231–240 of 389 posts
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I imagine it's on account of all the administration and intermediaries.
Physicians and hospitals have 2 of the most powerful lobbies in the US and have previously gatekept the doctor profession.
http://www.econ.yale.edu/seminars/strategy/st03/nicholson-03...
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Before coming to any conclusions on this topic, I highly suggest reading this extremely in-depth analysis on cross-country healthcare spending.[1] The simple answer is that Americans really do consume significantly more healthcare than Europeans. The most straightforward signature of this is the fact that a much higher proportion of Americans work in the healthcare industry than any other large country. The US also t…
> The strongest counterpoint to this is that despite America's high healthcare consumption, that health outcomes are significantly worse than Europe. In particular in terms of life expectancy. Just look at the life expectancy of France and Germany to disprove your theories. The big difference between the American healthcare system and the one in these countries is that people don’t have to worry about the bills, whic…
Let's use France as a comparison point since you mentioned it. Household disposable income in the US is about 36% higher than France. That's about equivalent to the wealth gap between France and Slovenia. The US spends about 70% more per hospital stay than France, and very similarly that's almost the exact same spending gap between France and Slovenia.
The point being it's easy to ask "why does the US spend more than Western Europe?" But, analogously you should also ask "why does Western Europe spend more than Southern and Eastern Europe"? And the most clear answer is because wealthier countries tend to spend a higher percent of their income on healthcare.
[1] https://i0.wp.com/randomcriticalanalysis.com/wp-content/uplo...
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For completeness, a couple of other health related actions by the current administration: - 'Most Favored Nation' drug pricing. Also as of 1/1, big pharma has to charge US payers the same price as the lowest price they charge to other countries. One example cited is insulin. Apparently, the price of Insulin from the same pharma is 10% the price in Canada as it is in the US. Now that this law is enacted, that pharma h…
We should not ignore the attempt to relax restrictions on Association Health Plans in 2019, which would have made it easier for small businesses to band together to negotiate insurance terms using combined group numbers on par with that of larger corporations. This was struck down by a federal court[0], but would have moderately improved one of the biggest barriers to small business ownership/employment - unobtanium…
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For completeness, a couple of other health related actions by the current administration: - 'Most Favored Nation' drug pricing. Also as of 1/1, big pharma has to charge US payers the same price as the lowest price they charge to other countries. One example cited is insulin. Apparently, the price of Insulin from the same pharma is 10% the price in Canada as it is in the US. Now that this law is enacted, that pharma h…
We should not ignore the attempt to relax restrictions on Association Health Plans in 2019, which would have made it easier for small businesses to band together to negotiate insurance terms using combined group numbers on par with that of larger corporations. This was struck down by a federal court[0], but would have moderately improved one of the biggest barriers to small business ownership/employment - unobtanium…
It's always fascinating to see that even compared to prices you pay as a self-paying patient in Germany (which are already 1.5x - 2x higher than what the "public" insurances, ie. 85% of the population, pay for the same procedures), the prices in the US are about 5x to 10x higher. The standard of care seems to be quite comparable if you look at outcomes, so there must be huge inefficiences in the American system (doct…
Chargemaster prices (the non-negotiated price) are ridiculously high in the US. They’re so high that some hospitals will give uninsured patients a break of “half off” without even negotiating. The reason for this is that chargemaster price is a fake dollar price resulting from a broken incentive structure and process. Here’s a setup: A hospital is working out a negotiated rate for aggregate services with an insurance…
I agree that the chargemaster prices are fake, but what you are proposing is:
Hospital: "Our insurance partners pay us a fraction x of Chargemaster charge X, so let's make C larger."
The insurer understands the game being played here, just like you do. It's not like the insurer doesn't also realize just like you do that the chargemaster price is fake.
The insurers are not going to say "Oh C got bigger this year? Well, let's pay more!"
More important are failures of competition in the marketplace, especially consolidation on the hospital side (most markets are now served by large hospital systems, so insurers cannot plausibly threaten to exclude hospitals from networks), the lack of exposure of consumers to most of the price, and the lack of incentives on the consumer side to search for cheaper prices (plus a general lack of any information about which facilities might be cheaper).
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Could you enlighten me and name some of those things? Not things he said, but things he did according to you.
His attacks on the immigration and asylum systems were particularly insane and cruel. A just future will forever associate the man with this dark period of Family Separation and caged children.
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Why add additional steps, government should open hospitals and provide healthcare directly.
Why? (Seriously - you seem to be assuming the answer here.) Would the same statement be true for food and shelter (also necessary for life)? Should the government be the provider for all food and shelter in order to avoid additional steps?
The same is not true for healthcare. Even when purchasing shelter, people are not sufficiently informed to be able to make a good decision, hence the existence of electrical, plumbing, and structural codes and inspections.
With healthcare, people are extremely uninformed. The costs are extremely high. The government doesn’t necessarily need to vet the doctors’ diagnoses and prescribed remedies, but they could. So could insurance companies, which is what currently happens in the US.
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It's true that US doctors are paid more (although the gap isn't as big as it used to be). However, pay for US doctors makes up a fairly small portion of overall US medical expenditures (less than 10%). So, you could ask every doctor to work for free and not significantly change costs.
There’s a similar (but smaller) differential for other medical professionals too. But more generally, when I’ve done high-level comparisons of medical spending between the US and Western European countries, it seems like every single cost element is more or less proportionately higher in the US. It seems like basically everyone is spending money in roughly the same proportions, including on things like doctors’ salar…
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Just throwing some data, average general practice doctor is 150k$ in US vs 61k$ in germany. https://www.payscale.com/research/DE/Job=Physician_%2F_Docto... https://www.payscale.com/research/US/Job=Physician_%2F_Docto...
I believe that doctors in the US get paid more than in germany, but 60k seems very very low. Teachers have an income in that range.... Edit: Looking at some german articles, maybe they did not convert from eur to usd, ~80,000-100,000$ (depending on expertise etc) seems more likely for a dr working at a hospital (which is still low imho compared to US salaries...). https://www.arzt-wirtschaft.de/wie-hoch-ist-das-gehal…
