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Health care is turning into a consumer product

economist.com

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Re: Health care is turning into a consumer product

#131

Post by syshum »

andrekandre wrote: post #85
bluGill wrote: post #61

Earlier quoted context omitted.

The US government is involved in ways that make it inefficient. For example, I don't get to choose my insurance, the government has ensured that instead my company does for me. While I can in theory get insurance elsewhere I lose a large subsidy in doing so, no insurance I can buy can possibly be a better deal for me, even the company insurance is bad. The incentives for insurance are to ensure that I don't quit, not…

> I don't get to choose my insurance, the government has ensured that instead my company does for me. how did that happen?

WWII Wage Freezes is where it started, the government regulated that employers could not raise wages so employers started offering services to attract talent, in those days it was having a doctor on site at the factory, or office that employees and there families could see for free.

years later that transitioned to comprehensive benefits packages

Re: Health care is turning into a consumer product

#132

Post by toolz »

onlyrealcuzzo wrote: post #120
toolz wrote: post #97

Earlier quoted context omitted.

I'm curious how you can suggest the US government spends the most money in the world, by far, on healthcare and the simultaneously suggest there's less government involvement. The government is involved in every step of American healthcare. As you can imagine of a system that gets all of its funding thru companies completely overseen by regulatory bodies or thru social programs.

Compared to a single-payer socialized system, this is less involvement - even if it is a lot of involvent.

by what metric?

Re: Health care is turning into a consumer product

#133

Post by mtberatwork »

onlyrealcuzzo wrote: post #121
cntainer wrote: post #44

It's interesting to see that "Health care consumes 18% of GDP in America" compared to ~10% in most developed countries. In my (non-american) opinion part of that difference comes from the fact that healthcare is already a consumer product in the US. Maybe not entirely, but much more than in Europe, where universal healthcare sponsored by the state is the norm. Another point is that US healthcare is considered the mos…

One point that gets skipped over a lot - the US is also one of the most unhealthy countries in the advanced world. This is a big /part/ of the "worst outcomes" in the "highest cost, worst outcomes". It is possible that you can spend a ton of money on healthcare - yet smoke and drink, drive everywhere and not exercise at all, and eat trash - that the healthcare spending is doomed to fail. Europeans walk & bike more an…

> Most Asians exercise much more, eat healthier, AND smoke and drink less.

Tobacco consumption in Asia is incredibly high: https://en.wikipedia.org/wiki/Tobacco_consumption_by_country

Re: Health care is turning into a consumer product

#134

Post by jethro_tell »

imglorp wrote: post #93
causi wrote: post #50

Earlier quoted context omitted.

Another point is that US healthcare is considered the most expensive and worst-performing in terms of outcomes compared to the other developed countries. Not that your thesis isn't correct but be careful there. You're combining the cost of care for the people who get care with an average outcome that includes people who don't get care. The quality of care for Americans who can afford care is excellent.

> the people who get care There is a sad trend where the small doctors -- who can't survive without group power -- join conglomerates, the conglomerates buy hospitals, and finally the conglomerates close the less performant facilities. You get large states with vast underserved geographies. The OP headline is we are careening towards a luxury retail arrangement like Trader Joes: they will only have "outlets" in the r…

Well that's the thing, for profit health care requires making cuts to maintain profit. That's why it's a bad idea.

You can't just say you can't close this hospital, you have to find a way to pay the bills on it.

Re: Health care is turning into a consumer product

#135

Post by thedougd »

dpierce9 wrote: post #125
pjc50 wrote: post #54

Earlier quoted context omitted.

The problem is that "market" is a really bad fit for meeting healthcare needs, and doubly so when it's intermediated by insurers. People get the amount of healthcare they can afford from their discretionary budget and work their insurers for - not the amount they need. So they may get "more" (or at least more expensive) care than they need, or less. Note that many of the European systems are semi-private, so you reta…

US healthcare is a four-party arrangement since employers are also intermediaries. Employers select the plan (or plan options) and they pay the bulk of the premiums. Their check is always bigger than yours even if you pay more for your policy than they do. As such, most of the sales effort by health insurance companies is directed at the employer and they exercise a lot of judgment. In contrast, I have never once spo…

Furthermore, a lot of employers self-fund and use the insurance company only for management and possibly secondary insurance.

