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Why Americans Spend So Much on Health Care–In 12 Charts

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Re: Why Americans Spend So Much on Health Care–In 12 Charts

#81

Post by jcadam »

y-c-o-m-b wrote: post #43

Healthcare costs are by far the #1 reason why I want to move out of the U.S. as soon as possible. I am well off, but due to recent experience I have a major anxiety about going bankrupt from another unexpected health issue. I had emergency spine surgery last year and despite coordinating everything I could to stay in network prior to entering the hospital - surgeon was in network, hospital in network, etc... - the mo…

> Healthcare costs are by far the #1 reason why I want to move out of the U.S. as soon as possible.

Hope you and your family are in perfect health if you plan to immigrate to a country with socialized healthcare. Most such countries will reject families with an autistic child, for example, based on the notion that said child will be heavily dependent on govt/health services.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#82

Post by sv123 »

RightMillennial wrote: post #71
sv123 wrote: post #61

Earlier quoted context omitted.

The democrats big mistake was trying to compromise with the republicans, who still refused to work on it. it's clear the whole system is borked, and I only see one party at least trying to do something about it.

What compromise? The ACA passed the House [1] and Senate [2] without a single Republican vote. [1]: http://www.washingtonpost.com/wp-dyn/content/article/2010/03... > The House voted 219 to 212 to approve the measure, with every Republican voting no. [2]: http://www.washingtonpost.com/wp-dyn/content/article/2009/12... > Vice President Biden presided over the 60 to 39 party-line vote, ...

It was watered down to make it a "budget bill" under the Senate rules so it could withstand filibuster. (In doing this, the ACA had to be stripped of almost all its cost-containment features.)

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#83

Post by t1lthesky »

Americans spend too much on nearly all government provided services. Anyone who thinks that more government spending is the solution really doesn’t understand the underlying issues at all.

When it costs 5x as much to build a new subway line in NYC compared to Paris [1], spending 20% more on infrastructure isn’t going to do anything. Arguably it will make things worse, allowing the existing inefficiencies to continue.

This problem occurs in all the areas where America lags behind other first world countries. Education, healthcare, infrastructure - spending is equal or greater than comparable nations, but the returns on each dollar spent is much smaller.

People try to simplify this issue in a partisan manner to having bigger government (Democrats) vs having more free markets (Republicans), but when you look at each of these areas in greater depth you realize that it’s not that simple. There are a multitude of causes unique to America that contributes to costs being so high, as exemplified in this thread’s article. In the case of health care, elsewhere in the world there exist both free market and government provided solutions that deliver better outcomes than the American system.

For a more in depth coverage on this topic, I highly recommend: http://slatestarcodex.com/2017/02/09/considerations-on-cost-...

[1] https://www.nytimes.com/2017/12/28/nyregion/new-york-subway-...

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#84

Post by goodells »

JimboOmega wrote: post #22
howard941 wrote: post #12

> Consumers, meanwhile, buoyed by insurance and tax breaks, have little idea how much they are really spending and little incentive to know underlying costs. Almost weekly there's another post showing that consumers literally cannot find out costs usually because the provider cannot supply it. It's time to put a stake in the heart of the recurring blame-the-consumer trope.

I don't read it as "blame the consumer" but "the system is opaque". The consumer doesn't know and can't find out. Articles have been written for, I don't know, a decade or more decrying the opacity of the "Chargemaster", etc, and how if you call a hospital to ask the charge for a procedure, they probably can't give you a quote. If you have certain kinds of insurance, you're not even incentivized to care - you tolerat…

Obviously some situations are complicated or don't lend themselves to doing so in a timely manner, but my healthcare/insurance provider (UWHealth and Quartz) has a priceline and online message center for immediate quotes without insurance. I use it even though I have insurance, especially before appointments where I anticipate what tests the doctor is going to order. They're usually reasonable, at least by American standards. Surgery has been more difficult to pin numbers down for because of the facilities.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#85

Post by richmarr »

harryh wrote: post #79
richmarr wrote: post #72

Earlier quoted context omitted.

Not to mention the fact that companies can write off insurance contributions against tax, and individuals can recieve that benefit without paying income or payroll tax on it. In effect that's a subsidy in favour of the middle classes and 1% to the tune of "between $174 billion and $429 billion over a six-year period". https://www.nytimes.com/2017/07/07/health/health-insurance-t... (Edited to include the missing point…

You say this like it's some special provision in the tax code, but it's not. Companies pay taxes on profits, not revenue. And insurance contributions (like many many other things) are an expense that reduces profits.

Yep... thanks, wrote that too quickly, I'll update

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#86

Post by tzs »

I wish we didn't overpay compared to other first world countries, but although that is very annoying it is probably sustainable. Furthermore, we have several examples of other first world countries paying much less, using systems ranging from full socialized medicine (the UK) to almost fully private systems with some government regulation (Switzerland), so that fixing this is not a matter of figuring out something that works. It is a matter of getting enough people to agree on the same fix.

What worries me more is how the costs keep going up, and that's when measured as a percentage of GDP, so you can't just hand wave it away as part of everything going up over time due to inflation.

