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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

#171

Post by tablespoon »

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.

>> 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.

But isn't the essence of an externality that it's a social cost not factored into the market price?

Re: Health care is turning into a consumer product

#172

Post by CraigJPerry »

syshum wrote: post #128
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…

"better outcomes" when talking about health should be things like 5 year cancer Survival rates, Wait time for Surgery, Wait time for Heart Stints, 5 year heart Attack Survival rates, Wait time for Specialist Care, etc Not bankruptcy statics, or costs

You’re assuming universal access to healthcare then, which is not the case.

What is the 5 year survival rate for someone who cannot afford cancer care?

Re: Health care is turning into a consumer product

#173

Post by rkk3 »

kgarten wrote: post #147
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…

Obesity is also very high in the United Kingdom (~27 % versus ~35 % ) and not the same problems ( https://www.bbc.com/news/uk-42950587 ). US is also a super bad infant mortality rate compared to other countries: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856058/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5844390/

which too seems like it's probably a complicated issue, from one of your papers.

> Consistent with past evidence that has focused on comparing the US with Scandinavian countries, we find that birth weight can explain around 75% of the US IMR disadvantage relative to Finland or Belgium. However, birth weight can only explain 30% of the US IMR disadvantage relative to Austria or the UK

Re: Health care is turning into a consumer product

#174

Post by nradov »

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…

There are huge variations in performance depending on what metric you look at. The US is at or near the top in 5-year survival rates for most types of cancer.

Re: Health care is turning into a consumer product

#175

Post by decafninja »

mtberatwork wrote: post #133
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…

> 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

Alcohol consumption is fairly high too.

https://worldpopulationreview.com/country-rankings/alcohol-c...

Though I suppose China and India, which combined probably comprise the biggest block of population, are a slightly better shade of red than the US and Europe.

Re: Health care is turning into a consumer product

#176

Post by vorpalhex »

netizen-936824 wrote: post #86
virgilp wrote: post #84

Earlier quoted context omitted.

But how is that not "expected"? Feels like the argument that "communism is good, it just wasn't implemented well anywhere so far". Well, sorry, but by this point I chose to believe that a full state-run system is vulnerable to under-funding in the long term.

So we should just expect people to be greedy and try to ruin systems for their own benefit. That raises the question of how to make these systems more robust to defend against that sort of attack.

That is the pro of a market system. A market with a malbehaving dominant party is liable to be upset by a new contender who will undercut them, thus depriving the misbehaving party of income.

Re: Health care is turning into a consumer product

#177

Post by donatj »

howdydoo wrote: post #140
dqpb wrote: post #111

Earlier quoted context omitted.

> 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?

I suspect the argument is "Healthcare has never been allowed to be a market" Given how many legal restrictions are placed on it, I tend to agree.

Re: Health care is turning into a consumer product

#178

Post by nopenopenopeno »

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.

Employer-based healthcare was won by an alliance of corporate and healthcare industry lobbies against a state healthcare plan in the 1950s when the so-called “free market” healthcare system was failing the public. Prices were increasing and the New Deal corporate powers pacified the public with social security and employer-based healthcare.

Edit: updated 1960s to 1950s per info in replies

Re: Health care is turning into a consumer product

#179

Post by CraigJPerry »

sniperjoe360 wrote: post #170
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…

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.

>> look at the survival for various cancers in the NHS vs the US

The figures i can find ignore people who can’t afford to become cancer patients in the US - there’s an unknown, but suspected large, number of people cut out of the figures in the US making that stat unfairly stacked vs UK (where everyone regardless of affordability gets access). The people who can’t afford in the US are typicslly the ones more pre-disposed to adverse outcomes in that statistic.

Re: Health care is turning into a consumer product

#180

Post by pydry »

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…

>In principle, you're correct. In practice ...

It sounds like you are disputing empirical evidence as well as standard economic theory regarding monopsonies.

>The UK public might "adore" the NHS, but they have a pretty poor understanding of how it is funded.

Not really. It's mostly funded with taxation.

They are not so aware of the corruption going on underneath with taxpayer money.

>If the government kept funding the NHS by an extra X percent

"X" percent? Is this a serious point? That "X" is demanded by the public and X is also too costly? Where "X" is undefined?

What is even the point of that sentence?

>The ruling party, being the Tories, that have been "in charge" of the NHS for the majority of its 70 or so years?

A) If it is a majority of years it's a fairly slim majority and B) they werent there when it was set up.

>And who on earth would buy a loss making healthcare system

Somebody who knew that they could start charging either customers or government through the nose and make it fantastically profitable.

Richard Branson is one example (Virgin Healthcare sucked £2 billion out of NHS coffers, yay for crony capitalism).

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