[HN Gopher] Why conventional wisdom on health care is wrong (a p...
       ___________________________________________________________________
        
       Why conventional wisdom on health care is wrong (a primer) (2020)
        
       Author : jeffreyrogers
       Score  : 136 points
       Date   : 2024-10-17 15:57 UTC (2 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.
        
               | AlexandrB wrote:
               | Using the free market to respond to a shortage requires
               | competition. Patents can make this impossible. When you
               | have a fixed supply of something and no other entity can
               | produce it having an uncapped price doesn't really help
               | the market respond. Consider the example of a Taylor
               | Swift concert. Are scalpers creating more supply by
               | raising the prices of tickets or is it pure rent seeking?
               | 
               | And, to many, the difference between "expensive bread"
               | and "no bread" in the case of drugs is entirely academic.
        
               | Ray20 wrote:
               | Define gouging.
        
               | 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?
        
               | sqeaky wrote:
               | I thought we were talking about developed nations
               | participating in the global economy.
        
               | michaelmrose wrote:
               | There are other markets than Russia and the US what about
               | all of Europe.
        
               | Ray20 wrote:
               | First, define the "basic quality of life" and what are
               | you going to do when demand will exceed supply. Because
               | we might as well just start the money printing machine
               | and expect everyone to become a billionere.
        
               | 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?
        
               | jltsiren wrote:
               | The same way as in any other business contract. How much
               | the government is willing to pay, how much they expect to
               | benefit, what other uses they have for the money, and so
               | on. In practice, the company will likely get a bit more
               | profit from the license fee than it would get from
               | selling the drug normally.
        
           | 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?
        
               | kelseyfrog wrote:
               | The reality is we have no evidence that other countries
               | other countries wouldn't start developing drugs. Our fear
               | that no one else would do is not grounded in the rational
               | and we shouldn't let irrational fears decide what we do.
               | This isn't something we can logic out ahead of time, we
               | simply need to commit to not doing it.
        
               | airstrike wrote:
               | Other countries already develop drugs. They just charge
               | more in the US market.
        
               | XorNot wrote:
               | People always forget it's "what the market will bear".
               | 
               | Price caps set a very explicit bar and then ask a company
               | to think very carefully if they truly think the drug
               | can't be sold at that price (and surprise: turns out when
               | motivated a ton of them discover that yes, it can be).
        
               | zaphar wrote:
               | What the market will bear affects an already existing
               | product. R&D is driven by one of two things:
               | 
               | 1. An expectation of profit at the end. 2. A highly
               | desired outcome from a motivated pool of Investors.
               | 
               | Price caps can dampen #1. Which can put more of the
               | burden on #2 as a source of funding. Whether you think
               | that is an improvement or not probably depends on your
               | particular ideological position around markets and
               | healthcare.
               | 
               | But there is definitely an objective argument to be made
               | that this might decrease the speed of improvements in
               | healthcare technology.
        
               | pfdietz wrote:
               | What the US could do is cap prices in the US at some
               | modest multiple of the cheapest price charged in other
               | countries. The drug maker would then have a choice: cater
               | to either the US market at an elevated price while losing
               | the cheaper markets, or abandon the US market to have a
               | possibly larger market elsewhere at lower prices.
        
               | nradov wrote:
               | That is one option. It would mean that some drugs,
               | especially those for rare conditions, are never brought
               | to market in the first place because the expected
               | worldwide revenue would be too low to justify spending
               | $1B+ on a stage-3 clinical trial that might fail. Is that
               | a good trade-off? Depends on your perspective I guess.
        
               | pfdietz wrote:
               | It might actually increase world revenue, if it causes
               | some countries to bite the bullet and accept a higher
               | price.
        
               | nradov wrote:
               | Well then we have a game theory problem. Every country
               | wants to freeload on drug development spending to
               | minimize their own expenses. It's unrealistic to expect
               | that countries like India or France will voluntarily
               | accept higher drug prices just to incentivize new drug
               | development. If the USA decides to stop subsidizing the
               | rest of the world then the most likely outcome will be a
               | permanent reduction in the rate of new drug development.
               | Would that be an improvement?
        
               | michaelmrose wrote:
               | We have people dying of treatable ailments that have been
               | understood for decades which cost less than the labour
               | used to deny them treatment and lobby against their
               | interests.
               | 
               | A slower pace for rare ailments seems like an obviously
               | acceptable trade off.
        
               | throwaway14356 wrote:
               | you make a committee of old doctors and have them set the
               | prices.
        
               | vundercind wrote:
               | Let the market figure it out--it'll adjust, companies
               | will raise prices in other markets and simply not serve
               | the ones that won't let them charge enough to make it
               | worth it--and then _explicitly_ , collectively subsidize
               | it if that produces a shortfall? Pinning the bill for a
               | _subsidy_ on the sick people--but _only in our country_
               | --we're claiming to be trying to help, while also
               | claiming our entire country is and must remain, uniquely,
               | a martyr to the cause is a deeply weird way to go about
               | providing a subsidy.
        
               | ForOldHack wrote:
               | The market has figured it out. The market has figured
               | out, that tech bros will charge you as much as possible
               | for that last dyeing grasp, seeking as much profit, while
               | just glossing over mistakes and oversites that unalive
               | you and your loved ones. The very best of luck with that.
               | Hope you have an immediate and effective alternative.
        
               | vundercind wrote:
               | I meant use monopsony government buying power and/or
               | price controls like 100% of the rest of the developed
               | world, and let the market figure it out. Though I
               | definitely didn't make that clear, my bad.
               | 
               | Then subsidize, on purpose and directly, not by some
               | lopsided roundabout more-expensive-than-it-needs-to-be
               | scheme, if problems arise.
        
               | michaelmrose wrote:
               | Please define "their fair share". How much of the money
               | for US advertising shall they bear whilst we are at it.
        
               | ToValueFunfetti wrote:
               | If advertising wasn't net positive for drug companies,
               | they wouldn't do it, ie. paying for advertising means
               | paying less. But if you disagree with that reasoning,
               | advertising accounts for ~3% of US drug spending, so
               | taking it or leaving it isn't going to make a big
               | difference in prices.
        
               | rsynnott wrote:
               | It is notable that the industry spends more on marketing
               | than R&D. Virtually all of this spend is in the US; very
               | few countries allow the marketing of prescription drugs
               | to consumers.
               | 
               | Quite a bit of the high pricing for Americans is also by
               | companies who _don't even do_ R&D to any significant
               | extent; companies who only make generic price them
               | dramatically higher in the US than elsewhere.
        
               | Workers_Own_Co wrote:
               | > > other countries to pay their share, but how do you
               | propose to do that?
               | 
               | They cannot pay with money, but honestly speaking they
               | could "pay" with risk taking, I mean trying drugs that
               | the FDA is too risk averse to approve . For example the
               | risk profile of basically every day activity is much much
               | higher in India or Nigeria compared to the U.S. and so
               | the same should be for drugs, medicine is an extremely
               | risk averse field as it is, but with the FDA being the
               | world authority over medicine safety basically the risk
               | profile of the US is being transferred over to the rest
               | of the world which is nuts. Consider for example the risk
               | profile of daily driving in the U.S. vs India or Thailand
               | where everybody goes around in scooters without helmets,
               | it works for them, their economy would collapse if they
               | tried to have the safety of the U.S. drivers going around
               | with 20ft long 7500lbs cars.
               | 
               | The unfortunate thing is that the whole world relies not
               | only on the U.S. for drug research but also drug
               | approval. If the FDA says no to something then not even
               | Lesotho would try it , even though maybe from a risk
               | reward standpoint it would make so much sense for Lesotho
               | to try it .
        
             | kiba wrote:
             | Not all subsidy is a bad thing. The money is used to fund
             | real expertise and industrial capacity.
        
           | 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!
        
           | KingOfCoders wrote:
           | "I've heard it quipped that Americans are subsidizing the
           | discovery of new medical techniques for the rest of the
           | world."
           | 
           | The way Trump touted an invention from the German company
           | BioNTech as "Invented in America".
        
             | inglor_cz wrote:
             | To be fair, very critical elements of mRNA technology
             | _were_ developed in the U.S. Nothing is purely German or
             | American nowadays.
        
               | KingOfCoders wrote:
               | To be fair, writing a paper is not developing a
               | technology. And someone from the town I live discovered
               | oxygen. No oxygen, no mRNA.
               | 
               | "Nothing is purely German or American nowadays."
               | 
               | I know that, not everyone seems to though:
               | 
               | "I've heard it quipped that Americans are subsidizing the
               | discovery of new medical techniques for the rest of the
               | world."
               | 
               | And not even nowadays. Like with the Wright Brothers, who
               | used data from Otto Lilienthal.
               | 
               | But the Wikipedia article could not stop trying to
               | minimize his impact,
               | 
               | "Lilienthal's research was well known to the Wright
               | brothers, and they credited him as a major inspiration
               | for their decision to pursue manned flight."
               | 
               | where someone felt the need to add
               | 
               | "They abandoned his aeronautical data after two seasons
               | of gliding and began using their own wind tunnel data."
               | 
               | and make it all about the Wright Brothers. In an article
               | about "Otto Lilienthal" not the Wright Brothers.
        
               | inglor_cz wrote:
               | Going far enough, we should credit some anonymous Homo
               | erectus for discovering fire... Not that I am completely
               | joking, the tree of human knowledge is fascinating by its
               | depth and goes deep into the pre-literate age.
               | 
               | That said, I wouldn't dismiss Kariko's and Weissman's
               | discovery of replacement of uridine with pseudouridine as
               | merely "writing a paper". It was a pretty crucial
               | technological stepping stone that made mRNA treatment
               | orders of magnitude less dangerous to humans. Same with
               | their discovery of the way how to deliver mRNA into cells
               | (using lipid nanoparticles).
        
         | 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.
        
