The market has solved it.
You just don't realize what the market has solved for. It didn't solve the problem of expensive healthcare, it solved the problem of how to maximize profits for the wealthy.
That's what people don't understand about "the market". What you think it's doing isn't what it's actually doing.
Yup, the free market and health care are not compatible because the free market works on principles of supply and demand. But when you have a limited resource that people will literally pay anything for (their health) - well you can see where the problem is.
If the free market had any real competitors, the problem would genuinely solve itself in favor of the consumer. We see this with any new tech where a bunch of new firms try to win customers by any means necessary in those first few years.
The problem as always is: where are the competitors after X years, and are these "competitors" actually competing anymore?
The solution as always is: regulate. Ensure competition. Ensure cartels aren't price fixing. But no one wants to hear that
I have an honors minor in medical humanities and took several medical policy courses. We looked at this exact graph from previous years as well as several other huge sets of data/graphs/studies and anything else related to insurance you can imagine. Insurance is not a standard market commodity and does not follow the same trend or logic. The only way you can lower premiums in insurance is by reducing the risk in the pool, or increasing the pool size to dilute the risk. This is either increasing the total pool size by increasing premiums, getting more people, or being selective about who joins the risk pool. The third one was what was called "preexisting conditions" and kept high cost people from entering the risk pool and draining the funds. This got banned and increased premiums. By increasing competition you end up splitting up the pools, making everyone's premiums go up. This happened multiple times post ACA after the GOP started stripping out the funding and safeguards to prevent this. More and more competition opened up with artificially low premiums being subsidized by federal dollars, but then when the subsidies ended the premiums started jumping. Then when the premiums were jumping, new companies opened up to make more competition advertising lower rates, but then further fractured to pool sizes, leading to premiums skyrocketing. If you look back just 10 years ago there was a 3-5 year stretch of premiums increasing almost 30% year after year. It was due to all the competition opening up every year. This is why single payer systems have the lowest rates. If you have even one private company monopoly with a regulated cap on profits you would still end up with lower premiums. Then, if this single paying company was nationalized to take out the profit making middle man, the premiums are that much lower because your risk is spread across a massive pool. More competition in insurance makes the problem worse. I would agree with your stronger regulation though. There is a lot that can be done there.
By the time the system has consolidated enough that there is little effective competition, those companies have also become so large that they can lobby for regulatory capture. It's not zero regulation, but rather a form of regulation that solidifies their position while still providing the same shitty service they always have.
Regulation won't work. The system is too far gone.
Everybody knows this. You don't have to state it so pretentiously like you're the only jerk who knows it. It's been said on the internet billions of times for 2 decades at least.
I N N O V A T I O N Doctors in the US spend about 25% of their time dealing with insurance companies
In Germany the adminstrative effort including documentation is at 50%.
Those seem like two radically different things. Documentation is extremely important for doctors. That's not the same as dealing with insurance companies.
That seems low
I think some areas bring down the curve (ER etc, maybe). It might be like 50% for GPs, idk
My doctor has added a few extra checks to visits so it can be billed to the insurance company as a general checkup, and not the specific thing I came in for that would bill at a much higher rate. I appreciate him doing that, but he shouldn't have to.
The best part is that it's only State spendings, people in the USA also pay for private insurance individually!
Americans essentially pay for our insurance 4 times.
we pay more tax dollars per patient than ay other country
We pay hundreds per person per month in insurance premiums
We pay all healthcare expenses until we hit our annual deductible
We they pay a co-pay percentage after all treatment beyond the deductible.
Everyone knows it's a broken system, but people are adamant that anything else would be communism or would make you lose an election.
The people worried about "losing an election" are paid by the people who profit from the broken system. The communism fear is a strawman that liberals use to excuse their worthless party.
Wait the life expectancy in the US is that low?!
That's average. So if you have a lot of money and are spending it to raise the average cost, you probably live as long or longer than the other countries. On the other hand, the poors have a live expectancy that much lower to average it out. So call it 70 for the poors and 82 for the rich.
..how did the line come about? How did they determine what the life expectancy would have been with less expenditure per capita?
My guess is that this was a gif at some point and the line is historical data
Definitely, you can see some lines in the top left zigzagging back left, which would not be possible if each was a function of the x-axis. In fact, both axes are a function of the hidden z-axis, which is time and comes in discrete yearly steps, the latest of which (2021) is highlighted.
