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US spends most on health care but has worst health outcomes
51–60 of 134 posts
Re: US spends most on health care but has worst health outcomes
#52This isn't at all surprising, for multiple reasons. The entire insurance industry existing is a big one. That we are all overweight is another. I'm generally a very conservative person. But even I am for government funded healthcare. Who in the hell is against it? I've not met a single person completely against it, mostly just people against people abusing emergency rooms. Certain big media and politicians are agains…
> That we are all overweight is another. https://en.wikipedia.org/wiki/List_of_countries_by_obesity_r... Obesity vs overweight (the former is surely a better predictor of health outcomes anyway) aside, we’re definitely higher than comparable nations, but I wouldn’t say significantly so.
Yes you are, especially when it comes to the "landwhale" category of 400+ pounds.
Even the link you provided says that the US would fit among the Arab countries, but would be a major outlier in Europe. There are people with bellies here, BMI > 30, but the "unable to walk without a motorized wheelchair" category is rare.
I live in the Czech Republic, a notorious beer-guzzling nation that was never known for being slim. But the kind of obscene, ballooning fatness that is ubiquitous in the US was never seen here until, say, 2015. Unfortunately I slowly see it slowly emerging among the youth, probably the ones who live on the fastfood diet.
(Fast food used to be relatively expensive compared to Czech salaries, so people wouldn't gorge on it everyday, but this has changed and now it one of the cheaper options out there.)
Re: US spends most on health care but has worst health outcomes
#53>the system is bad Doctors aren't paid when you are healthy. How would you suggest fixing such a system? Because if you figure it out, there's a whole system of auto mechanics that could probably benefit from the solution.
> Doctors aren't paid when you are healthy
Isn't it worst that doctors are paid if you are not healthy? Doesn't it create an incentive for them to prevent you from being completely healthy?
Anyway, most countries in Europe pay their doctors regardless of you health status and that money comes out directly of taxpayers' pockets whom most of them are 100% happy to make it that way
Re: US spends most on health care but has worst health outcomes
#54Earlier quoted context omitted.
The NHS in the UK is after a decade of sabotage by a Conservative government who would like nothing more than to see it scrapped and replaced with private healthcare insurance like the US has. As it stands it is a system that is being starved of resources and yet it is still outperforming the US.
Can you explain how 6.5%/year increases in budget over 12 years is "starving"? Also curious how you square "outperforming" with the worst ever waiting times for critical surgeries.
> Can you explain how 6.5%/year increases in budget
Yes! It needs more. Glad to have cleared that up.
> Also curious how you square "outperforming" ...
This is the conclusion of the study in the article you're commenting on
Re: US spends most on health care but has worst health outcomes
#55Of course it does. Three reasons: * A big chunk of the money goes to private insurance, never materializing into “health”. * Health centers being run as a business, not a national necessity (like roads or the military) * An obscurity in health practice pricing that would be illegal in any other activity.
I would ass a fourth reason: health is a very much a public (as in collective) issue, not a sum of individual medical problems. Something that is fundamentally at odds with the dominant ethos of how to deal with problems in america in the past 50 years or so.
Re: US spends most on health care but has worst health outcomes
#56This isn't at all surprising, for multiple reasons. The entire insurance industry existing is a big one. That we are all overweight is another. I'm generally a very conservative person. But even I am for government funded healthcare. Who in the hell is against it? I've not met a single person completely against it, mostly just people against people abusing emergency rooms. Certain big media and politicians are agains…
I'm a conservative also. Stuff that basically everyone needs to deal with should be out of pocket with tranparent ahead-of-time pricing. Doctors and occasional specialists, non-exotic meds, normal chronic conditions, etc. State covers/helps it if you can't (means testing with sliding scale, no cliff). Paying for stuff kinda sucks, but less so than brutal waste pulled out of your paycheck or taxes. Financially major i…
> but less so than brutal waste pulled out of your paycheck or taxes.
Are you suggesting that universal systems are more wasteful? Wouldn't that imply that a simple natural experiment of total healthcare spending vs average health outcomes should show a benefit to private over universal/tax funded?