               | eszed wrote:
               | > It isn't even really a "system" in any meaningful way,
               | in the sense of being a unified entity working towards a
               | common goal.
               | 
               | Well said. That this could be equally applied to the US
               | as a whole likely explains subsidiary disfunctions.
        
               | 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.
        
               | whoitwas wrote:
               | So what if they have health plan coverage if they can't
               | afford to use it? Insurance is wildly out of control and
               | needs to be reformed out of it's current form of
               | existence. Health insurance companies act in bad faith
               | against patients and doctors and many people with
               | insurance go bankrupt anyway. What percentage of
               | bankruptcies are from medical bills? It's impossible to
               | objectively defend unless the goal is to make money at
               | the cost of human health.
        
               | nradov wrote:
               | The vast majority of consumers with health plan coverage
               | do use it. At a minimum they can access preventive care
               | benefits at zero out-of-pocket cost.
               | 
               | https://www.healthcare.gov/coverage/preventive-care-
               | benefits...
               | 
               | About 4% of bankruptcies are from medical bills.
               | 
               | https://doi.org/10.1056/NEJMp1716604
        
               | XorNot wrote:
               | That study (full text[1]) is extremely selective: namely,
               | the only factor they looked at was hospitalizations
               | causing bankruptcies, and ignored emergency care
               | expenses, chronic conditions and other long term
               | treatment. In fact from their introduction you can very
               | much see the problem:                 the fraction of
               | people filing for bankruptcy who happen to have
               | substantial medical expenses.
               | 
               | Like...that is a weird factor to just try and wash away
               | with sample selection.
               | 
               | The only factor they considered was the proportion of
               | people who filed for bankruptcy by years before/after
               | hospitalization, which they found was about 4% of total
               | bankruptcies - _for non-elderly adults_.
               | we estimate that hospitalizations cause only 4% of
               | personal bankruptcies among nonelderly U.S. adults, which
               | is an order of magnitude smaller than the previous
               | estimates described above.
               | 
               | Now let's put that in perspective: one of the most common
               | routine surgeries for a healthy person would be having
               | your appendix out. That's a hospitalization, you stay
               | overnight. It's also fairly cheap and immensely routine.
               | 
               | It is also notable that the study was focused on patients
               | at a single Californian hospital -                 we
               | therefore selected a sample of people who were admitted
               | to the hospital in California            Our study was
               | based on a random stratified sample of adults 25 to 64
               | years of age who, between 2003 and 2007, were admitted to
               | the hospital (for a non-pregnancy-related stay) for the
               | first time in at least 3 years
               | 
               | In short, the way this study is being thrown around to
               | assert how medical bankruptcy works is invalid. And I'm
               | calling completely bullshit on this methodology. Even
               | their conclusions more or less paint the picture:
               | We have found that hospitalizations cause: *increased
               | out-of-pocket spending on medical care*, *increased
               | medical debt*, and decreased employment and income
               | 
               | * asterisk emphasis mine.
               | 
               | [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC5865642/
        
               | whoitwas wrote:
               | You work for an insurer? I'm sorry for you. Save your
               | soul and quit!
        
               | tightbookkeeper wrote:
               | Work for an internet ad company instead!
        
               | whoitwas wrote:
               | I suggest you try purchasing insurance through a state
               | market place for you and your family for next year and
               | then report back on your experience if you're still alive
               | in 2026.
        
               | XorNot wrote:
               | > longer queues for advanced treatments
               | 
               | Americans always toss this out like it means something.
               | If you're not in queue because you can't afford it, then
               | you are in the queue it's just infinitely long but you're
               | not counted.
               | 
               | Your entire culture here is so broken you are
               | fundamentally incapable of even beginning to understand
               | how other countries discuss these metrics: when they
               | discuss wait times it's for _everyone who needs it_ - no
               | one is unable to afford it or being denied it by their
               | health insurance.  "The queue" is triaged against
               | available resources - i.e. patients needing urgent care
               | will get it earlier then those who are stable.
               | 
               | Could it be shorter? Of course it could, but it also
               | _includes_ everyone who needs it. And if you don 't like
               | the queue the _gasp_ you can still pay to be treated
               | privately and receive prompter service under most
               | systems.
               | 
               | Your system is so broken you literally can't comprehend
               | the wording of complaints about other systems because you
               | contextualize it through your own. Built into the entire
               | model is that "the queue is long _and also we already
               | kicked a bunch of people out of it_ , which is not what
               | anyone is talking about in regards to the NHS, or
               | Australian Medicare or any other system.
        
               | nradov wrote:
               | I am quite familiar with the systems in other countries.
               | Every country rations care. Some do it by condition
               | severity, others by ability to pay. The vast majority of
               | US consumers have health plan coverage and the co-
               | insurance or co-payment amounts are fairly low. I won't
               | attempt to defend the vagaries of the US healthcare
               | system but let's not pretend that everyone who needs
               | treatment in other developed countries actually gets it
               | in a timely matter. Why are 5-year cancer survival rates
               | higher in the USA than the UK?
               | 
               | It's pretty common to see affluent Canadians come to the
               | US as medical tourists and pay out of pocket for
               | procedures like MRI scans or joint replacement surgery.
               | This is a real thing that happens all the time. Depending
               | on your perspective that might be acceptable in the name
               | of fairness and cost control but there are always trade-
               | offs.
        
               | Yeul wrote:
               | Ah yes the kind of health plan coverage that still
               | requires you to pay thousands of dollars out of pocket...
        
         | 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.
        
           | eszed wrote:
           | The amount of wasteful overhead in the American "healthcare"
           | system never fails to shock me. The last two companies I've
           | worked for (one a self-insured non-profit, the current a
           | "conventionally"-insured for-profit) have both,
           | coincidentally, had ~500 employees, and each dedicated about
           | one-and-a-half full-time positions to administering their
           | healthcare plans. Now scale that up across every company in
           | the country: it's... Insane.
           | 
           | Forget any of the squishy humanitarian impulses behind
           | "socializing" medicine; eliminating all that un-productive
           | labor would be of immense economic benefit.
           | 
           | (Health-plan administrative cost is a moat which advantages
           | large businesses to the detriment of small. That goes some
           | way to explaining why an economic-efficiency / dynamism
           | argument has never gained traction in American political
           | discourse.)
        
             | vundercind wrote:
             | Right, it's _so bad_ that if we Did A Socialism and somehow
             | had the worst cost outcome for such a move on the planet
             | such that our direct healthcare spending remained
             | identical(ly crazy-high)... it'd still be a win because of
             | the huge drag on the rest of the economy and our QOL the
             | current system imposes in indirect costs.
        
               | actionfromafar wrote:
               | But that would be morally wrong and lead to communism and
               | satan worshipping.
        
           | rsynnott wrote:
           | One thing I've noticed from American colleagues talking about
           | healthcare stuff (insurance and copays and vouchers and HSAs
           | and so on and so forth) is that it's just mind-numbingly
           | complex. It just seems like an incredible mess. Like, the
           | amount of mental energy that goes into it just from the users
           | has to be a significant cost to society.
        
         | frsoafdslfdlsa wrote:
         | Have you tried phoning a GP or for an ambulance recently?
        
           | psd1 wrote:
           | No, let me instead tell you about my healthcare experience in
           | America.
           | 
           | I wanted to get travel vaccinations in New Orleans. In my
           | ignorance, I just looked up a clinic and went. Apparently I
           | don't understand the coding for black clinic.
           | 
           | It was a shack with 30 poor rural black women sitting
           | motionless on mismatched folding chairs. We sat and sweated
           | for an hour; no practitioner or even receptionist appeared.
           | 
           | I don't think there was a phone at that shack. There weren't
           | many cars about, so those women probably walked a decent
           | distance to sit and wait.
           | 
           | One of them had an enormous tumour on her face.
           | 
           | It could be that we just killed the vibe. But these women
           | were motionless. Like waiting was all they did. I believe
           | they waited in that shack for days in a row.
           | 
           | We went to that clinic from a bar where we'd been drinking
           | seven-dollar beers while a waspy college band played poor-
           | hillbilly music to oyster-guzzling yuppies in raybans.
           | 
           | I've generally found Americans to be smart, humble, funny,
           | kind and warm. But when I encounter an American being
           | arrogant or self-centred, I think about that New Orleans
           | shack.
        
             | frsoafdslfdlsa wrote:
             | I could trade stories about experiences with UK and US
             | healthcare (I've lived in both countries), but the facts
             | speak for themselves. The UK and US are near opposite ends
             | of the scale of healthcare expenditure per capita in the
             | developed world, yet the average life expectancy is about
             | the same.
             | 
             | I am not defending either system - I would strongly prefer
             | something like the rest of continental Europe, which is a
             | pragmatic mix of private and public healthcare. However,
             | the idea that fully-public healthcare (a unique experiment
             | in the world) is a sustainable model is a joke. It's hard
             | to defend, when our current standard healthcare at the
             | point of service could charitably be called "usually better
             | than the 3rd world".
        
         | 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.
        
               | psd1 wrote:
               | I was asking about Switzerland, since you brought it up.
               | It's a fascinating place, I'm keen to hear your
               | observations.
               | 
               | Don't conflate bankruptcies. _Purely financial_
               | bankruptcy is recoverable, given good health and time.
               | (Not to trivialise it.) But, for a peasant with terminal
               | cancer: _medical_ bankruptcy generally means a miserable
               | and undignified death. There's worse pain than pain, you
               | know?
               | 
               | So, while I have to respect the dispassionate argument
               | that "not _that_ many people die in a ditch", I reply
               | that my PS200 buys me not just passable healthcare but
               | also some pride in my nation finding some fucking
               | compassion.
               | 
               | That moral point is also an economic point, but I'm not
               | ready to articulate it concisely. Let me say simply that
               | a nation needs to find character on the way up and then
               | again on the way back down, and America is currently
               | fumbling for the second step. A nation is founded on its
               | citizens. The cost of a zeitgeist of rage and distrust
               | is, eventually, everything. What price empire?
        
