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This article from NPR illustrates the fact that the same things cost far more in the American health care system than anywhere else. It costs $13,000 to have a hip replacement done in Belgium. In the United States that same procedure is over $100,000 (7 X as much).
Whether we have Obamacare, a single payer system, or a national health service like Britain, the truth is the fundamental problem in America is simply cost. Whatever system we put in place has to do two things:
1. Cover everyone; 2. Do so at a lesser cost than we have been paying.
Whether it cost 10,000 or a hundred thousand, we never pay those prices and you know it. We also have some of the best doctors in the world practicing right here and when we need care, it is available, we don't wait for months or years. How many people do you know in say, Canada or UK who have been able to get things like back surgery without a long wait or even wait a year or more to be assigned a doctoe? Does that answer your question???
We have recently added a vast array of new things into Healthcare: Insurance, MRIs, Cat-scans, blood-gas testing, ...
I think that every year new procedures are being added into the mix.
We have never seen this level of healthcare, nor this level of expense.
you said it yourself; we have never had this level of healthcare. You have to pay for what you get or did you think all this advanced research and all the available care we have comes without a price tag?
you said it yourself; we have never had this level of healthcare. You have to pay for what you get or did you think all this advanced research and all the available care we have comes without a price tag?
Which is why health care is expensive in the USA [the topic of the thread].
Whether it cost 10,000 or a hundred thousand, we never pay those prices and you know it. We also have some of the best doctors in the world practicing right here and when we need care, it is available, we don't wait for months or years. How many people do you know in say, Canada or UK who have been able to get things like back surgery without a long wait or even wait a year or more to be assigned a doctoe? Does that answer your question???
One of the benefits of a national system like that in the UK is that wait times are monitored ands statistics published:
"In 2012, the average patient waited around eight and a half weeks to start admitted treatment, four weeks to start non-admitted treatment, and the average patient waiting for treatment at the end of the month had been waiting around five and a half weeks."
So not quite the "year or more" that you threw out there without any evidence whatsoever to back it. However, if they do have to wait, at least they have access to health care:
"Lack of health insurance is associated with as many as 44789 deaths per year in the United States"
Now, back to cost and a couple of personal examples to illustrate the point.
Example 1: I had a nuclear cardiac stress test at the beginning of this year. Total cost was around $7,000. It ate up all of my deductible plus some other-out-of-pocket costs so actual cost to me was around $3,000. That is on top of the roughly $3,000 I pay in health insurance premiums. Had I been in the UK, my out of pocket costs would have been zero.
Example 2: My brother-in-law was treated for bladder cancer this summer. A course of chemotherapy plus surgery. Treatment was performed via Medicare. Total out-of pocket to him was $10,000 which he didn't have (we paid it). Total out-of-pocket in the UK, zero.
But you are absolutely right that most ordinary Americans do not pay those headline numbers that get cited in the various articles. The problem is that we do have to pay the deductibles and, depending on your insurance plan, that can be a lot of money for a pretty routine procedure and especially as more and more people are being pushed onto high-deductible plans by their employers.
The reality is - as has already been pointed out in this thread - Americans are paying on average twice as much as people in other developed countries for health care which - also on average - does not deliver noticeably better outcomes.
And the big problem in this thread as in others is the tendency to try to denigrate other country's health care systems in an effort to show that the US system is somehow better. Qualitatively, our health care is very good but there is no evidence to suggest that it is better. And, in terms of cost, it is far too expensive. We would be far better off trying to figure out how to get costs down while maintaining quality than throwing rocks at other countries who, it would seem, have already figured that one out.
Whether it cost 10,000 or a hundred thousand, we never pay those prices and you know it. We also have some of the best doctors in the world practicing right here and when we need care, it is available, we don't wait for months or years. How many people do you know in say, Canada or UK who have been able to get things like back surgery without a long wait or even wait a year or more to be assigned a doctoe? Does that answer your question???
Stop and think about what you've just said. If we really did pay for health care at that rate across the board than the cost of health care in this country would be 750% more than in those other nations. The prices that are actually paid though are very high and health care in America is still substantially more than in any other country, including Switzerland, which has the second highest health care costs per capita in the world. As it is, we spend about 17% of our GDP on healthcare. The Swiss spend about 11% to !2%
You allude to rationing of health care and waiting lists in foreign countries for specialized medical procedures. You don't think we ration care in this country? Of course we do. We just use dollars to do our rationing for us. Those who have dollars get care. Those without dollars don't. I guess for many people with dollars that sounds like a fair way to ration health care. It may not seem so fair for someone who has battled a chronic or life threatening illness since childhood and has not had a way to earn and accumulate dollars.
I've waited a long time in this country to get specialized care because our insurance plan sometimes only has a handful of specialists who participate in the plan. I waited two months to see one specialist on one occasion. I waited even longer to get a certain test done once.
Whether or not a system has "the best doctors in the world" practicing here becomes irrelevant for people who cannot afford care at all. I have repeatedly told people who express the idea "that the care they get is wonderful, so don't change anything" that this isn't a discussion about them and their doctor. Its a discussion about improving access to the system so that the vast majority of people in this country receive quality, affordable care.
