[HN Gopher] Why conventional wisdom on health care is wrong (a p...
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       Why conventional wisdom on health care is wrong (a primer) (2020)
        
       Author : jeffreyrogers
       Score  : 51 points
       Date   : 2024-10-17 15:57 UTC (1 days ago)
        
 (HTM) web link (randomcriticalanalysis.com)
 (TXT) w3m dump (randomcriticalanalysis.com)
        
       | psd1 wrote:
       | Well, that was interesting.
       | 
       | What I'm unclear on is whether "health spending", in this
       | analysis, is defined as money paid to care providers such as
       | hospitals and dentists, or money paid by citizens for healthcare.
       | Because you've got insurers and PBMs taking profit.
       | 
       | The ratio of those two numbers is the efficiency of the American
       | insurance model. How does it compare to the administration of a
       | single-payer system such as the NHS?
       | 
       | Until I see some data indicating otherwise, I'm going to look at
       | my PS200pcm national insurance and my PS9.90 prescriptions and my
       | free ambulances, and Americans' $500pcm insurance and their
       | unlimited prescription costs and their four-figure bills even
       | when insured, and I'm going to continue to believe that Americans
       | are punching themselves in the face.
        
         | xvedejas wrote:
         | Well, there's also the rate of new drug and procedure
         | discovery. I've heard it quipped that Americans are subsidizing
         | the discovery of new medical techniques for the rest of the
         | world. Whether that's worth a higher cost is arguable but I
         | think the effect is there.
        
           | bozhark wrote:
           | Exactly this, example: biologics.
           | 
           | I am currently prescribed a medication that is over $30,000
           | per injection every 12 weeks.
           | 
           | Because we have absolutely atrocious health organization.
           | Pharmaceutical companies can set their prices regardless of
           | anything but their profit.
        
             | nradov wrote:
             | How should pharmaceutical prices be set?
        
               | BobaFloutist wrote:
               | In general, anything that's mandatory for life/basic
               | quality of life but still needs to be produced by
               | industry should should be regulated to artificially
               | reduce prices in order to compensate for inelastic demand
               | and prevent price gouging. This regulation should include
               | supply-side subsidies _and_ dynamic, carefully considered
               | price controls.
               | 
               | This should apply to food, water, housing, health care,
               | transportation, internet; all those good things that you
               | can't do without and are extremely vulnerable to market
               | manipulation.
        
               | claytongulick wrote:
               | It's worth researching the inevitable consequences of
               | price controls, it's a predictable outcome that's been
               | tested many times.
               | 
               | Price controls are Hobson's choice: Would you prefer
               | expensive bread, or _no bread_?
        
               | ElevenLathe wrote:
               | That's right, which is why basic healthcare (including
               | production of normal, well-characterized, non-
               | experimental drugs) should be taken out of the price
               | system altogether and run directly by the government.
        
               | AnthonyMouse wrote:
               | Normal off-patent drugs are already pretty cheap. You can
               | get a bottle of ibuprofen for like $5. Drugs still under
               | patent are, of course, expensive on purpose.
        
               | BobaFloutist wrote:
               | By price controls I literally just mean "anti-gouging
               | regulation", not "you can't charge more than exactly $5
               | for x"
        
               | AnthonyMouse wrote:
               | Describe the operation of "anti-gouging regulation" that
               | isn't just a price ceiling or a cap on how much the price
               | can increase in response to a sudden supply constraint
               | that would otherwise result in a shortage.
        
               | michaelje wrote:
               | Every other country appears to have the "bread" at a
               | reasonable price. Ironically, it's the US which has the
               | same bread for 100x the cost.
        
               | dgfitz wrote:
               | Did you know Russian citizens spend half their take home
               | pay on food? Wanna keep running with that point of yours?
        
               | jltsiren wrote:
               | One model is that a government pays a license fee that
               | allows them to produce the drug in unlimited quantities
               | for their country. (In practice, they could buy the drug
               | from the manufacturer at the marginal cost, or they could
               | use another pharmaceutical company as a subcontractor.)
               | Sometimes there is a deal, and the country may get orders
               | of magnitude higher health benefits for a marginally
               | higher price. And sometimes the company refuses, because
               | the deal would interfere with their business model in
               | other countries.
        
               | AnthonyMouse wrote:
               | > One model is that a government pays a license fee that
               | allows them to produce the drug in unlimited quantities
               | for their country.
               | 
               | How does this determine how much the license fee should
               | be?
        