               | TMWNN wrote:
               | > I was asking about Switzerland, since you brought it up
               | 
               | sarah_eu brought up Switzerland, in comparison to the UK
               | NHS. I don't know what percentage of Swiss bankruptcies
               | are because of medical bills, but can cite the statistic
               | for the US (which of course is the main topic here).
               | Also, as I alluded to, "[ _insert large percentage here_
               | ] of bankruptcies in the US are because of medical bills"
               | is a common incorrect trope in/about the US, which I
               | wanted to fend off before it came up yet again.
               | 
               | >But, for a peasant with terminal cancer: _medical_
               | bankruptcy generally means a miserable and undignified
               | death.
               | 
               | Obamacare mandated that the 15%[1] of Americans pre-
               | Obamacare that did not have health insurance get it or
               | pay a penalty. The figure is 8% now.
               | 
               | And before you say "Well, that's not 100%", while the
               | penalty for Obamacare noncompliance is not high enough,
               | 92% of Americans having health insurance is not very far
               | from the 95-97% elsewhere, and some large share of the 8%
               | is from illegal aliens who are ineligible or avoid
               | signing up for government health insurance. In every
               | country there are people who fall between the cracks,
               | whether a German who neglects to sign up for a new
               | sickness fund after changing jobs, or a Canadian who
               | neglects to sign up for a new provincial health care card
               | after moving. The only way to get actual 100% coverage is
               | to use the UK NHS model of having no membership card at
               | all.
               | 
               | [1] Yes, 85% of Americans before Obamacare had health
               | insurance. How many of you non-Americans (heck, many
               | Americans) thought that "0% of Americans have healthcare"
               | before or after Obamacare? It's OK; you're not alone in
               | believing everything you read on Reddit.
        
               | davidgay wrote:
               | > Only 4% of US bankruptcies are because of medical bills
               | 
               | I'm going to hazard a semi-informed guess (I grew up in
               | Switzerland, live in the US), that 0% of Swiss
               | bankruptcies are because of medicals bills.
               | 
               | And https://www.amjmed.com/article/S0002-93430900525-7/fu
               | lltext disagrees with you, claiming 62% of US
               | bankruptcies are due to medical bills... (other links
               | report somewhat lower figures, e.g.,
               | https://www.self.inc/info/medical-debt-bankruptcies-
               | statisti..., but definitely nothing as low as 4%).
        
               | arpinum wrote:
               | Neither of your links are primary source data and give an
               | incorrect interpretation. If you follow the links to the
               | primary data you will find the phrasing changes from
               | "medical problems contributed to..." in the source to
               | "health care expenses were the most common cause of
               | bankruptcy" in your citation.
               | 
               | The numbers you cite are the percent of bankruptcies that
               | include medical debt. The data doesn't say the medical
               | debt caused the bankruptcy, or that this debt type was
               | the largest percentage of debt. People declaring
               | bankruptcy typically have many types of debt as they
               | generally fall behind on all their bills.
        
               | TMWNN wrote:
               | The _Washington Post_ piece I linked to (Permanent URL:  
               | <http://web.archive.org/web/20180326154159/https://www.wa
               | shin...> discusses the Himmelstein article the letter you
               | cited cites. As arpinum said, Himmelstein et al. conflate
               | any debt that includes medical bills at time of
               | bankruptcy with "medical bills caused bankruptcy".
        
             | pierrebeaucamp wrote:
             | > But my concern is always what happens to the poor.
             | 
             | There are subsidies available to low-income households. I'm
             | unsure about the specifics as subsidies differ from one
             | canton to another and usually depend on your income and
             | family status.
        
             | BlueTemplar wrote:
             | Yes, exactly, while the average USian might still keep up
             | with the rising costs of healthcare,
             | 
             | (and in fact being the cause of rising costs because that
             | is where they are going to spend their disposable income),
             | 
             | the median USian will _not_.
             | 
             | Partially this also comes from statistical effects that
             | aren't scale-invariant :
             | 
             | Countries with more people are more rich (including per
             | capita).
             | 
             | Countries that are richer are more inequal.
             | 
             | Countries with more people are more inequal.
        
           | 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!
        
             | xmddmx wrote:
             | Exactly. I think they are confusing the employee portion
             | with the overall cost? As an example, I currently pay about
             | $200/ month but my employer is paying $1800, so total cost
             | is $24000/year.
        
             | deathanatos wrote:
             | TBF, the $300 is a "more" number in their post, the
             | difference I think from the further upthreads comparison of
             | $200/mo cost of non-US, vs. $500/mo cost for US. So,
             | 
             | > _don 't care about loosing (sic) an extra 300 USD on
             | health insurance_
             | 
             | It's the difference we allegedly don't care about. But
             | they're claiming the cost is $500/mo, not $300/mo.
             | 
             | Still, I think they're wrong: $300/mo or $3,600/y would be
             | a decent sum to a lot of people that they would like to
             | have, to spend on things like housing or basic items.
             | 
             | Also, my searching says $500/mo is a bit below the average
             | single-person coverage premium. And if you have a family,
             | my Google searches suggest you'd _love_ to see $500 /mo for
             | healthcare, as you're paying >>$500/mo.
             | 
             | Even if we (I think generously) use $500/mo, I think we can
             | only generously call that a premium-only number. But if
             | you're comparing my private insurance premiums to a nation
             | with universal/government insurance, I think you have to
             | add in both the higher costs I pay out of pocket for things
             | insurance won't cover, and the taxes I pay for government
             | healthcare programs.
        
           | Yeul wrote:
           | I very much doubt that every American makes 9k per month.
           | 
           | Ofcourse what it really comes down to if poor people deserve
           | healthcare or if we should just pretend that they don't exist
           | (the state of healthcare in Europe before WW2).
        
             | deathanatos wrote:
             | > _I very much doubt that every American makes 9k per
             | month._
             | 
             | We know they don't[1]:
             | 
             | > _For the year 2022, the U.S. Census Bureau estimates that
             | the median annual earnings for all workers (people aged 15
             | and over with earnings) was $47,960; and more specifically
             | estimates that median annual earnings for those who worked
             | full-time, year round, was $60,070._
             | 
             | The upthread's figure is $/mo; the higher (full-time)
             | figure there is $5005/mo.
             | 
             | $9k/mo is within top 20%'tile. Every trying to read the
             | statement as "most Americans" doesn't work.
             | 
             | [1]: https://en.wikipedia.org/wiki/Personal_income_in_the_U
             | nited_...
        
         | 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.
        
               | nradov wrote:
               | The price transparency requirement I linked above applies
               | to health plans, not providers. (There's a separate price
               | transparency requirement for hospitals but it's less
               | useful to consumers with health plan coverage.)
               | 
               | I'm not sure what you mean about different codes for the
               | same thing. The health plan MRFs all use the same
               | CPT/HCPCS codes. Each code has a unique meaning.
               | 
               | Health plan member portals also have online shopping
               | tools where you can do price comparisons for every
               | network provider within a certain distance. So what
               | you're asking for pretty much already exists, although
               | many consumers aren't aware of this.
               | 
               | https://www.cms.gov/healthplan-price-
               | transparency/consumers
        
             | lukeschlather wrote:
             | > Of course as an individual health plan member that won't
             | tell you your out-of-pocket cost for a particular service
             | 
             | If I can't get this, there's no price transparency. Of
             | course it's even worse than this in practice, since not
             | only can no one tell me my out-of-pocket cost for a service
             | I'm about to purchase, they can't tell me what the
             | negotiated rate is going to be, and it could be over a year
             | before anyone can tell me either the negotiated rate or my
             | share of the negotiated rate. (Odds are it will take at
             | least a month and these figures will be renegotiated
             | multiple times before I get a bill.)
        
               | nradov wrote:
               | If you're a health plan member then you can access
               | consumer price transparency data through their mandatory
               | comparison shopping tool.
               | 
               | https://www.cms.gov/healthplan-price-
               | transparency/consumers
               | 
               | Reimbursement rates are negotiated between payers and
               | network providers at most once per year. Rates don't
               | change monthly.
        
             | chiefalchemist wrote:
             | > and are accountable for patient outcomes will probably
             | work better for everyone.
             | 
             | What's to stop providers cherry-picking who they treat?
             | Who's going to treat the patients who are high risk? That
             | will ruin the outcomes metric?
        
               | nradov wrote:
               | Accountable care organization (ACO) contracts between
               | payers and providers usually don't allow cherry picking.
               | They have to take all comers. There are typically higher
               | capitation rates for older, sicker patients. It does take
               | some actuarial sophistication to price those risks
               | correctly but with large numbers of patients things tend
               | to average out.
        
               | chiefalchemist wrote:
               | Who and how is that going to be monitored and enforced?
               | What's the punishment? Cost-of-doing-business fines that
               | the market only ends up paying anyway?
               | 
               | I'm not disagreeing w/ the theory of your proposal. I
               | haven't - yet? - seen how it can actually work.
        
               | nradov wrote:
               | For Medicare ACOs you can read about monitoring and
               | enforcement here.
               | 
               | https://www.cms.gov/priorities/innovation/innovation-
               | models/...
               | 
               | For ACO agreements between provider organizations and
               | commercial payers, the parties can negotiate any contract
               | terms they like. The agreements are usually confidential
               | but payers aren't naive about this stuff and are fully
               | aware of how to protect their financial interests against
               | cherry picking by providers.
        
         | 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>
        
           | twoodfin wrote:
           | Kaiser's effectively an HMO, right? Consumers (i.e. employees
           | evaluating their corporate benefits) _hated_ HMO's at their
           | peak in the '90's so much that the initials became
           | politically toxic.
           | 
           | Cheaper plans with more restrictions could exist more
           | broadly. Consumers don't want them, politicians make hay on
           | the consumer unhappiness and ban the things that allow the
           | plans to be cheap in the first place.
        
