Health care?

[DoingHomework]

I think your numbers are off. We spend more than 51% more than the next highest country which is Norway, and about 90% more than Canada and nearly 100% more than France.

I agree, we as a population are over weight and that is definitely a factor.
I don't think anyone would argue that. The poorest population are generally the most obese, and the wealthier Americans are the most fit (as a rule - not always) I think there is a direct correlation to income and intellect and being fit or obese. If you have traveled to other countries, you will see some significant differences in their eating habits, and food available.

We are the Fast Food capital of the world, and the general accepted diet for Americans is not exactly healthy. But our government does not seem willing to promote better eating. Look at the problem they are having with the school lunches, and the critisism Michele Obama got when she planted her garden and advocated eating more vegetables. Yes, it is not our government's job to take care of our health, but it wouldn't hurt for them to participate in some education.

I don't know what percentage to allocate to this fact. I don't know where you came up with your 3%. I concur, it is a factor, but how much I don't know. Certainly not attributing to 50-100% increase.

My numbers might be off. They came from the Kaiser Family Foundation. I have no idea what, if any, bias they have. But numbers were % of GDP. I don't think it is even possible that we spend double what a European country does. So, I might have an error in numbers but I am confident that simply improving the efficiency a little bit could go a long way toward fixing the system.

I lived in a European country that was quite socialist, many Americans believed they were communist. This was about 30 years ago. They had great, free health care. I went to the doctor there and here in the US and I knew others that had more major problems. Their system was better than ours in almost any measurable way. I'm not sure if it still is but I do know, because I still go back and have some ties with that country, that anyone who says that our care is much better is mistaken. Developed countries everywhere have the most modern medical care. You have access to the technology, drugs, and care you need. I think our care is equal but not better.

But in the country I am familiar with, the cost has gone up. "Free" care now involves expensive copays, higher taxes, and other charges that rival or exceed what we pay here in the US if we have insurance. That's enough to make people get the routine care they need but avoid unnecessary tests and procedures. A friend had here wisdom teeth out a few years ago about the same time I did. We compared costs and out out-of-pocket was about the same even though hers was supposedly "free."

As for the fast food comment, I totally agree. When/where I lived in Europe it was unusual to see a fat person. When you did it was usually just a little overweight. And it was always middle-aged or older people. When I go back now I see a lot of obesity. And I see a lot of fat kids which was never seen 30 years ago. It is really sad.

When I talk with friends there about it they tend to blame the lifestyle changes rather than fast food. The "traditional" diet has been replaced with a lot of quick, packaged food, not necessarily fast food but unhealthy garbage of any type.

 

[ERD50]

ERD, I'm not sure our system was designed that way (employer based, etc). Perhaps it just evolved, and now is stumbling because there is no central structure.

It probably was not a conscious 'design', but the laws that were passed promoted employer based HI over other methods of obtaining HI, and put an artificial value on it (making it cheaper than salary in some ways). That has created many problems.

Designed or not, I've seen rational viewpoints expressed from all different sides that breaking the employer-healthcare connection would be a positive, and that was not done in this last go-around.

-ERD50

 

[modhatter]

Snowbird, you brought up a good point in the size of the US. We have so many hospitals and medical institutions in place, that any kind of conversion will be a very large undertaking. Also, you mention doctors. We also have a shortage of doctors here, or at least GP's, and the cost to go to medical school is very high, so doctors expect a good return for their education.

I wish we had more altruistic people entering the profession based on a desire to heal, as opposed to making big bucks. We of course have some, but I don't know if it is the main focus of those entering the profession. I suspect in some cases it may be both.

As you can tell from some of the responses you have gotten, there is a great deal of government apprehension and disdain from a certain percent of the population - to any kind of government involvement in health care.

We have medicare for the elderly which has been great for seniors, but costs are very high and not sustainable, as the government is not getting the benefit of collecting premiums (or taxes for) from the younger healthier population. The government gets the old, and consequently most expensive, and the insurance companies get the younger and healthier.
Not a good business plan.

I agree whole heartedly with your opinion as to some of the causes for our overpriced system. I do not feel there is any place for profit in health care.
It is a total waste of money, and not only is profit taken off the top, administrative costs are much higher because of all the different entities involved. But with such a divide in opinion on this with the US population, it is doubtful our government will do anything. They are very influenced by the large corporations, and concerned with not getting their political donations if the cross the money flow from the corporations. (both parties)

We got something past about two years ago, which made some improvements, but lacked any real cost saving measures. And that was a h-ll of a fight, and sqeked through by only one vote and not following the normal path of legislation. Twenty six states now have filed suit against the new health care act, stating it is unconstitutional to mandate that everyone carry insurance. (in order to lower the overall premiums for everyone) The divide amongst the population tends to follow a party line, so it has turned into a political divide as well as independent issue over health care, though this is not always the case. Just makes it more complicated and difficult to come together.