           | vundercind wrote:
           | When this gets brought up as a _positive_ to our high
           | healthcare spending (which you 're not exactly doing, more
           | just making note of the existence of the argument) it's such
           | a head-scratcher for me.
           | 
           | 1) OK... maybe we should stop, then? Like, that seems like a
           | terrible deal? How is that a justification at all? It seems
           | like just a description of something very stupid we're doing.
           | 
           | 2) This _would_ be a good deal if we were getting _other
           | countries_ to also pay high prices and bringing that money
           | "home", but basically the exact opposite is happening. WTF.
           | 
           | 3) More often than not, the side of the issue that raises
           | this as a _good_ thing is also the side full of folks who
           | think we should e.g. reduce spending on foreign aid, so it 's
           | _especially_ weird that they 're bringing it up.
           | 
           | Plus, I'm very skeptical that the idea that drug development
           | would dramatically slow down if the US stopped over-spending
           | to the tune of 2x-100x on lots of drugs is even true. But
           | setting that aside, it's still just a bizarre line of
           | argument, to me.
        
             | AStonesThrow wrote:
             | You see, development of new drugs, devices, and treatments
             | is definitely something that we must continue at breakneck
             | pace, by any means necessary, because people keep
             | discovering how awful and harmful the existing ones are, so
             | we need to make consistent progress beyond the _status
             | quo_.
             | 
             | If you move faster than the science and the lawsuits, then
             | you can keep selling deadly crap to a naive and trusting
             | populace.
             | 
             | https://en.wikipedia.org/wiki/Reye_syndrome
             | 
             | https://en.wikipedia.org/wiki/Thalidomide
             | 
             | https://en.wikipedia.org/wiki/Tardive_dyskinesia
             | 
             | https://en.m.wikipedia.org/wiki/Fenfluramine/phentermine
        
             | AnthonyMouse wrote:
             | > OK... maybe we should stop, then? Like, that seems like a
             | terrible deal? How is that a justification at all? It seems
             | like just a description of something very stupid we're
             | doing.
             | 
             | The US pays for drug development and then the rest of the
             | world caps prices and gets the drugs cheaper. If the US
             | stops then the money for drug development goes down, which
             | is not great. What you really want is to get the other
             | countries to pay their share, but how do you propose to do
             | that?
        
           | BurningFrog wrote:
           | Yeah, it's unfortunate for the US, but since no one else is
           | stepping up to pay for the medical research that benefits all
           | of humanity, we have to do it.
           | 
           | The recent "negotiated prices" for Medicare drugs could be
           | the beginning of the end for this system though.
        
           | saulrh wrote:
           | Wouldn't it be _even better_ to explicitly funnel our money
           | to R &D, rather than hoping that it gets there eventually
           | after insurers and paperwork maximizers and intentionally-
           | inefficient providers all take their cuts?
        
             | basementcat wrote:
             | Which researchers do you funnel money to?
             | 
             | The majority of basic research is done in academic research
             | laboratories which are predominantly funded by government
             | research grants. If one of these studies pans out and
             | something can be patented, a business or investor group may
             | license the patent and fund an applied R&D program with the
             | goal of getting through FDA trials. This effort is either
             | funded by investor capital or internal company funds
             | (likely from revenues from the sales of FDA approved
             | medications or other products). Presumably if a business or
             | investor group has a track record of bringing treatments to
             | market (e.g. having a revenue stream from a previously
             | economically successful product) they are entitled with the
             | option to invest more funds, etc.
        
           | doctorpangloss wrote:
           | High interest rates have stopped way more drug development
           | than lower or higher drug prices ever have.
           | 
           | Between 2019 and 2022 there were like 88 biotech IPO lockup
           | expirations and only 3 were trading higher than post lockup
           | for any period of time.
           | 
           | Macro determines the rate of risk taking. Not "details." You
           | simply 100% cannot have drug discovery without risk, and risk
           | wants returns.
           | 
           | Should we have low rates and high inflation for the sake of
           | more "discovery of medical techniques?" Inflation and high
           | costs: dude, they are exactly the same thing!
        