At least one of those lines goes back on itself at some point, so my assumption is that it's tracking where each country has been over time.
Ooh good catch. That makes sense. Not sure I would call this beautiful, especially without any way to tell how much time has passed, but fair enough
My guess is that the line tracks what the life expectancy was when the expenditure per capita was that much? Might have to dig into their source to get more details.
There is a minimum amount which is likely the least some people spent on their health. So there is no interpolation I can see.
That doesn't make sense unless this was personal expenditure, which it doesn't seem to be
Abolish private health insurance corporations. The middlemen are bleeding us fuckin dry.
High life expentancy is communism tho
Yeah, but think of all that value generated for shareholders in America: What's a few million dead people compared to profit?
That, and half of the system is designed to discard people that are no long useful for the machine, unless of course they're wealthy or have a wealthy benefactor.
This makes complete sense as getting you to pay more for less is what private businesses are all about.
I think it's clear from the graph that USA is doing it right and the rest of the world needs to smarten up!
/s
We can do better. There’s still empty pixels on the right to fill.
I would really like to know how this graph was generated, because some expenditure per capita values have three different corresponding life expectancy values. Just look at Spain for example.
One could poke around on those sources: https://population.un.org/wpp/Graphs/DemographicProfiles/Line/1832
https://www.oecd.org/els/health-systems/health-data.htm
My understanding is that the largest part of expenditures on health is generally at end of life, at least in developed countries, rather than spending a smaller amount on disease prevention earlier in life, which would be expected to have a larger effect on morbidity and mortality.
EEAGLI looks to be some sort of marketing/ PR firm. shrug
Yes this is a huge problem. Keeping people healthy instead of mitigating the obvious consequences of their unhealthy life
Also, smaller people live longer.
in case you've not gotten the memo, the entire world has been telling you for more than fifty years that under your shitty model you pay more for worse results.
It doesn't take a genius to see how retarded the way you're doing things is.
Retarded? You obviously don't understand that it is working perfectly and exactly as intended. Only, it is not a system to maintain the health of the average citizen, it is instead a system to siphon as much wealth from the regular people as possible towards the few corporate entities who managed to buy themselves the monopoly to exploit the poorer castes and drain any poor fuck who needs medical assistance dry for all they're worth.
The average American is prey, but there are enough reserves of these human resources to simply not care that it's either bankruptcy or death in the average case of a medical emergency.
Thanks USA, for fucking up so hard the rest of us can slack off on improvement because you're pulling the average so far out.
Cool, can the stupid meme "security is why the US has no free healthcare" finally die?
Only if you keep reminding people that Medicare for All would be cheaper than our current system.
The good news is that if you live in America, living part 80 is a terrible experience that nobody would want to do anyways.
Well, now I’d like to learn what the differences between the US and the Australian Healthcare System are!
Why is Australia so damn high up?
Turns out it seems the Australians have public health insurance for everyone - Medicare. And you have optional additional private insurance. Communism I guess. Surely wouldn’t workout for the US…
Turns out it seems the Australians have public health insurance for everyone - Medicare.
To follow from your comment , because Australia has a publicly funded health system, the government actively works to reduce preventable diseases because it reduces the load on the system.
So they have had:
A sunscreen campaign and skin cancer check initiatives since the '80s.
Anti-smoking campaigns (and high tobacco taxes) where resources are available to help quit.
Every citizen gets a free bowel cancer test mailed to them when they turn 50 to help find and treat cancer earlier.
Road safety laws are tight and helmet / seatbelt regulations are strict as it reduces hospital loads.
Vaccinations for a multitude of easily preventable diseases are given for free in childhood, particularly now for the virus that causes cervical cancer.
Those and a myriad of other public health initiatives all help Australians to live longer.
Coupled with the fact that the cost for the whole population is borne by an income tax of approximately 2% , it means that if you are poor or unemployed, you still have access to health services. That also means that small health issues among low income earners don't snowball until they are life threatening.
It has the knock on effect that people don't end up trapped in a job because it offers "good benefits and a low deductible" and concerns about pre existing conditions interfering with insurance and etc when changing jobs is generally moot.