             | TMWNN wrote:
             | Kaiser is like the NHS in that it does everything in-house.
             | Kaiser members go to Kaiser doctors, stay at Kaiser
             | hospitals, and get prescriptions fulfilled from Kaiser
             | pharmacies.
             | 
             | I agree on "HMO" being tainted. Kaiser has a good
             | reputation in its territories, as does Intermountain, the
             | other big western US integrated system.
        
         | 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.
        
           | xapata wrote:
           | It'd still occur in a single-payer system. The problem is
           | fees for services instead of fees for results.
        
             | looping__lui wrote:
             | So the wealthy can finally cheat death efficiently once and
             | for all ;-)
             | 
             | On a more serious note: that might be hard in medicine per
             | se to pay for "results". And I found some of the insights
             | from "Outlive" quite interesting: how we focus in cure but
             | not prevention; and how in the bigger scheme of things
             | Antibiotics was almost the only "real big invention" in
             | western medicine for a very long time (e.g., in terms of
             | actual medical impact)
        
             | contrast wrote:
             | Any evidence for that claim? The issue is not whether there
             | is administrative overhead, but the amount of it. It's not
             | obvious to me that completely different funding models
             | would incur the exact same amount of overhead on the
             | practitioners.
        
               | cmrdporcupine wrote:
               | It does happen in a fashion in the Canadian system where
               | family doctors at least operate as private businesses
               | that bill the gov't, and because of that have to spend
               | quite a bit of time on paperwork which then requires a
               | whole edifice which there has been a lot of complaint
               | about recently.
               | 
               | A search will find you plenty of articles about this.
               | 
               | That and the nature of the relationship introduces
               | conflict. Plus the bulk of provincial governments
               | administrating the thing are ideologically biased against
               | it because they are conservative or neo-liberal in bent,
               | and have been chronically underfunding it for years....
        
               | xapata wrote:
               | If I only earn when I treat, then I have an incentive to
               | over-diagnose. Insurance thus forces me to document my
               | diagnoses, and I spend much of my time on documentation
               | and appealing denials.
        
             | btilly wrote:
             | How would you measure results? Go to a doctor, get a
             | prognosis, get a treatment then a new prognosis? The
             | incentive to inflate results is obvious.
             | 
             | How else would you measure it? Survival rates? Doctors now
             | have a strong incentive to avoid taking on sick patients.
        
           | miki123211 wrote:
           | > 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
           | 
           | This is most definitely not just a US problem. I work
           | adjacent to this industry in Poland, where we basically have
           | a single-payer system[1], and I'd say 20-30% is definitely in
           | the ballpark.
           | 
           | Especially in larger institutions (think hospital, not a
           | single doctor's office), records must be kept and handovers
           | between different doctors must occur. This means that you
           | have to do all this work anyway, regardless of how much of it
           | is actually transmitted to the insurance provider, and in our
           | case, it's definitely far, far too little.
           | 
           | [1] we do have private healthcare, but that's typically small
           | / less-complicated procedures and usually covered out-of-
           | pocket by those who can afford it, so there are no insurance
           | considerations there.
        
             | inglor_cz wrote:
             | "This is most definitely not just a US problem. I work
             | adjacent to this industry in Poland, where we basically
             | have a single-payer system[1], and I'd say 20-30% is
             | definitely in the ballpark."
             | 
             | I wonder if _this_ could be the killer app for AI. Teach it
             | how to do this sort of bureaucracy instead of humans, and
             | let doctors treat actual people instead.
        
           | btilly wrote:
           | _I 'm skeptical of claims that this waste doesn't translate
           | into the higher level metrics._
           | 
           | The claim is that the size of the pot of money to be split is
           | determined by the willingness of consumers to pay. Which is
           | determined by their wealth. Therefore the inclusion of a lot
           | of administration changes the split of where that money goes.
           | More administration = less money for nurses and doctors. Less
           | administration = more money for nurses and doctors.
           | 
           | This fits observed behavior in other places. Your potential
           | client has a problem and a potential budget for the solution.
           | Clients are remarkably indifferent to how that budget is
           | split up, as long as a solution to the problem is worth
           | spending the budget. Here is the example that originally
           | brought this point home to me. When Oracle moved from Solaris
           | to Linux around the year 2000, it was able to charge more
           | money for the database. Why? Because companies were willing
           | to spend money on Oracle that previously went to the hardware
           | and operating system. This incentive to open source the
           | complement of whatever product you're providing is one of the
           | reasons why so much money has been invested into creating
           | open source.
        
             | seadan83 wrote:
             | Interesting point, though would you agree that an
             | individuals budget for healthcare is unique? The budget for
             | healthy vs not, tends to be 'all of it.' Hence, excessive
             | healthcare costs.
        
               | btilly wrote:
               | Exactly. And the relationship seems to be that if your
               | income goes up 1%, your available wealth at a point in
               | crisis goes up 2.8%.
               | 
               | However your willingness to spend at the moment of crisis
               | is dictated by your problem and available wealth. And now
               | how that money is going to be split among different
               | parties.
        
           | rsynnott 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.
           | 
           | It's not just for that. Documentation and checklists exist in
           | public health systems, too, and IIRC there's some fairly hard
           | evidence that they do reduce errors. Doctors hate them, tho.
           | 
           | I was in hospital a few years back for a fairly inoffensive
           | surgical procedure (public hospital, though in Ireland's
           | rather weird hybrid system, because I had private insurance
           | my insurance was paying), and I'd say I was asked at least
           | ten times if I was allergic to anything, and had the barcode
           | on my wristband read more times than I can count. This was
           | extremely irritating... but apparently it does _work_; some
           | patients don't always give the same answer to that question
           | every time.
        
           | ForOldHack wrote:
           | "our highest paid most valuable people spend 20-30% of their
           | time on a flavor of administrative junk..."
           | 
           | By choice. Medical coders are a dime a dozen. Front
           | office/back office/in office. You hire and train other people
           | or you whine and complain, and be unproductive. Hopefully you
           | will get one of the smart ones who understand this.
        
         | 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 in the 1960s.
         | 
         | Prices rose with inflation until 1968, when they started
         | angling up steeply. 1968 was soon after the advent of Medicaid
         | and Medicare.
         | 
         | The 1962 FDA amendments also resulted in a steep rise in drug
         | costs, and a sharp reduction in new drugs being developed.
        
           | 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?
        
             | WalterBright wrote:
             | It is true. Look at graphs of it.
             | 
             | > Why?
             | 
             | I don't know how other countries manage their health care
             | systems, though I know that the British one is facing
             | bankruptcy, and while health care was free in the Soviet
             | Union patients had to pay for anesthetic for root canals,
             | and bribery was the norm.
             | 
             | Here's a link to what's wrong with the American system:
             | 
             | https://www.theatlantic.com/magazine/archive/2009/09/how-
             | ame...
        
               | tonyedgecombe wrote:
               | >British one is facing bankruptcy
               | 
               | No it isn't.
        
             | tightbookkeeper wrote:
             | By reasonable do you mean 30-50% of your income for your
             | entire life? Regardless of whether you use the services?
        
               | Galaxeblaffer wrote:
               | No country in the world has you paying 30-50% og your
               | income to health care, it's more like 15-18%
        
               | Angostura wrote:
               | Where on earth are you getting that figure from?
        
               | tightbookkeeper wrote:
               | The uk tax receipts in 2024 was 342.2 billion.
               | 
               | The nhs budget was 181 billion. Half of all government
               | money appears to be going to healthcare.
        
               | immibis wrote:
               | What percentage of people's money is government money?
        
               | rsynnott wrote:
               | ... Where on earth are you getting that? As a high earner
               | in a European country, about 8-9% of my income goes on
               | the health service (though that includes some non-
               | healthcare stuff). And I'm an extreme outlier;
               | multinational salary and equity, single, no kids. For a
               | single childless person on the average wage it's about
               | 2.5%.
        
               | tightbookkeeper wrote:
               | What's your effective tax rate?
        
           | mindslight wrote:
           | Didn't the de jure government get involved in WWII with
           | prices caps on wages yet exempting benefits, and this set the
           | stage for the anticompetitive bundling of healthcare with
           | employment? And wasn't the standard of care back then
           | predominantly flavoring plus opium, which has a quite low
           | cost basis?
        
             | WalterBright wrote:
             | Yes, employers during WW2 started offering health care as a
             | fringe benefit because the US had wage caps. Even earlier,
             | the government required licensing of doctors, the original
             | purpose of which was to drive out Jewish and Black doctors.
             | 
             | https://www.amazon.com/Competition-Monopoly-Medical-Care-
             | Fre...
             | 
             | But the big government push into health care happened in
             | the 60's.
             | 
             | Another big driver of American health care costs is the
             | FDA:
             | 
             | https://www.amazon.com/Regulation-Pharmaceutical-
             | Innovation-...
        
         | Amezarak wrote:
         | The US government(s) spend about as much money per capita on
         | health care as the average European country. Obviously US
         | health care costs are out of control for other reasons than the
         | existence of private insurance.
         | 
         | To be clear because that's easy to misunderstand: despite the
         | fact Americans do _not_ have universal public health care, the
         | government _already spends_ as much as many European countries
         | that _do_ , _per capita_. Part of this, of course, is because
         | US public health care spending is concentrated on the old
         | (Medicare) and disabled /poor (Medicaid). But it's still a
         | shocking testament to US health care costs.
        
         | naming_the_user wrote:
         | NI does not pay for the NHS, it comes from general taxation,
         | you're comparing the wrong figures.
        
           | tonyedgecombe wrote:
           | NI is part of general taxation in all but name. Nominally
           | there is an NI fund but any money deposited there is
           | immediately lent back to the government to be spent on
           | whatever they want.
        
           | psd1 wrote:
           | Oops. I've spoken enough already in the thread, but I do want
           | to thank you for the correction.
           | 
           | In my defense, I'm attempting to perform data operations on a
           | kilo of fatty grey meat from a savanna hominid. I've been
           | meaning to upgrade but have you seen gpu prices lately.
        
