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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

#521

Post by int_19h »

refurb wrote: post #323
int_19h wrote: post #276

Earlier quoted context omitted.

It should also be noted that this arrangement in Canada is not typical of other countries with universal healthcare. There's more than one way to skin this particular cat; Canada just gets unduly much attention in the debate because of its proximity, and the "Canadians waiting in endless lines come to US for treatment" conservative meme. On the other hand, one thing that is usually ignored about Canadian healthcare w…

All good points. However, I’d take issue with federalism being more developed in the US than Canada. In my experience, the federal gov’t wields much more power in Canada than the US. However, your point stands that nothing is stopping the states from creating their own system. In fact, a few like CA and VT have proposed such arrangements, but they always fell through once the cost was apparent.

> However, I’d take issue with federalism being more developed in the US than Canada. In my experience, the federal gov’t wields much more power in Canada than the US.

Federalism being more developed means exactly that - that regions have more power relative to the center. The stronger the central government is, the less federalism, and the more country is a unitary state rather than a federation.

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

#522

Post by CryptoPunk »

hannasanarion wrote: post #401
skookumchuck wrote: post #367

Earlier quoted context omitted.

> 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.

How often do you get rushed to your local software company in need of an immediate node.js webapp or you'll die within the hour?

The vast majority of healthcare costs are not related to emergency care. For that portion, there is indeed an argument for government-provisioned services being more efficient.

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

#523

Post by NeedMoreTea »

dogma1138 wrote: post #520
NeedMoreTea wrote: post #519

Earlier quoted context omitted.

The NHS's trust structure is more about forcing a market into somewhere it has no place than about healthcare outcomes. When we once elected to go private to queue jump we got to see an NHS consultant privately, in an NHS hospital, and all follow on treatment was on the NHS. So it was a simple case of a few hundred pounds for private scan and consultation. Most hospitals and maternity units have private rooms as an o…

Yes but those funds aren’t going to the trust as in the actual public pool. Most hospitals have private wings, but the NHS doesn’t see any profit from that.

Hmm, I didn't realise this.

If I see an NHS consultant privately they get a little extra personal income. So if I took a private room where does the profit go in the current system? Treasury?

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

#524

Post by closeparen »

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…

There are mutual (policyholder-owned) life insurance companies; why not mutual health insurance companies?

Healthcare is extremely regulated, but poorly. In addition to the much-talked-about “more vs. less” dimension of regulation there is the much more important “better vs. worse.”

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

#525

Post by asdff »

RHSeeger wrote: post #447
asdff wrote: post #321

Earlier quoted context omitted.

Yet everyone uses the roads, schools, and safety paid for by everyone to ultimately get to their advantaged economic position. Healthcare is a public effort just like any of the above, and no one should suffer unequally due to class favoritism being built into public efforts. We shouldn't compromise with people who lack the humanity to see this.

To be clear, I'm in favor of everyone having healthcare. To some extent, I'm playing the devil's advocate here. Also to some extent, I think getting from where the US is to everyone having healthcare is a very difficult trip to make. That being said... - There is no way to support roads without everyone supporting them for everyone. It's not possible to pay for "just the roads I use". - Educating the next generation…

It does help you in a real way just as existentially as educating the next generation helps everyone. A healthy population is an economically productive population, and ensuring people get preventative care on time prevents strain on emergency services and saves the whole system money. In fact, this is how private insurance works too, your regular bill pays for other customers services, yet private insurance is somehow not viewed with the same contempt by conservatives.

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

#526

Post by collyw »

djrobstep wrote: post #299
vasili111 wrote: post #235

Earlier quoted context omitted.

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

No, the US needs to stop over-paying their doctors. And doctors need to stop being corrupt by reducing supply of doctors through restrictive medical school entry.

Is it bad that medical school entry is restrictive? Isn't the idea that you only want smart people to do it.

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

#527

Post by OliverJones »

tripzilch wrote: post #391
OliverJones wrote: post #372

Earlier quoted context omitted.

It's true. But the US drug marketers also move lots of money to television companies (watch any non-sports show and look at the ads). They finance lots of perks for prescribers. Their clinical trials for new compounds are extremely expensive, freeway-tunnel-under-harbor expensive, Carl Sagan expensive (billions and billions). They pay generic-drug manufacturers to refrain from making competitors to their compounds fo…

Can confirm. And it affects medicine outside the US as well. A bit over a decade ago, one very popular modern antidepressant drug used to be citalopram (cipramil). This is the racemic mixture (meaning it contains both the left and right-handed versions). The new one, escitalopram (lexapro) only contains the active stereoisomer. Its dosage is exactly half of the previous version because racemic mixture always (?) occu…

Exactly. Somebody I know with scientific training and depression was offered Lexapro (escitalopram) to replace a citalopram script: "It works better for some people." She wasn't so depressed that she didn't explain the scam to her doc, who accepted the explanation and stopped prescribing the new version with a reduced concentration of the ineffective stereoisomer.

But this doc wasn't getting visits and kickbacks from Allergan.

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

#528

Post by joelx »

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…

Americans spend more on healthcare but get less for one simple reason. We artificially restrict the number of new doctors each year through licensing and other government regulations, which reduces the supply of medical professionals. When you restrict the supply of anything and demand is inelastic, prices go up.

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

#529

Post by _benedict »

DennisP wrote: post #418
luckydata wrote: post #196

Earlier quoted context omitted.

Ok but why focusing on the insurance systems that are still sub-par compared to Italy, UK and Spain where the single payer system yields even better results for less money?

The book did cover the UK and Canada, and found they did not get better results for less money. The author didn't visit Italy or Spain. For quality results, the book used rankings by international organizations, based on statistics like "cure rate after diagnosis of major disease." For cost, it used percentage of GDP and cost per capita. Germany, France, and Japan were tops in quality, and Japan was also the cheapest…

I'm not sure what statistic you are referring to, but for cancer at least the definition of 'cure' is typically a number of years of life after detection (e.g. 5). In jurisdictions with less aggressive testing, this can give a worse measurement of cancer survival rates than the reality, since earlier detection by definition gives a higher chance of surviving to a time X years after detection.

https://www.bmj.com/bmj/section-pdf/187734?path=/bmj/346/789...

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

#530

Post by hippich »

max76 wrote: post #333
int_19h wrote: post #260

Earlier quoted context omitted.

> Does this make us immoral for "freeloading", because we prefer putting our limited money into cost effective treatments? It depends on whether some drugs that your system considers affordable today as generics, would have not existed without being funded by US taxpayers, I suppose.

> without being funded by US taxpayers It's not US taxpayers that are footing the R&D bill, but United States based customers of non-generic prescription drugs. These are technically two different sets of people.

I believe Medicare pays for like half of overall healthcare spending. So at least half of such R&D bill is paid by tax payers.
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