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Yes. I was just charged $655 for the first physical I've had in over three years because my private health insurer refuses to cover preventative physical exams. I know what rationing is.
"Beware of the man who works hard to learn something, learns it, and finds himself no wiser than before. He is full of murderous resentment of people who are ignorant without having come by their ignorance the hard way. "
-Bokonon
Survival rates are a bad measurement. Much of that has to do with how quickly the cancer is caught, which requires self-investigation.
And the results are mixed. The US is much better with breast cancer, which is by far the most common cancer of those listed. If you were to do a case-by-case look, I'd wager Americans were more likely to survive cancer then Canadians.
Scouse Git (2)La Fayette Adam SmithSolomwi and Loinburger will not be forgotten.
"Remember the night we broke the windows in this old house? This is what I wished for..."
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Yes, thanks for the complete lack of data backing up your point. Deal in empirical evidence or go away.
"Beware of the man who works hard to learn something, learns it, and finds himself no wiser than before. He is full of murderous resentment of people who are ignorant without having come by their ignorance the hard way. "
-Bokonon
A problem with those statistics is selection effects. If you catch cancer earlier, then you bias the survival rates upward, even if catching it earlier does not lead to better survivability.
BTW, I have no idea which direction that bias would go. Just mentioning it because it seems to me like it could easily overwhelm any actual differences due to quality of treatment.
The point I wanted to emphasize was the relatively limited variation in outcomes. If there were large selection biases, I'd expect less tightly clustered data.
One can nitpick with a lot of health metrics, but the story is basically the same: we have mediocre health outcomes for a very expensive system. There appear to be rapidly diminishing returns past a certain amount of health expenditures.
"Beware of the man who works hard to learn something, learns it, and finds himself no wiser than before. He is full of murderous resentment of people who are ignorant without having come by their ignorance the hard way. "
-Bokonon
1) You have to be careful about what's being counted as a health care expense and what's not. Other countries subsidize the education of doctors, while the US does not (largely). How much would it add to the spending of other countries if you counted medical school costs?
2) Much of the savings lies in higher remuneration to doctors in the US. Any time the government exercises monopsony power it reduces the price paid for services. However, such savings are in reality largely just transfers from doctors to the general public.
3) If some relatively wealthy people spend much much more in the US than the relatively wealthy do in other countries then such spending can skew the per capita cost of health care. If stupid rich people in the US want to blow money on doctors they don't need then why should we care? Say that 70% of Americans spend the same amount (or slightly higher) per capita that other OECD countries do and receive comparable outcomes. 30% spend a whole hell of a lot more. Is this really something that needs "fixing"?
These are all questions which need to be answered before you can really make valid comparisons between countries.
Well, (1) and (2) are pretty closely related. The AMA insists on expensive, graduate medical education for your standard issue GP. However, we do heavily subsidize undergrad education - so that's still accounted for. The problem is that this is a large cost sink that reform is not able to address right now. That's one big reason why I'd like to see the state have a large amount of leverage over the industry through a single payer.
As for stupid rich people getting treatment they have marginal use for, one problem is that they help to set the norms for medical treatment. I highly recommend the New Yorker article that Arrian cited for elaboration.
It's also cash floating around the system that could subsidize the poor.
"Beware of the man who works hard to learn something, learns it, and finds himself no wiser than before. He is full of murderous resentment of people who are ignorant without having come by their ignorance the hard way. "
-Bokonon
Ramo: "floating around the system"? How is this any different than any other non-necessity that the rich spend their money on?
Basically, you aren't doing a good job of convincing me that there's an efficiency argument to be made here. Merely a distributional one. And if the issue is distributional then the obvious preference is for redistribution to be made in cash, not in kind.