When we were young and single we lived in affordable housing with roommates so we could afford things like medical insurance, etc.
When we were young and single, every employer covered its employees for next to nothing in cost. What a far cry from today (at least up until the ACA goes into effect).
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Also, if she works at a job making 60K/year, she probably has access to an employer plan for less then $250/month...
you said it yourself; we have never had this level of healthcare. You have to pay for what you get or did you think all this advanced research and all the available care we have comes without a price tag?
The reason the price of at least drugs is much higher in the U.S. is because of price discrimination. The same U.S. companies sell the exact same drugs in Canada for much less than the U.S. because the U.S. is the sole payer for all research.
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Prescription drugs, even those manufactured by American companies, cost much less in Canada than in the United States. Why?
The simple answer is price controls. A Canadian law authorizes a review board to order a price reduction whenever the price of a drug exceeds the median of the prices in six European countries plus the United States. Since all the European countries intervene in various ways to hold down drug costs, Canada in effect piggy-backs on other countries' price controls.
So why not do the same thing south of the border? Trouble is, drug companies are willing to sell for less in Canada and elsewhere only because they can sell for more in the United States.They are engaging in what economists call "price discrimination"--that is, charging different prices to different buyers of the same product. Price discrimination works in the drug industry because drugs are very expensive to develop, but fairly cheap to manufacture. As long as companies can recoup their research and development costs by charging high prices in the United States, they can make a profit in Canada and elsewhere by merely covering the cost of making the pill (or tube of ointment or whatever). Similar price discrimination occurs within the United States, with HMOs and other large buyers able to negotiate lower prices while the uninsured pay top dollar.
Congress has routinely rejected legalizing the importation of the drugs we export to other nations to protect the current price discrimination. And it has refused to require pharmaceuticals to spread development costs evenly across all countries because it would result in higher prices in Canada which might mean they go to other international sources for their drugs and which would put Mexico out of business period because of the number of poor people in that nation.
In other words, like the "defense of the world," the cost of pharmaceutical health care is provided to the rest of the world by rich Americans.
Don't like that answer? See how far you get complaining to your Congressman who has been bought lock, stock, and barrel by the pharmaceutical industry.
Agreed - but the focus for sports coaches is some pituitary cases and some obsessed fans. Our doctors and the people running complicated health care systems that deliver good care to us should be among the best compensated professionals in our country - and we shouldn't try to be short-changing them. That will hurt all of us - because we get what we're willing to pay for (sometimes less but hardly ever more). I value the quality of my health care more than a winning football or other sports team. And have never resented 99% of the dollars I've spent out of pocket for health insurance or health care (I do get PO'd about my current Comcast bill - but that doesn't have anything to do with the price of onions). Perhaps I am unusual? Note that I have a ton of doctors in my family. The younger generation is pretty much going into specialties like interventional radiology. Areas where women can make a lot of money - and maintain a good work/family balance. Very rational IMO. Robyn
Robyn, I agree that the doctors should be well compensated, but typically, the doctors' fees are a fraction of the overall medical bill.
Robyn, I agree that the doctors should be well compensated, but typically, the doctors' fees are a fraction of the overall medical bill.
Interestingly, regular doctors only make in the region of 25% - 30% more in the USA than they do in other developed countries.
Specialists do tend to make quite a lot more but not so much as specialists in the Netherlands. They do, however, make about 50% more than specialists in the UK.
What we do not know is whether the remuneration in the tables is gross or net. If it is gross then costs of running the practice and practice protection need to be factored in. This latter is likely to be higher in litigious America than elsewhere.
Also, as the article points out, US doctors have to pay for their education and training which is not the case in most other developed countries.
In any event, the differences in doctor's remuneration are not large enough to explain the differences in the cost of health care.
Whether it cost 10,000 or a hundred thousand, we never pay those prices and you know it. We also have some of the best doctors in the world practicing right here and when we need care, it is available, we don't wait for months or years. How many people do you know in say, Canada or UK who have been able to get things like back surgery without a long wait or even wait a year or more to be assigned a doctoe? Does that answer your question???
No one in Canada or the UK has to wait any longer than in the U.S. for EMERGENT health care--health care for a heart attack or a broken leg or appendicitis.
We may have some of the best doctors, but we also have some of the worst. And hospitals are simply killing us. What hasn't made the headlines is that roughly four plane loads of people die every week in the United States because of either physician error or hospitals that don't have intra-hospital infectious diseases, often hand-borne, under control.
Read Dr. Marty Makary's book, Unaccountable,for details on it. The most shocking chapter for me was where Makary tells of attending a conference of over 2000 surgeons where the guest speaker, a physician himself, asked the question, "How many of you know about a doctor who should not be practicing medicine?" Makary states, "every hand in the room went up."
Canadian health care waits are terrible? Why do Canadians overwhelmingly support their system? The lies told in the U.S.--Canadians are flocking across the border to get health care more quickly here. The fact is that if the Canadian system cannot get to someone with a serious problem they will PAY TO SEND THAT PERSON to the U.S. to get the procedure done. Fewer than 2% of Canadians receive health care in the U.S., some of those receive emergency care while on vacation, and the majority are sent to the U.S. by their government who pays all their health care costs incurred in the U.S.