That's not sustainable.

Worse, the same thing is happening in other first world countries, with the costs going up at similar rates as they are here, so unlike the overspending problem this is not just a matter of getting the will to adopt one of the known solutions.

There's a great interactive view of the data at the OECD health spending page: https://data.oecd.org/healthres/health-spending.htm

Uncheck the "latest data available" box, and that will enable the year range sliders. Set them to 1970-2017 and the graph will show the growth over time for several countries. Mouse over the lines on the graph and it will give you number.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#87

Post by komali2 »

rayiner wrote: post #15
komali2 wrote: post #8

Do republican politicians, and others in charge of maintaining this healthcare farce we have, have some sort of training in "convince the downtrodden to vote for things that make their lives harder" or is it just something natural? I say this as a Wisconsin emigrant that watched my home state shoot itself in the face time and time and time again.

Do democratic politicians have some sort of training in maintaining the farce that more things should be handled by government, when governments in Illinois, California, New York, etc.--democratic strongholds where Republicans cannot be pointed to as the scapegoats--are on the verge of bankruptcy? I don't think, deep down, republicans think the current system is better. They just don't trust whatever replaces it won'…

Your first point needs expansion before it can be accepted.

Whether or not California is "on the verge of bankruptcy" is questionable. There's a lot of pension to pay out, sure, but the United States is over a trillion dollars in active debt about to add hundreds of billions more, and nobody describes the USA as "on the verge of bankruptcy."

Furthermore, you automatically assign this "on the verge of bankruptcy" aspect to a political party in power, ignoring the very important fact that you just named three states with the biggest, oldest metropolitan areas in the nation. And just because I'm expecting "but HOUSTON!", as a former houstonian, I say let's just hold tight and see what happens when the oil runs out, because the last time it did I was juggling hundreds of unemployed engineers living in houses they couldn't afford driving an hour to get to one interview.

You'll note in my post I never tried to argue the Democratic party was better - although if we want to I can argue about the value of leftist policy until I'm blue in the face. I will say this - if I walk into my house and the stove is on fire, but my dog has crapped ok the carpet, I put the stove fire out first.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#88

Post by harryh »

richmarr wrote: post #85
harryh wrote: post #79

Earlier quoted context omitted.

You say this like it's some special provision in the tax code, but it's not. Companies pay taxes on profits, not revenue. And insurance contributions (like many many other things) are an expense that reduces profits.

Yep... thanks, wrote that too quickly, I'll update

Ah, I was wondering if you meant to mention that health care benefits are (in most cases) not taxable and I see with your edit that you did. I agree with you on that point. It's a big problem.

Interestingly, McCain proposed fixing this during the 2008 election and was slammed for it by Obama.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#89

Post by nkw »

opportune wrote: post #64
nkw wrote: post #38

Earlier quoted context omitted.

So I like to think I'm pretty darn on the liberal side of the spectrum, but the (ACA if Democrat) (Obamacare if Republican) was overall a giant handout to the health insurance companies while carrying forward almost all of the pre-existing problems with health care in the US (see the charts in the original article). Both parties share substantial amount of blame for the current state of health care in the US. It is h…

This is it. Both parties have failed with healthcare - Republicans through complete inaction, and Democrats through pushing through legislation that simply expanded insurance coverage. While I think the ACA made things better than before (it got a lot more people insured and thus no longer easily susceptible to medical bankruptcy), it was a very imperfect and inefficient solution. Because of the donors to each side -…

I'm actually surprised there has not been more pressure by the business community to decouple health care/health insurance from employment. Health insurance costs, and the administrative effort to provide it, are an enormous burden on businesses/employers. From small business to giant corporations, it is an extraordinary burden that is only going to increase and at some point is going to start seriously impacting the competitiveness of US business. It should be an issue the Republicans have front and center.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#90

Post by komali2 »

bepotts wrote: post #59
komali2 wrote: post #8

Do republican politicians, and others in charge of maintaining this healthcare farce we have, have some sort of training in "convince the downtrodden to vote for things that make their lives harder" or is it just something natural? I say this as a Wisconsin emigrant that watched my home state shoot itself in the face time and time and time again.

I don't understand how the "downtrodden" who rejects help from the government is somehow naive, but the billionaire who votes to have his taxes increased is somehow smart, noble, and a patriot. At the end of the day everyone votes for the policy initiatives that they prefer - whether the program is trying to help them or not. The thing about lots of "downtrodden" people is they want opportunity - not support from the…

As someone who was once downtrodden, I completely disagree with your second part. I also sense a whiff of self defeating hypocrisy - if everyone votes for what benefits them, why wouldn't the downtrodden try to get as much as possible?

Poor people want a fucking break. When I was poor we'd watch all the rich people on TV get arrested and let off with a slap on the wrist and ask ourselves, "what the fuck?" We'd see pics of OJ partying with cocaine and porn stars in expensive clubs, then get away with murder. I don't know where you get this sense of "righteous wholesome poor people just trying to skip coffee for a day so they can put two more pennies in the savings account and one day be able to support their kids," poor people want to support their kids today, right now.

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