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The American Healthcare Conundrum

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Re: The American Healthcare Conundrum

#461

Post by rexroad »

Aurornis wrote: post #125
rayiner wrote: post #96

Earlier quoted context omitted.

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.

The US is a wealthier country and wages are higher here than Japan. The median equivalised household disposable income of a US household is over twice that of a household in Japan. This is one of many reasons why it’s so misleading to compare prices across countries in a vacuum. All of the people doing the work for those education, transportation, and other services and all of their inputs aren’t going to work for Ja…

The wage adjustment is worth testing with data. Japan's GDP per capita on a PPP basis is roughly $47,000 versus the US at $80,000, a 1.7x income gap. The per-capita healthcare spending gap is $14,570 vs $5,790, a 2.5x ratio. Healthcare costs outpace the income gap by a meaningful margin even on PPP terms.

The outcome data is what makes the adjustment argument hard to sustain. Japan has the highest life expectancy in the OECD (84 years) and the lowest infant mortality (1.7 per 1,000). If higher spending were buying proportionally better outcomes, the wage argument would carry more weight. The US spends 2.5x more and gets worse population health statistics. PPP narrows the gap, it doesn't close it.

Re: The American Healthcare Conundrum

#462

Post by buellerbueller »

some_random wrote: post #387
46493168 wrote: post #380

Earlier quoted context omitted.

The United States will never have universal healthcare because a subset of the population would rather pay more for worse health outcomes than participate in a system the provides abortions, HRT, or PreP, or any healthcare at all to Black people. See, for example, “Dying of Whiteness: How the Politics of Racial Resentment Is Killing America’s Heartland” by Jonathan Metzl

[flagged]

That's good, love how you're co-opting anti-semitism for your own political ends.

"Blood libel" refers to a specifically anti-Jewish trope of alleging that Jews murder Christians, especially children, to use their blood for religious rituals. Grandparent comment is 100% not blood libel.

Re: The American Healthcare Conundrum

#463

Post by triceratops »

estearum wrote: post #448
klipt wrote: post #342

Earlier quoted context omitted.

I notice the repo has no data on supply of doctors per person in different countries. It's well known that the US residency system with its limited slots constrains the supply of doctors who can practice in the US.

Clarification because people get this wrong a lot: There is no imposed limit on the number of residency slots. There is a limit to the amount of money the US government is willing to spend on slots.

Why does the government need to spend money on slots at all? Do other countries do it like that?

Re: The American Healthcare Conundrum

#464

Post by joe_mamba »

bigfudge wrote: post #408
joe_mamba wrote: post #356

Earlier quoted context omitted.

Like which places are those? This is some idealist fairytale view that people like to believe in but doesn't actually exist.

This is unnecessarily confrontational. The real point here is that there better functioning democracies than the US. They have faults, but Scandinavia and much of northern Europe (partially excluding the UK) much better approximates what you call a fairytale than a US perspective might allow you to believe. Trust in and satisfaction with government institutions in Scandinavia and Finland are much, much higher than in…

>This is unnecessarily confrontational.

Why?

>but Scandinavia and much of northern Europe

That's like 3-5 out of 195 countries and only 0,3%-0,5% of the world's population. Being born there is like winning the lottery so maybe take that into consideration when arguing with such examples since that's not the norm. Like what are the odds that people you talk to online are part of that 0,5%? So who's the one being needlessly confrontational?

>Trust in and satisfaction with government institutions in Scandinavia and Finland are much, much higher than in the US

I don't care about the situation in the US since I don't live there. I'm talking from the perspective in Europe(not Scandinavia) where I can't say the democracy is representing or serving me. No law maker asked about the major decisions the EU made.

Re: The American Healthcare Conundrum

#465

Post by a3w »

Removing cars and fast food would probably equal things out a bit in terms of life expectancy.

Removing some patent protections earlier and having a national healthcare system own the clinics and insure people would reduce the cost?