         | nradov wrote:
         | Profit margins for insurers are pretty low on a percentage
         | basis. The Affordable Care Act (Obamacare) imposed a minimum
         | medical loss ratio on commercial payers. You can read the
         | financial statements for those that are publicly traded. Some
         | of the largest insurers such as Blue Cross Blue Shield
         | Association members are non-profit.
         | 
         | The NHS isn't really a "single-payer system" in any meaningful
         | sense. In the UK, most healthcare providers are employed
         | directly by the government and their wages are fixed below the
         | market rate to control costs. There are internal financial
         | transfers but there aren't really arms-length negotiations and
         | payments between separate payer and provider organizations.
         | 
         | If the USA was to adopt a single-payer system like the various
         | "Medicare for All" proposals that politicians have floated that
         | wouldn't do much to reduce costs. Any meaningful cost reduction
         | for the system as a whole would require driving down provider
         | wages, rationing care, and ending the way that we subsidize
         | drug development costs for the rest of the world. Those
         | measures might be good things to do on balance, but they aren't
         | politically popular.
        
           | bozhark wrote:
           | For profit non profits exist. There is no "metric" for how
           | much a 501(c)(3) must ratio in order to be considered tax
           | exempt.
           | 
           | They must follow their own discipline set in their founding
           | documents.
           | 
           | Calling blue cross blue shield nonprofit is disingenuous as
           | they made $749,000,000 in 2022.
           | 
           | Per their 990's: https://www.causeiq.com/organizations/view_9
           | 90/135656874/101...
        
             | wahern wrote:
             | $749 million is revenue. Revenue less expenses (i.e.
             | profit) was $57 million, which admittedly is a decent 7.5%.
             | But as a nonprofit there are no shareholders or partners to
             | siphon off that profit. The common argument is that
             | management siphons off that money through salaries, and I
             | can't say they don't, but if you look at their assets &
             | liabilities it seems like some significant amount of their
             | profit is going into savings.
             | 
             | Anyhow, the Blue Cross/Blue Shield system has a very
             | complex structure so if you're looking to find where the
             | real money is being siphoned off it's unlikely to be at the
             | top. BC/BS affiliates are independent, that's why the org
             | at the top for a system insuring over a hundred million
             | people pulls in less than a billion dollars in revenue.
        
             | abound wrote:
             | "Nonprofit", at least in the US, is usually shorthand for
             | having received a 501c3 (or similar) designation from the
             | IRS. It has little bearing on your ability to make money as
             | an organization (with caveats like the public support
             | calculations)
             | 
             | Source: Ran a nonprofit for a few years that made money
             | doing software consulting
        
           | _DeadFred_ wrote:
           | This is so misleading. What you are saying it technically
           | true, but also why our system is broken.
           | 
           | If I can only make 10% profit (or whatever the law is), what
           | is my incentive to keep healthcare costs down? The ONLY way I
           | can grow my income if it healthcare costs go up. 10% profit
           | on a $100 medication is way less than 10% profit on a
           | $1,000,000 medication. The road to hell is paved with good
           | intentions.
           | 
           | Another disingenuous argument on non-profits. Is all of Blue
           | Cross Blue Shield non-profit or only the certain parts you
           | want us to look at? A 'Pay no attention to the man behind the
           | curtain' argument.
           | 
           | Final disingenuous argument is you just asserting 'meaningful
           | cost reduction'. There is no way ambulance rides went from
           | $200 to $10,000 because of EMT pay.
        
             | FireBeyond wrote:
             | > There is no way ambulance rides went from $200 to $10,000
             | because of EMT pay.
             | 
             | Absolutely not. EMT pay can be as low as $12 an hour.
        
             | wahern wrote:
             | > If I can only make 10% profit (or whatever the law is),
             | what is my incentive to keep healthcare costs down? The
             | ONLY way I can grow my income if it healthcare costs go up.
             | 
             | You're missing the step where you also have to increase
             | premiums, i.e. price. And what normally keeps any seller
             | from increasing their prices whenever they want is
             | competition--some other insurer will get your business.
             | 
             | That begs the question of how competitive the insurance
             | market is. Let's assume it's woefully uncompetitive. But in
             | that case I don't see how the ACA 80/20 rule on
             | administrative overhead changes incentives and the
             | evolution of price inflation one way or another. At best it
             | temporarily disrupted existing inflationary schemes, at
             | worst it does nothing.
        
