U.S. HC Spending Compared to other countries

[Rianne]

2017 data compares U.S. HC spending per capita to other countries. Are we a sicker nation?


https://www.healthsystemtracker.org...iDMrQvOvZmkpZ5-2O1w&_hsmi=68267802#item-start

 

[MichaelB]

Are there any highlights or data points you can share with us? Perhaps your own view and interpretation of the data or conclusions?

 

[DEC-1982]

It does say HealthCare growth was an annualized 7.2% from 2000-2005 but annualized 3.6% from 2015-2017. My personal experience is that it was much higher than 3.6%.

For healthcare fund investors, higher costs and lower services to patients is good translating to higher profits . That does seem to be our model. I don't know if this is sustainable though.

 

[TwoByFour]

Are there any highlights or data points you can share with us? Perhaps your own view and interpretation of the data or conclusions?

The average cost among our peer nations is about half what the US spends is the main highlight.

My belief is that medicine has become big business in the US and thus has powerful lobbying which keeps the business environment friendly toward the goal of making money. The AMA is complicit in this to a degree.

This anecdote I think illustrates the problem:

In France a colon-cancer screen consists of a poop smear test which costs less than $100. If it is positive, they do a colonoscopy. In the US colonoscopies are the standard test that is done, costing over $1000. The efficacy is about the same for the two methods, but the US way is very lucrative for GI docs so it continues to be pushed.

 

[Rianne]

Are there any highlights or data points you can share with us? Perhaps your own view and interpretation of the data or conclusions?

I interpret the data two ways.

1. We as a society are influenced by food companies to eat a certain way based on cost (fast food co. are super cheap. So are processed foods in the grocery store) and convenience. Do we consider how "cheap" eggs, fresh peppers (and all fresh veggies, fresh fruit, greens really are? Eggs are .87 a dozen. That's 6 meals and if you add veggies and toast, you might pay $2.00/meal. But you have to prepare it. And you know what ingredients are in there.

2. Doctors are not trained in nutrition. Diabetes, cancer, heart disease are all related to nutrition. The labels on processed food gives a paragraph of ingredients no one can identify. We don't know what we're eating in processed foods.

And one more if I may, what is the difference in our HC system vs all the other countries?

 

[Alan]

I interpret the data two ways.

1. We as a society are influenced by food companies to eat a certain way based on cost (fast food co. are super cheap. So are processed foods in the grocery store) and convenience. Do we consider how "cheap" eggs, fresh peppers (and all fresh veggies, fresh fruit, greens really are? Eggs are .87 a dozen. That's 6 meals and if you add veggies and toast, you might pay $2.00/meal. But you have to prepare it. And you know what ingredients are in there.

2. Doctors are not trained in nutrition. Diabetes, cancer, heart disease are all related to nutrition. The labels on processed food gives a paragraph of ingredients no one can identify. We don't know what we're eating in processed foods.

And one more if I may, what is the difference in our HC system vs all the other countries?

The article is all about cost, nothing in there comparing illness and diseases among the countries, so jumping to the conclusion that America is sicker is a bit of a big leap I think.

 

[Rianne]

The article is all about cost, nothing in there comparing illness and diseases among the countries, so jumping to the conclusion that America is sicker is a bit of a big leap I think.

So you are saying, the cost of being healthy has nothing to do with the cost of HC? It's my understanding the cost of our healthcare has something to do with a pool of healthy people to offset the expense of sick people.

 

[DEC-1982]

IIRC, all Europeans take vacations. Americans take shorter vacations while answering calls from their office throughout their vacation. Some % of Americans don't take vacations. I expect this makes a difference.

 

[MichaelB]

So you are saying, the cost of being healthy has nothing to do with the cost of HC? It's my understanding the cost of our healthcare has something to do with a pool of healthy people to offset the expense of sick people.

.
.

 

[Rianne]

Ha! I've seen that Monty Python sketch a few times. If you want to go in that direction, my argument is we should get more stars for reading than for posting. I would then have 10 stars. Not to distract from my original post.

 

[Alan]

If you want to go in that direction, my argument is we should get more stars for reading than for posting. I would then have 10 stars.

No you wouldn't.

 

[Silver]

The average cost among our peer nations is about half what the US spends is the main highlight.

My belief is that medicine has become big business in the US and thus has powerful lobbying which keeps the business environment friendly toward the goal of making money. The AMA is complicit in this to a degree.

This anecdote I think illustrates the problem:

In France a colon-cancer screen consists of a poop smear test which costs less than $100. If it is positive, they do a colonoscopy. In the US colonoscopies are the standard test that is done, costing over $1000. The efficacy is about the same for the two methods, but the US way is very lucrative for GI docs so it continues to be pushed.

This sums it up pretty well. After 30 years in the health care industry, 15+ in upper management....it's all about the money. Not to say that individual HC providers don't care about their patients....some do. But the HC industry within which those providers work? Money is all that matters.

 

[Rianne]

No you wouldn't.

Aren't you from England? And how would you know how much I read? Hmmm.

 

[Rianne]

This sums it up pretty well. After 30 years in the health care industry, 15+ in upper management....it's all about the money. Not to say that individual HC providers don't care about their patients....some do. But the HC industry within which those providers work? Money is all that matters.

Do the HC providers push more tests and procedures b/c of money? This concerns me. I always wondered if a disease was eradicated, would the HC industry lose money. I'm thinking of diabetes and cancer.

 

[REWahoo]

And how would you know how much I read? Hmmm.

Maybe he's Santa Claus?

