Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Why does this not happen in other single payer countries then? The hospitals in Scandinavia are quite far apart.
Most of the European countries use a clinic based model. America uses a hospital based model. Depending where you live you won't have a choice but to use a hospital for even small medical issues. Canada also uses a clinic based model
Quote:
Actually, the main drives of US costs are unneccessary services and excessive administration. And the lower cost of medical care in the UK and Australia are in no way proportional to their lower median income.
Unnecessary services and admin might explain the disparity, but technology and affluence are the 2 main drivers of healthcare costs. We don't use generics, and don't use multi bed rooms, we want the ease of suing, we want expensive machines available for use. The studies that compared the cost of surgery in the USA and Canada attributed to cost difference to admin and drugs.
Actually, preventive healthcare can affect lifestyle. And how the healthcare system deals with teen pregnancy, car accidents, premarture births, HIV, stress-related illnesses etc can be quite important. The effects of violence, accidents etc on life expectancy has been looked at, and the only report that found a significant effect had such poor maths that the authors had to admit they'd never intended it to be right!
What is more, if you look at the average lifespan of other developed counties with a lifestyle problem, there does not seem to be that much of a relation. In other words, while smoking, obesity etc does have an effect, the US seem to lose far more lifespan than other countries with lifestyle issues.
Preventative medicine can affect lifespan, but so can genetics. Japan has the longest lifespan, but Asian American females have the longest lifespan - they are also the most affluent. Affluence is not the sole determinant as you can see from the "Hispanic paradox". Having said that, there isn't a way to ignore the fact that we have higher rates of illnesses and factors that lead to higher mortality rates. Even if you take medicine for HIV you will still have a shorter lifespan. We can have the best gun wound specialists in the world, but gunshots do reduce life expectancy. D.C. has good hospitals, is a pretty violent place and not surprisingly has the lowest life expectancy for black men, but DC has the highest life expectancy for white people.
If you want a real cross country comparison you have to control for age, sex, region, income, payer status, condition, illness, race, etc and then look at outcomes. As it stands, private insurance patients have the best mortality odds and medicaid patients have the worst.
Most of the European countries use a clinic based model. America uses a hospital based model. Depending where you live you won't have a choice but to use a hospital for even small medical issues. Canada also uses a clinic based model
Unnecessary services and admin might explain the disparity, but technology and affluence are the 2 main drivers of healthcare costs. We don't use generics, and don't use multi bed rooms, we want the ease of suing, we want expensive machines available for use. The studies that compared the cost of surgery in the USA and Canada attributed to cost difference to admin and drugs.
Preventative medicine can affect lifespan, but so can genetics. Japan has the longest lifespan, but Asian American females have the longest lifespan - they are also the most affluent. Affluence is not the sole determinant as you can see from the "Hispanic paradox". Having said that, there isn't a way to ignore the fact that we have higher rates of illnesses and factors that lead to higher mortality rates. Even if you take medicine for HIV you will still have a shorter lifespan. We can have the best gun wound specialists in the world, but gunshots do reduce life expectancy. D.C. has good hospitals, is a pretty violent place and not surprisingly has the lowest life expectancy for black men, but DC has the highest life expectancy for white people.
If you want a real cross country comparison you have to control for age, sex, region, income, payer status, condition, illness, race, etc and then look at outcomes. As it stands, private insurance patients have the best mortality odds and medicaid patients have the worst.
Let's look at what the typical Medicaid patient is, compared to private insurance. Private insurance patients are more likely to be white, live in low crime suburbs, less likely to be violently attacked, less likely to eat contaminated, poor quality food and is usually middle class and up.
Medicaid patients, on the other hand, tend to be black or Hispanic, all are poor, most eat some of the poorest quality food you can buy. As a result, much of their diet are empty calories, lack exercise (obesity is worst among African-Americans), Medicaid patients usually suffer more from diabetes than non-Medicaid (again, diabetes is more common among ethnic minorities), and most live in high crime areas and that comes with lethal or very significant wounds, and a high stress lifestyle as a result. Taking those parameters into account, Medicaid (ergo, government) cannot be the biggest reason why there's a disparity between Medicaid and private patients.
The CBO is stupid. It doesn't assume different situation. For example the CBO's original ACA projections called for the law costing roughly 900 billion over 10 years.
Yet immediately after the ACA was signed into law in 2010. The Medicare "cuts" the ACA and the CBO projected its calculation took into account that there would be a 500 billion dollar Medicare savings those automatic payment reduction to physicians.
But guess what happened 2 months after the ACA was passed? Congress passed the doc fix. Thereby erasing all the assume "savings" the hill article proposes.