Then throw in mandatory government regulated retirement funds that require all employers to put in 12+ percent of an employee's gross earnings into an employee's fund of their choosing for their retirement. That coupled with public health generally means the whole US style worker=slave arrangement can't exist.
Which means the US will get nothing like this as all that screams of nanny state overlords and death panels and moar taxes killing freedom and so on and so forth. Sorry guys.
You have to have a will to live, also.
If you want more fun info: if you move abroad you still owe Medicare & Medicaid, the national healthcare plan. Neither of these can you get an tax exemption, reimbursement, or a voucher to use in another country even if you haven’t stepped foot on US territory in decades. You will pay into these services your whole life if you have a passport to that shitty system & never get anything in return unless you fly to the US to have a procedure that will cost more than it does in the country you might be living in (even without insurance).
During COVID when Sleepy Joe Biden promised vaccines for all Americans that want vaccines, the health minister had to step in when asked to clarify that historically the US does not help its citizens abroad & to go ask the host country instead--or to get on a plane, in a pandemic, quarantining both ways, if you want a shot. The cherry on top was sending vaccines aboard for political favors & if you asked if the embassy if any of those will be used for citizens abroad to be told these were for diplomatic purposes only (meanwhile France & China sent its citizens shots).
The market will solve it, Germany is an example. But there's no free market in US healthcare, that's the issue.
Hell no where did you get that from?
I mean the US healthcare market has huge amounts of regulatory and liceance capture that makes for free market healthcare impossible in the states. Its also, because of this subsidized a lot but practically forbidden to be efficient (because most of the industry is ran by for profit).
Kind of worst case of government stepping in only to prevent meaningful markets but not to support people in need (not to say Medicare and medicaid don't help some, they are the better example IMHO even if they pay out so bad most places practically refuse to take it).
From facts. German healthcare system is 100% privatised and it works very well due to minimal market regulations, but extensive safety regulation. The US healthcare system is bound to insane licensing processes and fees, yet close to zero safety regulations.
For example, the US only has a few medical air transport companies, because getting a license is very very expensive. Only big corps can afford it and they have a cartel like grip on the market as there's no competition. At the same time the US doesn't regulate their performance and pricing. So you end up with an artificial cartel monopoly which sets sky high prices for their services.
Similar licensing in Germany is much cheaper and any decent air company can afford it, so there's a lot of healthy competition. But they also have price caps, so services are actually affordable.
So, in short the difference is that Germany has a free market with pro-consumer regulations and the US has cartel monopoly without any pro-consumer regulations at all. And this approach goes through the whole healthcare system.
The free market always sorts itself out, especially with a small nudge from the state, that's why US corporations are lobbying hard to prevent all and any competition to themselves. And that's why corporate lobbying is called corruption elsewhere and is illegal.
I mean… there is a LOT broken with the healthcare system in the US that you all know. However, in the US -granted you have the dime- you can get the best care in the world. If you can pay for that. If you have been to a hospital in the UK and to one in the US… you will exactly know what I mean.
However, this specific graphic shows that there are likely other contributors for higher life-expectancy than only professional/paid healthcare. E.g. lifestyle aspects like dietary consideration (Italy, Japan…).
Does not mean, that there is no need to fix the System.
Actually Australia is pretty high up. High radiation (i.e. skin cancer), I dont expect a way better diet than in the US.
Sure, it is just not as one dimensional as this cherry picked graphic implies. Education is also a likely contributor.
The optimization would be : cost low, life expectancy at max… however… it is not that easy… ‚Let’s Just copy the system of Japan‘ just would not work… or maybe it would!
However, best healthcare will not help you if have a unhealthy lifestyle which is known to be a common issue in the US especially. Not sure how it is about Australia though!
UK hospitals have been excellent in my experience, though I've obviously only seen some of them.
Plus, although our system is very different from America in theory, our government has, for decades (especially under the Conservative Party), been undermining the NHS through cuts, market-based policy decisions and creeping attempts at privatisation.
If the NHS was supported the way it deserves to be, it would be even better than it already is.
NHS underfunding is notorious. Not sure how situation has developed but I have seen quite some hospitals in the UK until 2016… Cannot really imagine it developed to the better. All the worst compared to continental Europe. And the few ones I saw in the US where excellent too. Of course some are exceptional in the UK. Not sure how situation has changed since 2016 though.