         | o11c wrote:
         | Certainly a significant number of its points were defined to
         | explicitly exclude insurance overhead, which I have often seen
         | cited as "very high in the US".
         | 
         | It's also completely ignoring the possibility of Hollywood-
         | style accounting.
         | 
         | One thing I'm curious about is any correlations to number of
         | grandchildren.
        
         | refurb wrote:
         | > 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.
         | 
         | This is a odd position to take. You're going to firmly hold
         | onto a view despite admitting it's not that informed?
         | 
         | Not to mention you're not even comparing the right costs. What
         | the patient pays is not the total cost.
        
         | simonh wrote:
         | You forgot to mention the taxes they pay to support CHIP,
         | Medicaid and Medicare. Which are not far off what many
         | Europeans pay for universal health care, before most Americans
         | even start to look at private health insurance so they actually
         | get health care for themselves.
        
           | tightbookkeeper wrote:
           | > Which are not far off what many Europeans pay for universal
           | health care,
           | 
           | Effective tax rates of 40-70% do not exist in the Us. It's
           | still a ridiculous amount of the economy to tax and spend.
           | 
           | But what I think is more annoying is that the US has health
           | systems for special interest groups:
           | 
           | - seniors - veterans - native Americans - women and children
           | - government employees (especially teachers) - immigrants
           | seeking asylum
           | 
           | This must be getting close to half the population. Either get
           | rid of them, or pay for everyone.
        
             | 9dev wrote:
             | > Effective tax rates of 40-70% do not exist in the Us.
             | It's still a ridiculous amount of the economy to tax and
             | spend.
             | 
             | That isn't true. In Germany, where we have fairly high
             | taxes, I get to keep about 60% of my gross income, and I'm
             | in the maximum taxation group. This 40% includes universal
             | health care, pensions, tax, and mandatory insurance for job
             | loss.
        
               | inglor_cz wrote:
               | Don't forget the effects of VAT and various consumption
               | taxes. If you buy stuff with your net income, ~ a sixth
               | of the money spent will be indirect taxes again.
        
             | bdauvergne wrote:
             | Those tax rates have nothing to do with healthcare, to take
             | France as an example most of it is for other things, like
             | pay-as-you-go pension plan or free education. Budget of
             | french "assurance maladie" is 25% of the PIB or 450 billion
             | euros for 68 million people, most of it paid by salary
             | taxes. All things being equal, for the USA the same system
             | would cost 2322 billion dollars.
             | 
             | https://www.securite-sociale.fr/la-secu-cest-
             | quoi/chiffres-c...
        
             | eszed wrote:
             | The way that I've seen GP's point expressed that makes
             | sense to me is that the per-person cost to provide health-
             | care for those special interests you mention is roughly
             | equivalent to the per-person tax burden in most other
             | developed countries _to care for everyone_. That gives me a
             | useful handle on how _gob-smackingly_ wasteful the US
             | system (writ large) actually is.
        
             | rsynnott wrote:
             | Very high tax rates in Europe are generally less about
             | healthcare than about pensions, really, in most cases. Most
             | European countries are a bit further down the demographic
             | crisis road than the US is (and they mostly have higher
             | life expectancies, too), so the cost of pensions has really
             | become quite a big deal. Most European countries also have
             | either very cheap or free university tuition; if you don't
             | qualify for a grant it's 2k here, say. (This is an
             | increase, due to the GFC; when I was in university it was
             | 50 euro a year...)
             | 
             | That said, for _most_ countries, 40-70% effective tax is
             | very high, and not encountered by the average person. To
             | pay 40% effective in Ireland, say, you'd have to be earning
             | at least 150k, and that's assuming you're single, have no
             | kids, don't pay rent or mortgage, and have no private
             | pension (401k equivalent) contributions. Realistically,
             | almost no-one hits those sorts of rates; for realistic
             | setups you're looking at closer to 200k for a single
             | childless person.
             | 
             | It is impossible, here, outside of ultra-contrived
             | circumstances, to pay over a 52% effective tax rate.
        
               | luckylion wrote:
               | > It is impossible, here, outside of ultra-contrived
               | circumstances, to pay over a 52% effective tax rate.
               | 
               | It depends on what you include though. You could look at
               | someone earning 100k, having it taxed, paying all the
               | things that are not taxes but obligatory just the same
               | (social security, depending on the country), and then
               | spending the rest on rent, travel, food & entertainment
               | (and paying sales tax and various other specific taxes).
               | How much of their total income has gone to the state?
               | 
               | If you want to extend that comparison, look at someone
               | running a company. The value they create with their
               | company will be taxed as well, then they receive
               | dividends from their company which also will be taxed at
               | different rates.
               | 
               | Of course, you'd need to either compare to individual US
               | states, or make some choices about how to average their
               | very different tax levels.
        
               | rsynnott wrote:
               | At least here, social security (PRSI) is a tax. Rent
               | isn't subject to VAT, nor is a lot of food. Someone
               | running a company wouldn't normally pay themselves with
               | dividends, becuase it's not tax efficient; they'd take a
               | salary from it instead (that's a cost, and thus is not
               | subject to corporation tax).
               | 
               | Someone earning 100k (assuming single, no kids, no
               | private pension) pays about 33% effective tax (including
               | social security) and some VAT on spending. 50-70%, again,
               | is just kinda nonsense.
        
               | AtlasBarfed wrote:
               | We have immigration (illegal or otherwise) to stave off
               | demographic cliffs. As much as the right hates illegal
               | immigration, it is mostly Christians and they integrate
               | well.
               | 
               | The EU either has to integrate muslims, which is a
               | rougher ride, or Russians/Ukrainians, of which there is a
               | more limited number to import.
               | 
               | The country with the worst demographics, South Korea,
               | still IMO has an out: it can topple North Korea and
               | import a huge number of people from there.
               | 
               | China is in deep, deep trouble. They have restated
               | demographics downward, and probably it is still worse
               | than that. Combined with increasing levels of
               | totalitarianism, allegedly a huge financial house of
               | cards in real estate and regional governments, and a
               | likely invasion of Taiwan that results in blockade and
               | sanctions...
               | 
               | Russia was having huge problems before the war. Now they
               | are throwing away a badly needed generation, and causing
               | 2-5x that amount to flee the country.
               | 
               | Democracies have the potential to pivot from demographic
               | disaster, but totalitarian regimes don't care about them,
               | because demographic cliffs mean there is just an older
               | more compliant population to suppress. Of course it means
               | long term their country will fade to irrelevance and
               | perhaps starvation/economic collapse, but totalitarian
               | regimes exist primarily to ensure the survival of the
               | regime, not the population.
        
               | galdosdi wrote:
               | > We have immigration (illegal or otherwise) to stave off
               | demographic cliffs. As much as the right hates illegal
               | immigration, it is mostly Christians and they integrate
               | well.
               | 
               | Indeed, but, even Mexico and much of Latin America now
               | has below replacement fertility too. So now what?
        
         | djtango wrote:
         | This may be tangential but the NHS is not without some
         | sickening expenses. The costs are just opaque and hidden but
         | ultimately taxpayers are paying for PS300 for a stainless steel
         | bucket for patients to pee in thanks to bureaucracy and
         | government contracrs. (that figure is pre 20s inflation)
         | 
         | So every month the government siphons off 40-45% of your income
         | and donates a lot of it to Big Healthcare. So a case of being
         | damned if you do and damned if you don't...
        
         | snarf21 wrote:
         | We should also not forget the $1B in drug advertising spend
         | that must be recouped. People from other countries are
         | frequently dumb-founded when they see US tv with prescription
         | ads. Also look at all the companies buying up old drugs and
         | immediately raising the price 10X or more.
        
           | oceanplexian wrote:
           | Doesn't advertising drive prices down? For example there is
           | currently a booming industry for GLP-1s and the prices are
           | dropping as the drug is becoming more available. Consumers
           | know they have lots of choices and therefore price discovery
           | is occurring.
        
         | ericjmorey wrote:
         | If you used those two profit numbers you would be missing all
         | of the expenses that medical insurance companies have, none of
         | which do anything for providing healthcare. Furthermore, you
         | would be missing all of the expenses which exist to accommodate
         | the systems insurance companies invented to account for things
         | that only they care about. Insurance is the least efficient
         | method of providing healthcare and we've committed hard to it
         | for the benefit of few.
        
           | FredPret wrote:
           | The most efficient system would be direct payments only.
           | 
           | The downside is only the very roch can afford expensive
           | medical emergencies.
           | 
           | But with insurance individuals get to pull the value of
           | future premium payments forward to pay for large expenses in
           | the present. There's also a degree of socialization.
           | 
           | The downside is there will always be an overhead.
           | 
           | Government health care is insurance writ large and has the
           | same tradeoffs, just on a larger scale.
        
             | miki123211 wrote:
             | > Government health care is insurance writ large
             | 
             | I would argue that it has even more tradeoffs; unlike
             | private insurance, it's usually both mandatory and a
             | monopoly, and that can go very wrong very quickly.
             | 
             | The US system is extremely overregulated and preventing
             | true competition, even though US insurance is private, so
             | there aren't really any good data points to compare,
             | though.
        
               | actionfromafar wrote:
               | Public systems can work very well and I can't name one
               | system which went downhill very quickly.
        
               | fao_ wrote:
               | Exactly, the NHS is only going downhill because the
               | dominant ideology among MPs has been that the NHS is the
               | first place to get gutted for cheap savings. A lot of
               | very efficient systems were removed and farmed out for
               | "cheaper" private systems, that end up being rather
               | costly in the long term with respect to increased error,
               | price rising, and all the myriad ways incompetence and
               | explicit money-grabbing messes with healthcare. They
               | gutted the administration systems and now doctors have to
               | work overtime on the weekends just to get their notes in
               | the system, and now because doctors are overworked,
               | they're putting more work into the hands of the
               | incredibly underqualified PAs. And on top of all of this,
               | repeated mismanagement of the money that is distributed
               | to the NHS -- including, of all things, incredibly inept
               | bartering, putting hospitals on a "target system" where
               | underfunded hospitals are given less money for not
               | hitting targets, etc. It's a complete joke, but every
               | step was damned near deliberate for the case of farming
               | public money into the pockets of the friends of MPs.
        