             | nradov wrote:
             | I'm not asking you to look at anything. Many US healthcare
             | payers are private non-profit corporations. That includes
             | some (but not all) Blue Cross Blue Shield Association
             | licensees. The BCBSA isn't a payer itself and merely
             | provides some shared services to their independent
             | licensees. Outside of the Blues system there are other
             | large non-profit payers such as Kaiser Permanente, HCSC,
             | Geisinger, EmblemHealth, etc. This isn't secret
             | information, you can just go look it up instead of arguing.
             | 
             | Commercial health plans have conflicting financial
             | incentives. Most of them no longer provide much insurance
             | (in terms of bearing financial risk) but rather primarily
             | act as administrators for self-insured employers. So while
             | payers can potentially boost short-term profits by paying
             | out higher claims, employers comparison shop between
             | competing health plans every year. Your HR department would
             | happily switch from Aetna to Cigna (or whatever) next year
             | if their analytics forecast shows that would save a few
             | dollars on expected claims.
             | 
             | Ambulance fees are a mess but those represent a tiny
             | fraction of overall US healthcare spending. Some reform
             | there would be a good idea but that wouldn't do much to
             | reduce costs.
             | 
             | Significant systemic cost reductions will require some mix
             | of lower provider wages, care rationing, and reduced
             | spending on new drug and device development. Countries with
             | more socialized healthcare systems are more financially
             | efficient in some ways but they also just do less stuff:
             | less drug development, longer queues for advanced
             | treatments, underpaid doctors (relative to market wages),
             | care restrictions based on QALYs (or similar metrics).
             | Complaints about payer profits, while perhaps somewhat
             | legitimate in certain cases, are largely a distraction from
             | more fundamental problems. That's just basic math dictated
             | by the cashflows. There are no simple solutions and we're
             | eventually going to have to make hard choices. No one wants
             | to face this reality.
        
               | _DeadFred_ wrote:
               | Edited out frustration.
               | 
               | I wrote hospital medical software for 20 years passing on
               | way better pay because I wanted to make a difference. And
               | I gave up because the system WANTS to be how it is today.
               | Everyone in medical is CHOOSING to make it this way, then
               | claiming 'ah it's too big, it's too complicated, we can't
               | change it'. Americans being to scared to call an
               | ambulance means emergency care has completely failed
               | them, not a small little thing to be brushed off.
               | Americans are making hard choices about medical care
               | every day already.
        
               | nradov wrote:
               | We're all frustrated. No one is happy with their
               | available choices. Join the club.
               | 
               | The system can't want anything. It isn't even really a
               | "system" in any meaningful way, in the sense of being a
               | unified entity working towards a common goal. US
               | healthcare is just a bunch of disconnected people and
               | organizations pursuing their own interests, often in
               | conflict with each other. Any major improvements will
               | require changes at the federal policy level to better
               | align incentives with desired outcomes. This is hard
               | because we collectively can't even agree on the desired
               | outcomes or how to measure them. I mean at a high level
               | most people think that everyone should have convenient,
               | affordable access to high-quality care but once you get
               | into specifics everything gets complicated and making
               | trade-offs which disadvantage some voters is unpopular.
               | Like should we spend $100K to give a terminal cancer
               | patient another month of life? Should surgeons make $700K
               | per year?
               | 
               | It's easy to complain and cast blame. And we should
               | certainly cut out waste and abuse where we find it. But
               | that won't significantly move the needle on overall
               | system costs. The problems are much more fundamental.
        
               | selimthegrim wrote:
               | Good Lord I wonder what the unexpurgated version was like
        
           | whoitwas wrote:
           | This is nonsense. Health care costs about twice as much in US
           | as everywhere else and only the rich can afford it. Health
           | insurance companies fight against doctors and patients to
           | subvert health and profit as much as possible.
        
             | nradov wrote:
             | 92% of Americans have health plan coverage, so we're not
             | talking only about the rich here. There are certainly
             | problems that we should fix but spreading misinformation
             | about basic facts doesn't help anything.
             | 
             | https://www.cdc.gov/nchs/data/nhis/earlyrelease/Quarterly_E
             | s...
             | 
             | It's easy for populists to demonize health insurance
             | companies. But even if we somehow magically cut all payer
             | profits to zero that would only marginally reduce total
             | system costs. Much of what they do in fighting against
             | doctors by negotiating lower reimbursement rates and
             | denying claims that don't meet coverage rules actually
             | helps to control costs for their main customers, the large
             | self-insured employers that purchase health plans for their
             | employees. At the national policy level, one change that
             | would probably help would be breaking the linkage between
             | employment and health plan coverage in order to better
             | align incentives.
             | 
             | Other countries that spend less on healthcare also have
             | lower provider wages, longer queues for advanced
             | treatments, rationed care based on QALYs (or similar
             | metrics), and less innovation in drugs and medical devices.
             | Maybe that would be better overall but let's not pretend
             | that there aren't severe trade-offs. You can't have your
             | cake and eat it too.
        
