Why is healthcare so expensive in the states? People seem to focus on private Heath insurance vs Obama care. But neither should be so expensive. Why are other countries able to provide way cheaper care?
1. The USA has the best doctors and hospitals. The marginal benefit to having better doctors and hospitals is completely dwarfed by their higher prices. Would you be willing to pay 2x to have a 5% better chance of no complications on a surgery for a rare condition? Well the USA does exactly that.
2. The USA subsidizes drug development for the rest of the world. All the R&D happens here, and the only reason so much money is spent on this R&D is because the drug companies can charge maximum price to Americans. Other countries negotiate as a block to lower prices. This is great for those countries (cheaper drugs) and the drug companies (marginally expanded markets), but it increases the fraction of money from the US going to that R&D.
Cuba has people in a different climate, with a different culture, and different inherent susceptibility to disease.
If we were to supply Cuba with bacon double cheeseburgers and unlimited soda refills, that life expectancy would not be so hot. Also, give them all desk jobs.
Healthcare is better in the USA. We just like to do bad things to ourselves.
Canada, then. They have a very similar culture, and I don't think anyone would call their climate substantially more hospitable. They spend half as much on healthcare and live three years longer. Their approach (publicly funded, free at the point of use) would seem to be much more effective than the US approach.
I mentioned Cuba because I've heard many anecdotes about how skilled and well-trained their doctors are -- they don't have the money and resources for lots of modern drugs and equipment, so they invest in their workforce instead. I'm not saying Cuba is in great shape overall, just that I have heard they have excellent doctors. (I don't have data to back that up, though)
It seems to me that the system is just very inefficient. There's a huge amount of bureaucracy, and not a lot of serious competition between healthcare and insurance providers. It's hard to switch providers and the pricing structures are very confusing.
Similar to broadband and mobile phone services, the free market hasn't been able to drive prices down as effectively as it theoretically should. I think it's because the incumbent providers have successfully lobbied for a network of regulations that protect their monopolies. What's actually needed is better regulations (a la net neutrality) to level the playing field.
Or alternatively, just run it as a free public service like many other countries do. That approach works pretty well.
It's a feedback loop that started because of government intervention in the free market and it continues simply because of government intervention in the free market. There are many examples of this, such as your broadband and mobile phone markets, and university tuition loans.
Well, hang on now, wouldn't you agree that the free market has sometimes left us stuck with cartels and monopolies? (In the US, look at the railroads and telephone network.) Sometimes you need regulations to break out of those traps.
Yes, there are examples of the free market creating monopolies. This is even more possible today than years past. But in those examples I'm willing to bet the only way they are maintained is from the assistance of government.
Sometimes it is good thing, I admit, but in most cases it is not consumer friendly.
The telephone network hasn't had anything to do with a free market since 1934 at the latest. The Justice Department chose a monopolist winner in 1913.
The USA freight rail system exhibited some monopoly through the 1880s, but since has been quite regulated. Perhaps the current level of regulation may not be ideal, but since the USA freight rail system is the best in the world it would seem foolish to tamper with it.
I didn't mean those are monopolies now, I meant that they had wandered into monopoly territory in the past, and regulation has been somewhat (not entirely) successful in fixing that.
I guess we agree about the railroads. However, telecom has never been a natural monopoly, and the USA government has had to work hard for a century to make and keep it one (...and to convince the public that telecom monopoly is unavoidable.) VZN and ATT may not have merged officially yet, but they certainly act in concert to maintain their duopoly position. This will only change when the FCC ceases to stifle modern radio technology.
In a lot of countries people find it perfectly reasonable for the doctor to say something like "Your father is old, and we can operate to remove his tumor, but he's not going to live much longer no matter what we do. We don't have unlimited resources so we're not going to operate."
People in the US aren't use to making those kinds of tradeoffs, which is why we spend half of our medical dollars on the last year of people's lives. We might decide not to operate, but financial considerations won't enter into the decision.
That's why I will be surprised if anything the government does short of rationing care will affect the cost of medicine in the US. It's about expectations.
I burned my foot without insurance. Out of pocket this twenty minutes in the doctor's office, two pain pills, and a nurse assuring me that it wasn't quite a third-degree burn cost me $2000+.
It's not six MRI's the uninsured need to worry about, it's incidental injuries and illnesses that potentially cost several month's wages.
Under many of ACA policies, you would still end up paying that amount, because they have ridiculously high deductibles. So if you are a relatively healthy person that does not regularly go to the doctors to get that chewed up earlier, you are still going to be left holding the bag for non-catastrophic, but expensive services.
The problem with this reasoning (and by extension, any system where there's a possibility to opt out of healthcare) is that if you have a serious ailment that you can't afford to treat, we have to let you die.
But I believe even in the USA you will get (emergency) treatment and the bills racked up, right?
The problem now is health care plans are so expensive the right thing to do from a green-eyeshades perspective is to pay the fine for not having a plan and go to the ER if you have a problem.
The problem with insurance is that literally everyone will have a serious ailment one day. Very few people die instantly, huge majority of deaths are from cancer and cardiovascular
Cardiovascular problems aren't necessarily expensive. Sometimes people just drop dead. There's the cost of an ambulance ride and some hubbub in the ER, but that wouldn't make a dent in the amount they paid in.
The real problem with insurance is there are people with long-term, expensive medical conditions who will never, in their entire lives, make enough money to pay for their treatment. That just doesn't work under an insurance model.
imho the problem with insurance is that it only serves to take money out of medical care, while inflating the costs. It makes sense to insure against terrible driving or burning your house, but taking insurance against something very likely to happen is simply giving money to insurance industry for nothing. Single payer models appear to be more effective.
I will assume that gozur88 has some source on the 85% increase. If that isn't true, ignore this.
A prerequisite for an 85% increase is some payment beforehand. If they had no health insurance, they wouldn't have been paying for health insurance, and therefore their rates could not increase.
My guess is an increase compared to the first-year prices under the ACA. Nobody who talks about the premium increases does so from the perspective that those who are impacted by the increases started at zero. I've seen mine nearly double each enrollment period.