               | detourdog wrote:
               | The problem with the system in the USA is that paperwork
               | can make all the different in costs. The burden is on the
               | individual to comprehend all the implications of their
               | choices. These choices are beyond do I want my ailments
               | addressed.
        
               | fao_ wrote:
               | Often, people in situations where they require healthcare
               | are least able to assess the implications of their
               | choices, as well. It is very literally praying on the
               | sick.
        
               | Spooky23 wrote:
               | You could provide every American with extremely robust
               | healthcare for a trillion dollars a year. Probably less
               | as you allocated resources based on need.
               | 
               | We choose to spend that on the military. Basically you
               | can choose guns or butter, we choose guns and empire.
               | Whether that is a "correct" decision is an exercise for
               | the reader.
        
               | FredPret wrote:
               | The US spends more on healthcare than arms.
               | 
               | You could argue for lower defense spending, but there's a
               | hard lower limit (which is unknown) and if you cross that
               | threshold, the world changes for the worse very quickly.
               | 
               | The rules-based order is underpinned by tanks and planes
               | and nukes. Diplomacy is a layer of abstraction over
               | violence and potential violence.
        
               | CrazyStat wrote:
               | Medicare costs $800 billion/year and only covers 20% of
               | the population. They are on average the most expensive
               | 20%, but I doubt you're going to cover all the rest for
               | another $200 billion.
               | 
               | Medicaid is another almost $1 trillion/year.
        
               | uoaei wrote:
               | I've resorted to calling this kind of breathless
               | fearmongering out for what it is. There are too many
               | people suffering too greatly in the existing system to be
               | civil at the expense of maintaining the fictions of
               | libertarian idealogues.
               | 
               | Hyperfixation on an idealistic interpretation of real-
               | world dynamics will always be thought-terminating. In the
               | dichotomy of map vs territory, _the map is definitionally
               | a cliche_. We can be better than that.
        
             | actionfromafar wrote:
             | With many insurance companies there are lot of coordination
             | costs.
        
             | thayne wrote:
             | Government "insurance" has several advantages:
             | 
             | - it has a much larger pool of insured, which reduces
             | overall risk, and thus can have lower premiums/taxes
             | 
             | - there is no need for profits, which again lowers costs
             | 
             | - providers only have to deal with a single "insurer",
             | which significantly reduces complexity of getting paid.
             | Patients no longer have to waste time filling out paperwork
             | about their insurance provider, and dealing with
             | misunderstandings and miscommunication about whether they
             | are insured, who they are insured by, etc.
             | 
             | - You no longer have to worry about if your preferred
             | provider is "in network". Which also removes needless
             | beurocracy.
             | 
             | - There is more of an incentive to care about longterm
             | health, because the government will pay for all healthcare
             | over the life of the patient. This used to be the case for
             | private insurance, back when people stayed with the same
             | employer, and same insurance company for most of their
             | life. But now, insurance companies just want to minimize
             | costs while you are with them, which probably won't be that
             | long.
             | 
             | - Employers no longer have to waste time and resources
             | providing health insurance for employees, and employees no
             | longer need to spend time, energy, and anxiety on "open
             | enrollment" every year.
        
               | g-b-r wrote:
               | Furthermore, you can have rich people and big companies
               | pay for a good portion of it, through taxes
        
         | detourdog wrote:
         | It does feel that way. The worst part is that enough of our
         | elected officials insist we enjoy the abuse.
        
       | 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.
        
           | 3D30497420 wrote:
           | Agreed. I have trouble squaring an argument like that with my
           | own personal experience. (I also did not read the article,
           | but I get the gist from the comments, for whatever that's
           | worth.)
           | 
           | To take two ER-related examples:
           | 
           | * In the USA, I had some brief, sharp chest pain and my
           | general practitioners office refused to set an appointment
           | without be going to the ER. I was quite certain it was not a
           | heart attack, but I complied. I was briefly triaged and not
           | admitted. I believe the bill (with very good insurance) was
           | more than 2000 USD.
           | 
           | * In Germany, my wife had an eye injury that required a trip
           | to the ER. She was triaged, saw several doctors, including a
           | specialist. She fortunately did not need treatment, but was
           | required to check with another specialist within a few days
           | to check how things were healing. There was no cost for this
           | beyond our public insurance.
           | 
           | I can cite dozens of other examples where medicines were
           | free/cheap, tests or specialists were covered by default,
           | elective procedures were dramatically cheaper, etc. And this
           | doesn't even include several fights with US insurance
           | companies over tests that were recommended by a doctor.
           | 
           | Is the system here perfect? Certainly not, FAR from it. But
           | it is a big reason why I'm not interested in moving back to
           | the US.
        
           | ninalanyon wrote:
           | Is a primary care physician what we would call a family
           | doctor or general practitioner (GP) in the UK? In Norway an
           | employed adult will pay about 240 NOK (about 22 USD) to visit
           | their family doctor (allmennlege). I'm not sure what the
           | rules are for the unemployed but I'm sure they pay less,
           | children (under 18s), full time students, and pregnant women
           | pay nothing. Median income is about 55 kNOK/month.
           | 
           | I don't normally have to wait unless I turn up at the surgery
           | without an appointment. If the previous appointments run over
           | I sometimes have to wait but rarely ore than half an hour.
        
             | darth_avocado wrote:
             | Yes a PCP is what family doctors or GPS are elsewhere.
        
         | HDThoreaun wrote:
         | The outsize portion of gdp that healthcare takes up is why it
         | is likely to bankrupt you in this country, although it isnt the
         | reason for the lack of transparency.
        
       | 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/
        
             | smnrchrds wrote:
             | What I could never understand is why government funding is
             | needed for residency spots in the first place. From the
             | outside, it seems like residents are cheap labour for
             | hospitals. Even without getting any money from the
             | government, the value of residents' labour should exceed
             | their relatively small salary--so hospitals should be
             | incentivized to hire many more residents. What are the
             | economics (or regulations) of residency that make this not
             | work?
        
               | nradov wrote:
               | It's tough to get an accurate sense of the economics of
               | teaching hospitals. Much of the analysis comes down to
               | highly subjective management accounting decisions about
               | how to allocate fixed costs to various cost centers.
               | Residents (especially the junior ones) require a lot of
               | supervision by attending physicians, and much of that
               | work isn't directly billable. The fact that those
               | hospitals aren't rushing to voluntarily take on more
               | residents indicates that the programs are net losers
               | without government subsidies.
        
               | programmertote wrote:
               | Wife is a doctor at a Miami suburb hospital (it's
               | relatively well known), so I can tell you with confidence
               | that the hospitals CAN absolutely pay $64K/year salary of
               | residents on their own. It's just that they are cheap and
               | do the bare minimum.
               | 
               | But yeah, AMA should stop requiring 8 years of education
               | + 3 years of residency to become a garden-variety doctor.
               | I can look up UpToDate, which most doctors and residents
               | do, to diagnose and treat myself for most common
               | illnesses IF I can purchase medication from pharmacy on
               | my own.
        
           | mullingitover wrote:
           | > 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.
           | 
           | This. The primary purpose of the AMA is to _prevent_ doctors
           | from existing and providing care, all in order to drive up
           | their wealth and status.
           | 
           | Korea has a similar problem right now, their doctors just
           | flexed their power to gain the upper hand economically[1].
           | 
           | [1] https://www.npr.org/2024/09/15/nx-s1-5113082/as-medical-
           | stri...
        
             | matheusmoreira wrote:
             | You should be _very_ careful with this narrative. It
             | invariably concludes that the market should be flooded with
             | doctors. They are minted by medical schools, so naturally
             | the mechanism to flooding the market involves opening more
             | of them and dumbing down the graduation requirements.
             | 
             | I live in a country where that exact process is happening
             | right now in real time. It's not pretty. The level of
             | charlatanism and straight up incompetence in this country
             | is off the charts. There are people graduating medical
             | school right now who don't know how to diagnose a heart
             | attack, let alone treat it. And these are the people
             | manning the emergency services. Because wages were driven
             | down, no doctor worth his salt is gonna accept that job.
             | Why work in some shithole hospital when you can be a
             | dermatologist? Emergency services turned into "reassigned
             | to Antartica" tier jobs only failed doctors put up with. I
             | don't even want to think about the number of people who are
             | dying as a result of this.
        
               | mullingitover wrote:
               | > They are minted by medical schools, so naturally the
               | mechanism to flooding the market involves opening more of
               | them and dumbing down the graduation requirements.
               | 
               | Nope, in the US we have an extra filter that takes
               | perfectly good med school grads and _throws away a large
               | fraction_ for no good reason other than their bad luck in
               | not getting into a residency program. These are people
               | who passed four years of quite rigorous medical school at
               | great expense, and we effectively ruin their lives (and
               | create artificial health care shortages) by denying them
               | careers arbitrarily. In the US it doesn 't matter if
               | you're in the top 1% of the graduating class in the best
               | medical school in the country: if you don't get into a
               | residency program (required before you can be an MD) your
               | medical career is over before it begins.
               | 
               | Even if we did nothing but guarantee a 1-1 relationship
               | between graduates of our medical schools and residency
               | program seats we would have more doctors and would not be
               | watering down our talent pool of doctors one iota.
        
               | rangestransform wrote:
               | On the other hand, the medical school admissions process
               | in Canada has become such a pissing contest between
               | people who are extraordinarily high achieving. I don't
               | think the difference between someone who got a 99th
               | percentile MCAT and a 95th percentile MCAT will ever make
               | a difference in patient outcomes.
        
