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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

#61

Post by bluGill »

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…

The US government is involved in ways that make it inefficient. For example, I don't get to choose my insurance, the government has ensured that instead my company does for me. While I can in theory get insurance elsewhere I lose a large subsidy in doing so, no insurance I can buy can possibly be a better deal for me, even the company insurance is bad.

The incentives for insurance are to ensure that I don't quit, not that it is good healthcare or a good deal.

Re: Health care is turning into a consumer product

#62

Post by CraigJPerry »

JumpCrisscross wrote: post #60
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…

> 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.

Yeah you’re right, s/patients/citizens/

Re: Health care is turning into a consumer product

#63

Post by pydry »

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.

As opposed to what, the Singaporean system where you get sent to jail for charging above government mandated price caps?

American healthcare has the least involved government of any first world country.

Only an overly credulous interpretation of Koch-style market-knows-best propaganda would make you think that the "level" of government involvement was the root cause of its problems.

Re: Health care is turning into a consumer product

#64

Post by sokoloff »

robbiep wrote: post #39
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…

Better end of life care would revolutionise healthcare. No country does this well

Not everyone agrees on what “better” means though. When you start putting dollars and days into formulae around dying, many people lose their damn minds…

Re: Health care is turning into a consumer product

#65

Post by throw_m239339 »

unixhero wrote: post #24

Healthcare in the Nordics is free. Just saying.

> Healthcare in the Nordics is free. Just saying.

It isn't free, it's paid by people's taxes AKA redistribution of wealth, a % of the salary and mandatory health insurances. Private hospitals also do exist. Nothing is for free.

Re: Health care is turning into a consumer product

#66

Post by DavidPeiffer »

MomoXenosaga wrote: post #43
amcoastal wrote: post #30

Earlier quoted context omitted.

You use an absurd scenario, not sure why, but we both know there are tons of times you go to a medical provider where if you could pay less for a slightly longer car ride, you'd do it. But that information isn't even available now. The only fucking industry that is allowed to sell you stuff without telling you how much it will cost.

Who cares how much it costs if your health insurance cover it? The reality is that healthcare is so expensive that it can bankrupt anyone who isn't a millionaire- which is why it needs to be mandatory and comprehensive. Right now millions of Americans are basically committing fraud: they go to a doctor who has taken an oath to help you. The bill is not getting paid so the government has to step in anyway. May as well…

>Who cares how much it costs if your health insurance cover it?

At least under the current model, many people don't hit their deductible or max out of pocket. I know some older retired couples who are buying insurance on the market with 10k+ deductibles because they're generally in really good health, and the cost of insurance isn't absolutely insane with that level of deductible.

They would absolutely drive an hour rather than 5 minutes for non-emergency situations!

Re: Health care is turning into a consumer product

#67

Post by mrsuprawsm »

Rainymood wrote: post #59
mrsuprawsm wrote: post #36

Earlier quoted context omitted.

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.

I would guess that you are also including "anvullende verzekeringen", additional cover for e.g. dental/glasses/physiotherapy etc in your premium, because if you check a price-comparison site [1], then the majority of insurance policies are in the €110 - €120 range.

The extra insurance (dental/glasses etc) is also a bit of a scam, because the amount covered is often less than or just equal to the premiums that you pay in a given year, and you'd need to also be buying a new pair of glasses every year, always visiting the dentist, and so on. It's probably more economical to simply pay these costs out of pocket.

[1] https://www.independer.nl/zorgverzekering/intro.aspx

Re: Health care is turning into a consumer product

#68

Post by cntainer »

causi wrote: post #50
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…

Another point is that US healthcare is considered the most expensive and worst-performing in terms of outcomes compared to the other developed countries. Not that your thesis isn't correct but be careful there. You're combining the cost of care for the people who get care with an average outcome that includes people who don't get care. The quality of care for Americans who can afford care is excellent.

> You're combining the cost of care for the people who get care with an average outcome that includes people who don't get care.

Well that's the point, I think everybody should be taken into account in order to paint a comprehensive picture of the quality of the system at country level. The resulting stats reflect the health of a society as a whole not just of the part that can afford it. Not having universal healthcare is still part of the system, even if we don't like it.

I get it that health outcomes of those left out are probably very different. But leaving those numbers out of the comparison doesn't really work with these type of statistics.

At that point how could you compare it to the other countries that take everyone into consideration? The stats are GDP/capita percentages, should I remove the ones who can't afford healthcare from the GDP stats as well to not skew the ratio? I don't really like where I might end up taking this route.

I don't have any experience with US healthcare and I'm sure the quality of the services is really high, but the fact that you need to afford basic healthcare and it's not guaranteed by the government for everyone makes me see it as closer to just another "consumer product" compared to other systems.

Re: Health care is turning into a consumer product

#69

Post by dkjaudyeqooe »

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,…

When I was living in NL with no income, after subsidy the cost was around 10 euros.

The arrangement was indeed strange though with the government paying me to pay the insurance company and then for the employed there was then a further health care tax amount.

Re: Health care is turning into a consumer product

#70

Post by zimpenfish »

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…

> a full state-run system, which is vulnerable to undercapacity (which the UK is currently suffering from)

That's more because we've had decades of deliberate underfunding due to the "austerity"/"capitalism++" lunatics in charge than a natural consequence of a state-run system though.

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