Health Care Spending: Why Is America Soooooooo Stupid?

[eniwetok]

Last edited Mon Feb 20, 2017, 07:32 PM - Edit history (1)

Here are OECD comparative per capital health care spending numbers by nation measured in 2010 US dollars.

We spend $8714.90 where Canada spent about 50% of what we do: $4289 and THEY COVER EVERYONE.

Obviously Canada has wrung the inefficiencies out of their system while we haven't. Any weaknesses in the Canadian system critics complain about could easily be fixed if they just went to 60 or 70% of what we spend.


Australia 4 164.2
Austria 4 451.2
Belgium 4 120.0
Canada 4 289.0
Chile 1 595.5
Czech Republic 2 166.4
Denmark 4 484.5
Estonia 1 613.1
Finland 3 628.0
France 4 027.9
Germany 4 772.3
Greece 1 994.1
Hungary 1 676.6
Iceland 3 712.7
Ireland 4 730.3
Israel 2 292.3
Italy 2 954.1
Japan 3 930.7
Korea 2 480.3
Latvia 1 229.8
Luxembourg 6 758.8
Mexico 956.2
Netherlands 4 885.6
New Zealand 3 184.0
Norway 5 926.4
Poland 1 527.9
Portugal 2 319.4
Slovak Republic 1 916.9
Slovenia 2 353.3
Spain 2 896.9
Sweden 4 906.9
Switzerland 6 062.3
Turkey 974.8
United Kingdom 3 755.9
United States 8 714.9


You can recreate this data here http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT

Variables used to create the proper chart...
Health expenditure and financing
FUNCTION = Current expenditure on health (all functions)
FINANCING COSTS = All financing schemes
PROVIDER = All providers
MEASURE= Per capita, constant prices, constant PPPs, OECD base year

[Calculating]

1. Fraud, greed and overpricing run rampant in our health care system

Just look at the prices of pharmaceuticals, medical equipment etc. There's also a lot of wasteful spending on building unnecessary new hospital buildings with all of the latest and greatest equipment. All of that needs to be paid for somehow. Personally I think healthcare and pharma costs should be regulated like utilities. If they consider a price increase to be necessary, they should need to prove it with facts in support of the increase.

Our total mess of a healthcare system is what happens when you allow a utility like healthcare to be privatized. Healthcare provides have a captive audience and they know it.

[ileus]

5. That latest and greatest equipment saves lives.

Or at the very least allows a better quality of life. It may be a intra aortic balloon pump, or something as simple as a digital wifi thermometer on a medication fridge.

[eniwetok]

6. How much more research could we afford.... once we get rid of innefficiency?

And I don't mind targeted capital gains breaks for investments in critical areas of research. I just oppose it for reckless speculation.

And I'd LOVE to see NIH fund and coordinate all pharmaceutical research. Big Pharma pisses away more on overhead including promotion than it does on R&D. Then NIH could farm out contracts to make the drugs cheaper.

[eniwetok]

7. I think we also need to look at patent law...

Patent law serves a useful purpose in encouraging innovation. But usually the best ideas from different research teams never make it into the same product... meaning all may be inherently inferior to the product that contains the best ideas from all design teams.

VHS vs Beta is a perfect non-medical example. One had better picture quality, the other longer run time. It cost more for the consumers to support the two incompatible format than one. But that's not how the game is played... until the DVD. To avoid another expensive format war the electronic industry pooled their best ideas into one format. Same happened with the DV digital video tape standard. As soon as there was a consumer format... Panasonic and Sony developed two incomparable pro variants.

If we want better products we have to tame this dysfunctional side of capitalism.

[crazycatlady]

9. advertising

No need to advertise drugs or hospitals.

And definitely no need to advertise hip replacement surgery.

[Initech]

11. I think the marketing and advertising industry is killing us.

Stuff would probably cost about half as much as it does if the owners of the products didn't have to advertise 24 hours a day. That includes medication and health care providers.

[Wounded Bear]

20. This

It's also why our election cycles last 2 years, or are basically continuous when you think about it.

[eniwetok]

24. There was an article in the NYT about how US companies were developing propriatary hips and tools...

And how this was raising prices for hip replacements....

I think this is it

http://www.nytimes.com/2013/08/04/health/for-medical-tourists-simple-math.html?pagewanted=all&_r=0

[Kimchijeon]

12. Yes, I agree with you there.

This is what happens when a utility like healthcare gets privatized. And we can compare the data with other countries, easily.
It is a mess.

[RedWedge]

2. Because god forbid somebody get something that someone else doesn't think they deserve.

[Ezior]

3. Thanks for the numbers

That is mind-blowing. I expected per capita spending in the US to be much lower compared to other countries. Some people in the US just die instead of getting proper treatment, because they can't afford it. That should make things cheaper in total.

US politicians (and some voters, obviously!) are really exceptionally stupid or crooked...

I guess the German per capita cost could be brought down quite easily, if we change the crazy "118 payers system" into an actual "single payer system". No need to have 118 insurance companies all selling basically the same, very strictly regulated product that most citizens are forced to buy.