Medicare is the 800 pound gorilla in the room. Some thing even Dems do not want to touch to reduce benefits for senior voters.
Let's look at what the typical Medicaid patient is, compared to private insurance. Private insurance patients are more likely to be white, live in low crime suburbs, less likely to be violently attacked, less likely to eat contaminated, poor quality food and is usually middle class and up.
Medicaid patients, on the other hand, tend to be black or Hispanic, all are poor, most eat some of the poorest quality food you can buy. As a result, much of their diet are empty calories, lack exercise (obesity is worst among African-Americans), Medicaid patients usually suffer more from diabetes than non-Medicaid (again, diabetes is more common among ethnic minorities), and most live in high crime areas and that comes with lethal or very significant wounds, and a high stress lifestyle as a result. Taking those parameters into account, Medicaid (ergo, government) cannot be the biggest reason why there's a disparity between Medicaid and private patients.
When compared to private insurance, mortality rates are higher for medicare, medicaid, and the uninsured after you control for region, sex, race, income, age, comorbid condition, and operation. Medicaid and uninsured payment status are identified as risk factors because the mortality rate is so much higher. I've posted the research articles numerous times.
My theory is the uninsured, medicare, and medicaid patients can't afford the good doctors and good doctors don't work for discounted prices as much. Just a theory, as there aren't any studies that looked at compensation and compensation isn't solely tied to quality.
What is boring is cherry picking a post to take things out of context and deliberately ignoring those key elements of the post that run counter to your assertions.
My entire post you reference:
What do you NOT understand when your refer to "ALL UHC as being rediculously taxed" as referring to all UHC countries?
You say one thing then go on to tell us you only have experience with the European model without declaring your statement of ALL as being modified one itota.
Your post is written in such a manner that any reasonably intelligent person would surmise you mean ALL regardless of you only having familiarity with some. Cripes!
I took umbrage with your use of All UHC countries.
Had you only mean't to describe the European countries perhaps that what you should have said at the outset
Did you intend to mean ALL or NOT! Grow a pair and admit your error.
It obviously has some effect but doesn't explain away all of the admin stuff you are paying quadruple for in light of these salaries: Registered Nurse Salary Canada
The absolute lowest paid of $15.65 pr/hr is making 2400 a month. The mean average in Canada is closer to $70-80K per year.
Again. The real reason it's really hard to push for universal care in the USA is because politicians (both Dems and Repubs) don't want to **** off the middle class.
The truth is the middle class needs to shoulder the burden of taxes for healthcare. It's the simple hard truth. Yet the Dems want to tax the rich. We all know you cannot fund a social system like universal healthcare by relying on tax revenues from just 3-5% of the population. The republicans obviously need to get off their holier than now "no new taxes stance".
In the US we have unequal participation. And that's not a way to run a social program.
Many libs think the ACA is a step in the right direction. It isn't. It's just cost shifting and eventually there will be less revenues than expenditures. Already there is We all know the law is severely underfunded.
Assuming you are one of the middle class currently shouldering the burden of those figures posted describing your per person cost as being roughly double and perhaps three times greater (gov't including private pay) than other counties per-person costs; would it not seem reasonable if you were to duplicate in it's entirety, just one of those other countries method of providing UHC, you would realize a whopper of a tax savings.
ERGO: that burden you talk about only your 50% shouldering would be substantially reduced!
It obviously has some effect but doesn't explain away all of the admin stuff you are paying quadruple for in light of these salaries: Registered Nurse Salary Canada
The absolute lowest paid of $15.65 pr/hr is making 2400 a month. The mean average in Canada is closer to $70-80K per year.
If we can do it why can't you?
Our system is monopolistic for starters.
How much does it cost to see a Dr. at a private clinic?
It obviously has some effect but doesn't explain away all of the admin stuff you are paying quadruple for in light of these salaries: Registered Nurse Salary Canada
The absolute lowest paid of $15.65 pr/hr is making 2400 a month. The mean average in Canada is closer to $70-80K per year.
If we can do it why can't you?
So, in other words, it definitely ain't RN salaries that bump up the costs here. Australia is the same way, they have a very generous benefits package for RNs (Queensland nurses can get up to 8 weeks paid vacation at half pay or 4 weeks at full pay, New South Wales has similar provisions) and higher salaries than the US. Australia still spends much less on healthcare per capita than the US.
How much does it cost to see a Dr. at a private clinic?
NHS is largely monopolistic as well. Still costs £0 upfront to see a doc in the NHS. And, yes, you can get a same day appointment. Oh, another good thing about having public healthcare and private healthcare at the same time, the public healthcare forces private to seriously reduce their costs. Private health insurance in the UK is substantially less than private insurance here.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