         | vundercind wrote:
         | We spend even more money on healthcare administration than
         | what's directly spent on it. HR departments screwing around
         | with insurance. Various government benefits & other agencies
         | having to mess with private health insurance issues. Attorneys
         | general offices and state rep offices spending time to get
         | insurers' and hospital billing departments' heads out of their
         | asses (they do a _lot_ of this).
         | 
         | There are also untold hours lost in unpaid labor on the part of
         | "clients" messing with insurance and hospital billing
         | departments. It's not uncommon for someone who is, or is
         | connected to a person who is, seriously sick for even a few
         | days to spend a work-week or more of time that year messing
         | with the billing from the incident. This can include uneventful
         | pregnancies and births.
        
         | frsoafdslfdlsa wrote:
         | Have you tried phoning a GP or for an ambulance recently?
        
         | sarah_eu wrote:
         | Americans look at their 9k a month salary and don't care about
         | loosing an extra 300 USD on health insurance. I've experienced
         | the British and Swiss systems - Swiss is like the American -
         | pay roughly 600 CHF a month - and it's way better than the NHS.
         | You can see a specialist the next day, get a scan the next day
         | etc.
        
           | psd1 wrote:
           | Is medical bankruptcy common in Switzerland?
           | 
           | 600chf sounds like passable value for money, as long as you
           | get excellent care and as long as that's all you pay.
           | 
           | But my concern is always what happens to the poor. Yeah,
           | yeah, the Swiss are rich - but not literally every Swiss, I
           | presume.
        
             | TMWNN wrote:
             | >Is medical bankruptcy common in Switzerland?
             | 
             | Only 4% of US bankruptcies are because of medical bills
             | <https://www.washingtonpost.com/blogs/post-
             | partisan/wp/2018/0...>. A tipoff that _[insert large
             | percentage here]_ of bankruptcies aren 't actually because
             | of medical costs is that only 6% of bankruptcies by those
             | without health insurance are because of that cause. The
             | biggest cause of bankruptcies is lack of income, which
             | health insurance doesn't affect in any country.
        
           | Loudergood wrote:
           | 9k a month is not typical for sure.
        
           | DaveExeter wrote:
           | $300x12 = $3,600/year for US health insurance?
           | 
           | I think it costs more than that!
        
         | nonameiguess wrote:
         | It is surprisingly hard to track down what is meant exactly. It
         | is not either of the options you listed here, but closer to the
         | first. Chasing a very long chain of citations to other
         | citations, it appears this paper contains the original
         | explanation of where the data come from: https://sci-
         | hub.st/10.1007/s11205-015-1196-y.
         | 
         | They survey all of the possible healthcare goods and services
         | available across OECD nations, make their best attempt to
         | select a representative basket that is both available across
         | all nations and reasonably similar, then estimate what they
         | call a "quasi-price" per unit of good and/or service, to
         | account for the fact that the actual charged price is often
         | artificially suppressed or set to zero by government fiat. This
         | seems to be done by scouring management accounting databases to
         | figure out what the payers and providers consider to be
         | reasonable reimbursement rates for accounting purposes, whether
         | or not that is what they actually receive.
         | 
         | I get what they're trying to do, but this probably explains
         | some of the counterintuive results, because mostly people are
         | probably thinking more along the lines of "add up all premiums
         | paid to insurers, out of pocket expenses paid directly by
         | consumers to providers, and all government outlays classified
         | as healthcare" and that's how much your country spends on
         | healthcare.
         | 
         | That's a reasonable comparison to make, but as the blog and the
         | OECD report both point out, it does nothing to account for
         | differences in quantity and quality of healthcare goods being
         | paid for. The problem is this discourse then inevitably leads
         | to "well the US gets worse outcomes," but to what extent is
         | that fair? The only reason I can walk today is because of US
         | healthcare. If you incur a musculoskeletal injury that requires
         | intervention in various different countries, how likely are you
         | to fully recover? If you get cancer, how likely are you to go
         | into remission? I don't necessarily know exactly what _should_
         | be measured, but I know that when the discussion goes straight
         | to lifespan, that is heavily confounded. Americans drive more,
         | own more guns, are fatter. There has been tremendous industrial
         | pollution in various places, though I don 't know how that
         | compares to the rest of the OECD. I wouldn't be surprised if we
         | have more backyard pools. There are many, many reasons we might
         | live shorter lives that have nothing at all to do with the
         | quality of the healthcare we receive.
        
