Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

jhsph.edu

Post reply on HN
Print view View original

491–500 of 537 posts

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

#491

Post by AngeloAnolin »

cmrdporcupine wrote: post #221
DennisP wrote: post #104

Earlier quoted context omitted.

I read that book too, and agree it's phenomenal. It's not just about capping insurance profits. The countries doing the best also have price controls on the healthcare providers. Doctors make a lot less money. On the other hand they generally don't have to pay for medical school. France, Germany, and Japan all have similar systems, according to the book. They have private nonprofit insurance, some kind of mandate to…

One of the problems with the Canadian system is frankly its proximity to the U.S. A large portion of our homegrown medical talent goes immediately south of the border for higher salaries (see your point about price controls on healthcare providers above).

Going south of the border is not necessarily an easy option for any medical professional in Canada. Even though the standards in terms of education are the same, there are licensing and professional standards that needs to be hurdled by the individual.

The problem in Canada seems to stem from an inefficient manner with which health care is being administered. In hindsight, Canada's health care is following the US model, which have for a lot of reasons, failed spectacularly to provide what it was mandated to do - provide health care accessible for all.

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

#492

Post by EvanAnderson »

macintux wrote: post #477
EvanAnderson wrote: post #396

Earlier quoted context omitted.

Both parties are equally guilty of being more worried about holding on to the reigns of power than serving the public.

No, I reject that equivalency. One party is suppressing the vote and constantly sabotaging the workings of the government to retain power.

Those aren't the equivalencies I'm asserting. My position is that members of both parties expend far too much energy working on re-election fundraising versus working for the people. That's the equivalency I'm asserting.

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

#493

Post by dogma1138 »

VBprogrammer wrote: post #483
dogma1138 wrote: post #440

Earlier quoted context omitted.

Only if you use the NHS, private insurance would require you to pay extra if you don’t live there especially for inner London Hospitals.

Have you lived in the UK? I personally haven't encountered anyone who has had that issue. Most people primarily use the NHS and private health insurance is provided only occasionally as an employee benefit (often by American companies). That's nice for perhaps getting faster treatment for minor issues and maybe getting a nicer room but generally not required. I'm sure that the 1% have other arrangements but that's an…

If you get private insurance you pay extra to cover inner London hospitals unless you live there.

I haven’t used the NHS for the 6 years that I’ve lived here tried it once when I was looking for some physiotherapy for my knee got told by the GP that it will take 3 months called AXA which was then my provider and got an approval for 3 sessions which was then extended to 12 the same week.

I don’t even book GP appointments via the normal NHS route any more all of the GPs are technically private anyhow they just accept NHS patients and getting a booking via private health care is just that much more convenient since they see you within 24 hours and evening appointments are much more available.

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

#494

Post by dogma1138 »

craigc wrote: post #30
dogma1138 wrote: post #19

Earlier quoted context omitted.

The US spends more on biomedical R&D and produces more drug patents than the entirety of the world combined. https://assets1b.milkeninstitute.org/assets/Publication/Rese... As far as it’s implications on the cost of healthcare in the US I don’t think there is data for it since it’s pretty hard to measure.

Good to know, but my question really has to do with if the extra cost for doctors, hospitals, drugs, etc. is used to offset R&D costs. What I am getting at is that in theory, it should still be possible to do a lot of great R&D work while still providing affordable health care to citizens. I don’t think they are necessarily tied together. Also more patents is not necessarily a good thing since they can create more le…

Could be but the fact is that still the country with the highest cost of health care is the one that producing more drugs than the rest of the world combined.

The US is also 40% or so of the global pharmaceutical market given its population it literarily funds the profits of the global pharmaceutical industry doesn’t matter if it’s American Swiss or Indian company they all make their buck on the back of Uncle Sam. It’s not clear what the impact would be if the US would say start paying 50% less for health care on the world.

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

#495

Post by nerdponx »

vasilipupkin wrote: post #407
nerdponx wrote: post #205

Earlier quoted context omitted.

I think you misread my post. By "these problems" I meant "overspending on things that don't improve outcomes." But if paying for extra care is illegal in Canada then my argument doesn't work.

Being able to see my doctor for a health problem on short notice improves my quality of life but it probably doesn’t change outcomes as there is a very low likelihood that my problem is both life threatening and urgent. But choosing to pay doctors more to reduce wait times is not right or wrong - it’s just a different preference.