           | naveen99 wrote:
           | 10 years ago radiology residency spots were going unfilled in
           | the usa. Now there aren't enough radiologists. but if chatgpt
           | can do radiology in 10 years, once again residency spots will
           | go unfilled or worse.
        
         | _heimdall wrote:
         | > It actually proves we would be better off if we spent less
         | and focused on lifestyle.
         | 
         | Speaking purely anecdotally, I can 100% get behind this. I live
         | in a more rural area, work outside regularly, and a large
         | majority of what I eat is either grown locally (without
         | pesticides/herbicides) or I grow it myself. I haven't been to a
         | doctor in 7 or 8 years and am in better shape, and feel better,
         | than I ever have.
         | 
         | Its amazing the difference fresh air, fresh food, and time
         | working in the sun and dirt can make.
        
           | AlexandrB wrote:
           | How old are you?
           | 
           | I work from home, sit on my ass all day, love to eat
           | processed foods and _also_ haven 't been to the doctor in 7+
           | years but feel great. But I'm (just) under 40.
           | 
           | A lot of stuff doesn't catch up to you until you're older.
        
             | _heimdall wrote:
             | I'm also almost 40.
             | 
             | It absolutely could make no difference in the long run,
             | though I do know quite a few people in our age group
             | (including siblings) already dealing with an assortment of
             | health issues, regular doc visits, medications, etc.
        
             | Zelphyr wrote:
             | I'm 51 and I'm healthier than I was 20 years ago because I
             | improved my nutrition and started moving my body on a
             | regular basis. I go to the doctor about once a year for a
             | physical and I actually had a provider tell me recently
             | that she rarely sees someone my age as healthy as I am.
        
           | watwut wrote:
           | I mean, not being sick enough to need a doctor for 7 or 8
           | years is super common for people in cities too. And rural
           | living people do get diseases and injuries requiring doctors
           | too.
        
             | _heimdall wrote:
             | Well that is partly why I made clear that I was just
             | sharing my anecdotal experience, everyone is different and
             | there is no one miracle cure.
             | 
             | Though I would find it hard to believe that fresh air,
             | fresh food, and a bit of time working outside each day
             | would make anyone's health worse.
             | 
             | Injuries and trauma care in general are absolutely a
             | different story. While I am less certain about the net
             | positive of many modern treatments that only treat symptoms
             | and ignore root causes, modern trauma care seems to have a
             | massive pile of evidence showing how beneficial it is.
        
       | 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?
        
             | nradov wrote:
             | Which specific asthma inhalers are you referring to?
             | Generic albuterol inhalers are available for $27 cash
             | price, or less if you have health plan coverage.
             | 
             | https://costplusdrugs.com/medications/albuterol-90mcg-
             | inhale...
             | 
             | Obesity obviously doesn't cause high drug costs but it is a
             | risk factor for asthma. Non-obese people are less likely to
             | have to spend anything on inhalers.
             | 
             | https://www.cdc.gov/asthma/asthma_stats/asthma_obesity.htm
        
             | cmiles74 wrote:
             | The argument here is that the US will have worse health
             | outcomes than another country because the people are less
             | healthy. Cost of care doesn't factor into this argument.
        
       | 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. ;)
        
         | cmiles74 wrote:
         | Health insurance in the US is a large, complicated mess. OTOH,
         | hospitals and healthcare providers are also a large,
         | complicated mess. In my opinion they are somewhat codependent
         | and, in many cases, fighting for the same dollars. That is, I
         | suspect any dollars you save on insurance will be eaten up by
         | increasing money spent on providers and vice versa.
         | 
         | I think the author made the right choice to leave these lumped
         | together. It would be interesting to see how these costs
         | confound over time but would make this article even longer.
        
       | 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.
        
       | not2b wrote:
       | I notice that the terms "debt" and "bankruptcy" (and their
       | variants) appear nowhere in the article.
        
         | cryptonector wrote:
         | So what? TFA is about national aggregates, not individuals.
        
       | cryptonector wrote:
       | > Health spending is determined by income
       | 
       | Whoa. That's eye-opening. If country X spends less than country
       | Y, rather than surmise that country X is more efficient with
       | their healthcare spending we might want to look at whether
       | country X has less per-capita income than country Y.
       | 
       | This makes sense, though it's very surprising. I've seen so much
       | commentary here about how much better the Europeans are at
       | dealing with healthcare than us Americans...
        
         | mullingitover wrote:
         | You can look at the health outcomes to gauge the efficiency.
         | Does the population in country X live longer? Are infant
         | mortality rates higher? Preventable deaths?
         | 
         | We know the US healthcare system is a ripoff _exactly because_
         | while the spending as a percentage of GDP in the US is
         | dramatically higher, the measurable outcomes are embarrassingly
         | bad across the board.
        
           | getnormality wrote:
           | Why would we assume that the health of a country is mainly
           | determined by its healthcare system?
           | 
           | I think the big drivers of worse American health outcomes are
           | things like obesity, car-based lifestyles, and long working
           | hours, all of which have nothing to do with our healthcare
           | system.
           | 
           | The healthiest countries succeed by rarely needing their
           | healthcare system because people behave in healthy ways.
           | Needing the system a lot means you've already failed.
        
             | mullingitover wrote:
             | I don't think lifestyle explains our problem with infant
             | mortality rates. That's something where you, first thing in
             | life, depend on the health care system before you even have
             | a lifestyle.
             | 
             | In addition, yes, I think we _can_ blame obesity on (the
             | lack of) healthcare. If people routinely met with a
             | physician and got advice, they might be able to turn things
             | around before merely being overweight becomes obesity.
             | 
             | We're effectively in a shortage situation, and by design.
             | If you don't get preventative care, that's considered a
             | good thing by the healthcare system because they would
             | honestly collapse if everyone got the recommended doctor
             | visits. So we have people not getting preventative
             | treatment and dying of preventable causes at depressingly
             | high rates. This is generally considered fine, because the
             | health care system is bursting at the seams with more money
             | than it can count, so it's considered successful.
        
               | getnormality wrote:
               | I'm not sure the infant mortality has much of an impact
               | on longevity, and while there may be things the US could
               | do about obesity within the healthcare system, I doubt
               | that the reason for the US-world gap is that the rest of
               | the world does these things and the US doesn't.
               | 
               | You can name things that are bad about US healthcare and
               | could be improved but that's a different topic than why
               | Americans are in relatively poor health compared to other
               | developed countries.
        
               | mullingitover wrote:
               | > I'm not sure the infant mortality has much of an impact
               | on longevity
               | 
               | Infant mortality is a measurable performance indicator
               | for the healthcare system regardless of overall
               | population's longevity.
        
               | getnormality wrote:
               | There's still the same problem of disentangling the
               | population health from the efficacy of the system. Maybe
               | mothers are less healthy in the US and that affects
               | infant mortality.
               | 
               | Not an expert by any means, just confused by the
               | complexity of it all.
        
               | chiefalchemist wrote:
               | > If people routinely met with a physician and got
               | advice, they might be able to turn things around before
               | merely being overweight becomes obesity.
               | 
               | Anecdotally, two stories:
               | 
               | - A while back, I had dinner with two friends who do
               | pharma research. At the time they were working on
               | treatment for T2 diabetes. Naive me asked, "Why not just
               | focus on prevention?" They said it's doesn't happen. Too
               | few people are willing to change.
               | 
               | - More recently I had a conversation with a doctor at a
               | social event. A similar topic came up, again I suggest
               | prevention. And again I was told the same, it just
               | doesn't happen.
        
               | ninalanyon wrote:
               | I'm sure these anecdotes are true. But is it true because
               | this behaviour is immutable or is it because there has
               | been no serious attempt to change it? For instance why
               | not teach how to be healthy in primary school and in
               | society generally? The US and other countries have a high
               | incidence of Type 2 diabetes largely because of over
               | consumption of sugar. This is a social issue. I saw this
               | very clearly when I took my family to the US for three
               | months many years ago and we visited one om my colleagues
               | for Thanksgiving. Our host's wife was astonished when my
               | children asked for a drink of water, she asked them
               | several times if they would not prefer a sweet fizzy
               | drink. But my children were thirsty and knew that water
               | was the best remedy.
        
           | chiefalchemist wrote:
           | I'm not so sure that's the healthcare system. The USA doesn't
           | do well in preventing that which is preventable.
           | 
           | The System is only as healthy as the population it serves. In
           | the USA demand is high, price naturally follows. Reduce
           | demand, prices will fall.
           | 
           | This link just happened to be what I found. I'm certain I've
           | seen others.
           | 
           | https://www.thelancet.com/journals/lanpub/article/PIIS2468-2.
           | ..
        
           | refurb wrote:
           | > You can look at the health outcomes to gauge the
           | efficiency. Does the population in country X live longer? Are
           | infant mortality rates higher? Preventable deaths?
           | 
           | Those aren't great metrics as they are highly confounded by
           | other factors that have nothing to do with a healthcare
           | system.
        
         | avidiax wrote:
         | I don't find this to be surprising.
         | 
         | Healthcare services have inelastic demand. If you have a broken
         | leg, and the average income is $X or $2X, clearly the hospital
         | can charge twice as much in the second case and still mend
         | legs.
         | 
         | What is surprising is the third section:
         | 
         | > The rising health share explained by rising quantities per
         | capita (not prices!)
         | 
         | I don't think the author really makes the point, however.
         | 
         | They don't seem to claim that higher income people are getting
         | more doctor's visits or more procedures done or taking more
         | medicine (though this may all be true).
         | 
         | Rather, they claim that the we are putting more resources into
         | healthcare, a somewhat orthogonal claim.
        