         | AnthonyMouse wrote:
         | > What I'm unclear on is whether "health spending", in this
         | analysis, is defined as money paid to care providers such as
         | hospitals and dentists, or money paid by citizens for
         | healthcare. Because you've got insurers and PBMs taking profit.
         | 
         | > The ratio of those two numbers is the efficiency of the
         | American insurance model.
         | 
         | The ratio of those two numbers is quite divorced from the
         | efficiency of an insurance model.
         | 
         | On the one side, this would count wasteful spending on
         | unnecessary tests or overpriced services as an efficiency
         | _improvement_ because proportionally more money is going to
         | providers. On the other side, if insurers better at preventing
         | fraud have lower premiums and therefore get more customers and
         | make more money, that would count as  "inefficiency" and the
         | fraud _prevented_ would _also_ count as inefficiency (because
         | that money went to  "providers"), even if the net result is
         | less fraud and lower premiums.
         | 
         | That isn't to say that the US system is efficient. It's clearly
         | quite broken. But its brokenness is because the government has
         | been thoroughly captured by the industry -- which is the
         | providers as much as the insurers -- and they oppose any
         | measures that would improve actual efficiency because the
         | inefficiency is their profit. Which is why the US system costs
         | more than the systems in other countries regardless of whether
         | the other countries use public or private systems.
         | 
         | An efficient regulatory system for a private insurance market
         | would be something like, a schedule of service codes where each
         | provider is required to publish a fee schedule representing the
         | uniform fee paid by all institutional insurers, eliminating the
         | overhead of "negotiating prices" (a major source of
         | inefficiency) in favor of price transparency and allowing
         | patients and insurers to choose a provider on the basis of
         | price and distance, while still subjecting providers to
         | competitive pressure because people would naturally favor
         | providers with lower fees. But the existing US system doesn't
         | do that at all.
        
           | nradov wrote:
           | I generally agree with your points, but the US healthcare
           | system does now have pretty much the level of price
           | transparency that you want. Commercial health plans have been
           | required to publish their negotiated network provider fee
           | schedules since 2022. You can just download the files and
           | take a look. Of course as an individual health plan member
           | that won't tell you your out-of-pocket cost for a particular
           | service, but it is useful to self-insured employers
           | comparison shopping between health plans.
           | 
           | https://www.cms.gov/healthplan-price-transparency/plans-
           | and-...
           | 
           | Longer term though we should move away from the fee-for-
           | service model based on providers submitting claims for
           | service codes. A value-based care model where provider
           | organizations bear at least some financial risk and are
           | accountable for patient outcomes will probably work better
           | for everyone.
        
             | AnthonyMouse wrote:
             | > the US healthcare system does now have pretty much the
             | level of price transparency that you want.
             | 
             | They made a little progress toward it but the providers are
             | fighting it every way they can. Apparently one of the
             | methods is to use many different codes for the same thing
             | so they can't easily be compared. You need to get to the
             | point where it's like a price comparison service; your
             | doctor tells you to get a scan and you get a list of every
             | service in the country that offers it, sortable by both
             | price to you and distance from your house. They should also
             | eliminate the premise of "in-network" and just have all
             | providers publish their prices and insurers publish the
             | amount they cover in your region.
             | 
             | > A value-based care model where provider organizations
             | bear at least some financial risk and are accountable for
             | patient outcomes will probably work better for everyone.
             | 
             | It would probably be better to combine them, i.e. you get
             | primary care your way but when primary care wants you to
             | get a scan or take a medication you have competing
             | providers. Lumping the entire network into one entity is
             | likely to lead to market consolidation and then
             | inefficiency.
        