My point is that you don't see people spending extra to see private doctors in Canada despite it being a generally wealthy nation. There is more at play than the original suggestion that high spending is simply a function of being a richer nation with more money to spend on "extras" like short waiting times.

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

#496

Post by dogma1138 »

jfoutz wrote: post #57
dogma1138 wrote: post #19

Earlier quoted context omitted.

The US spends more on biomedical R&D and produces more drug patents than the entirety of the world combined. https://assets1b.milkeninstitute.org/assets/Publication/Rese... As far as it’s implications on the cost of healthcare in the US I don’t think there is data for it since it’s pretty hard to measure.

200 billion is a lot, but something in the ballpark of just 7%. [1] I agree, it’s hard to measure, but do you think those estimates are more than 3% off? Best case, eliminating all drug research saves you 10%. Although if costs in other areas are bloated, that is a scarier number. [1] https://www.cms.gov/research-statistics-data-and-systems/sta...

The US is also 40% of the world wide revenue which is probably a more important figure.

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

#497

Post by VBprogrammer »

dogma1138 wrote: post #493
VBprogrammer wrote: post #483

Earlier quoted context omitted.

Have you lived in the UK? I personally haven't encountered anyone who has had that issue. Most people primarily use the NHS and private health insurance is provided only occasionally as an employee benefit (often by American companies). That's nice for perhaps getting faster treatment for minor issues and maybe getting a nicer room but generally not required. I'm sure that the 1% have other arrangements but that's an…

If you get private insurance you pay extra to cover inner London hospitals unless you live there. I haven’t used the NHS for the 6 years that I’ve lived here tried it once when I was looking for some physiotherapy for my knee got told by the GP that it will take 3 months called AXA which was then my provider and got an approval for 3 sessions which was then extended to 12 the same week. I don’t even book GP appointme…

> If you get private insurance you pay extra to cover inner London hospitals unless you live there.

That's kind of the opposite of what I was saying anyway. It's fair enough if you are making a decision to go to a more expensive hospital for your own reasons.

Yeah, private healthcare in the UK is convenient but far from essential. Physiotherapy was actually exactly what came to mind, I believe it's one of those parts which are always chronically under-resourced.

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

#498

Post by [deleted] »

macintux wrote: post #477
EvanAnderson wrote: post #396

Earlier quoted context omitted.

Both parties are equally guilty of being more worried about holding on to the reigns of power than serving the public.

No, I reject that equivalency. One party is suppressing the vote and constantly sabotaging the workings of the government to retain power.

[deleted]

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

#499

Post by dragonwriter »

entity345 wrote: post #458
dragonwriter wrote: post #453

Earlier quoted context omitted.

> "Regalian functions of the state" is a common term It's really not; I mean, I've got a poli sci degree so I've seen it, but it's not really a common term. > that means the basic powers of the state (monarchy or not) that used to be the prerogative of the sovereign. I.e. law & order, military, and taxation. The pre-modern-limited-governnent prerogatives of sovereigns were much broader than law enforcement, defense,…

> while healthcare delivery systems that broadly and effectively serve the whole population are in the third. That's your interpretation but that's really a political view, and indeed the definition of that third duty is highly subjective. As I wrote in another comment, the line must be drawn somewhere. Note that my point wasn't to discuss regalian functions in general but to counter the argument that calling the Bri…

> That's your interpretation but that's really a political view

Smith's concept of regalian functions is just as much a “political view”.

> and indeed the definition of that third duty is highly subjective.

So are the definition of what particular actions of sovereign are within the boundary of the what is essential within the other two (and all three expressly vary by context, including available physical and social technologies, as perusal of the relevant parts of the Wealth of Nations makes clear.)

> Note that my point wasn't to discuss regalian functions in general but to counter the argument that calling the British NHS 'socialist' was like calling the police or the army 'socialist'.

Which the reference to regalian functions fails to do: all fall within the broad ambit of what could be considered those functions, and whether the dpecifics of either do is debatable, and, in any case, whether or not a function is within the scope of regalian functions is irrelevant to whether or not it is socialist.

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

#500

Post by jonathankoren »

thousandautumns wrote: post #468
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…

Why should pharma companies not be allowed to market their products?

Who said that?
Post reply on HN