U.S. Spends 141% More on Health Care

[chinaco]

No surprise here.

141%: How much more the U.S. spends on health care, per person, than the average OECD nation

Number of the Week: U.S. Spends 141% More on Health Care - Real Time Economics - WSJ

 

[haha]

No surprise here.
Number of the Week: U.S. Spends 141% More on Health Care - Real Time Economics - WSJ

Interesting that our per capita public spending alone is greater than every nation other than Norway, which is a genuinely rich nation instead of a phony like US. Then very high US private spending is added onto the top.

But hey, at least our system employs the fine functioning mechanisms of the private market. Can't call us socialists!

The text of the article has some misstatements. For example, they say all the other systems have patient "skin in the game" and they illustrate this with copays. But the UK for example has no copays, and the US for the most part does, although in Medicare with certain supplement plans those get bundled into the supplement price.

Ha

 

[NW-Bound]

Eh, better dead than red.

 

[M Paquette]

Eh, better dead than red.

Better [-]dead[/-] in the red than red.

Fixed that for ya. There ya go.

 

[unclemick]

I have a reasonable number of past aquaintances who died with unpaid medical bills.



heh heh heh - In America you don't have to die with your last dollar - you can die in the hole so to speak.

 

[NW-Bound]

Nice tip there, unclemick! I'll keep that in mind. Heh heh heh to you...

 

[chinaco]

Gotta admit... something looks wrong.

It looks like we should be able to fund national heath care with our current public funding level.

Too bad the overall debate in 2009 was not about doing something like that instead of the scare and fear tactics that went on.

 

[NW-Bound]

Eh, better dead than red.

Better [-]dead[/-] in the red than red.

Fixed that for ya. There ya go.

I have a reasonable number of past aquaintances who died with unpaid medical bills.



heh heh heh - In America you don't have to die with your last dollar - you can die in the hole so to speak.

I just thought of a catchy motto for this plan: "Dead in the Red".

Heh heh heh... Obviously, many of our fellow citizens already knew how to do that. They spent all their money or gave it all to their heirs, then had the "other people" pay for their final hospital or nursing home bills. They are no fool, are they?

 

[dex]

No surprise here.

It will all even out when the dollar falls some more. What will people point to then? Will people say 'It is all good, the USA pays the same as OECD nations'?

 

[samclem]

Interesting that our per capita public spending alone is greater than every nation other than Norway, which is a genuinely rich nation instead of a phony like US.

So, we must be spending a tremendously bigger amount on each public-sector patient. So how come Medicare is going broke, Medicaid is bankrupting the states, the waiting lists keep getting longer for our public medical programs? Obviously, the problem isn't a lack of resources, it's the efficiency with which we deliver government paid-for medical care. We can't expect Medicare to have figured it out yet after just 45 years. If only someone would propose a way to improve this public health care delivery system.

 

[chinaco]

So, we must be spending a tremendously bigger amount on each public-sector patient. So how come Medicare is going broke, Medicaid is bankrupting the states, the waiting lists keep getting longer for our public medical programs? Obviously, the problem isn't a lack of resources, it's the efficiency with which we deliver government paid-for medical care. We can't expect Medicare to have figured it out yet after just 45 years. If only someone would propose a way to improve this public health care delivery system.

One interesting observation... the public spending and the private spending look to be about the same (roughly).

USATODAY.com - Medicaid insures historic number

There are roughly 42M Medicare recipients and roughly 46M Medicaid Recipients.

There are roughly 46 M uninsured.... they probably only spend on health when absolutely necessary (so they represent at least a small amount of the cost figures)

The US population is roughly 307 M

So the (roughly 90M) publicly insured people (1/2 likely younger and 1/2 older). Spend as much as the 2/3 publicly supported people.


While The public figures cover older people (who one would think are likely to receive more care)... and that may introduce some distortion in drawing conclusions!! I believe it the overall program could be more efficiently managed.

If the political parties would get together and try to work out a better solution (gives and takes jointly)... we would all be better off.

Unfortunately, there is too much political brinkmanship!

 

[Midpack]

In terms of costs and results it appears every developed nation does better than the US. According to a NYT article, after factoring out GDP per capita our excess costs are due to (not surprisingly):

Health-services researchers call the difference between these numbers, here $1,895, “excess spending.” That term, however, is not meant to convey “excessive spending,” but merely a difference driven by factors other than G.D.P. per capita. Prominent among these other factors are:

1. higher prices for the same health care goods and services than are paid in other countries for the same goods and services;
2. significantly higher administrative overhead costs than are incurred in other countries with simpler health-insurance systems;
3. more widespread use of high-cost, high-tech equipment and procedures than are used in other countries;
4. higher treatment costs triggered by our uniquely American tort laws, which in the context of medicine can lead to “defensive medicine” — that is, the application of tests and procedures mainly as a defense against possible malpractice litigation, rather than as a clinical imperative.
​

I would think our poor general health/obesity isn't helping either.