         | TMWNN wrote:
         | Studies have found that Kaiser Permanente (an integrated health
         | insurance/care provider--basically a non-governmental
         | equivalent of the NHS in comprehensiveness--that is available
         | in many US states) is more efficient and effective than the NHS
         | for about the same cost.
         | 
         | Examples:
         | 
         | * <https://www.bmj.com/content/324/7330/135>
         | 
         | * <https://www.bmj.com/content/327/7426/1257>
        
         | zaptheimpaler wrote:
         | Anecdotally anyone can talk to a few doctors and find out just
         | how much time they spend on updating charts/documenting
         | information that's not directly relevant to the care, its just
         | to protect against liability or work with insurance. Or how
         | many hours they spend on phone calls fighting with insurance
         | companies. The people who actually understand medicine wasting
         | hours with some clueless rep with 0 understanding and a
         | flowchart who's only job is to deny claims. Dr. Glaucomflecken
         | on youtube has many videos about that too.
         | 
         | So on the ground level, it's already clear some of our highest
         | paid most valuable people spend 20-30% of their time on a
         | flavor of administrative junk which isn't necessary in a
         | single-payer system. I'm skeptical of claims that this waste
         | doesn't translate into the higher level metrics.
        
         | akira2501 wrote:
         | > I'm unclear on is whether "health spending",
         | 
         | They list their source as 2017 OECD data. OECD seems to define
         | this as:
         | 
         | "Health spending is the final consumption of health care goods
         | and services including personal health care and collective
         | services."
         | 
         | Their charts are also drawn in a standard and more
         | understandable way.[0]
         | 
         | > Americans are punching themselves in the face.
         | 
         | Hurtful, but okay, I do hope you realize it's the rampant
         | monopolization of health care that is the problem in this
         | country. Yours solved it by simply creating a single publicly
         | held monopoly.
         | 
         | It's not as if either system is perfect and doesn't create it's
         | own share and particular style of inhumane healthcare outcomes.
         | Prescription label prices are noticeably different but are they
         | meaningfully different where outcomes are concerned?
         | 
         | [0]: https://www.oecd.org/en/data/indicators/health-
         | spending.html
        
         | WalterBright wrote:
         | Health care prices in the US were reasonable until the
         | government got involved in it.
        
           | keldaris wrote:
           | If that's true, how are they so much more reasonable in most
           | developed countries with far greater government involvement
           | still? Is the US government just uniquely bad at healthcare
           | somehow? Why?
        
       | throwme0827349 wrote:
       | This is fine as a high level economic discussion, but I think it
       | misses the point of the complaints from actually US consumers:
       | when I consume healthcare as an individual I am paying with a
       | blank check, and I am therefore likely to be tricked into
       | consuming more health care than I would otherwise choose to
       | afford, perhaps to a ruinous degree.
       | 
       | I think ordinary consumers care much less about whether their
       | country spends a nominal share of GDP on the heath sector, than
       | about whether they will be unexpectedly bankrupt by consuming
       | health services, and this is why people are actually mad.
        
         | kcsavvy wrote:
         | I started and sold a company in the industry, and agree that
         | macro level analysis misses this. In the us healthcare as a
         | "product" has an AWFUL customer experience. On so many levels.
         | And the worse it gets the more people want to "burn it all
         | down", despite the fact that it might not be as dire as we
         | think when we do the high level analysis. Whether or not that's
         | a good thing is up for debate.
        
         | darth_avocado wrote:
         | > The claim that US health care prices are inexplicably high
         | was never well-evidenced
         | 
         | I can provide anecdotal evidence that prices inexplicably high.
         | A primary care physician will charge anywhere between $200-$500
         | for a visit. If you have good insurance, you don't pay out of
         | pocket. In the same city, I once had to go to a PCP who would
         | only work without insurance. I had to wait a lot because of how
         | many people were lined up in front of the office, but I paid
         | $50 for the visit. I'm already paying 4-10x in a comprable
         | market for the same services.
         | 
         | When I was abroad, I had to visit a doctor's office for food
         | poisoning. I paid 200 in the local currency. I could have gone
         | to a hospital and they would charged me 500 in the local
         | currency. But what's important to know is that the median
         | monthly wages in the country were 25000 in the local currency.
         | So all in all, you'd pay a smaller portion of your wages for a
         | simple checkup.
         | 
         | And that tbh is why people are actually mad.
        
