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The US spends more on healthcare for no gain says new report from Johns Hopkins

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Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#251

Post by refurb »

tdhoot wrote: post #134
jeromeparadis wrote: post #110

Earlier quoted context omitted.

> ...rather they fear that it will result in them receiving worse care. In Canada, we have free healthcare. If you have the money you still can go private if you think you'll get a better care. But I guarantee you won't go private for hearth surgery. There's not market for it because the care you get is already the best in the public sector.

I'm Canadian and as far as I know you don't have a private option in most provinces. The only option is to travel to the United States and pay for it yourself. https://en.wikipedia.org/wiki/Healthcare_in_Canada#Restricti...

This is correct. Canada's single payer system means doctors can't work in both the public and private systems. They have to choose one over the other.

There has been plenty of efforts put into allowing private clinics outside of the public system, but they have all been shutdown.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#252

Post by JAlexoid »

airstrike wrote: post #147
jonathankoren wrote: post #89

Earlier quoted context omitted.

This is common PhRMA talking point that needs perspective. Large pharmaceutical companies spend twice the their readers h budget on marketing, a good percentage of now is that is spent on patient oriented marketing. (e.g. “Talk your doctor about Xyzzy!”) If there would be a loss of revenue, any reduction in R & D costs lies purely with c-suite’s priorities. https://www.washingtonpost.com/news/wonk/wp/2015/02/11/big-p…

They spend on marketing because they are trying to sell as much as possible of the drug during the patented years. If people do not realize there's a superior drug out there, they will never part with the money for the improved treatment

Why do I get that information from my doctor when I'm outside of US? Why do American doctors just throw antibiotics at you, as soon as you sneeze in their office?(Getting a test for bacterial infection is cheap and fast. No bacteria - no effect by antibiotics.)

There's a lot of issues with drug awareness and appropriateness in US.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#253

Post by InclinedPlane »

whiddershins wrote: post #246

I believe there is an economic analysis I saw mentioned by Scott Alexander that basically the cost of healthcare can be predicted as a function of the quality of care and the wealth of the country. Allegedly healthcare in the United States costs exactly as much as that formula would predict. I don’t have a citation here, and if anyone has one that would be great. But if it is true, we might be trying to fix something…

I don't give a shit even if we ultimately have to pay more than we are now on healthcare (spoilers, we won't) as long as we can have universal coverage.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#254

Post by asdff »

JAlexoid wrote: post #194
arcticfox wrote: post #167

Earlier quoted context omitted.

> As a Bank of America emplyee he had somewhat goog insurance that paid some. He was left with $180,000 bill. Forgive my ignorance but how is that possible? The highest out of pocket maximums for Marketplace plans is $15700 for an entire family.

There are interesting cases, where doctors prescribe stuff they get no valuable information from. I had this in US. Shoulder pain, that was diagnosed via an XRay... But the doctor decided he wanted an MRI. That's no unusual, but unnecessary in my case. Got charged extra $500 for the pleasure. Thankfully I was on an HDHP, so the HSA savings got hit.

That negative MRI result can be just as informative as a positive one. Maybe your XRay gave the doc only 80% confidence in the diagnosis, and the MRI was to rule out a larger issue. Like an engineer, doctors work deductively to rule out potential diagnoses, so all that is left is the correct one. Inductive logic brings in subconscious bias and assumptions.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#255

Post by refurb »

6nf wrote: post #232
bedhead wrote: post #105

Where does the money go? Aside from the waste and fraud, two places. First, we pay for convenience. We want to see a doctor now . We want immediate access to all the best equipment, and specialists, and drugs, and we don't want to wait around or travel far. And we increasingly want it for every citizen. Second, over treatment of the dying - no subject is more uncomfortable. When asked what the biggest problem Kaiser…

> We want to see a doctor now. We want immediate access to all the best equipment, and specialists, and drugs, and we don't want to wait around or travel far. And we increasingly want it for every citizen. Australians can get these at a fraction of US prices though

Can they?

Mr Meschemberg’s cancer is HER 2-positive (HER 2 is a protein found on the surface of some cancer cells). HER 2-positive cancer cells tend to be far more aggressive, as they divide and grow faster than normal. “That makes [my cancer] a bit different,” he said. “There are drugs that are available to help but they’re not on the PBS.”

https://www.news.com.au/lifestyle/health/health-problems/mee...

