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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

#161

Post by CraigJPerry »

DrBazza wrote: post #127
CraigJPerry wrote: post #56

Earlier quoted context omitted.

Counter point: the NHS in the UK has more government involvement than the US healthcare system. The NHS (despite fairly extreme under-funding) has better health outcomes for patients than in the US. “Better outcomes” needs more detail: Medical bankruptcies per year: ~200k in US, ~0 in UK. Caveat: bankruptcies often don’t have one clear root cause, the other ~600k bankruptcies per year in the US may or may not have an…

> The NHS (despite fairly extreme under-funding) has better health outcomes for patients than in the US. It really isn't underfunded. It's grossly inefficient, which is what happens to most if not all publicly funded bodies. It is actually ok to criticise the NHS organization. They're a monopsony, so actually get absolutely gouged by the pharmaceutical companies. They (currently?) refused to recycle crutches, plastic…

>> It's grossly inefficient

I think it’s more nuanced than that. There’s inefficiencies for sure but we need perspective to assess them against.

E.g. A triple heart bypass, the most common major heart surgery in the world, costs:

Approx 110k USD in the US system

Approx 50k EUR (56k USD) in Germany

And just under 9k GBP (12k USD) in the UK

>> I'm not sure how much more money the UK general public really thinks the UK government can come up with to keep giving the NHS "more!" money

Can you clarify what you mean by “come up with” in the context of the GBP which is a fiat currency?

Re: Health care is turning into a consumer product

#162

Post by bluedino »

fartcannon wrote: post #136
onlyrealcuzzo wrote: post #121

Earlier quoted context omitted.

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?

Not basically the same people. Canadian and US culture aren't the same. And the racial makeup is quite different.

57% of the USA is white, compared to 73% of Canada. Nearly 20% of the USA is hispanic, compared to 1% of Canada. There are many more Asians in Canada and much less people of African origin.

Re: Health care is turning into a consumer product

#163

Post by avgDev »

rkk3 wrote: post #158
avgDev wrote: post #155

I don't know how any American can accept the pile of trash that the US healthcare is. The only good thing is that in some cases you will get state of the art care, this is "rare" and may not result in better outcomes. 1. The cost is insane. It doesn't matter how much money you have, if you stay long term in a hospital your bill will be insane and more than an average cost of a house. 2. Single ER visit? 10 different…

> the pile of trash that the US healthcare is There are significant problems but whose Vaccine did you take for Covid-19? Pfizer (Us), Moderna (US), Johnson and Johnson (US)...

Do you think universal healthcare would affect pharmaceuticals?

I think it would not be relevant to the vaccines as we would still spend money on R&D under the pandemic threat.

Re: Health care is turning into a consumer product

#164

Post by CraigJPerry »

DrBazza wrote: post #154
pydry wrote: post #130

Earlier quoted context omitted.

>They're a monopsony, so actually get absolutely gouged by the pharmaceutical companies. You've got that exactly back to front. NHS's immense buying power lets them negotiate lower prices for drugs, exactly as medicare used to (before pharma lobbying stripped them of that power). Pretty much any trade deal negotiations with the US involve the UK being asked to dial down NHS buying power on behalf of pharmas by making…

> You've got that exactly back to front. NHS's immense buying power lets them negotiate lower prices for drugs, exactly as medicare used to (before pharma lobbying stripped them of that power). In principle, you're correct. In practice the fact that they're the only buyer, means in many cases that they pay at whatever a drugs company sells at since there's no "but company X is only paying Y, why are you charging us Z…

>> If the government kept funding the NHS by an extra X percent every year, we run out of public funds

Lets say the uk gov allocated 10x to the nhs in the next budget - to be clear, this would put just nhs spending at more than total govt income for the year. If this were a company we’re talking about, they’d be insolvent.

But we’re talking about a govt with a sovereign currency. So what would happen in this scenario? It doesn’t go bankrupt…

How is money created? What is fractional reserve lending? How is money destroyed? Can a country issue a fiat currency without an associated public debt? Or to put that last bit another way - could you settle your tax bill in GBP if there was £0 public debt?

