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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

#51

Post by ErikVandeWater »

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…

> 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.

Re: Health care is turning into a consumer product

#52

Post by refurb »

rscho wrote: post #25
refurb wrote: post #21

Earlier quoted context omitted.

I’ve got several friends who specifically moved to the US from Canada because the pay was so much better. No doubt it varies by circumstance, but docs ive known in the US pay off their $500k in student debt pretty quickly if they specialize. And sure insurance CEOs are paid more, but there are also a several magnitude more doctors than insurance CEOs. You could pay all the CEOs $1 and the cost of healthcare isn’t goi…

And, in the US, you could pay all doctors $1 and you'd still be left with more expensive healthcare than most western countries...

Please show your math.

Re: Health care is turning into a consumer product

#53

Post by throwaway0a5e »

Griffinsauce wrote: post #7
neuro_image2 wrote: post #4

The greatest healthcare improvements in the US could be brought about by: - Dismantling the insurance/big hospital complex that milks the US population for the enrichment of c-suite executives. - Removing the capacity for lobbying by insurance companies, large hospital groups, device and pharma companies (so they're less able to price gouge consumers). - Price transparency on all links of the chain of healthcare deli…

"- Removing the capacity for lobbying by insurance companies, large hospital groups, device and pharma companies." This should be step one, always. While those perverse incentives exist everything else is an uphill battle.

>This should be step one, always.

No, no it shouldn't

There's a really, really, really fine line to walk between preventing the AMA from lobbying congress to screw us and preventing actual grass roots people from paying someone to argue on their behalf.

Re: Health care is turning into a consumer product

#54

Post by pjc50 »

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…

The problem is that "market" is a really bad fit for meeting healthcare needs, and doubly so when it's intermediated by insurers. People get the amount of healthcare they can afford from their discretionary budget and work their insurers for - not the amount they need. So they may get "more" (or at least more expensive) care than they need, or less.

Note that many of the European systems are semi-private, so you retain choice of providers. It doesn't need to be a full state-run system, which is vulnerable to undercapacity (which the UK is currently suffering from).

There's also an informational problem; in a fully free speech environment it's much easier to sell people unreliable cures, Theranos passim.

Re: Health care is turning into a consumer product

#55

Post by throwaway0a5e »

jounker wrote: post #17
qwerty456127 wrote: post #10

Earlier quoted context omitted.

This probably also is the hardest part. And the most alien to the whole American model of which lobbying is an integral part. IMHO you can only counter lobbying by allocating more to fact checking so it would be harder for them lobby things which are objectively wrong.

We had such a congressional fact check organization. It was called the OTA (Office of Technology Assessment). Sadly it stood in the way of institutionalized lobbying (The K Street Project), so the Republicans eliminated it shortly after they came to power in congress in 1994.

It was on borrowed time anyway. The OTA was a threat to the fiefdom of literally every other agency. Their job was to butt in and ruin everyone's gravy trains of "not quite graft".

Imagine the OTA weighing in on the recent net neutrality shitshow. Wouldn't have made the FCC look to smart would it have? That same threat existed for every agency and congress and the executive. Literally everyone wanted them gone.

Re: Health care is turning into a consumer product

#56

Post by CraigJPerry »

ErikVandeWater wrote: post #51
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…

> 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 aspect of healthcare costs.

Cost of triple bypass heart surgery: US: $110,000, UK: £8,500 (paid by the taxpayer, not by the patient at the point of care - free for them). (P.s. private healthcare is available in the UK too - the procedure costs around £20,000 privately, payable by the patient or their insurance)

Life expectancy… you get the idea.

Re: Health care is turning into a consumer product

#57

Post by throwaway0a5e »

pjc50 wrote: post #54
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…

The problem is that "market" is a really bad fit for meeting healthcare needs, and doubly so when it's intermediated by insurers. People get the amount of healthcare they can afford from their discretionary budget and work their insurers for - not the amount they need. So they may get "more" (or at least more expensive) care than they need, or less. Note that many of the European systems are semi-private, so you reta…

Market is a fine fit for every healthcare need that doesn't start with a trip to the ER which is the overwhelming majority of healthcare dispensed in the US.

Using insurance, government or some other centralizing layer (e.g. the church) for routine activity would raise massive "you're pissing money away" red flags in literally any other context. We shoehorn so much economic activity (healthcare) though a middle man (insurers) and then act surprised that they take a fat cut. The solution isn't to government-ize the middle man. That will almost certainly just be a wash. It's to get rid of the middle man where possible.

There's no reason someone shouldn't be able to get a physical or a colonoscopy the same way cosmetic surgery and dental care are done. These are cookie cutter outpatient services. The deviation from instance to instance is small and predictable so insurance should not be needed on the consumer side.

Edit: Anyone wanna do me the courtesy of explaining why I'm so wrong?

Re: Health care is turning into a consumer product

#58

Post by neuro_image2 »

anovikov wrote: post #47
neuro_image2 wrote: post #4

The greatest healthcare improvements in the US could be brought about by: - Dismantling the insurance/big hospital complex that milks the US population for the enrichment of c-suite executives. - Removing the capacity for lobbying by insurance companies, large hospital groups, device and pharma companies (so they're less able to price gouge consumers). - Price transparency on all links of the chain of healthcare deli…

It is 100% obvious that amounts spent on the military in the U.S. today are insufficient and will have to go much, MUCH higher than they are today. Probably 5x higher - to the Cold War 10-12% levels - because of standoff with China and Russia at same time. It will still not be enough to win over China, but at least enough to keep the free world in existence. Otherwise democracy will be just simply gone from the world…

I encourage you to rethink this stance.

https://worldbeyondwar.org/ - is an organization dedicated to the abolition of war. I encourage you and anyone reading this to take a look.

Also take a look at possible alternatives. (A global security system that doesn't require violence) - there's an ebook discussing this system in full.

https://worldbeyondwar.org/alternative/

Continuing to head in the direction of militarism, will continue the disaster of a world that we live in, and almost certainly guarantee the end of mankind.

Re: Health care is turning into a consumer product

#59

Post by Rainymood »

mrsuprawsm wrote: post #36
DoingIsLearning wrote: post #31

Earlier quoted context omitted.

Healthcare in the Netherlands or Switzerland is not free and neither of them have the social disruption and problems you find in the US. There is no point in making broad generalizations, it is a complex issue were you have a multi-decade and multi-billion dollar business tightly coupled with the healthcare of millions of people.

The cost of healthcare in the Netherlands is however extremely affordable, which I think is the most important difference between Europe and the US. In NL, you pay ~€110/month annually, with a max out-of-pocket cost of €385 per year. So, maximum €1600 cost annually. People with a low income, students, etc, get approximately the same amount of money as a cash benefit to cover these costs. I'm not saying this is good,…

>In NL, you pay ~€110/month annually, with a max out-of-pocket cost of €385 per year. So, maximum €1600 cost annually.

My provider, CZ, charges ~€150/month with max-out-of-pocket ~€385. If you get the full ~€850 out of pocket then your monthly payment drops to ~€110/month.

Re: Health care is turning into a consumer product

#60

Post by JumpCrisscross »

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…

> NHS (despite fairly extreme under-funding) has better health outcomes for patients than in the US

The American system’s problem is exclusion, not quality of care. If you get care in America, your outcomes are among the best in the world.

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