Why health care is at above market prices

[Hayabusa Rider]

UHC doesn't take away choice. You can choose your physicians under most of those plans.

As for better health factors this is not always the case. I've lived in Germany up until 3.5 years ago and smoking was much more prevalent there than in in the States.
Sure that may have changed a little in 3 years but the change from in attitudes toward smoking in the states took a look time to change and I make a guess based on personal experience that they are about 20-30 years behind us.

Nice regurgitation of illusionary talking points. Nations with UHC do have better outcomes for their patients overall than our system and for less cost per capita. Populations in Europe are not as homogeneous as you would like to make them out to be. There is an amount of diversity, from what I have seen with my own eyes, that is about the same as what I have seen in the states.

There are not nearly as many bankruptcies from catastrophic illness in those countries as there are here. In fact those are practically unheard of. The costs do not hit the middle classes the hardest at all. In fact since the population feels better about going to seeing a physician earlier before they get too sick it contributes to the costs actually being less than in the States. It's a variation of that saying that "an ounce of prevented is worth a pound of cure".

For the moment I'll pass over commenting on your points and ask you this question. Considering that something as simple as a budget confounds Congress, which they are supposed experts on, how do you think they'll do with that which is far more complex and beyond their understanding? How would your ideas compare to what would come out of the supercommittee?

 

[Anarchist420]

UHC doesn't take away choice. You can choose your physicians under most of those plans.

As for better health factors this is not always the case. I've lived in Germany up until 3.5 years ago and smoking was much more prevalent there than in in the States.
Sure that may have changed a little in 3 years but the change from in attitudes toward smoking in the states took a look time to change and I make a guess based on personal experience that they are about 20-30 years behind us.

Nice regurgitation of illusionary talking points. Nations with UHC do have better outcomes for their patients overall than our system and for less cost per capita. Populations in Europe are not as homogeneous as you would like to make them out to be. There is an amount of diversity, from what I have seen with my own eyes, that is about the same as what I have seen in the states.

There are not nearly as many bankruptcies from catastrophic illness in those countries as there are here. In fact those are practically unheard of. The costs do not hit the middle classes the hardest at all. In fact since the population feels better about going to seeing a physician earlier before they get too sick it contributes to the costs actually being less than in the States. It's a variation of that saying that "an ounce of prevented is worth a pound of cure".

In Europe, the population is 70-80% native european, and most of them are pissed that the immigrants have brought it below 100%. In U.S. the majority isn't anywhere near 70% and on top of that it's going down fast when it will only be a plurality in less than 30 years. A majority of the States in this country have no business telling a minority of the States what they have to do.

Wikipedia says that the VAT pays for 50% of the costs of the French government.

Most people may not have a choice if they're taxed so hard that they can't afford private care.

The U.S. still has one of the most progressive tax systems in the world. The middle class pay much more in european countries.

Also, health care in the US is expensive in large part due to Federal government intervention. If the government didn't intervene in the health care industry at all, then the average price of all health care would go down by at least 1/3.

 

[guyver01]

Why health care is at above market prices

because people pay the price.

/thread

 

[blankslate]

In Europe, the population is 70-80% native european, and most of them are pissed that the immigrants have brought it below 100%. In U.S. the majority isn't anywhere near 70% and on top of that it's going down fast when it will only be a plurality in less than 30 years. A majority of the States in this country have no business telling a minority of the States what they have to do.

Wikipedia says that the VAT pays for 50% of the costs of the French government.

Most people may not have a choice if they're taxed so hard that they can't afford private care.

The U.S. still has one of the most progressive tax systems in the world. The middle class pay much more in european countries.

Also, health care in the US is expensive in large part due to Federal government intervention. If the government didn't intervene in the health care industry at all, then the average price of all health care would go down by at least 1/3.

http://www.theatlantic.com/business/archive/2010/03/how-does-a-value-added-tax-work-anyway/36834/
the VAT is built into the cost of a product at each stage from raw materials to components a component maker makes to the end product that is sold.
While the French government is 50% funded by the VAT that fact by itself doesn't mean all of a sudden that the VAT tax is evil.

"...may not have a choice if they're taxed so hard that they can't afford private care." Ok. but who needs private care when a UHC system is in place?

Let me point this out again. The U.S. spends the most as a percentage of it's GDP on health care and many people go without coverage. If you go bankrupt because of health care costs that's a fairly good indication that even health care insurance is not affordable for everyone.
The other industrialized countries spend less of their GDP on health care than the U.S., cover a much larger percentage of their populations than the U.S. system and overall have outcomes that compare very favorably to the U.S. system.


How can Health care be more expensive in large part due to government intervention in the U.S. when other countries pay comparatively less while having arguably more regulation?

Total Health Expenditure per Capita, U.S. and Selected Countries, 2008​

Source: Organisation for Economic Co-operation and Development (2010), "OECD Health Data", OECD Health Statistics (database). doi: 10.1787/data-00350-en (Accessed on 14 February 2011).
Notes: Data from Australia and Japan are 2007 data. Figures for Belgium, Canada, Netherlands, Norway and Switzerland, are OECD estimates. Numbers are PPP adjusted.