           | _DeadFred_ wrote:
           | I recently had skin cancer surgery. I was offered a 20%
           | discount to self pay. Because of my deductible I would have
           | paid more if I used insurance than if I just paid. We are now
           | to the point where it's not cost effective to use our private
           | insurance for cancer surgery. How anyone is defending this
           | system is crazy to me.
        
             | BirAdam wrote:
             | My wife had a kidney transplant. Two of her medicines cost
             | hundreds each per month with insurance, but without
             | insurance are under one hundred each for three months.
        
       | pessimist wrote:
       | This analysis in the end doesn't show what it claims to show and
       | actually proves the reverse - US Health care spending _is_ much
       | larger than other countries, it eats up _significant_ fraction of
       | productivity gains in other sectors (rises faster than income as
       | shown by the 1.8 slope in the very first graph), and _does not_
       | lead to better health outcomes. It actually proves we would be
       | better off if we spent less and focused on lifestyle.
        
         | YetAnotherNick wrote:
         | What was it claiming exactly that it proved to be reverse?
         | 
         | > we would be better off if we spent less and focused on
         | lifestyle.
         | 
         | I didn't see any claim opposite of this.
        
         | betaby wrote:
         | > US Health care spending is much larger than other countries
         | 
         | The thing is that in USA (and Canada) radiologist compensation
         | went from 300k/yer to 500k/year over the last 10 yeas. It's the
         | same radiologist. While spending is growing quantity of doctor
         | per population is diminishing.
         | 
         | In USA/Canada there is cartel enforced cap on how many new
         | doctors can be minted per year, and this cap is not even
         | scaling up with the population growth.
        
           | nradov wrote:
           | The immediate limit is a government (Medicare) funding cap on
           | the number of residency (graduate medical education) program
           | slots. At one time the American Medical Association lobbied
           | to put that cap in place but they reversed course years ago.
           | Congress still hasn't acted, and so every year there are some
           | students who graduate from medical school but are unable to
           | practice.
           | 
           | https://savegme.org/
        
       | neves wrote:
       | A quick reading of the summary shows a lot of debunking and just
       | one item that explains the bad health of North Americans:
       | 
       | Diminishing returns to spending and worse lifestyle factors
       | explain America's mediocre health outcomes
       | 
       | https://randomcriticalanalysis.com/why-conventional-wisdom-o...
        
         | firejake308 wrote:
         | As an armchair economist, this is my personal favorite theory.
         | With one of the most obese populations in the world, I think
         | it's obvious that we'll also be the most sick and we'll have to
         | spend a lot to try to dig ourselves out.
        
           | pessimizer wrote:
           | How does people being fat make asthma inhalers from the 50s
           | cost $70 when they're $5-$10 everywhere else in the world?
        
       | nickpsecurity wrote:
       | I skimmed what I can while on break. What I didn't see is
       | something I've heard from doctors but can't verify. It's that
       | insurance companies require them to do extra procedures or have
       | extra employees they don't think they need. Some who didn't take
       | insurance say it keeps their cost down.
       | 
       | One told me the insurance companies incentivize him to treat
       | patients like an assembly line where cash only lets him spend one
       | on one time with customers. He also might treat people for
       | several things on the same bill which he claimed he'd have to
       | itemize and charge separately for with insurance.
       | 
       | So, do people here have specific examples (esp links) to support
       | or refute those anecdotes? If they were true, it would mean
       | insurance rules were driving much of the cost. Looking at their
       | causes, my first guess would be how they respond to losses from
       | both real malpractice and greed-driven lawsuits. I can't imagine
       | that costs aren't impacted by this with all the lawyer ads I see
       | for suing insurance companies. ;)
        
       | aDyslecticCrow wrote:
       | GDP per capita and other "per capita" metrics are also unreliable
       | metrics for household income, as they suffer from the same issue
       | as averages. This is a common trap that is done in population
       | statistics, as mean and averages are always easier to calculate
       | and reduce the complexity of the calculations.
       | 
       | Large wealth inequality makes GDP per capita and average
       | household spending not representative of a real-world median
       | household. If healthcare costs have outpaced median income but
       | kept up with mean income, that is a MASSIVE societal issue.
       | 
       | Most of the plots and arguments in the article overlook this, so
       | I don't trust the arguments much.
       | 
       | However, it is still interesting how strong the correlations are.
       | It gives some interesting insights into what goes into the cost
       | of running hospitals, I suppose.
        
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