Re: Health care is turning into a consumer product

#165

Post by brainwipe »

rkk3 wrote: post #158
avgDev wrote: post #155

I don't know how any American can accept the pile of trash that the US healthcare is. The only good thing is that in some cases you will get state of the art care, this is "rare" and may not result in better outcomes. 1. The cost is insane. It doesn't matter how much money you have, if you stay long term in a hospital your bill will be insane and more than an average cost of a house. 2. Single ER visit? 10 different…

> the pile of trash that the US healthcare is There are significant problems but whose Vaccine did you take for Covid-19? Pfizer (Us), Moderna (US), Johnson and Johnson (US)...

Pfizer was BioNTech, developed in Germany. They might have also had Astrazeneca (UK) or any number of vaccines developed in tandem globally. Also, worth pointing out that healthcare is a separate and distinct industry from pharma. Co-dependent but dealt with under very different rules globally.

Re: Health care is turning into a consumer product

#166

Post by mbg721 »

rscho wrote: post #139
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…

Yes, that's the response, but healthcare in America is far from a free market. It's more a circle of sloppy middlemen, in much the same way that I hear privatized passenger rail in the UK described.

Re: Health care is turning into a consumer product

#167

Post by KittenInABox »

bluedino wrote: post #162
fartcannon wrote: post #136

Earlier quoted context omitted.

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?

Not basically the same people. Canadian and US culture aren't the same. And the racial makeup is quite different. 57% of the USA is white, compared to 73% of Canada. Nearly 20% of the USA is hispanic, compared to 1% of Canada. There are many more Asians in Canada and much less people of African origin.

I don't reasonably consider that we can attribute black people and hispanic people simply existing to an additional 8% of GDP in healthcare consumption. That seems like a huge claim with no evidence provided.

I'd like to first see evidence that people of different race has a causality effect on healthcare consumption.

Re: Health care is turning into a consumer product

#168

Post by wreath »

dragonwriter wrote: post #149
wreath wrote: post #145

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. In what way is it the worst-performing? I mean, what are the outcomes that are measured to determine its performance? Yes, healthcare is a lot cheaper in Europe (even if your employer wouldn't pay their part) compared to the US, but the quality of the service is r…

> but the quality of the service is rather poor with very long waiting lists, stubborn doctors who don't want to perform certain tests (as simple as a Vitamin D or a testosterone test) so they don't have to justify it to the insurance. That's exactly like US healthcare if you aren't either a wealthy private-pay client or someone with top-flight private insurance; we just pay twice as large a share of GDP and even a h…

> leaving you uninsured and uninsurable.

This one is pretty messed up indeed. What's the purpose of being insured to begin with if it will fuck you over when you need the insurance?

Re: Health care is turning into a consumer product

#169

Post by nopenopenopeno »

omosubi wrote: post #119
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…

Re: prisons - This isn't necessarily the case. Florida's private prisons have air conditioning and the public ones don't in part because of democratic control and the private ones have fewer deaths from heat stroke as a result.

No post body was provided.

Re: Health care is turning into a consumer product

#170

Post by sniperjoe360 »

CraigJPerry wrote: post #56
ErikVandeWater wrote: post #51

Earlier quoted context omitted.

> So you basically get the worst performing being also the most expensive. Which doesn't really fit the view that less government involvement results in a more efficient system. The US healthcare is an example of the government being massively over-involved and creating massive inefficiencies.

Counter point: the NHS in the UK has more government involvement than the US healthcare system. The NHS (despite fairly extreme under-funding) has better health outcomes for patients than in the US. “Better outcomes” needs more detail: Medical bankruptcies per year: ~200k in US, ~0 in UK. Caveat: bankruptcies often don’t have one clear root cause, the other ~600k bankruptcies per year in the US may or may not have an…

To add a little nuance, look at the survival for various cancers in the NHS vs the US. Cancer care for example is measurably better in the US in terms of overall survival, early detection, and access to drugs. You "get what you pay for" when it comes to highly specialized care.
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