I don't agree when I hear people say "they know what Canada's or the UK's or Frances health care is like" I feel they may know about numbers, but what they can't say with certainty is the countries feelings and experiences with their health care. No one can actually speak for that except the person who lives the walk. And many people living in these countries don't understand Americans and are curious as to why. We are becoming a global society and are talking together now, and sharing our experiences and or differences. What's wrong with that?

Doinghomework. Here are the numbers. It is higher now. We are over 17%. This is from 2008.
http://www.kff.org/insurance/snapshot/oecd042111.cfm

 

[Midpack]

During the debate about Obamacare a couple of years back I decided to do my own research on health care systems around the world. Having lived in Europe I know for a fact, or at least to my own satisfaction that their quality of care is at least as good as ours.

Europe spends about 14% of GDP on health care

USA spends about 17%.

I believe the extra 3% here comes from inefficiencies and from poor health choices.

From what I've seen, the differential is about double that. Here's one source, another I posted earlier, post #97.

 

[Snowbird100]

Snowbird, you brought up a good point in the size of the US. We have so many hospitals and medical institutions in place, that any kind of conversion will be a very large undertaking. Also, you mention doctors. We also have a shortage of doctors here, or at least GP's, and the cost to go to medical school is very high, so doctors expect a good return for their education.

I always forgot about the huge population in the US when talking about health care but I said to myself I would have to mention it in the forum.

Once the institutions were established (so many hospitals, institutions ...) in that scale for so many people (US population), it's so difficult to make changes ...

Doctors/education: Yes, it is so expensive to go to medical school in the US compared to Canada, that's why Canadians' first choice is alwasy home universities first, if not then out of province universities, then finally universities in the US.

 

[nun]

Europe spends about 14% of GDP on health care

USA spends about 17%.

All the numbers I've seen put European countries in the 8% to 12% of GDP range. If you had other data please present it.

 

[Snowbird100]

I wish we had more altruistic people entering the profession based on a desire to heal, as opposed to making big bucks. We of course have some, but I don't know if it is the main focus of those entering the profession. I suspect in some cases it may be both.

Canadians doctors, in general, and when they entered medical schools in Canada, they didn't go into the professions to make big bucks ... Not at all !

I think it's sad that doctors in the US (I don't know how many) entered the profession to make big bucks ! There's one dentist in the US who used paper clip as post for root canal, yes PAPER CLIP instead of stainless steel post for root canal.

Paper clip is allowed for temporary measure, not permanent root canal. And he performed so many root canals using paper clips to save $ or make $.

What a shame !

 

[MichaelB]

A McKinsey study comparing health care in the US with other major countries dated 2007, linked in previous discussions. Accounting for the Cost of Health Care in the United States | McKinsey Global Institute | Americas | McKinsey & Company

They find and quantify many reasons for the difference in costs.

Instead, MGI found that the overriding cause of high US health care costs is the failure of the intermediation system—payors, employers, and government—to provide sufficient incentives to patients and consumers to be value–conscious in their demand decisions, and to regulate the necessary incentives to promote rational use by providers and suppliers.

 

[Midpack]

If we look at the costs between Canada/US:
- Canadian doctors gets half of American doctors
- No private hospitals/Hospitals for profit in the US
- Less red tape / private insurance companies, more red tape
- Less procedures, no unnecessary procedures / Unnecessary procedures driven by for profit hospitals (top up insurance)

While we appreciate your zeal, unfortunately it's even more complicated IMO. Here's my personal (unprofessional) list of reasons in no particular order:

• lifestyle (obesity, smoking, drugs)
• high cost and profit for intermediaries (insurance)
• excessive profit for some product and service providers
• administrative burden (millions of microplans)
• high charges for specialized services
• forced use of expensive specialized facilities for routine medical needs (emergency room)
• multiple regulations around the country
• punitive legal awards
• diagnostic overuse (expensive tests even for routine matters)
• treatment overuse (especially end of life)
• excessive unproductive labor vs technology

And here's a better list from a TIME magazine author (full article http://moneyland.time.com/2010/02/25/why-is-health-care-so-expensive-let-us-count-the-conspirators/)

Why Is Health Care So Expensive? Let Us Count the Conspirators
I wonder if anybody is talking about health care reform today. If they are, instead of grandstanding and bickering, perhaps it’s worthwhile to take a hard look at the factors leading to more expensive care for everyone, and to make a real effort at bringing those costs down to earth. Because while one of the noble goals to health care reform is providing insurance to more people, it’d be a whole lot easier to do that if health care didn’t cost so darn much to begin with.