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Agreements between Detroit hospitals and the Ontario Ministry of Health and Long-Term Care for heart, imaging tests, bariatric and other services provide access to some services not immediately available in the province, said ministry spokesman David Jensen.
The agreements show how a country with a national care system -- a proposal not part of the health care changes under discussion in Congress -- copes with demand for care with U.S. partnerships, rather than building new facilities.
The health care industry pays more money on lobbying and elections than any industry other than banking and finance (hence the taxpayer bailout).
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There are 3,000 registered health care lobbyists on Capitol Hill -- that's six for every single member of Congress. And in many cases, those lobbyists are former members of Congress who shaped laws that benefitted the industry they joined.
The so-called "revolving door" is perfectly legal, CBS News investigative correspondent Sharyl Attkisson reports. Yet it leads critics to ask whether some who are supposed to be watching out for taxpayers have other interests.
In 2003, the pharmaceutical industry got a multi-billion dollar windfall with Medicare Part D prescription drug coverage for seniors. Congressman Billy Tauzin, and Senators John Breaux and Don Nickles each held key roles in passing or shaping Part D. All three then left their government jobs and became lobbyists for the pharmaceutical industry.
P.S. about the above quote--Part D which prevents Medicare from negotiating with pharmaceuticals over the cost of drugs--is the primary reason for the rapid increase in debt for the medicare system.
And from an American who lived and worked in Canada:
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There's another, factual view - by those of us Americans who've lived in Canada and used their system.
My wife and I did for years, and we've been incensed by the lies we've heard back here in the U.S. about Canada's supposedly broken system.
It's not broken - and what's more, Canadians like and fiercely defend it.
Example: Our son was born at Montreal's Royal Victoria Hospital. My wife got excellent care. The total bill for three days in a semi-private room? $21.
My friend Art Finley is a West Virginia native who lives in Vancouver.
"I'm 82, and in excellent health," he told me this week. "It costs me all of $57 a month for health care, and it's excellent. I'm so tired of all the lies and bull**** I hear about the system up here in the U.S. media."
Finley, a well-known TV and radio host for years in San Francisco, adds,
"I now have 20/20 vision thanks to Canadian eye doctors. And I haven't had to wait for my surgeries, either."
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Five years ago, while we were on vacation in lovely Nova Scotia, the Canadian government released a long-awaited major report from a federal commission studying the Canadian single-payer system. We were listening to CBC Radio the day the big study came out.
The study's conclusion: While the system had flaws, none was so serious it couldn't be fixed.
Then the CBC opened the lines to callers across Canada.
Here it comes, I thought. The usual talk-show torrent of complaints and anger about the report's findings.
I wish Americans could have heard this revealing show.
For the next two hours, scores of Canadians called from across that vast country, from Newfoundland to British Columbia.
Not one said he or she would change the system. Every single one defended it vigorously. The Greatest Canadian Ever
Further proof:
Not long ago, the CBC asked Canadians to nominate and then vote for The Greatest Canadian in history. Thousands responded.
The winner? Not Wayne Gretzky, as I expected (although the hockey great DID make the Top 10). Not even Alexander Graham Bell, another finalist.
The greatest Canadian ever?
Tommy Douglas. Who? Tommy Douglas was a Canadian politician - and the father of Canadian universal health care.
Most Americans still believe the lies being told by politicians to prevent us from demanding a single payer system that would vastly improve our health care, while lowering the total costs. Because if profits were limited in our health care system, it's going to be tough for those politicians to find replacement dollars for their re-election bid.
Oh, by the way, what industry pays more into its lobbying efforts than any other industry in the U.S.? Oil and Gas? Defense contractors? No, that would be the health care industry.
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There are 3,000 registered health care lobbyists on Capitol Hill -- that's six for every single member of Congress. And in many cases, those lobbyists are former members of Congress who shaped laws that benefitted the industry they joined.
The so-called "revolving door" is perfectly legal, CBS News investigative correspondent Sharyl Attkisson reports. Yet it leads critics to ask whether some who are supposed to be watching out for taxpayers have other interests.
In 2003, the pharmaceutical industry got a multi-billion dollar windfall with Medicare Part D prescription drug coverage for seniors. Congressman Billy Tauzin, and Senators John Breaux and Don Nickles each held key roles in passing or shaping Part D. All three then left their government jobs and became lobbyists for the pharmaceutical industry.
The conclusion is obvious, neither is our health care system economically efficient, nor the care itself the best, and limited not just to those who have insurance, but those with the BEST insurance, it doesn't perform any better than the Canadian system, and our Congressmen are owned by health care lobbyists.
The only way to fix it, is to dismantle both the health care system, and outlaw all lobbying efforts of Congress.
Neither appear likely to happen, which is why the coming economic disaster is not an "if", it's only a "when."
Last edited by Wardendresden; 11-04-2013 at 09:47 AM..
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