Re: US spends most on health care but has worst health outcomes
#57Earlier quoted context omitted.
> Who in the hell is against it? Roughly half the country is against it! And ironically, it's often because they want "choice" in their medical care, despite the fact that health insurance is tied to your employment and you barely have any choices under your control anyway -- you go with the clinic or hospital that takes your plan, and you go with the doctor that's available.
It's such a complete lie that our current system confers any advantages whatsoever. It's a line trotted out by insurance lobbyists, then politicians, then shitty news media, and finally by the poor brainless voters themselves. If Americans had any international perspective at all it would be much harder to keep that fiction alive, but Americas generally are completely ignorant of how people live outside the us, and n…
From the international perspective, US is probably closer to the EU than to, say, France or Britain, (both in size and in relative decentralization), and we do not have a common healthcare system in the EU either - plus there seems to be even less support for it than in the US.
Re: US spends most on health care but has worst health outcomes
#58Earlier quoted context omitted.
A small group chat I’m a part of has one person who works for an insurance company. Reading his messages about his work day is just depressing. “Oh, yeah, if someone has that cancer and they’re under 45 it’s an auto-reject from me. Just too unlikely for them to have it” was one message that’s stuck with me. You (or your company) pays thousands of dollars a year (or more) to an insurance company to cover you for when…
how.... how... can they reject anything that the hospital says?
They are rejecting on the presumption that the billing is erroneous. The hospital would follow up and get it approved. It’s a crude system and I’m not excusing it.
Re: US spends most on health care but has worst health outcomes
#59Earlier quoted context omitted.
It's a fallacy to claim US healthcare is not "government funded". Aside from that, Canadian wait times for surgery are substantially worse than the United States (even before they stopped necessary surgeries during lockdown). [1] The amount of Canadians who visit the United States has increased dramatically over the last 10 years, many of which seek services which are simply not available at all in Canada -- such as…
I find it interesting that whenever socialized healthcare in the US is mentioned, there's always someone eager to point out the failings of Canada's and the UK's systems, yet I never hear mention of any of the other socialized healthcare systems that basically every highly developed nation maintains. I truthfully don't know any statistics on this sort of thing, so I couldn't tell you how good Finland or Greece or Spa…
Lack of access to doctors is a big issue in Canada. E.g., here's a list of posts on /r/canada about family doctors in the past year: https://www.reddit.com/r/canada/search/?q=family%20doctor&t=...
Canada is almost unique among developed countries with government healthcare in that it doesn't also have a parallel private medical system for those who can afford to pay for it. So naturally rich Canadians will often pay for private healthcare in the US.
I'm originally Canadian but have lived in Australia for the past 10+ years (in Melbourne). We've never had any issues getting medical appointments with local doctors (usually "bulk billed" so we pay nothing or a very nominal amount for the appointment). But we also have private medical insurance, which is required above a certain age (30 something), that we use occasionally for specialist appointments. But even then the out-of-pocket fee is something like $70 which is fine.
Unlike Canada, AFAIK most countries in Europe (e.g., Sweden, France, Spain, Germany) have parallel private medical care, so Canada really is unusual in that respect.
Re: US spends most on health care but has worst health outcomes
#60Earlier quoted context omitted.
A small group chat I’m a part of has one person who works for an insurance company. Reading his messages about his work day is just depressing. “Oh, yeah, if someone has that cancer and they’re under 45 it’s an auto-reject from me. Just too unlikely for them to have it” was one message that’s stuck with me. You (or your company) pays thousands of dollars a year (or more) to an insurance company to cover you for when…
how.... how... can they reject anything that the hospital says?
Because they are allowed to. Having no (useful) regulation allows that and more. And no it's not abuse, it's the system working as designed. If there's a problem with it, don't take it with the people in the system, as tempting as it might be. They will be replaced by others with the same reject-happy finger. It needs a new system, heavily regulated like in Europe, and this means exactly the uphill battle you would expect.