 

[chinaco]

...
I would think our poor general health/obesity isn't helping either.

I would think so. It leads to all kinds of serious problems and high cost for chronic treatments for diabetes, heart disease, etc. Along with constant medical monitoring

I have also noticed that most every person I know that is morbidly obese seems to have knee problems in their 50's or 60's. I assume the average human knee was not designed to withstand all of the stress (i.e., load limit).


Obesity and Weight | The Knee


Many company plans and private insurance plans rate smokers and people with a high BMI (pay higher premiums).

If we do wind up going to a private insurance model... I have no doubt that tobacco use and BMI will cause people to pay higher premiums.

 

[donheff]

So, we must be spending a tremendously bigger amount on each public-sector patient. So how come Medicare is going broke, Medicaid is bankrupting the states, the waiting lists keep getting longer for our public medical programs? Obviously, the problem isn't a lack of resources, it's the efficiency with which we deliver government paid-for medical care. We can't expect Medicare to have figured it out yet after just 45 years. If only someone would propose a way to improve this public health care delivery system.

It seems obvious. If we are incapable of achieving what other governments routinely achieve we need to outsource the whole health care sector to Canada or an EU country -- how about France?

 

[lets-retire]

I really do need to just save the "extra" reasons these comparisons are a fools errand at best. They never take into account all of the reasons why the cost of care in the US appears higher than pretty much everywhere else. They never take into consideration the differences in society or social norms. It is like comparing a top of the line Mercedes to an the entry level Kia. Well no kidding really, I never would have guessed the Mercedes is more expensive?

I'm not going into the explanations again but a few reasons:

We are vain and outspend almost every country (I haven't found one we outspend, but there could be one) in cosmetic surgery.

We subsidize the socialized systems of other countries who will only pay x dollars for items. Any lost income is transfered to American patients.

We, overall, are involved in more dangerous and extreme sports than any other country.

Many American border hospitals in large metro areas routinely treat serious emergency medical issues for foreigners who hospitals can't handle the workload. These costs are laid on Americans when they were incurred and paid by foreigners.

Many Americans live in the 'burbs away from work while many foreigners live in the city center near work.

When adjusting the cost of care to take into account the average wage (not GDP) the amount spent for health care is much closer.

You have good, fast, and cheap. Pick two you can't have all three. We have good and fast, others have good and "cheap".

 

[chinaco]

...

I'm not going into the explanations again but a few reasons:

....

Yes those are contributors to the problem.

 

[obgyn65]

Amazing - this thread has not turned into political rants (yet).

 

[Martha]

You have good, fast, and cheap. Pick two you can't have all three. We have good and fast, others have good and "cheap".

Not quite true. Waits in the US can be long if you need to see a specialist, need a non-emergency appointment with your primary care doctor or are sitting in an emergency room. I do not have the info at hand, but a number of other countries outshine us on wait times and have good care and are less expensive than us.

 

[donheff]

We subsidize the socialized systems of other countries who will only pay x dollars for items. Any lost income is transfered to American patients.

Dobbs:Look Yossarian, suppose, I mean just suppose everyone thought the same way you do.
Yossarian: Then I'd be a damn fool to think any different.

 

[nun]

The US system does poorly compared to other nations because it uses a free market model without a functioning market. If there was true competition beteen hospitals and insurers it might have a chance to deliver less expensive services. However the patient cannot easily change insurers and doctors are encouraged to provide unnecessary diagnostics and treatments to avoid litigation and also to bump up their earnings. Patients are often not informed consumers and just take what's given them.

Other systems vary from those completely paid for by taxation as in the UK to a combination of private and public financing that are highly regulated like in Japan and France. Most nations realize that getting market forces to work in health care is very problematic so they have taken the route of government regulation to control the costs of hospitals, insurance companies and the final fees paid by the patient.
This regulation means that if you sprain your ankle you won't get an MRI, even is you scream for one, because it is not medically necessary. You might get one in the US. Also universal healthcare not linked to employment if the norm elsewhere in the world and to be without health insurance is, rightly, seen as the province of Third World countries.

