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I have never seen people who claim that UHC would save significant amounts of money back up their statements with data relevant to the United States healthcare market.
The small number of proponents of UHC who try to back up their specious claims with data at all almost universally cite the experience of other countries.......while conveniently ignoring different health profiles, different pharmaceutical costs (R&D research is spread globally......and the rest of the world - UHC or no - free-rides off America to their benefit and our detriment), different costs of the time of health professionals (doctors, nurses etc.), different demographic profiles, etc. (the list goes on.) Just because other countries with UHC have lower costs than America doesn't mean implementing UHC in America would lower healthcare costs here. After all, every other country without UHC ALSO has lower costs than America too.The degree of socialization is by no means the only causal factor in healthcare expense.
I mean, heck, I could start pointing at the lower healthcare costs of all the countries with less socialized systems than we have as evidence that moving to a more free-market system would lower healthcare costs, but, that would be equally dumb.
There is absolutely no empirical reason to believe that who spends money on healthcare - individuals, employers, or the government - matters more than the price sensitivity of buyers, the extent to which we allow the rest of the world to continue to get cheaper care at our expense, and the amount of healthcare resources (hospital beds, trained doctors and nurses, medical technology, etc.) available. You don't cure the sick by giving them insurance (private or public), you cure the sick by giving them treatment, and for all that people who dislike the insurance industry or people who dislike the government claim their respective object of dislike wastes, the simple fact of the matter is that most healthcare dollars - both those routed through insurance corporations and the state - are spent on actual medical care.
Of course proponents of UHC cite the experience of other countries -- those are real-world examples. Citing Europe, where cigarette smoking is more prevalent, makes the case stronger.
If you are suggesting that Americans are appreciably more expensive to insure than Canadians or Europeans, it is up to you to quantify those differences.
The real reason medical insurance is 40-45% more expensive in the U.S. is identified by ABC News’ former medical editor Tim Johnson, who said that a third of what we spend is unnecessary.
Oregon wastes $4 billion annually in private insurance administration
Princeton economics professor Uwe Reinhardt, speaking recently before the Senate Finance Committee, said of Duke University's 900-bed hospital: "We have 900 billing clerks at Duke. I'm not sure we have a nurse per bed, but we have a billing clerk per bed. It's obscene."
A Chicago doctor faces as many as 17,000 different sets of benefits for her patients. Your physician in Oregon might deal with only 300. But that's still a lot of paperwork that doesn't provide health care.
Oregon wastes $4 billion annually in private insurance administration
Princeton economics professor Uwe Reinhardt, speaking recently before the Senate Finance Committee, said of Duke University's 900-bed hospital: "We have 900 billing clerks at Duke. I'm not sure we have a nurse per bed, but we have a billing clerk per bed. It's obscene."
A Chicago doctor faces as many as 17,000 different sets of benefits for her patients. Your physician in Oregon might deal with only 300. But that's still a lot of paperwork that doesn't provide health care.
Of course proponents of UHC cite the experience of other countries -- those are real-world examples. Citing Europe, where cigarette smoking is more prevalent, makes the case stronger.
If you are suggesting that Americans are appreciably more expensive to insure than Canadians or Europeans, it is up to you to quantify those differences.
The real reason medical insurance is 40-45% more expensive in the U.S. is identified by ABC News’ former medical editor Tim Johnson, who said that a third of what we spend is unnecessary.
One reason we pay more is because of all the medical liability insurance and expensive lawsuits. We also have countries like Canada who set price control for drugs and medicine, so the pharmaceutical industry just charges US customers more, to recoup their losses.
Just about every small city in the US has more then one MRI, and almost every doctor has a sonogram, but in Europe and Canada you go on a waiting list for those scanners.
A Guardian analysis of official NHS data on England's six main waiting time targets shows that five are increasingly being breached. The number of patients waiting more than six weeks for a diagnostic test such as an MRI scan has quadrupled in the last year, an extra 2,400 people a month are not being treated within 18 weeks, and 200,000 patients waited longer than four hours in A&E this year compared with the same period in 2010, the data reveals.
BTW, why would ABC News’ former medical editor Tim Johnson predict a “pessimistic” future for the United States health care industry, including a potential financial crisis due to rising medical costs, during his Tuesday lecture, “The Truth About Getting Sick in America.”
One reason we pay more is because of all the medical liability insurance and expensive lawsuits.
Malpractice premiums is estmated to make up 2% of the difference between the US and OECD average costs. Defensive medicine a further 9 %. It is a contributing factor, but not one of the larger ones.
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Originally Posted by OICU812
We also have countries like Canada who set price control for drugs and medicine, so the pharmaceutical industry just charges US customers more, to recoup their losses.
