Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

The American Healthcare Conundrum

github.com

Post reply on HN
Print view View original

251–260 of 690 posts

Re: The American Healthcare Conundrum

#251

Post by wonnage »

legitster wrote: post #91
graemep wrote: post #60

> The US spends ~$14,570 per person on healthcare. Japan spends ~$5,790 and has the highest life expectancy in the OECD. That gap is roughly $3 trillion per year. The difference in life expectancy will be influenced by multiple factors and may have more to do with diet and lifestyle than with healthcare. Japan also spends less per capita than the UK, France or Germany. The US spends a lot more than any of those so th…

The US also has GDP per capita of $90k and Japan has a GDP per capita of ~ $35k. Put another way, in both countries a hip replacement surgery is almost exactly 1/8 of someone's per capita GDP.

“someone” in this case is in the 73rd percentile in the USA and ~40th in JP.

So the USA is still significantly more expensive as a portion of actual income. “GDP per capita” is a relatively useless figure

Re: The American Healthcare Conundrum

#252

Post by nradov »

lotsofpulp wrote: post #231
nradov wrote: post #197

Earlier quoted context omitted.

Your experience is irrelevant. Insurance carriers have some standard default policies but they'll write whatever custom policy that a group buyer is willing to pay for.

Your claim was > Commercial insurers would be happy to sell plans that pay every claim that comes in at 100% with zero denials. And yet I have never seen one of these after buying insurance in 3 different states. Again, the grandparent claim was that insurance companies can increase profits simply by increasing their expenses. Yet there is no evidence of this, and the fact that everyone has to deal with approval and…

You're really missing the point. Have you ever been in charge of employee benefits for a large group buyer? Obviously such plans aren't available to individual consumers but commercial carriers will absolutely customize products for larger customers.

Re: The American Healthcare Conundrum

#253

Post by paulmist »

As a European I would think a large part of the problem is that Americans are just sick more seriously and often. Your car culture, quality of food, and general preventative healthcare accessibility seem all terrible there. The prevalence of obesity in younger population is staggering. In my (engineering) programme I see one very obese person and a couple fairly overweight, but that's about it.

Re: The American Healthcare Conundrum

#254

Post by paulmist »

novok wrote: post #247

When you really dig into the difference it's metabolic health that is driving most of it, and that will be fixed by agricultural and food regulation for the most of it, starting with going with the whitelist system that japan and the EU have for food additives & manufacturing processes vs. the wild west that is GRAS in the USA, and way more strict food quality / inspection standards than you would think.

This! I flew from Madrid to SF last year and I can't begin to describe the difference in the quality of food. The scale of agricultural industrialization is terrifying - I wish you luck but I don't think anything short of this becoming a major campaign issue will help you.

Re: The American Healthcare Conundrum

#255

Post by wonnage »

conductr wrote: post #232
Dylan16807 wrote: post #166

Earlier quoted context omitted.

"Obesity costs the US healthcare system almost $173 billion a year." So that's about 6% of the difference? I'm not immediately saying no, but it sounds like that's not the real problem.

Social reasons it would never work. I hate to mention anything race related online but simple truth is America has complicated history and African Americans are 30% more likely to be obese than White Americans and also earn approximately 60% of income that whites earn. A fat tax, especially one that properly allocated the cost burden to the individual, would erode race relations.

fwiw the “tax” in Japan is not paid by the individual, and generally taxing the behavior via e.g sugar taxes rather than the outcome has worked better without much public outcry after the fact

Re: The American Healthcare Conundrum

#256

Post by zdc1 »

paulmist wrote: post #253

As a European I would think a large part of the problem is that Americans are just sick more seriously and often. Your car culture, quality of food, and general preventative healthcare accessibility seem all terrible there. The prevalence of obesity in younger population is staggering. In my (engineering) programme I see one very obese person and a couple fairly overweight, but that's about it.

Australia and the US have similarly higher obesity rates. As you can see in the article, their system is simply just inefficient (arguably, by design)

Re: The American Healthcare Conundrum

#257

Post by paulmist »

nomilk wrote: post #99

I recently travelled to Vietnam for dental work, it's really shocking how easy to it to shop around when dentists actually publish their price lists online for easy comparison/perusal. In my native country, dentists rarely if ever publish prices online, and it's hard to get prices over the phone. If hospitals could be forced to publish price lists, it would be game changing, allowing patients to shop and compare qual…

In the Netherlands dental service prices are set by the government [1]. Under 18 are universally covered by basic health insurance; for adults average dental for regular work + emergency is 30/month.

[1] https://puc.overheid.nl/nza/doc/PUC_789284_22/1/

Re: The American Healthcare Conundrum

#258

Post by raw_anon_1111 »

ikr678 wrote: post #225
throw0101c wrote: post #173

Earlier quoted context omitted.

> Why is that inherently bad? Should I be able to buy fire insurance on pre-existing embers? What if someone gets Type 1 diabetes as a child so they can no longer get insurance because of that "pre-existing" condition: if they get cancer for unrelated reasons they should just be saddled with medical debt? Or because of your Type 1 you can't get coverage, and you get t-boned in your car by a drunk driver. Certainly it…

Pre-existing conditions also continue to frame healthcare as 'insurance' against a bad thing happening to you, when it should just be a regular service like any other. You don't need 'insurance' in order to get your vehicle serviced, but that is what the US does with healthcare.

The most it will ever cost me to go from “not having a working car” to “having a working car” is the cost of used car that will reliably get me from point A to point B.

I can’t say the same about health care

Re: The American Healthcare Conundrum

#259

Post by glitchc »

graemep wrote: post #60

> The US spends ~$14,570 per person on healthcare. Japan spends ~$5,790 and has the highest life expectancy in the OECD. That gap is roughly $3 trillion per year. The difference in life expectancy will be influenced by multiple factors and may have more to do with diet and lifestyle than with healthcare. Japan also spends less per capita than the UK, France or Germany. The US spends a lot more than any of those so th…

Try seeing a doctor in Japan as a foreigner. Just a simple consult costs $300 USD or so, and it goes up from there. It's actually a rather expensive system.

Re: The American Healthcare Conundrum

#260

Post by glitchc »

rayiner wrote: post #96
graemep wrote: post #60

> The US spends ~$14,570 per person on healthcare. Japan spends ~$5,790 and has the highest life expectancy in the OECD. That gap is roughly $3 trillion per year. The difference in life expectancy will be influenced by multiple factors and may have more to do with diet and lifestyle than with healthcare. Japan also spends less per capita than the UK, France or Germany. The US spends a lot more than any of those so th…

I suspect you would see the exact same trend comparing Japan and the U.S. in transit, education, and many other services. The U.S. spends more per capita to get less.

In domains like healthcare, education and transportation, the cost is primarily labour. A wealthier country pays its workers more, which gets passed down in higher prices to its consumers. And, while healthcare and education do not benefit from economies of scale, transportation does, so the denser population gets cheaper transportation per capita.
Post reply on HN