In my June 1st article, “The Cost Conundrum,” I explored the question of why two border towns in Texas of similar size, location, and circumstances—McAllen and El Paso—should cost Medicare such enormously different amounts of money. In 2006, McAllen cost $14,946 per enrollee, which is the second-highest in the United States and essentially double El Paso’s cost of $7,504 per enrollee. Analysis of Medicare data by the Dartmouth Atlas project shows the difference is due to marked differences in the amount of care ordered for patients—patients in McAllen receive vastly more diagnostic tests, hospital admissions, operations, specialist visits, and home nursing care than in El Paso. But quality of care in McAllen is not appreciably better, and by some measures, it is worse. Indeed, studies have shown that the care for patients in the highest-cost regions of the country tends to go this way—with more high-cost care across the board, but less low-cost preventive services and primary care, and equal or worse survival, functional ability, and satisfaction with care. The causes that I found locally was a system of care that was highly fragmented for patients and often driven to maximize revenues over patient needs. And I pointed to positive outliers across the country, including Grand Junction, Colorado, and the Mayo Clinic that deliver markedly lower-cost, higher-quality care.
"Beware of the man who works hard to learn something, learns it, and finds himself no wiser than before. He is full of murderous resentment of people who are ignorant without having come by their ignorance the hard way. "
-Bokonon
Ramo: that's Medicare, a gov't funded program. The real problem with your argument is why insurance companies don't find a cheaper way to deliver health outcomes. if they did so then they could charge cheaper premiums while still maintaining equivalent quality of care, take over the market and get rich(er).
The government using monopsony power delivers a large transfer from doctors to everybody else. Why will it also deliver efficiency gains?
It's also a transfer from pharmaceutical companies to everyone else for the same reason. And it's a reduction in administrative costs. You can also do things like incentivize preventative care, something that the status quo does not do. There's a good McKinsey study on estimated savings.
The name of the game in health insurance is to create a large risk pool to bargain more effectively with health providers. The reason why you don't see a private monopoly is anti-trust legislation.
The article refers to Medicare disbursements, because they're referring to a systematic study that investigates health care costs. That article is pointing out problems with the cost structure (i.e. what you were asking about), not a specific remedy.
"Beware of the man who works hard to learn something, learns it, and finds himself no wiser than before. He is full of murderous resentment of people who are ignorant without having come by their ignorance the hard way. "
-Bokonon
Yes. I was just charged $655 for the first physical I've had in over three years because my private health insurer refuses to cover preventative physical exams. I know what rationing is.
I wonder why they left out lung cancer, coronary heart disease and stroke?
I deal with dozens of insurance companies. Each one has its own rules for referral, its own coverage plan and its own drug formulary. It's a madhouse. Let me assure you, corporate bureaucracy is no better than government bureaucracy. Private insurance companies have taken to outsourcing their call centers, so when I want to find out why Mr. X isn't being permitted to fill a medication I prescribed for him even though the company's website says the drug is covered I call a number, where after pushing a bunch of buttons and some discussion with an operator my call is forwarded to another center, where the same process occurs until I'm finally connected with the insurance company's pharmaceutical management center. The list of annoying nickel and dime stuff with these insurance companies just goes on and on forever. Everyone is fed up with this system and it is time for it to go.
The unbe-****ing-lievable amount of red tape we have to go through now for the simplest of visits and prescriptions, quite simply, can not be made any worse by the government. It is simply not possible.
"My nation is the world, and my religion is to do good." --Thomas Paine
"The subject of onanism is inexhaustable." --Sigmund Freud
Yes, thanks for the complete lack of data backing up your point. Deal in empirical evidence or go away.
Incidence differentials are far higher then the differentials between the countries. If Breast cancer is 40 percent more likely, this means that a difference in maybe 10 percent on colorectal will correspond to a difference in 4 percent of breast cancer.
I could run the math on that but I'm being lazy today. Thanks for finding the source on Breast Cancer though.
Scouse Git (2)La Fayette Adam SmithSolomwi and Loinburger will not be forgotten.
"Remember the night we broke the windows in this old house? This is what I wished for..."
2015 APOLYTON FANTASY FOOTBALL CHAMPION!
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