I don't really see how that works. A company charges what the market will bear. If they didn't make a profit in Canada, they wouldn't sell drugs there, and if they made a massive profit, they'd still screw America out of as much as they could. Thats just business.
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Originally Posted by OICU812
Just about every small city in the US has more then one MRI, and almost every doctor has a sonogram, but in Europe and Canada you go on a waiting list for those scanners.
One of the larger contributors to costs in the US -three times as large as the total costs of malpractice and defensive medicine combined- is overprovision. The US simply has more MRIs and scanners than needed because of the lack of coordination between health care providers.
Also remember that there is triage. The most serious cases will be attended to right away. The long waits are people with bothersome dandruff, snoring problems, and the like. And most people do not have serious ilnesses.
Nor can you say that you go on waiting lists in Europe. the two only countries you've mentioned is Canada and the UK. And Canada is known as the one country with longer waits for treatment than the US. What happens in Germany, France or Luxembourg?
Quote:
Originally Posted by OICU812
BTW, why would ABC News’ former medical editor Tim Johnson predict a “pessimistic” future for the United States health care industry, including a potential financial crisis due to rising medical costs, during his Tuesday lecture, “The Truth About Getting Sick in America.”
I'd expect it to be because health care costs are estimated to hit 25 % of GDP by 2025. Meaning another two military bugets worth of money needs to be dug out over the next three presidentla terms.
I don't have individual statistics. The GAO report here is an overview of several companies with medical-loss anywhere between 60% and >1%. As for 50%, that comes from the White House, and 3% comes from this conservative spin site owned by Rich Berman, spin-doctor.
I trust the White House's opinion more than a corporate shill.
EDIT: Forgot to include the GAO report.
Before responding more broadly, I'd like to say that I really appreciate the citation of arguments and sources, it's refreshing.
That said, the reason I ask for specific statistics is that people with ideological, economic, or political skin in the game making up numbers, then those numbers getting quoted by others as truth has become endemic to the healthcare debate. Neither the Obama administration nor conservative spin sites have been honest or above lying or distorting statistics since the PPACA was being debated. This is why specific examples matter here, because so many of the often quoted sources simply aren't credible - either directly or because they quoted someone else making up a number. The alternative to specific samples is to cite a more technical/nonpolitical resource, which brings us to the third source you listed.
The Massachusetts GAO report, unlike the other two, is a quite legitimate source. I didn't see any discussion of plans with a medical loss ratio under 50% (maybe I just missed it), but, it states that the average loss ratio there is about 90%, which isn't terribly surprising and implies that 10% is the strict upper bound (aka it would be less, possibly negative possibly positive, but certainly less) for how much could in theory be saved by moving to a UHC system
Quote:
Originally Posted by Grim Reader
Thats a total myth, you know. America does spend slightly more per person than other countries, but the total research production still lags the EU by about 10 %. And thats before we even get started on countries such as Japan, South Korea, Russia, etc, all of which have quite healthy research environments.
(Source: BMJ. 2005 July 23; 331(7510): 192–194)
Also, there is another issue...if you are not familiar with numbers on this scale it is easy to lose perspective. America spent about 2,6 trillion dollars on health care in 2010. That is about 1,3 trillion more than you'd expect from the population. 1 300 billion.
The entire worlds health care research spending (2004) was about 106 billion.
So no. Not only is the US nowhere near subsidizing the rest of the worlds research, but even if America paid for all the worlds research, the amount would be too little to make much of a dent.
It is one contributing factor, not the sole cause. Although in all honesty I hadn't researched the numbers and going off those you provided, the impact of the effect is less than I had thought it was.
Quote:
Originally Posted by Grim Reader
No, what does mean that is; every country with UHC has lower costs than America. All of them. And not by a small amount either.
Every country has lower costs than America. All of them. And not by a small amount either.
This is why it is meaningless to say that UHC would be cheaper in America than the status quo because it is cheaper elsewhere.
An argument 100% logically equivalent to this would be saying that every NBA player can shoot 3 pointers more consistently than I can shoot 2 pointers, and thus if I tried to shoot more 3 pointers while playing basketball and less 2 pointers I would get a higher proportion of my shots into the hoop. The problem with this logic is of course, that the reason the NBA players are doing better than me is that they are awesome at basketball and I, to put it mildly, am terrible. If you looked at players shooting 2 pointers instead, they'd also be doing better than me. Does why the comparison is meaningless make sense now?
edit: MTA-tech, are you making the case that higher smoking rates increase the medical costs of a population over time? Smoking increases the cost of an individual right now, yes, but that impact is reversed by the fact that it kills people off before they get too old and hit the peak healthcare cost consumption years. In fact, the argument runs the other way (although I doubt it makes up a large magnitude of the US/Europe difference).
