And yet when people are required to pay a share of their health care costs, (in the USA these are high deductible policies or high excess) people use less healthcare and shop around – and have the same health outcomes as those who have full coverage policies.
Rand did a study where two groups of people were covered, one group had to pay the first $1000 (5% reimbursement) and another group had to pay nothing. They had the same health outcomes, yet the first group used less healthcare and cost less (about 30%).
In singapore where every one has to pay what they can afford for healthcare, they spend less than 5% of GDP on healthcare.
America’s healthcare system is a classic case of market failure. In the land of free markets!.
Very interest, sounds like they could do with King Solomons wisdom.
My malpractice insurance here – $1560/year. Colleagues in the same field in the US – $250,000/year. Surely this has at least some bearing on costs.
Also, having worked in public and private hospitals in NZ, Aus, UK and also a hospital in the US, I can tell you that the standard US hospital room is up with the private rooms elsewhere amenity and privacy-wise. This will have some bearing on inpatient costs I suppose.
Also, single centralised buying for implants can lead to selecting out-of-date (how else do you get 10-15 year follow-up?), cheap, unsupported (why bother turning up to support the surgeon at the operation if you already have guaranteed sales for the next few years) implants. Innovation is not supported and it is left to ‘someone else’ (i.e. the US currently) to move things forwards.
More importantly, most of the massive advances in healthcare in the last few decades have come from the US and that is not least of all because the manufacturers, the researchers, and the doctors, can all make a ton of money from getting it right.
The rest of the world should frankly be damn grateful that the US pays so much for their healthcare and then happily shares the benefits of this with the rest of us.
p.s. don’t get me wrong, there is an awful lot to criticise in the US health system, not least of which is the fact that it is for some reason assumed to be the employer’s responsibility to pay for health insurance…
Actually one of the keynote speakers at this year’s HIMSS conference warned that the US is falling behind in healthcare innovation…
But I was disappointed that this dude didn’t mention the elephant in the room. For those who don’t know, healthcare in the US is said to be private, but when you hit 65 you become eligible for taxpayer-funded Medicare. Great scheme- profitable early years privatized, expensive later years socialized. Problem is that Medicare now has an unfunded deficit of $47T that makes the banking crisis look like chump change. Politicians propose increasing tax to start addressing it- but today’s working young resent paying taxes towards a scheme they know will be gone before they can benefit from it, to benefit a generation who refused to pay enough tax to cover their own predictable needs so they could accumulate personal assets that they now fiercely protect. Generational conflict, anybody? Everything else is “rearranging deck chairs on the Titanic” until people start to engage the $47T question.
As someone who has to live in the USA and deal with it, the American system of healthcare delivery is FUCKED. It is the worst of all possible worlds.
The idea that there is somehow a “free market” in the US for healthcare is a myth. For starters, if you are over 65, a military veteran, or earn under $12k a year, you get *relatively* free healthcare. So, in other words, the three biggest users of healthcare – the old and the poor and the war-damaged, get their care for pennies on the dollar. So naturally, if this is happening, somebody else has to pay. That “somebody else” is mostly employers, who end up subsidising healthcare premiums, and getting tax breaks for doing so in the process. All this means that healthcare IS PAID FOR MOSTLY BY TAXPAYERS ANYWAY, JUST FAR MORE UNFAIRLY AND INEFFICIENTLY.
(did I say that loud enough for all the Leftists whining about “capitalist” healthcare in the US?!)
In addition to this bizarre situation, because of the market distortions, prices are ramped up. It is literally cheaper for me to fly myself to NZ and stay in a Southern Cross private hospital for care than spend even one night in a US hospital paying cash.
Furthermore, if you work more than 30 hours a week, the government MAKES your employer offer subsidised healthcare to you. Combined with the highest company taxes in the western world, who would want to hire a full time employee? Companies go out of their way to avoid employing low wage workers for more than 30 hours, depriving the working poor of both healthcare and income.
To solve the problem, US politicians need to do either one of two things: Get rid of all the regulations and government interference so private individuals can buy health insurance at affordable prices, or simply extend Medicare to everybody, hiking taxes to cover it. I’m not going to be ideological about it, despite my libertarian views. Either system would be better and cheaper than what is in place now. Unfortunately the politics of it guarantees neither option will happen.
I can also tell you that health care in the USA is very “lumpy” in terms of quality. In the UK, Aussie and NZ the standards are broadly similar throughout the regions. Definitely not so over there. Great video, spot on.
Heck – “no centralised negotiation” over there on prices.
Jeez….. no wonder their costs are going through the stratosphere. I would have thought that would be the *first* thing that you do when setting up a healthcare system.