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07/26/2009

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Anonymous

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Anonymous

Isn't lung cancer the largest killer of women in the United States, and isn't a great part of the breast cancer situation reliant on a huge public advocacy campaign which funds the research?

Heart disease is the top killer in the us overall, why not use that as a comparison?
Why not question why most clinics charge $375 for 4 sutures if you have insurance and $750 if you do not.

Anonymous

"Why not question why most clinics charge $375 for 4 sutures if you have insurance and $750 if you do not."

Why is any price the price? Because people pay it.

The difference in medicine is that people are not able to negotiate or haggle over a price when he or she is in need of urgent care.

It would be an interesting study to see if the urgency of a procedure influences the size of the gap between the insurance company negotiated price and the general price.

Still, even in non-urgent situations a gap would be expected to exist. It is no different for anything else. Let's say I tell a bar owner that I'll bring 100 people to his bar on the condition that we get $2 Budweisers. I'll probably be able to get that deal before the guy who's negotiating for himself and only himself.

See insurance companies for what they are. Not the evil profit making machines they are painted to be, but negotiating powerhouses among other purposes such as risk pricers.

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Anonymous

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Anonymous

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Anonymous

You have not been into a French cafe or British pub lately. The assertion that in these countries, people live "healthier lifestyles" is one that is really not a valid one. Both the French and the British still smoke like chimneys, the Swiss have diets loaded with eggs and cheeses etc and they are not the low fat versions. The consume as much, if not more alcohol.

There is no real argument in this.

As it stands, the government directly or indirectly subsidizes about 60 percent of the cost of health care in the United States. Medicare, Medicaid and Federal Employees insurance makes up a portion of this, but not a large portion. The majority comes from various government grants to businesses that provide health care for their employees, the tax breaks that employers get for giving them, and other area. The HHS has 300 different grant, and awards 75,000 of them a year. This accounts for 60 percent of all government grant monies.

The private sector is singularly unequipped to create a national risk pool. It is not in their interests to. The only way the private sector handles health care is by creating risk pools in which they can exclude those most likely to need the insurance, and only include those less likely to use it.

There is NO solution that can be solved by resorting to the private sector alone. The best solution is a mixed on, as exists in France.

France has created the best health care system in the world. It IS single payer. But the government does not administer a single program. The private insurance industry administers all of the French health care system. The catch is that the insurance companies are not the gatekeeper. That was what the doctors demanded to come into the deal. They get the last word on what the insurance system MUST pay for. The insurance companies make money administering the program, but they make even more selling add on policies that cover the patient's co payments, etc.

The national health system pays 70 percent, the patient pays 30. But because of these add on private insurance policies, the French have one of the lowest out of pocket expenses in the world. About 7.7 percent.

The Doctors are happy, the insurance companies are happy, and the patients are very happy.

Anonymous

P.S. the current health care system in America costs the average household 20,000 dollars a year (117 million households divided into 2.4 trillion dollars in health care) The government spends about 500 billion to insure a total of about 78 million people on Medicare, Medicaid and Federal Employees health insurance. The figure of 47 million uninsured that has been batted round for years is rather low, and currently excludes the about 6.6 million unemployed who have lost their health coverage and to be even more succinct are less likely to get a job that does offer it than they were when they were hired for their last job. Since an all time high in 2000 of 64.3 percent of working Americans who had job based health insurance, today, the figure is 59.2 percent. There is no sign that the rate of employer based health care will go up again and the rate at which employers are dropping coverage is accellerating.

Eventually and not too long in the distant future, the rate at which employers provide heath care to employees will fall below fifty percent.

Another thing to ponder is that there have been many estimates that indicate that in a very short time, the cost of providing ALL employees who have employer based health care in the United States will exceed the profits of companies outside of the health insurance sector. The only option at this point is to shift more of the cost onto the employee, or simply stop providing the insurance.
This is only logical as the increase in the cost of insurance is annually greatly exceeding the annual growth of the entire U.S. economy.


Or the government will have to subsidize even more of the shortfall than it already does. This will mean that allowing corporation to deduct the cost of health insurance as a business expense will not cut it. The government will have to offer direct grants of some sort to employers who provide it, but this will only be treading water. Only the largest corporations will be able to do so.

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Anonymous

Another measure of health care effectiveness is infant mortality. The United States ranks 46th in the world (CIA World Factbook, 2009 est.).

In your cost-effectiveness calculations you should balance the number of life years gained to the over-50s against life-years lost due to the surplus death of infants, as compared against other developed nations. This would strongly skew your analysis the other way.

Anonymous

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Anonymous

In order to compare health systems you have to look at the overall picture. Selecting, say, cancer rates as opposed to, say, liver disease cannot but mislead. Becker must know this.

The blunt fact is that overall, US healthcare provision is inferior to that in some, but not all, European countries. It is plainly inferior to France for example (I am not claiming that the French system is perfect.)

The real problem is that US healthcare is both very expensive (a much higher percentage of GDP than in either the UK or France) and overall gives poor results. How can this be so? Because for those fully covered, healthcare is superior than in many European states. For those not fully covered by insurance, it is significantly worse.

How much collective provision do you want? Some public goods are already collectively provided (education, police, fire). To what extent do you want to move to a collective provision of healthcare. Overall, it will be cheaper, but will involve the rich paying for the poor, in some way. You cast your vote and take a choice. However, it is quite clear that US healthcare is not as good for the population as a whole as, say, that in France.

As an aside, the only countries we have proper obesity figues for are the US and UK. In France and elsewhere in the EU the figures are compiled on a basis of submissions by individuals. They are as a result wholly unreliable and hopelessly underestimate obesity rates.

Cigarette sales in continental Europe are significantly higher than in the US, by comparison. Saying that Americans have worse lifestyles than, say, the Spanish is frankly silly.

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Anonymous

In order to compare health systems you have to look at the overall picture. Selecting, say, cancer rates as opposed to, say, liver disease cannot but mislead. Becker must know this.

The blunt fact is that overall, US healthcare provision is inferior to that in some, but not all, European countries. It is plainly inferior to France for example (I am not claiming that the French system is perfect.)

The real problem is that US healthcare is both very expensive (a much higher percentage of GDP than in either the UK or France) and overall gives poor results. How can this be so? Because for those fully covered, healthcare is superior than in many European states. High cost, high end care for those covered is better. For those not fully covered by insurance, it is significantly worse.

How much collective provision do you want? Some public goods are already collectively provided (education, police, fire). To what extent do you want to move to a collective provision of healthcare? Overall, it will be cheaper and better, but will involve the rich paying for the poor in some way. You cast your vote and take a choice. However, it is quite clear that US healthcare is not as good for the population as a whole as, say, that in France.

As an aside, the only countries we have proper obesity figues for are the US and UK. In France and elsewhere in the EU the figures are compiled on a basis of submissions by individuals. They are as a result wholly unreliable and hopelessly underestimate obesity rates.

Cigarette sales in continental Europe are significantly higher than in the US, by comparison. Saying that Americans have worse lifestyles than, say, the Spanish is frankly silly.

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