When traveling around in Europe I usually spent time in Bahnhoffs (their train stations) and the larger cities that they tended to be found in. So that colored my perceptions of their population diversity.
I guess I shouldn't be surprised since their are people alive in Europe who remember WWII while until recently we haven't really had major attacks on the mainland since the war of 1812 if I recall correctly.
I've heard someone suggest that the main difference of contention between conservatives and liberals in Europe is their views on immigration. Who knows?

As for a majority the of states not having a right to tell other states what to do... go read some history.

 

[blankslate]

For the moment I'll pass over commenting on your points and ask you this question. Considering that something as simple as a budget confounds Congress, which they are supposed experts on, how do you think they'll do with that which is far more complex and beyond their understanding? How would your ideas compare to what would come out of the supercommittee?

Why cut the tax rates that a democratic executive office and a republican legislature (for a significant portion of the 90's at least) arrived at? Especially when the 90's were coming to a close the budget was running a surplus.

So why does a budget confound congress? Because something as simple as letting the Bush tax cuts expire when they were originally supposed to expire is verboten to Republicans.

There. are. no. Republican. moderates. running. for. congressional. office. any. more.

That's why Congress is pretty much doing the equivalent of sitting there with their opposable digits up their proverbial behinds instead of actually doing serious work on balancing the budget.

When one side doesn't want to cut spending and when another side doesn't want to cut spending, something has to give. Medicare and Social security cuts were put on the table. Taxes were not put on the table. Hell, people started kicking and screaming over letting the original built in expiration date for the Bush tax cuts go through.


The Bush tax cuts cost around 1.8 trillion over the last decade by more sober and conservative estimates. Would this lost Federal intake have covered the increased costs of the last decade?
No but after starting with the initial tax cuts in 2001 you don't implement an additional tax cut in 2003 after we know that we're going to take on the increased costs of going to war in other countries.
Prior to the last decade that has rarely been done before. Kennedy did it during the Vietnam war, before it was escalated. During the war when it was apparent how serious a fight it actually was taxes were increased.

How would I have done it differently from the super committee?

That's an interesting conundrum because the way it was set up Health Care lobbyists and Defense lobbyists were pitted against each other for the first time in a long time.

http://www.reuters.com/article/2011/08/11/us-lobby-groups-idUSTRE77A6JG20110811

How would I handle it if I could tell the super committee what to do?

Repeal the Bush Tax cuts immediately on those making 500k+ a year.

Cuts:
1)Review foreign military aid.
2)Look at Medicare, Military Spending, Social Security, basically everything that might be a sacred cow.

Taxes:
1)Look at raising taxes on people making an income of $1 million dollars (not people whose net worth is $1 million) or more beyond what the repeal of the Bush tax cuts would accomplish.

2)Loot at Estate Tax rates. Contrary to popular belief not every founding father had an inherent disgust regarding "the death tax."

One of the more famous ones considered basic property necessary to survive should be exempt but that "all Property superfluous to such purposes is the Property of the Publick, who, by their Laws, have created it, and who may therefore by other Laws dispose of it, whenever the Welfare of the Publick shall demand such Disposition."

3)Trade Tariffs, Clinton did a good job along with Congress in the 90's in balancing the budget but the free trade agreements are something that he messed up on. Ross Perot despite being kinda insane was absolutely correct in regards to this issue.

 

[mattpegher]

First, I already deliver universal healthcare. In the ER, we docs dont even know what insurance you have.

I am in favor of complete universal health care. No insurance companies. First this will eliminate 1/3 of money spent on health care. It will also create a transparency of expenditures. No more charging $300 just to get paid $30.

Take every dollar paid to for profit insurance companies, and pay it in taxes.

Will the government be efficent, Hell no. Will services suffer, Hell yes. Will people die because the government will begin rationing, sure. But I am affraid it will have to get a hell of a lot worse before it can get any better.

The building is on fire. Its time to jump, we will likely break both legs but we may survive.

 

[Hayabusa Rider]

Blankslate you have some ideas worth examining and if reasonable people were in control we might have a fighting chance however the point of most policy goals is politics first. While coverage is obviously important no real mention of important issues like the system itself lacks a robust infrastructure which will cause huge problems for all industrialized nations including any system you care to name. Just look at the aging demographic. No one wants to talk about it.

 

[mattpegher]

An interesting read.

http://www.medpac.gov/documents/Jun11DataBookEntireReport.pdf

 

[TheVrolok]

4. Licensure. The EU regulates midwives less stringently than what is lobbied for by the AMA. As a result, the U.S. has a much higher infant mortality rate. The aforementioned is just one of many examples.

Infant mortality is higher in the US as a result of increased regulation on Midwives? ... ...

 

[LunarRay]

How is my basic premise flawed? Why is the health care market naturally not free?

Free... hehehe

Why then is the Tobacco 'market' not also free?

Is the cost of health care not driven by the rewards provided the supplier?