Such regulated systems deliver better health out comes and less cost than the US. eg Cuba and US have same life expectancy but Cuba spends 1/10 of the amount per capita on healthcare. UK spends half of what the US spends and people live about 2 years longer. I'm certainly glad my mother gets UK healthcare rather than Medicare which would require her to navigate a maze of drug plans, Parts X, Y, Z, pay premiums and deal with both government and private bureaucrats. She is currently dealing with the conditions of old age that include high blood pressure (on statins) and the onset of diabeties. Both conditions were caught early on as the doctor asked her to start coming in for regular checkups a few years ago. This sort of preventative care helps to keep costs down. She doesn't pay anything "at point of delivery" for her drugs, home visits from the doctor and nurse or recent cataract surgery.

I'm a bit pessimistic about the ability of the US to solve the healthcare issue. There are plenty of better systems abroad, but US hubris stops them from believing that anything foreign can be better. Thailand is an ecellent example of how a country looked abroad and took the best parts of foreign systems to create a system suited to it's particular economy and health problems. If only the US could do the same.

 

[chinaco]

The US system does poorly compared to other nations because it uses a free market model without a functioning market. ...

Good observation. It is a hodge-podge. The system is more of less inconsistent which opens it up to being gamed by certain participants (suppliers and consumers) as well at excluding some consumers.

 

[lets-retire]

Not quite true. Waits in the US can be long if you need to see a specialist, need a non-emergency appointment with your primary care doctor or are sitting in an emergency room. I do not have the info at hand, but a number of other countries outshine us on wait times and have good care and are less expensive than us.

Believe me the DW has to see a specialized specialist. The initial wait was three months for the appointment, but that was because we requested a certain day of the week. Not bad in comparison to other countries, since the appointment is for a condition that isn't immediately life threatening. From diagnosis to brain surgery was less than two weeks, not too bad for an issue not immediately life threatening. Her diagnosis was on the 17th and she was home after the surgery on the 1st. I've never had to wait more than a day for an appointment with a primary care doctor, except when I was in the military. Those civilian doctors were in three different areas ranging from very rural to major metropolitan. Granted emergency rooms can be a bit of a wait for those not in immediately life threatening situations, but often they could and should be seen by a family doctor. Unfortunately, the media has people afraid to go to those doctors because they are "so expensive". Approximately $100 for an appointment in the places I've used civilian doctors. Heck I even had one doctor who would provide medicine samples for those who's insurance didn't provide a drug benefit.

When I tore the cartilage in my ankle my wait time for a specialist was less than a week. I received a call from my primary care doctor on Saturday asking about my issue. I tore it on Friday night and I think my first appointment was on Wednesday. I was in surgery two weeks later.

 

[samclem]

One interesting observation... the public spending and the private spending look to be about the same (roughly). . . .

There are roughly 42M Medicare recipients and roughly 46M Medicaid Recipients.

I know you were just giving a rough estimate, but I think it may be a bit too rough. It overlooks all the privately-funded medical care received by those Medicare patients (Medigap policies, etc) and it overlooks cost shifting by medical providers when services are provided to public patients and the costs transferred to private ones.

I like donheff's outsourcing idea. Maybe Mexico? Right next door, low labor costs.

 

[haha]

I would think so. It leads to all kinds of serious problems and high cost for chronic treatments for diabetes, heart disease, etc. Along with constant medical monitoring

I have also noticed that most every person I know that is morbidly obese seems to have knee problems in their 50's or 60's.

As well as great many fit, active people. I don't know any obese people, but I know plenty fit people who have knee problems and/or artificial knees.

Obesity overall has to be a negative in health. But blaming everything on the sick people is just reaching to blame people, rather than look at a flawed system. But our medical system would bankrupt us even if every man in America weighed 140 and every woman 115.

Ha

 

[nun]

The vast differences in access and provision of health care in the US is a big problem. I've always had great experiences in the US system, but I have a good job with excellent benefits and I work in Boston so while the costs are high the standard of care is excellent. I pay $100 a month in premiums, $20 copayment and have other. Out of pocket costs for diagnostic tests. I had a small outpatient surgery recently. I had a cyst and my doctor got me an appointment the next week for minor surgery. However he wanted to put me on antibiotics just incase it was infected. I had no fever it wasn't hot and no discharge. So I refuse. The surgery took 10 mins and I paid $250 for lab tests etc and it was well done. However after the initial dressing there was no after care treatment and I had to care for a significant wound on my own. The US does the difficult stuff well but too often ignores basic care that ensures good outcomes.