They get better results with half the money. Longer lives, a greater fraction of which are spent healthy, everyone is covered, shorter waits to see specialists, better results...the list goes on and on.
So -don't manage it well compared to what? You can rank the systems individually, but that doesn't change the fact that you're going to have the UHC are going to be at the top and America near the bottom.
I think you've kind of missed the point here.
At the moment, you are paying more in tax towards government health care than Europeans do. No, it wouldn't be free. Every indication is that it would cost less than you pay at the moment for no coverage.
The present setup is so ineffective that you are paying more for the current setup than citixzens of UHC nations do for UHC. Big difference is, you are not only paying more, you are not getting UHC.
The number is not representative of the individuals reality in those countries.
There are people here who get better healthcare then they do there. We have the best hospitals in the world, along with the best doctors.
The problem in the United States are the massive number of people who aren't insured.
No, I'm paying a minimal amount to medicare, which I expect to be able to use, as well as my Social Security. The healthcare portion of the budget is minimal when you deduct medicare.
Do you want to live a long life? If the answer is yes (I hope it is), then it pays you to go and get check ups, screenings, etc.
I can (and do) do that without insurance. Routine stuff is cheap. MUCH cheaper than paying a monthly insurance premium.
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Originally Posted by Memphis1979
What you're saying is that you'll wait until the cancer has spread to a noticable level, then you'll go get insurance and go to the doctor.
That's not what I said at all.
If you stop inferring fictions from what other people write, you'll do a lot better in these discussions.
You failed miserably on your first attempt at a response... Care to try again? Would you like to once more attempt to explain why I should pay the premium instead of the fine?
A Guardian analysis of official NHS data on England's six main waiting time targets shows that five are increasingly being breached. The number of patients waiting more than six weeks for a diagnostic test such as an MRI scan has quadrupled in the last year, an extra 2,400 people a month are not being treated within 18 weeks, and 200,000 patients waited longer than four hours in A&E this year compared with the same period in 2010, the data reveals.
BTW, why would ABC News’ former medical editor Tim Johnson predict a “pessimistic” future for the United States health care industry, including a potential financial crisis due to rising medical costs, during his Tuesday lecture, “The Truth About Getting Sick in America.”
Didn't we sign ObamaCare into law?
Even if we did have waiting times, you're talking about healthcare for everyone, not just the people who can afford to get it. That alone is worth waiting a few days. And, from every report I've read on waiting times, they are pretty much in every case grossly exaggerated.
Quote:
Originally Posted by ALackofCreativity
Before responding more broadly, I'd like to say that I really appreciate the citation of arguments and sources, it's refreshing.
It bothers me too when I'm having an argument and my opponent has nothing in the name of data, sources, information, or credibility.
Quote:
That said, the reason I ask for specific statistics is that people with ideological, economic, or political skin in the game making up numbers, then those numbers getting quoted by others as truth has become endemic to the healthcare debate. Neither the Obama administration nor conservative spin sites have been honest or above lying or distorting statistics since the PPACA was being debated. This is why specific examples matter here, because so many of the often quoted sources simply aren't credible - either directly or because they quoted someone else making up a number. The alternative to specific samples is to cite a more technical/nonpolitical resource, which brings us to the third source you listed.
It's why I offered "the most extreme" of both sites. The White House claims as much as 50% of your dollar can go to healthcare, while the average I believe was 70%, and their law intends to make them provide 80%. I'll double check the video, but I wanted a more legitimate source originally than the RethinkReform site, which tries to definitely say that only 3% of the dollar goes to profits, which is patently absurd for all buy the largest of providers who can get away with small proportions because they make an stupendous amount of money in the first place.
The GAO report breaks down a number of companies, and while the average is 90%+ for large corporations and insurers that can afford the "smaller" margins, a lot of companies don't meet that.
[quote]The Massachusetts GAO report, unlike the other two, is a quite legitimate source. I didn't see any discussion of plans with a medical loss ratio under 50% (maybe I just missed it), but, it states that the average loss ratio there is about 90%, which isn't terribly surprising and implies that 10% is the strict upper bound (aka it would be less, possibly negative possibly positive, but certainly less) for how much could in theory be saved by moving to a UHC system[quote]
Are you saying the consolidation of undoubtedly hundreds of health-insurers into a single system wouldn't save any kind of money? To begin with, the system is naturally non-profit, so you're eliminating that, and you'll have a streamlined administrative interface because you only have one company, which I will later create a backronym for, instead of hundreds.
I don't think it's possible to supply reliable numbers on the savings due to the nature of the case. How many nations have gone from a for-profit private health-care program, to a national health-insurance service?
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