       | gcanyon wrote:
       | N=1, or, Story Time!
       | 
       | In 2017 my wife and I were living in Portugal for several months.
       | When we needed to refill her prescriptions, our short-term rental
       | host said, "Go to the ER."
       | 
       | Backstory: we're well familiar with ERs in the U.S. Due to
       | various conditions, we've been to at least a dozen ERs a total of
       | perhaps twenty times. For anyone who doesn't know, unless you are
       | actively dying, visiting the ER in the U.S. is sloooow. The
       | average time to see a doctor, in our experience, is about an
       | hour.
       | 
       | So we replied: "the ER? seriously?"
       | 
       | He assured us it would be fine, so we walked ten minutes to the
       | ER and signed in. We had barely turned in the history paperwork
       | when they called us to go back. No preliminary check-in with the
       | nurse -- straight to the doctor.
       | 
       | She said, "Why did you come to the ER? We could have been busy
       | and you would have had to wait."
       | 
       | We explained how our host had assured us this was the best way to
       | go, and that the ER would take care of us.
       | 
       | The doctor nodded and said, "Sure, I'll sign for the
       | prescriptions, but just remember it might take more time the next
       | time."
       | 
       | We went back to the front desk. Remember, we had no travel
       | insurance, this was full freight. "That will be twenty-eight
       | euro." We happily paid, and walked out the door, prescriptions in
       | hand, less than 30 minutes after we walked in.
       | 
       | Bonus: the cost to buy the prescriptions, again with no
       | insurance, was _less_ than the co-pay in the U.S. with employer-
       | healthcare.
       | 
       | N=2: When my daughter was visiting me in Bangkok, she got a bit
       | of a gastro issue. Same as in Portugal, we had no insurance for
       | her. I took her to Bumrungrad, one of the best hospitals in
       | Thailand. We were in and out in under an hour, including picking
       | up the prescription, and the total cost was under $100.
       | 
       | I'm not trying to rebut the article, just throwing out some
       | details.
        
         | qup wrote:
         | > visiting the ER in the U.S. is sloooow. The average time to
         | see a doctor, in our experience, is about an hour.
         | 
         | This is such a bizarre couple of statements for me. First, I
         | would consider an hour very, very fast. If I show up for an
         | appointment on time, I still don't see the doctor for about an
         | hour.
         | 
         | And for a non-emergency emergency room visit (even a fairly
         | serious one like a broken bone, abscessed tooth, etc) I've had
         | family give up after 8-12 hours of waiting in the lobby without
         | being admitted to see a doctor, often in relatively empty
         | lobbies. (The hospital is hoping for this, I'm sure)
        
       | obastani wrote:
       | If I'm understanding correctly, by "income", this article means
       | "actual individual consumption", which is the amount of money
       | spent by a household. Thus, the article is saying that for
       | countries where households spend more, they spend more on
       | healthcare. Given that healthcare is a huge fraction of household
       | expenditures (almost 20%), this seems tautological. Am I
       | misunderstanding something?
        
       | gcanyon wrote:
       | Summarized into 11 bullet points by Claude:
       | 
       | Here's a summary of the key points from the document in 11 bullet
       | points:
       | 
       | * Health spending is primarily determined by income levels, with
       | higher-income countries spending more on healthcare.
       | 
       | * The rising health share of GDP is driven by increasing
       | quantities of healthcare consumed, not primarily by price
       | inflation.
       | 
       | * Technological advancements and intensity of care are major
       | drivers of increased health spending.
       | 
       | * The U.S. health system is not uniquely inefficient; its high
       | spending is consistent with its high income levels.
       | 
       | * Commonly cited utilization indicators do not show that the U.S.
       | uses less healthcare than expected given its spending.
       | 
       | * Physician incomes and hospital profits do not explain the high
       | U.S. health spending.
       | 
       | * The U.S. healthcare workforce has grown significantly,
       | reflecting increased intensity of care rather than just higher
       | wages.
       | 
       | * America's mediocre health outcomes are explained by diminishing
       | returns to healthcare spending and lifestyle factors like
       | obesity.
       | 
       | * Rising healthcare spending does not mean reduced consumption in
       | other areas due to productivity gains in other sectors.
       | 
       | * Price comparisons between countries are often methodologically
       | flawed and do not accurately reflect true healthcare costs.
       | 
       | * The income elasticity of health spending is high, meaning
       | people spend proportionally more on healthcare as they get
       | richer.
        
       | Angostura wrote:
       | If anyone, like me was looking for the UK and the NHS on those
       | graphs - it's labelled GBR (I guess), assuming that's not
       | Gibralter
        
       | bluedino wrote:
       | Nothing makes sense.
       | 
       | One prescription I get is $1.30, another is $85.
       | 
       | My son goes to a specialist and all $395 is paid by insurance,
       | while my wife goes to a different one and we pay $86 out of
       | pocket after a $14 "insurance discount", insurance pays nothing.
       | 
       | They're both in-network. I save my old antibiotics and such
       | because it takes so long to get into urgent care, and it's
       | expensive, and I can't go to my regular doctor for a sinus
       | infection because it takes two weeks to get in.
       | 
       | Thankfully I pay $0 out of my check for Blue Cross since my
       | employer pays for it. I just have co-pays, deductibles, etc
        
         | zahlman wrote:
         | >I save my old antibiotics and such because it takes so long to
         | get into urgent care, and it's expensive, and I can't go to my
         | regular doctor for a sinus infection because it takes two weeks
         | to get in.
         | 
         | I cringed so much reading this.
         | 
         | * When you're prescribed an antibiotic, you're expected to
         | finish the course of medication. Not doing so leads to
         | resistant strains.
         | 
         | * Medication has an expiration date for a reason. You generally
         | shouldn't expect to be able to save it from one illness to the
         | next, nor to know that the one from before is applicable to the
         | current condition.
         | 
         | * The large majority of disease is caused by viruses, and
         | antibiotics won't help. Your "sinus infection" might not be a
         | local infection at all but just some respiratory illness
         | resulting in sinus congestion. Never mind whether it's viral or
         | bacterial.
        
       | NHQ wrote:
       | Healthcare became like public education in the USA, a political
       | ideology that subverts the body politic to support jobs for
       | people who do not have real skills but whose great granddad had
       | 33 degrees in secrecy. In other words it is entirely a support
       | system for the least of the privileged, while also paying huge
       | sums to the owners and "providers" of those systems (textbooks,
       | syringes, insurance, etc).
       | 
       | If U.S. Americans did not have an irrational verve for education
       | as the supposed panacea of democracy, there would be no public
       | education system. If they did not believe the intense
       | pseudoscience of the medical industry, they would not care about
       | health insurance.
       | 
       | But as they are under the sway of such false conscience, the
       | system of gradual decline called inflation pays for unqualified
       | people to keep a livelihood at the expense of a misled and
       | deluded public. That expense is not only the costs of running
       | these systems but their detriments to the health and education
       | they pretend to treat.
       | 
       | The increased spending on healthcare is no different than
       | spending more on education or the "homeless problem", it is
       | simply a politics of shifting more funds into systems that are
       | legally obligated to pay high sums for a lot of nothing. It only
       | appears different than education because we pretend its not
       | completely wrapped up in public spending and politics like
       | education is. Obama made sure that healthcare would hold such a
       | place as education in the system with the reforms to healthcare,
       | and the people applauded this.
       | 
       | High incomes paying more for healthcare is simply those who can
       | afford it using the system that ultimately pays for the health
       | and education of the rich at the expense of the health and
       | education of the poor. After all we know that nobody who is rich
       | is paying any of their healthcare bills, they have excellent
       | health insurance for that.
        
       | efitz wrote:
       | The big problem with modern health "insurance" (as opposed to
       | catastrophic major medical insurance, which is true insurance),
       | is that it prevents the formation of of health care businesses
       | that cater to different socioeconomic strata. I most other
       | businesses, there are usually product offerings at different
       | price points, eg Ford Fiesta vs Ford Raptor R, bespoke
       | steakhouses vs Denny's, Wal-Mart vs Nordstrom, etc.
       | 
       | There are some hard to discover offerings in healthcare but
       | overall very little differentiation.
       | 
       | Why don't we have multiple chains of monthly subscription
       | diabetes centers, for instance? If it weren't for insurance and
       | over-regulation of every aspect of healthcare, we would see
       | market flourishing in the US as there is an over abundance of
       | chronic illness.
       | 
       | I sympathize with the PoV that we want someone else to pay
       | because it's expensive, but another way to solve that would be to
       | remove all the regulatory capture and industry collusion and
       | predatory middlemen (PBMs I'm talking to you) and let new
       | delivery mechanisms evolve. Let supply adapt to demand.
        
         | phil21 wrote:
         | The biggest problem with modern health "insurance" is that it's
         | not insurance - it's a health care plan that presents a giant
         | principal agent problem throughout the entire medical system
         | starting with the patient and cascading from there.
         | 
         | I'm old enough to remember a time you could break an arm, show
         | up to your primary doctor's office that day without a pre-
         | scheduled appointment, and walk out with a cast on plus pain
         | meds all for less than a week's take-home pay for a blue collar
         | employee. This was largely due in part for the reason you were
         | the one paying the bill and there was almost no overhead. Plus
         | the doctors who charged absurd fees simply lost patients to the
         | competition down the street.
         | 
         | Principal agent problems are rife in modern society, starting
         | with medical care. They basically remove almost all pricing
         | competition from the equation.
        
         | hammock wrote:
         | What laws in the last 20 or so years have made this situation
         | better or worse?
        
       | Peteragain wrote:
       | Nope. The price of something is somewhere between the cost of
       | production and what the market will bear (with exceptions not
       | relevant here). The well-to-do in the USA will bear high prices,
       | and The State doesn't care about the rest. This is a bit of agi-
       | prop for the health insurance industry. The graphs go up on the
       | right: good; and down: bad. Arrrrr!!! There MIGHT be content, but
       | that is not the message. And btw the "(a primer)" in the tag line
       | is (according to this linguist) setting you up to think you're
       | stupid if you don't get it.
        
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