[eniwetok]

4. Choice is often inefficient...

I find it amusing that the right seems hung up on choice... as if more choices isn't more costly.
It costs more to administer all those ala cart plans, with all their separate coverage and billing procedures... and what good is choice if many of the choices are bad ones... for inferior policies. Canada and other Single Payer nations prove that covering everything and having simplified billing procedures is cheaper in the long run.

But it does raise the question why, if our system is so grotesquely inefficient, why is the GOP intent on preserving it? Why are the only options they propose all ridiclous such as HSAs and selling insurance across state lines?

I suspect this goes back to 1993. The 80% of GOP senators signed on to plans with an individual mandate. Then by 94 they changed to their current positions. I suspect a 1993 policy memo that a national health plan would ruin the GOP "brand" and posed an existential threat to the GOP. Of course they COULD just have signed on...

[Jim Beard]

8. We are talking about people here and there lies the problem. NOBODY wants to pay for something they

don't use or think they can get by without it. Everyone try's to dodge any system to save money or get someone else to pay.

They demand their employer pay for their insurance. The people of the USA would raise hell even if the cost of premiums were 1/4 of what they are today. They don't give a damn how its done but just make their cost less if less than all others.

I don't have much faith of todays citizen.

BTW, I don't like sounding like an asshole but I witness many more immigrants less inclined to support a Medicare for all system because of bad experiences from the old country. Being a Texan, from Mexican immigrants.

[eniwetok]

13. Mexico's per capita spending $956.2

Sure, everyone wants a deal... but sometimes the way to lower costs is to consolidate and standardize to reduce wasteful overhead. The question is why, with so much US GDP going into health care... stressing consumers, employers, and government programs... why WE can't follow a rational course. Part of the problem is, of course... companies don't want to give up their profit gravy train... and the GOP wants to milk government for private profit and possibly protect their "brand" as being for small government... or being more cynical that the GOP would rather piss away hundreds of billions on debt interest rather than have that money benefit the American people. But I'd argue that the GOP has the power to be irrational because of our defective electoral and political systems which gives power to minorities to block popular legislation. Election 2000 and 2016 prove we can't get a president the People want... and if my numbers are correct Dem Senators represent 33 million more Americans than the GOP, yet the GOP controls the Senate.

[Initech]

10. Profit, profit, profit, profit, and profit.

If we cut out the profit part of it, we could probably do that, but it would take a war or two to do so.

[eniwetok]

17. profit alone would not be an issue....

if the US had a political system that could just say ENOUGH! it's time for single payer... and universal coverage.

[DrDan]

14. profits of insurance/big-pharma companies

[Victor_c3]

15. When making the argument it is also important to mention the life expectancy of these nations

They on average pay less AND they live longer than us.

With that, the rest of their arguments fall apart.

1) the wait times. They don't matter, people still live longer in these nations (and I doubt the wait time argument is even true)

2) they have fewer pieces of major equipment like MRIs per capital. That doesn't matter either. People in these countries still live longer

Eycetera... I'm sure you get my point

[eniwetok]

16. sure... and if we compare US vs Canada

it's amusing when right wing critics of the Canadian system highlight longer waiting lines, lack of MRIs, or that some come to the US for surgery WITHOUT mentioning that Canada is spending only about half of what we do and we ALSO have some holes, BIGGER HOLES, in our system... such as 10s of millions un- or under-insured.

Any "problems" in the Canadian system could easily be fixed if they just went to 60 or 70% of what the US spends.

[eniwetok]

18. speaking of life expectancy... check out this spreadsheet!

You can generate your own at http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT

Numbers go back to 1960, and are broken down by sex, life expectancy at give ages etc... some numbers from non-OECD nations...

[Victor_c3]

19. This meme probably explains a lot too

FWIW, Ben Carson never actually said this. It's totally fake.

[eniwetok]

23. whew! I knew Carson was a crackpot... so it was wacky but not unbelievable. nt

[Wounded Bear]

21. This hardly something nobody knew about...

comparable numbers and charts have been flying around for years.

Like most data, RWers ignore it. Freedom and all that, you know.

[eniwetok]

22. numbers are one thing... how to USE them is another.

I've been involved in these discussions with right wingers forever... and their arguments are very predictable. But I've NEVER heard politician or Single Payer advocate make the argument that I did in the OP... that any shortcomings of the Canadian system could EASILY be addressed by merely going to 60% or 70% of what WE spend. Of course all talk of Single Payer disappeared after the ACA was passed... and after that Libs spent most of their time defending the ACA and largely gone was any talk of Single Payer.

And in that is the difference between the Right and Dems. The Right has had a vision from back in the 70s on how to turn America into Amerika. The Dems never seem to have any long term vision. They tend to think only as far as the next presidential election.

[lindysalsagal]

25. We're not stupid: We're greedy. We refuse to make healthcare non-profit.

Until we do, our democracy and economy are in the balance.

[mountain grammy]

26. What part of "for profit" do you not understand?

America is all about profit, always has been. We only have a middle class because unions had a brief heyday, but greed is as big as it's ever been. Funny, none of us gets out of here alive, so it all seems so senseless.