Does society not provide health care for those who can't afford it. Is it unreasonable to assume that the cost of heath care includes this feature 'at the end of the day'?

In... say, Ireland where health care is "Free" it is not Free.. Folks pay for it indirectly. The facilities get built and the providers are paid and the medicine is provided and all that has cost factors... It is simply controlled to provide what can be afforded so long as it meets the basic standard for medical care.

 

[mattpegher]

How is my basic premise flawed? Why is the health care market naturally not free?

Why would health care be free. Whenever one person provides a service to another there is a cost. We can say that this cost should be shouldered by society as a whole, but that only means it would be covered by taxes. And like any other part of society if you want good services it cost more than bad service, if you want innovation, it must be paid for. I suggest that you see health care the same as defense. Cost of soldiers, cost of equipment cost of infrastructure, cost of R&D, cost of training.

The biggest loss currently is the financing. In all aspects of healthcare there are middlemen who divert funds away from the actual care provided. Sure this is a billion dollar business that pays millions of people, but ultimately does not add to the welfare of the nation.

Problem is this like any other financial services (banks, insurance companies, etc), control the goverment at a level of magnitude that it is highly unlikely they will ever be ousted.

 

[Anarchist420]

Why would health care be free. Whenever one person provides a service to another there is a cost. We can say that this cost should be shouldered by society as a whole, but that only means it would be covered by taxes. And like any other part of society if you want good services it cost more than bad service, if you want innovation, it must be paid for. I suggest that you see health care the same as defense. Cost of soldiers, cost of equipment cost of infrastructure, cost of R&D, cost of training.

The biggest loss currently is the financing. In all aspects of healthcare there are middlemen who divert funds away from the actual care provided. Sure this is a billion dollar business that pays millions of people, but ultimately does not add to the welfare of the nation.

Problem is this like any other financial services (banks, insurance companies, etc), control the goverment at a level of magnitude that it is highly unlikely they will ever be ousted.

What I meant was "how is there is naturally no government intervention in the health care industry?"

 

[guyver01]

What I meant was "how is there is naturally no government intervention in the health care industry?"

http://www.hhs.gov/

The Department of Health and Human Services (HHS) is the United States government’s principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.

HHS represents almost a quarter of all federal outlays, and it administers more grant dollars than all other federal agencies combined. HHS’ Medicare program is the nation’s largest health insurer, handling more than 1 billion claims per year. Medicare and Medicaid together provide health care insurance for one in four Americans.

 

[LunarRay]

What I meant was "how is there is naturally no government intervention in the health care industry?"

Before your arrival on the planet there have been attempts to 'intervene'... And some of these attempts have proven fruitful... It is us who determine what economic form health care takes... In the Pharma industry where profits are expected by investors and salaries expected by the scientists and others it seems that the more pills they sell the better off they are given the fixed costs are borne by more pills and so they are favorably motivated to make less profit per pill over more pills... Competition is favorable... but investment demands secure payback...
This mind set also works for all the PPE that might be employed in the health care business. That MRI machine's cost is amortized over more patients and etc.

BUT... 'End of the day', health care cost is predicated on cost factors and the profit and salary expectations of investors and providers. Don't you want the best brains working on or in the health care industry? I'd rather have my heart worked on by the best Cardiologist than have his potential being devoted to developing bombs or determining the amount of dark matter in the universe... I say sate that aspect of motivation that is financial and brings him to the operating theater.

 

[mattpegher]

Before your arrival on the planet there have been attempts to 'intervene'... And some of these attempts have proven fruitful... It is us who determine what economic form health care takes... In the Pharma industry where profits are expected by investors and salaries expected by the scientists and others it seems that the more pills they sell the better off they are given the fixed costs are borne by more pills and so they are favorably motivated to make less profit per pill over more pills... Competition is favorable... but investment demands secure payback...
This mind set also works for all the PPE that might be employed in the health care business. That MRI machine's cost is amortized over more patients and etc.

BUT... 'End of the day', health care cost is predicated on cost factors and the profit and salary expectations of investors and providers. Don't you want the best brains working on or in the health care industry? I'd rather have my heart worked on by the best Cardiologist than have his potential being devoted to developing bombs or determining the amount of dark matter in the universe... I say sate that aspect of motivation that is financial and brings him to the operating theater.

I totally agree. Granted I am bias, being a health care provider, but I think that to compete for the best minds we need to have competative salaries for doctors vs lawyers, vs buisinessmen vs bankers, etc. I am a bit ashamed at what we pay scientist in this country.
Interestingly, our current system is reliant upon foriegn trained physicians, so to a certain extent we are pulling talent from the rest of the world.

Also if you look at the HHS document I posted earlier, physician reimbursement accounted for only 12% of Medicare costs. Down from 18% in 2000. And remember that 12% includes all private physician billing and therefore includes all office expenses including staff and malpractice. So you cant even say 12% is physician salaries. Therefore you could probably double physician salaries in this country and still only get the percentage up to 2000 levels, 18%.