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US spends most on health care but has worst health outcomes

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Re: US spends most on health care but has worst health outcomes

#71

Post by yourusername »

mcv wrote: post #28
silisili wrote: post #8

This 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…

Private insurance doesn't have to be bad. Netherland has private insurance, and it works fine. Admittedly we've got probably the most expensive healthcare system in Europe, but it's still about half of what the US pays. But it does need to be tightly regulated, and more importantly, the healthcare system itself needs to be regulated. There needs to be a drive to lower costs while increasing quality. And of course the…

>Netherland has private insurance, and it works fine.

Fine-ish. For example some medications are not available because the insurance companies decided they would pay only for the cheapest generics and then only the lowest prices of anyone. For some reason this means that manufacturers decide to only supply to the Netherlands when they have ample supply.

Also there are the inefficiencies of the insurance companies who are for profit entities that spend large ammounts of money on their executive teams and ad campaigns to convince people to switch their policy to a difference insurer.

Re: US spends most on health care but has worst health outcomes

#72

Post by forgetfreeman »

silisili wrote: post #32
khazhoux wrote: post #23

Earlier 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.

This is an extremely popular liberal talking point. I do not believe it to be true. The article linked below has it at 60/40. But that's just a simple yes/no survey. When you probe the 40, they are mostly for it too, just with extreme reservations. Talk to some. It's definitely not an 'I got mine, let everyone else die' as is painted. https://thehill.com/policy/healthcare/3826215-57-percent-sup...

You don't believe it to be true based on what? The fact that it's an extremely popular liberal talking point, or some actual data?

Re: US spends most on health care but has worst health outcomes

#73

Post by ZeroGravitas »

0xy wrote: post #39
smcl wrote: post #35

Earlier 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.

Growing and aging population is the main two.

The Financial Times has published stark data showing persistent underinvestment when Conservatives are in power, compared with peer countries.

Re: US spends most on health care but has worst health outcomes

#74

Post by chmod775 »

_vbnz wrote: post #69
tehCorner wrote: post #53

Earlier quoted context omitted.

> 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

But doctors in Europe are paid a pittance in comparison. Like less than a third or even a quarter of US wages. That's the real issue - they will never want to take a hit to living standards. It was possible in the UK because it was directly after the war and the Blitz had killed hundreds of thousands of people, and there was a real threat of communism. Whereas the USA is nowhere that situation today. Things are going…

> That's the real issue - they will never want to take a hit to living standards.

So what are they gonna do? Refuse to treat people and starve themselves to death? They'll be replaced by people willing to earn less and who probably care about the work they do rather than just caring about earning a fat paycheck - those exist, as other countries prove. Seems like a win to me.

Re: US spends most on health care but has worst health outcomes

#75

Post by junofan »

Arnt wrote: post #17
emodendroket wrote: post #10

Earlier quoted context omitted.

So they can spend a lot of money to convince people that reforms are bad, they can buy influence among powerful politicians, and all the rest of the moves that make it so elite preferences do a lot to dictate policy the world over. Are we being naive here?

I think so, yes. You're basically saying that there are lobbyists and that's an insurmountable obstacle, and throwing your hands up in the air. You're not, for example, trying to learn how the countries that executed reforms successfully did so. EDIT: You could easily find a list online of the top ten health systems. Learning about the reforms carried out by each of those in the past 30 years requires effort, but it'…

US health spend is bigger than the GDP of every country on that list. The biggest employer in nearly every congressional district is a healthcare system. It’s politically difficult.

Re: US spends most on health care but has worst health outcomes

#76

Post by daedalus_f »

0xy wrote: post #39
smcl wrote: post #35

Earlier 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.

> In 2017, the UK spent £2,989 per person on healthcare, which was around the median for members of the Organisation for Economic Co-operation and Development: OECD.

> of the G7 group of large, developed economies, UK healthcare spending per person was the second-lowest, with the highest spenders being France (£3,737), Germany (£4,432) and the United States (£7,736).

> As a percentage of GDP, UK healthcare spending fell from 9.8% in 2013 to 9.6% in 2017.

https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...

Health care inflation is significantly higher than the retail price index. The population is aging - older people consume far more health resources than younger people.

Re: US spends most on health care but has worst health outcomes

#77

Post by nivenkos »

chmod775 wrote: post #74
_vbnz wrote: post #69

Earlier quoted context omitted.

But doctors in Europe are paid a pittance in comparison. Like less than a third or even a quarter of US wages. That's the real issue - they will never want to take a hit to living standards. It was possible in the UK because it was directly after the war and the Blitz had killed hundreds of thousands of people, and there was a real threat of communism. Whereas the USA is nowhere that situation today. Things are going…

> That's the real issue - they will never want to take a hit to living standards. So what are they gonna do? Refuse to treat people and starve themselves to death? They'll be replaced by people willing to earn less and who probably care about the work they do rather than just caring about earning a fat paycheck - those exist, as other countries prove. Seems like a win to me.

Yeah, go on strike, or refuse to work with the public health system, etc.

Britain had all of these issues and it cost a lot of money.

There's also other issues - like the NHS doesn't cover circumcision unless there is medical need (this is not so controversial in the UK, but would be in the USA), and it does cover gender transition surgery, etc. (despite covering no other cosmetic surgery, and nowadays not covering dentistry or opticians) - all of these issues are controversial and difficult.

Re: US spends most on health care but has worst health outcomes

#78

Post by daedalus_f »

0xy wrote: post #66
smcl wrote: post #54

Earlier quoted context omitted.

> 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

France increased healthcare spending by 0.3%/year between 2010 and 2019. UK is outpacing France's spending increases by 2,066%. How does the UK need over 20x more spending increases than its close neighbor, exactly?

In 2017 (a year for which I have statistics) France spent 25% more per person on healthcare than the UK.

https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...

Re: US spends most on health care but has worst health outcomes

#79

Post by lotsofpulp »

bosie wrote: post #30
pigsty wrote: post #18

Earlier 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 not rejecting what the hospital says. I imagine pigsty’s account is missing some nuance, such as an uncommon diagnosis or prescription requiring further proof. The doctor might think (and might very well be guessing correctly), but the protocols require a certain level of evidence that was not provided.

It could also be malfeasance, but I doubt that is happening on a systemic level at the big health insurance companies. They benefit from more healthcare spending, so I do not see why they would want to tamp down on necessary expenses.

Re: US spends most on health care but has worst health outcomes

#80

Post by sokoloff »

MisterBastahrd wrote: post #34
silisili wrote: post #8

This 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…

The entire insurance industry, and almost all of the industries who make money from it, are against it, for one. There are many doctors and nurses who would also be incensed if you told them that they had to take less pay EVEN IF you also immediately eliminated all their education debts. Nurses in particular are heavily incentivized to work overtime because they usually work insane 12 hour shifts to begin with. You a…

Is the long-run alternative that future medicines like that are available for $0.50/month worldwide or not available at all?

> many doctors and nurses who would also be incensed if you told them that they had to take less pay EVEN IF you also immediately eliminated all their education debts

If the reduction in current value of their lifetime pay is greater than the value of their education debts, why wouldn’t they be incensed? I would be as well, as would most people.

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