Which firms profit most from America’s health-care system (2018) • Hacker News Board

Re: Which firms profit most from America’s health-care system (2018)

#11

Post by saddlerustle » Sat, Jul 04, 2020, 2:11 PM UTC

ntsplnkv2 wrote: post #6

> Everyone hates pharmaceutical firms, but their share of health-care rent-seeking is relatively trivial, especially once you include the many midsized and small firms that are investing heavily. This article misses the point. People hate pharmaceuticals because of ridiculously high drug costs, and that's about it. If they can't produce drugs at profit without gouging potential end users then it should be nationalize…

Why do you think that'll make drugs significantly cheaper? Drug companies are only about as profitable as other science-heavy industries.

Re: Which firms profit most from America’s health-care system (2018)

#12

Post by bluedino » Sat, Jul 04, 2020, 2:15 PM UTC

knubie wrote: post #5

> Every year America spends about $5,000 more per person on health care than other rich countries do. Yet its people are not any healthier. I think part of the reason Americans spend more on healthcare is precisely because they're unhealthy. According to the American CDC the obesity rate has reached a staggering 42.4% of adults[0], which brings with it a slew of health problems. This accounts for an additional $147 b…

If we fixed our diet problems, I’m not sure if we’d either have e or healthcare costs, or if the industry would find other ways to fill in the gap

Re: Which firms profit most from America’s health-care system (2018)

#13

Post by standardUser » Sat, Jul 04, 2020, 2:16 PM UTC

dan-robertson wrote: post #9

knubie wrote: post #5

> Every year America spends about $5,000 more per person on health care than other rich countries do. Yet its people are not any healthier. I think part of the reason Americans spend more on healthcare is precisely because they're unhealthy. According to the American CDC the obesity rate has reached a staggering 42.4% of adults[0], which brings with it a slew of health problems. This accounts for an additional $147 b…

A counter argument I see sometimes is that the reason Americans spend more on healthcare compared to other rich countries is that American consumers spend more on just about everything than most other rich countries (and also earn more money). I don’t really know how much merit the argument has.

And as a result we have bigger homes, bigger cars, bigger TVs.... but worse healthcare outcomes? Seems like some of that excess spending yields us more returns than others.

Re: Which firms profit most from America’s health-care system (2018)

#14

Post by standardUser » Sat, Jul 04, 2020, 2:17 PM UTC

HPsquared wrote: post #3

What's missing is the Bender solution: "I'll make my own system! With blackjack! And hookers!" Barriers to entry are too high for a really free market to emerge.

Are the barriers too high? I've seen a lot of "modern" medical offices pop up in recent years, like One Medical and Carbon Health. Not to mention the scores of startups that specialize on more narrow parts of healthcare.

Re: Which firms profit most from America’s health-care system (2018)

#15

Post by grecy » Sat, Jul 04, 2020, 2:17 PM UTC

dan-robertson wrote: post #9

knubie wrote: post #5

> Every year America spends about $5,000 more per person on health care than other rich countries do. Yet its people are not any healthier. I think part of the reason Americans spend more on healthcare is precisely because they're unhealthy. According to the American CDC the obesity rate has reached a staggering 42.4% of adults[0], which brings with it a slew of health problems. This accounts for an additional $147 b…

A counter argument I see sometimes is that the reason Americans spend more on healthcare compared to other rich countries is that American consumers spend more on just about everything than most other rich countries (and also earn more money). I don’t really know how much merit the argument has.

> American consumers spend more on just about everything than most other rich countries

Do you have a source for that?

In my experience living and working in a slew of countries around the world, the USA has the cheapest alcohol, cigarettes, cars, electricity, clothing, electronics, gas (and diesel), food at the supermarket, food at the restaurant and many other things of any developed country.

Because taxes are so low, stuff in America is extremely cheap compared to countries with tax-funded healthcare, higher education, etc.

Re: Which firms profit most from America’s health-care system (2018)

#16

Post by mchusma » Sat, Jul 04, 2020, 2:20 PM UTC

EconTalk has many great episodes digging into interesting aspects that are touched on here: why the US healthcare so expensive for so little extra value.

This episode about the Oklahoma group that has had low cost & transparent prices for surgeries for many years. http://www.econtalk.org/keith-smith-on-free-market-health-ca...

This one on why we get such expensive drugs with marginal benefit: http://www.econtalk.org/vinay-prasad-on-cancer-drugs-medical...

This one on benefit management companies terrifying behavior: http://www.econtalk.org/robin-feldman-on-drugs-money-and-sec...

(Also PS Russ Roberts on this show is a treasure. His way of thoughtfully engaging with others is something I try to learn from.)

Re: Which firms profit most from America’s health-care system (2018)

#17

Post by metalgearsolid3 » Sat, Jul 04, 2020, 2:21 PM UTC

knubie wrote: post #5

> Every year America spends about $5,000 more per person on health care than other rich countries do. Yet its people are not any healthier. I think part of the reason Americans spend more on healthcare is precisely because they're unhealthy. According to the American CDC the obesity rate has reached a staggering 42.4% of adults[0], which brings with it a slew of health problems. This accounts for an additional $147 b…

Personally I'm way more inclined to believe Americans are unhealthy because their health care system is too expensive, rather than the other way around. Obesity is treatable.

Re: Which firms profit most from America’s health-care system (2018)

#18

Post by DougWebb » Sat, Jul 04, 2020, 2:21 PM UTC

saddlerustle wrote: post #11

ntsplnkv2 wrote: post #6

> Everyone hates pharmaceutical firms, but their share of health-care rent-seeking is relatively trivial, especially once you include the many midsized and small firms that are investing heavily. This article misses the point. People hate pharmaceuticals because of ridiculously high drug costs, and that's about it. If they can't produce drugs at profit without gouging potential end users then it should be nationalize…

Why do you think that'll make drugs significantly cheaper? Drug companies are only about as profitable as other science-heavy industries.

Pharmaceutical companies have massive advertising/marketing budgets, which a nationalized drug R&D program would not need. That lowers overall costs. The R&D and manufacturing costs would also be spread across all Americans instead of only the patients who need the drugs, so the costs would be much lower for the patients as well.

Re: Which firms profit most from America’s health-care system (2018)

#19

Post by sytelus » Sat, Jul 04, 2020, 2:23 PM UTC

In the case of health care, consolidation has probably made things worse by muting competition. There are now five big insurance companies, three big wholesalers, three large pharmacy chains and three big benefit managers. In the case of health care, consolidation has probably made things worse by muting competition. There are now five big insurance companies, three big wholesalers, three large pharmacy chains and three big benefit managers.

Re: Which firms profit most from America’s health-care system (2018)

#20

Post by tomrod » Sat, Jul 04, 2020, 2:23 PM UTC

I can't read due to pay wall, but have a guess. Data systems, such as Epic, seem unnecessarily close walled. Is Epic the big winner, pharma, or something else?