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

economist.com

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

#81

Post by bawana »

tkeAmarktinClss wrote: post #45

I didn't see anyone mention physicians. The base rate of the profession is around 250k per year. Specialities are not included in that calculation. Specialities are closer to 400k to 500k per year. This is not natural. This is 130+ years of regulatory capture. Other countries pay their physicians half as much. Not to mention outcomes are basically the same.

Actually, you are wrong. PCPs start at 90-100k salary. If you are quoting gross income before expenses then its about 200k. The overhead of running a physicians office is high. In terms of specialists, it's come down quite a bit. Just check the ads in the back of professional journals. 400k is more like the 70s.

Also you can look at the training of all the recent physicians, - many are from abroad. Same thing that the Silicon valley industry has been doing , hiring foreigners at lower pay. Education for physicians abroad is FREE. Whereas here you have to go to college (>50k a year tuition x 4) AND medical school (60k a year x 4) and then training 3-7 years at low income (40k a year) and crap life style.

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

#82

Post by DougWebb »

satyrnein wrote: post #68
DougWebb wrote: post #18

Earlier quoted context omitted.

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.

At least some of those marketing costs would still be needed, they'd just be called "education" or "outreach" or "access" programs. Patients and doctors still need to be informed of new advancements to improve outcomes. For the second point, cost spreading helps particular people in particular circumstances, but doesn't lower overall cost. You're just running a wealth transfer or insurance program in addition at that…

Patients do not need to be informed of new drugs, and never were until pharmaceutical companies lobbied Congress to remove the ban on direct advertising, which had been put in place as a consumer protection law due to 19th century "snake oil" salesmen/con-men. For doctors, a monthly publication of drugs currently in development, their status, and their uses would be adequate. It'd be much better for doctors to get their information from a published journal than the advertisements in some trade magazine or attractive reps handing out free samples.

Regarding You're just running a wealth transfer or insurance program in addition at that point. Yes, that would be a major purpose of nationalizing drug R&D and manufacturing. You could say the same about every public service.

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

#83

Post by amanaplanacanal »

sushshshsh wrote: post #25
francisofascii wrote: post #8

Just got the bill yesterday for my "free" Covid test. $250, insurance pays $105, you owe $145. (The test was free, the office visit was not.)

Who is to blame? The government for not collecting taxes from you and using that money to pay the doctor? The doctor for billing too high for the visit? The insurance company for not covering more of the price? Personally I would seek to understand why the doctor is billing so much and how that can become more fair for everyone involved.

Part of the issue is that the supply of doctors is kept artificially low in the US. Another part is: why the heck do you need an office visit for this? Why can’t you go directly to the lab?

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

#84

Post by ianleeclark »

lotsofpulp wrote: post #67
ianleeclark wrote: post #57

Earlier quoted context omitted.

> Because that ability doesn't exist, there is no downwards price pressure anywhere at the consumer level for medical services. It's important to note that the downward pressure you'd see here is only for elastic goods which most healthcare-related things likely aren't.

There are plenty of healthcare related things that one can shop for, such as this COVID test. The price could easily be advertised on the healthcare facilities website. But it’s not because it would hurt revenue since price transparency benefits buyers, and price obfuscation benefits sellers by allowing them to price discriminate and charge each seller the most each seller is able to pay.

> But it’s not because it would hurt revenue since price transparency benefits buyers, and price obfuscation benefits sellers by allowing them to price discriminate and charge each seller the most each seller is able to pay.

Are you against a monopsony in healthcare? If you care about having a fair-shake for every consumer, then that's the most consistent way of wielding power against would-be price gougers.

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

#85

Post by Retric »

sushshshsh wrote: post #25
francisofascii wrote: post #8

Just got the bill yesterday for my "free" Covid test. $250, insurance pays $105, you owe $145. (The test was free, the office visit was not.)

Who is to blame? The government for not collecting taxes from you and using that money to pay the doctor? The doctor for billing too high for the visit? The insurance company for not covering more of the price? Personally I would seek to understand why the doctor is billing so much and how that can become more fair for everyone involved.

A huge factor is multiple insurance companies add a lot of overhead to the system as they all try to negotiate lower prices. It’s common for a doctor to spend more time dealing with your insurance company after a visit than you. Which clearly means they need to dramatically raise prices to cover that overhead.

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

#86

Post by tkeAmarktinClss »

bawana wrote: post #81
tkeAmarktinClss wrote: post #45

I didn't see anyone mention physicians. The base rate of the profession is around 250k per year. Specialities are not included in that calculation. Specialities are closer to 400k to 500k per year. This is not natural. This is 130+ years of regulatory capture. Other countries pay their physicians half as much. Not to mention outcomes are basically the same.

Actually, you are wrong. PCPs start at 90-100k salary. If you are quoting gross income before expenses then its about 200k. The overhead of running a physicians office is high. In terms of specialists, it's come down quite a bit. Just check the ads in the back of professional journals. 400k is more like the 70s. Also you can look at the training of all the recent physicians, - many are from abroad. Same thing that th…

Please post a citation

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

#87

Post by boublepop »

tkeAmarktinClss wrote: post #86
bawana wrote: post #81

Earlier quoted context omitted.

Actually, you are wrong. PCPs start at 90-100k salary. If you are quoting gross income before expenses then its about 200k. The overhead of running a physicians office is high. In terms of specialists, it's come down quite a bit. Just check the ads in the back of professional journals. 400k is more like the 70s. Also you can look at the training of all the recent physicians, - many are from abroad. Same thing that th…

Please post a citation

Perhaps you could post a citation yourself before asking it if others.

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

#88

Post by hef19898 »

take_a_breath wrote: post #66
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…

Colonoscopies in the US cost about $2,500 out-of-pocket, even with insurance. Most other countries are under $1,000 for the same procedure.

No idea how much my public insurance paid my doctor, but in Germany these things are free for the patient.

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

#89

Post by vgchh »

I recently got a shock when I went for a tooth extraction. A nurse and a surgeon spent an hour to complete the procedure. It came out to ~$6000. I had to pay for $700 for calcium grafting right then and there and they were going to get back to me for the remaining after consulting with insurance plan. I am still waiting for the call, albeit terrified of the possibilities.

I understand there are many parties in the food-chain. Still $6K for two people for an hour, feels like ripped to the gills - almost dirty.

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

#90

Post by phobar »

phaemon wrote: post #78
enaaem wrote: post #29

Earlier quoted context omitted.

Developing new drugs takes over a decade and costs billions. European countries are free loading of US drug research. https://www.wsj.com/amp/articles/how-other-countries-freeloa...

(I'm using 2015 figures because they were the latest available the last time I challenged this bullshit) Nope, drugs sales in the EU alone are enough to cover pharmaceutical R&D costs worldwide. What they aren't enough to cover is Marketing costs, but that's OK since most EU countries don't allow direct marketing of drugs. That's what the US covers. Not quite so noble sounding that you're covering the cost of adverti…

Good points but you should differentiate between generics and novel therapies that make up for the 190B USD in EU sales.
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