 

[MRG]

This sums it up pretty well. After 30 years in the health care industry, 15+ in upper management....it's all about the money. Not to say that individual HC providers don't care about their patients....some do. But the HC industry within which those providers work? Money is all that matters.

+1 as a patient who had a PCP from a public healthcare provider wow. Don't get me wrong I thought the world of my PCP but going to be the hospital he was associated brought a whole new meaning to "what will your insurance cover".

This place couldn't be bothered to properly insert an IV for three days. Wasn't until they couldn't perform an expensive test they finally bothered to check it. I hadn't been quite about it, they didn't give a crap.

I wrote a letter of complaint to them, their risk management director wrote me back. He didn't care about my situation only $$$.

 

[Alan]

Aren't you from England? And how would you know how much I read? Hmmm.

The internet knows everything

You were talking about reading on this site, not reading in general. Do you not think these sites log how many threads and posts you read?

 

[CRLLS]

No you wouldn't.

I see what you did there.

 

[Rianne]

Do you not think these sites log how many threads and posts you read?

Not sure, but do you know how often and how long I'm logged into this site? Let's discontinue this discussion after you answer.

 

[Rianne]

Silver, my cousin is an administrative nurse (over several departments) at Johns Hopkins. Let's say the opinion I gather, there is much more treatment given than is needed.

 

[REWahoo]

Not sure, but do you know how often and how long I'm logged into this site?

"He sees you when you're sleepin'
He knows when you're a wake
He knows if you've been bad or good,
so..."

...what.

 

[Chuckanut]

The last time I checked a few years ago, Italy spends about 1/2 of what we do per person on HC and has a slightly higher average lifespan. That could be due to things such as their having a more homogeneous population than the USA.

OTOH, I can buy a big tube of topical ibuprofen cream in Italy for about $25. A tube about 1/5 the size here requires a Rx - add in the cost of a doctor visit - and costs about $35.

Then there is this example of the difference between a hip replacement in the USA and one in Europe:

https://www.nytimes.com/2013/08/04/health/for-medical-tourists-simple-math.html

USA Prices:
$13,000 for the device - a deal thanks to some friends
+

the hospital charges would run another $65,000, not including the surgeon’s fee,

This was the alternative he took:

he ultimately chose to have his hip replaced in 2007 at a private hospital outside Brussels for $13,660. That price included not only a hip joint, made by Warsaw-based Zimmer Holdings, but also all doctors’ fees, operating room charges, crutches, medicine, a hospital room for five days, a week in rehab and a round-trip ticket from America.[/QUOTE]

FWIW, the local non-profit hospital in my area is a magnificent edifice, with a big airy entrance, somebody playing a grand piano at various times, fancy art on the walls, fine cushany furniture in the various waiting areas, etc. etc. etc.

 

[Midpack]

This thread is just one of many like it for years.

It's interesting how many times the data showing how much more expensive US HC costs per capita and how much poorer outcomes are compared to many developed countries with universal care - it's met with rebuttals based on hearsay re: wait times, medical tourism, superior HC (largely false), etc. US HC has been way less cost effective for decades, yet most people still blindly defend the status quo. It's bad enough special interests have very effectively protected the HC industry, but most/many US patients seem complicit with no factual basis. Partly it's because they have coverage and don't have any idea what it really costs them.

Where is the data supporting the cost and effectiveness of US healthcare? Sure the US leads HC technology is some areas, but where is the data showing the US HC "system" is more effective overall than all the developed countries with universal health care in various forms? I've yet to see it. When will someone start a solid fact based thread defending US HC, instead of another example of 'proof by exception' (so and so cured Uncle Bob's condition so it must be the best).

 

[Bir48die]

I enjoy this forum. Once in awhile someone starts a thread. There is some discussion and part of it is questioned. Then the OP gets their dander up and the string goes sideways. Then I feel like I've wasted time working my way through it. This is one of them.

 

[EastWest Gal]

Silver, my cousin is an administrative nurse (over several departments) at Johns Hopkins. Let's say the opinion I gather, there is much more treatment given than is needed.

I agree with way more treatment and way more testing than is needed, and it is getting much worse. Last year, I went back to work as a pediatric hospitalist. I was astounded at the aggressive approach to pediatric patients in the ER and the hospital that I have seen. My colleagues, residents, and medical students have no clue about the cost of what they are doing. Many more tests done, many more Xrays, and much more aggressive medical treatment than a decade ago, even when it is completely unecessary.

I think it is all done in the name of corporate greed, now that docs work for big companies.

Trainees are actively trained to cram too much in their medical notes and to "upcode", as illegal as it is. It isn't as if there are medical police going after and prosecuting folks for inaccurate medical records and upcoding. We are told not to do this, yet are trained how to do the thing we are told not to do!

An example: over the last year, I have seen my colleagues hospitalize and treat multiple children for constipation, with nasogastric tubes and Golytely, and IVs, rather than doing this on an outpatient basis, with their primary care doc. This should virtually never happen.

Second-the cost of medications has been skyrocketed by greed. There is currently a lawsuit winding its way through the courts about price-fixing of generics:

https://www.washingtonpost.com/busi...e2f864d47e7_story.html?utm_term=.2b21512e943f

A simple example is doxycycline. The cost in 2010 was probably about 3 cents a pill. It is an old, generic, cheap, and very useful drug.

In an article dated in 2015:

"According to a U.S. House committee investigating price hikes in several generic drugs, the average wholesale price of 500 tablets in October 2013 was $20. Seven months later, the average wholesale price for the same amount was $1,849, an increase of more than 8,000 percent."

We allow greed to dominate our society, even if it kills people. Yet we do nothing. I don't get it.