made free for everyone. I bet it would even be cheaper in the long run to buy an Equinox membership for every American than it would be to do nothing.

Free gym memberships are unlikely to result in higher use. I've had multiple workplaces where gym is free and I've rarely used it, thankfully, I am blessed with a skinny physique and parents who inculcated good food habits. In fact, places which charged for gyms explicitly saw slightly higher usage since some folks logic went, since I am paying for it, I might as well get my money's worth.

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

#367

Post by skookumchuck »

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…

> allows for-profit health insurance companies to exist with ZERO regulation to cap healthcare prices.

There's zero regulation on the software industry, and prices have trended to zero. I suspect the problem with the health care industry is much deeper than not enough regulation.

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

#369

Post by arethuza »

rscho wrote: post #364
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…

Absolutely true. As a doc, the US problem boils down to a cultural issue that can be summarized as: "there is no reason my money should pay for the care of others, but if I personally need care, then it should be of the absolute best quality and should be provided until my last breath no matter what" The people maintain the system themselves by insisting on that, and that is the root of every other problem. Before al…

"there is no reason my money should pay for the care of others"

Isn't the cultural issue largely a idealogical issue - things like the UK NHS are avowedly socialist? In the words of Aneurin Bevan, founder of the NHS:

" A free health service is pure Socialism and as such it is opposed to the hedonism of capitalist society."

https://en.wikipedia.org/wiki/Aneurin_Bevan

Personally, at least when it comes to healthcare, I'm a socialist:

"The collective principle asserts that ... no society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means."

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

#370

Post by wjnc »

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…

We run a health insurance company at my firm for some € 100 in cost per insured per year (the Netherlands). We do full bargaining with suppliers on our risk, give yearly premiums up front and have to accept everyone for a pretty much standardized premium. Dare say we even try to innovate in combination with other private insurances we offer like disability as well. Of course required for this to work is quite massive government intervention. They lay the backbone for proper risk equalisation and we try to work with that. 20% of total health spending would be about a 14-fold increase. (It gets a little murky since parts of health are outside of our market and the responsibility of local municipalities.)
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