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#256

Post by ThrowMeDown01 »

skwb wrote: post #219
bedhead wrote: post #105

Where does the money go? Aside from the waste and fraud, two places. First, we pay for convenience. We want to see a doctor now . We want immediate access to all the best equipment, and specialists, and drugs, and we don't want to wait around or travel far. And we increasingly want it for every citizen. Second, over treatment of the dying - no subject is more uncomfortable. When asked what the biggest problem Kaiser…

A good summary of the political economy that surrounds the US healthcare system is that people want healthcare that's: - fast - efficient - no restrictions on hospitals, doctors, or treatment - financed by taxes on the rich (defined in whoever is in a tax bracket higher than themselves) Now this is obviously untenable. In my professional estimation (ex-health policy analyst) I think you CAN have a public option be vi…

Somehow you missed that the main point of the article being discussed here is - again! - that the US already pays more than the other top countries and receives less. Somehow that doesn't fit what you wrote at all, it's the exact opposite, to get better care you could do with less money. So where do you get that "we would have to raise taxes" from?

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#257

Post by JAlexoid »

dogma1138 wrote: post #15
api wrote: post #3

Earlier quoted context omitted.

If this is in fact true it means the rest of the world is freeloading off the US system. Not saying I'm convinced it is true. I'd like to see a deeper unbiased analysis.

Define true, it is true that the US spends more on medical research than the rest of the world combined, and produces more drug patents than the rest of the world combined. https://assets1b.milkeninstitute.org/assets/Publication/Rese... This btw went up fairly recently especially since Indian generics became accepted world wide in the late 90’s and early 2000’s. The US used to produce 20-30% of the world’s drug paten…

Probably has something to do with the research facilities in US becoming better and better with time.

Since you don't really need to be in US to create drugs for US market.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#258

Post by JAlexoid »

taormina wrote: post #220
sdrinf wrote: post #171

PSA: As of 2019, federal law requires all hospital & doctors to post prices in a machine-readable format. The results are pretty striking, esp here in the Bay: eg UCSF ( https://www.ucsfhealth.org/about/pricing-transparency/ ) charges $2600 for 1-way and 2-way chest X-rays, but charges $220 (that’s two _hundred_) for 3-way chest X-ray. The difference? How many angles they take of your body -ie, a 3-way includes the 2…

This is astounding. It used to be that doctors were not allowed to post their prices! Openness is needed to fix medical billing.

Why would you care, when your copay is $30 flat?

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#259

Post by castlecrasher2 »

module0000 wrote: post #206
refurb wrote: post #118

Earlier quoted context omitted.

Why would you cap healthcare prices for insurers, they don’t set prices. You mean providers? Half of US healthcare spending is public payers - Medicare and Medicaid. They do set prices for providers and still spend far more than other countries. And if you’ve been involved in US healthcare you’d realize it’s drowning in regulations already. It’s not a free market by a stretch.

You cap healthcare prices for insurers because they are heavily influencing the provider prices. Both institutions work in tandem[0] with one another to establish pricing guidelines. That's why your hospital-purchased ibuprofen is $10 per pill instead of $6 per bottle. The insurer and hospital "work out" a price that let's them achieve the profit needed to pay their administrative costs, plus margin. In the USA(this…

>You cap healthcare prices for insurers because they are heavily influencing the provider prices.

Insurers already have an incentive to limit prices, though, which is essentially what their contracts with providers are. As in, they list how much they'll shell out for CPT codes.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#260

Post by int_19h »

cameronh90 wrote: post #44
airstrike wrote: post #2

It's worth noting that the U.S. market does pay for the lion's share of patented drugs, effectively funding a significant portion of R&D that benefits the whole world years later when generics come into market (at least for those drugs which are not costly to manufacture, which happen to be the majority). I'm not saying this model is right. I'm just saying that doing away with it will have fundamental consequences to…

It does appear to be the case that the US funds most pharma R&D due to Americans overpaying relative to the rest of the word. In some cases (China, India) this is due to weak IP protection, but in other cases (Canada, UK, Europe) it's more to do with our governments having a stronger negotiating position and setting hard limits on what they'll spend for a given benefit to patients. Some characterise this as freeloadi…

> Does this make us immoral for "freeloading", because we prefer putting our limited money into cost effective treatments?

It depends on whether some drugs that your system considers affordable today as generics, would have not existed without being funded by US taxpayers, I suppose.

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