Re: Health care is turning into a consumer product

#136

Post by fartcannon »

onlyrealcuzzo wrote: post #121
cntainer wrote: post #44

It's interesting to see that "Health care consumes 18% of GDP in America" compared to ~10% in most developed countries. In my (non-american) opinion part of that difference comes from the fact that healthcare is already a consumer product in the US. Maybe not entirely, but much more than in Europe, where universal healthcare sponsored by the state is the norm. Another point is that US healthcare is considered the mos…

One point that gets skipped over a lot - the US is also one of the most unhealthy countries in the advanced world. This is a big /part/ of the "worst outcomes" in the "highest cost, worst outcomes". It is possible that you can spend a ton of money on healthcare - yet smoke and drink, drive everywhere and not exercise at all, and eat trash - that the healthcare spending is doomed to fail. Europeans walk & bike more an…

Just look north. Canadians are basically the same people, eat the same diet, but they have free health care, and live 3-4 years longer on average.

Maybe you want to control for the cold weather too?

Re: Health care is turning into a consumer product

#137

Post by micromacrofoot »

neuro_image2 wrote: post #4

The greatest healthcare improvements in the US could be brought about by: - Dismantling the insurance/big hospital complex that milks the US population for the enrichment of c-suite executives. - Removing the capacity for lobbying by insurance companies, large hospital groups, device and pharma companies (so they're less able to price gouge consumers). - Price transparency on all links of the chain of healthcare deli…

The app thing is very true and so ridiculous, I at one point contracted for a health insurance company (with a team of 10 people) for over a year working on an app that never saw the light of day.

It was essentially a calorie and exercise tracker that also displayed your health insurance info, absolutely nothing special compared to fitness apps already out there, but millions of dollars down the drain.

Re: Health care is turning into a consumer product

#138

Post by ohgodplsno »

amelius wrote: post #16
neuro_image2 wrote: post #4

The greatest healthcare improvements in the US could be brought about by: - Dismantling the insurance/big hospital complex that milks the US population for the enrichment of c-suite executives. - Removing the capacity for lobbying by insurance companies, large hospital groups, device and pharma companies (so they're less able to price gouge consumers). - Price transparency on all links of the chain of healthcare deli…

> Its very typical of modernism (especially in the US) to think that the way to address everything is a nice app with a better UI. I'd be happy if the app could show medical expenses before the treatment.

So you're not qualified enough to fix what you don't know is wrong (is this pain in your leg a simple thing, is it an actual fracture you're just surviving on on pure adrenalin, is it microfractures that might take more to heal), but you think for some reason you (or an app) would be qualified enough to tell you how much you'd pay for "leg pain" ?

Re: Health care is turning into a consumer product

#139

Post by rscho »

cntainer wrote: post #44

It's interesting to see that "Health care consumes 18% of GDP in America" compared to ~10% in most developed countries. In my (non-american) opinion part of that difference comes from the fact that healthcare is already a consumer product in the US. Maybe not entirely, but much more than in Europe, where universal healthcare sponsored by the state is the norm. Another point is that US healthcare is considered the mos…

Yes, so. The typical American response to that is: "the government controls everything. Let the free market do its job!"

And then wonder why they get shit care for a huge price BUT swith nice marketing and a smiling "health dealer" getting you a 0% lease... oh sorry, we got you confused with a Chevvy!

And also, "we have the best care in the world because our docs are better selected". This one never fails to make me laugh, as a swiss MD

Re: Health care is turning into a consumer product

#140

Post by howdydoo »

dqpb wrote: post #111
dgb23 wrote: post #76

Earlier quoted context omitted.

I agree. The "everything is a market" ideology had a good run of almost half a century, but it should be heavily criticized in hindsight. Institutions like healthcare, education, public transport, prisons(!) and so on are more efficient, less corrupt and of higher quality when they are in large parts collectively and democratically organized and funded. The "in large parts" is important here: A community should agree…

> The "everything is a market" ideology had a good run of almost half a century But that never actually happened. Externalities were never part of the market.

Are you suggesting that healthcare-as-a-market would start working if externalities were priced in? How would that help?
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