Re: The American Healthcare Conundrum

#466

Post by samiv »

cmiles8 wrote: post #337
TuringNYC wrote: post #327

The problems are so vast it is difficult to even describe to outsiders. For example, if I purchase a particular medication at a local pharmacy, it costs $25. However, my insurer mandates that I purchase it via their Pharmacy Benefit Managers (PBM) Optum, which charges $125. Easy enough right, you price shop? Well then it doesnt count towards your deductible. The whole thing is an elaborate trap to not pay. Sometimes…

Prescriptions are a total racket. A good portion of actual medication literally costs a few dollars at most. Then there’s layer upon layer of bloat and bureaucracy that add no value but drive the cost up 10x or more. It’s totally bonkers. When these Rx cards and Marc Cuban CostPlus drugs came out where you just pay cash and a fraction of the price I thought there must be some catch or scam here. But turns out no, the…

"In many ways the quality of care in the US is far better than what folks get elsewhere"

This comment has very strong survival ship bias though because you're only looking and ranking the treatments that did happen. How about the cases when the person was denied treatment based coverage or whatever reason. These cases should rank too.

Re: The American Healthcare Conundrum

#467

Post by rjrjrjrj »

SV_BubbleTime wrote: post #390
raw_anon_1111 wrote: post #235

Earlier quoted context omitted.

So let’s talk about Canada, Great Britain, every country in the EU…

Is that Canada and Britain that the have an ever persisting complaint that the delays are absurd? Among the specific points that… With Canada now ending the life of 100k citizens a year making their MAID program now the leading cause of death in the country out ranking cancer and heart disease? How strange that in Canada you can deduct health expenses on your taxes… what a strange thing for a place with free healthca…

> With Canada now ending the life of 100k citizens a year making their MAID program now the leading cause of death in the country out ranking cancer and heart disease

Nope. Total MAID deaths (since 2016) is expected to reach about 100k in mid-2026. Most of them elderly people with a terminal cancer diagnosis.

Re: The American Healthcare Conundrum

#468

Post by a3w »

nradov wrote: post #120
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…

Japan also has the "Metabo Law" (aka fat tax). Do you think Americans would go for that?

Metabo is a saw producer, so cut fat in half should be their motto. /JK

Re: The American Healthcare Conundrum

#469

Post by joe_mamba »

cycomanic wrote: post #332
joe_mamba wrote: post #303

Earlier quoted context omitted.

>Last year this podcast said that nobody wants to solve this because solving it is going to eliminate (IIRC) hundreds of thousands of jobs. That's the reason why a lot of inefficiencies are kept in countries around the world: it keeps people employed and moves money through the economy. If broken things were suddenly to be made efficient overnight, the government wouldn't be able deal with masses of angry people/vote…

This reminds of a debate in the German parliament 30 years back or so, about the cost for the Eurofighter project (IIRC). Essentially one speaker had argued against the staggering cost, and a second speaker from the government defended the project by saying how many jobs it created. Someone shouted that building a pyramid in honor of Helmut Kohl and it would create a lot of jobs as well, that didn't mean it's a good…

The Kohl pyramid vs Eurofighter is a funny but very poor example that isn't remotely comparable. Useless defence projects have the advantage that it keeps institutional know-how from being lost and ready for the time when war actually comes for you. That's why Europe has been left unprepared by the war in Ukraine and why the US is the defense powerhouse.

Re: The American Healthcare Conundrum

#470

Post by sixothree »

CWuestefeld wrote: post #83
Retric wrote: post #78

Earlier quoted context omitted.

> nearly half of medical spending > something like 2 FTEs focusing just on the reimbursements from Medicare and Medicaid 2FTE’s vs what? The question isn’t is this free, the question is how large is the total staff including price negotiations, doctors, and IT time spent handling billing issues, and is Medicare more or less than 50% of the total. I am ware of one hospital and 2 medical clinics where the difference is…

2FTE’s vs what? versus nothing. Hospitals don't have to maintain a whole team for UnitedHealth, or for Anthem, etc. This is my point. Medicare cooks the books to look more efficient by offloading their administrative costs onto providers. Other payers can't do that because, even if huge, they don't operate at the same scale. Think about it: we often hear on the news about disputes about contracts when a local hospita…

Many providers report that dealing with Medicare has clear rules they can follow while dealing with private payers causes a huge burden.
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