Here are some of the reasons … which all lead to more expensive health care for everyone:
Insurance companies are businesses. Their business mission is to make money, not to make people healthy.
No electronic records. Without electronic records, doctors do not know exactly how a customer has been diagnosed and treated in the past, and they’re likely to order repeat tests and write prescriptions for medications that have already been proven ineffective.
“Perverse incentives.” Doctors and hospitals get paid not for keeping their patients healthy, but for the specific, expense-able services they provide. They earn more money for each test, office visit, and treatment that occurs.
Malpractice madness. As much as 10¢ of every dollar of your doctor’s bill goes to cover the doc’s malpractice insurance.
Malpractice madness #2. Doctors, ever fearful of being sued for doing too little, tend to go the other way and do too much.
What do statistics mean anyway? Studies demonstrating that expensive surgeries yield no benefits to patients are sometimes disregarded by doctors.
Premium pricing in the ER. Out of fear or panic, or simply because they feel they have no other place to turn, many people go to the ER even when their symptoms suggest simple illnesses such as urinary tract infections or sore throats.
We’re fat. Obesity adds $147 billion per year to our health care bills.
We take more pills, and the pills make us fatter.
Antitrust exemption. For some reason, way back when someone thought it was a good idea to give the health insurance industry exemption from federal antitrust laws. The result, as a recent NY Times op-ed says, is that a small pool of insurers have been able to dominate the market, and customers have few other places to turn.
No shopping across state lines.
What do I owe? That’s what you ask. “How much does it cost?” is a different question, and one that the average health care consumer cares little about.

 

[Snowbird100]

We have medicare for the elderly which has been great for seniors, but costs are very high and not sustainable, as the government is not getting the benefit of collecting premiums (or taxes for) from the younger healthier population. The government gets the old, and consequently most expensive, and the insurance companies get the younger and healthier.
Not a good business plan.

I think it is sad that a health care system (such as the one in the US) that doesn't look after the most vulnerable re: seniors

In a society, I think the younger and stronger should look after the older, I don't see anything wrong with that ?

Collect some kind of health taxes from young people who are employed and pay for the seniors. They are old, they can't work, and that's why the younger should look after the seniors. I am amazed it's not happening in the US !?

 

[REWahoo]

I think it is sad that a health care system (such as the one in the US) that doesn't look after the most vulnerable re: seniors

In a society, I think the younger and stronger should look after the older, I don't see anything wrong with that ?

Collect some kind of health taxes from young people who are employed and pay for the seniors. They are old, they can't work, and that's why the younger should look after the seniors. I am amazed it's not happening in the US !?

I'm not sure whether you are a troll or suffering a severe case of bull-in-the-china-shopitus. Either way, your posts are doing little more than finger pointing and inflaming.

 

[FIREd]

It is clear to me, Snowbird100, that you have a problem with facts. You are poisoning this conversation with provocative statements that have little to do with reality.

 

[nun]

A McKinsey study comparing health care in the US with other major countries dated 2007, linked in previous discussions. Accounting for the Cost of Health Care in the United States | McKinsey Global Institute | Americas | McKinsey & Company

They find and quantify many reasons for the difference in costs.

Mckinsey are at the center of the newest NHS reform proposals that are getting the Conservatives into a lot of trouble in the UK as they intend to open up some services to the private sector. It's all in the name of choice and competition, but most people in the UK are afraid that it will take care away from them. I don't know enough to know if this is true or not, but inertia is a big thing when it comes to healthcare. The guy in the video is the Minister for Health.

Conservative support shrinks as voters turn against NHS reforms | Politics | The Guardian

 

[Midpack]

Canadians doctors, in general, and when they entered medical schools in Canada, they didn't go into the professions to make big bucks ... Not at all !

I think it's sad that doctors in the US (I don't know how many) entered the profession to make big bucks ! There's one dentist in the US who used paper clip as post for root canal, yes PAPER CLIP instead of stainless steel post for root canal.

Paper clip is allowed for temporary measure, not permanent root canal. And he performed so many root canals using paper clips to save $ or make $.

What a shame !

Just my opinion but you're trashing your own credibility here. I am most interested in seeing US health care overhauled, but I'm confident that not all US doctors enter the profession "to make big bucks." Most medical professionals, not just doctors BTW, are probably good people who want to help people first and foremost, but they are trapped in a health care/insurance/political/legal maze that makes it almost impossible. I am sure they are frustrated too.

And while I'm the first to criticize the poor cost effectiveness of our US health care, the fact remains that at the leading edge our medical professionals are indeed the best in the world in many areas. Metaphorically, we can't block & tackle well at all (that's where the problems are), but we have more star quarterbacks than any other country.

It's nice to know Canadian doctors are entirely altruistic though...

 

[MichaelB]

This thread has run its course. Thanks all for participating.